Gigantomastia During Pregnancy Due to Burkitt Lymphoma

Gigantomastia is a rare complication of pregnancy usually associated with benign conditions and rarely with malignancies. This paper reports a non-Hodgkin lymphoma case associated with gigantomastia during pregnancy. The patient was a 30-year-old gravida one woman, with a history of rapidly enlarging right breast at 2 weeks prior to presentation. After the first diagnosis of benign gigantomastia, the continuous growth of the breast, despite the delivery and bromocriptine therapy, required further investigation of the case. The histological analysis revealed the presence of Burkitt lymphoma. Malignant causes of unilateral gigantomastia in pregnancy should be considered in the differential diagnosis of this condition

Thoracic endometriosis: A case of one step multidisciplinary surgical treatment

We describe a case of thoracic endometriosis in a patient with a repeated episode of spontaneous pneumothorax. Investigations revealed diaphragmatic fenestrations and right-sided pleural and lung endometriosis. Considering the ultrasound evidence of pelvic endometriosis, the patient was scheduled for multidisciplinary surgical management, to treat in one step thoracic and pelvic endometriosis

Poly (ADP-ribose) polymerase (PARP) as target for the treatment of epithelial ovarian cancer: what to know

Introduction: Poly (ADP-ribose) polymerase (PARP) inhibitors are being developed in maintenance and recurrence treatment settings of epithelial ovarian cancers (EOCs) with BRCA 1–2 gene mutation. PARP inhibitors are the first example of drugs targeting the loss of a gene suppressor: they block base-excision repair in the cancer cells, which have lost homologous recombination due to BRCA-mutation, resulting in loss of DNA repair and cell death, also known as synthetic lethality. Areas covered: This article provides an overview of PARP inhibitors in OC treatment and also an extensive section on the combined strategies of PARP inhibitors, including approved as well as currently investigated drugs. It also offers a section on the use of predictive biomarkers for PARP inhibitors treatment. Ongoing trials, including novel combinations, are discussed. Expert opinion: In recent years, there is increasing evidence that PARP inhibitor therapy can have life-long percussion in the treatment of EOC, even if some questions have to be solved yet, such as its use in combination therapy, the possibility to retreat with a PARP inhibitor, and finally how to overcome a resistance mechanism to this therapy. In this way, PARP inhibitors can obtain an important role in making a personalized therapeutic program in the case of first-line, neoadjuvant, platinum-sensitive, and resistant high-grade serous OC treatmen

Hysteroscopy and Retained Products of Conception: An Update

Retained products of conception (RPOC) can occur after early or mid-trimester pregnancy termination and also following vaginal or cesarean delivery. It is frequently associated with continuous vaginal bleeding, pelvic pain, and infection. Late complications include intrauterine adhesions formation and infertility. Conventionally, the management of RPOC has been with blind dilation and suction curettage (D and C); however, hysteroscopic resection of RPOC is a safe and efficient alternative. In this review, we analyze the current available evidence regarding the use of hysteroscopic surgery for the treatment of RPOC comparing outcomes and complications of both traditional curettage and hysteroscopic technique. Data search has been conducted using the following databases MEDLINE, EMBASE, Web of Sciences, Scopus, Clinical Trial. Gov., OVID, and Cochrane Library interrogate all articles related to hysteroscopy and the preserved product of conception, updated through September 2020

Hysteroscopic vaginoscopy. An additional diagnostic tool for recto-vaginal deep infiltrating endometriosis

Endometriosis is the presence of endometrial tissue outside the uterine cavity. Rectovaginal infiltration is present in 5% to 25% of the patients diagnosed with endometriosis. Accurate diagnosis is imperative for adequate counseling. Hysteroscopic vaginoscopy allows the inspection of the posterior vaginal fornix, not only providing better visualization of the area due to image magnification, but also allowing to obtain biopsy providing pathologic confirmation. We report the case of a 49-year-old nulliparous patient with long history of severe dysmenorrhea, deep dyspareunia and debilitating chronic pelvic pain not responding to medical treatment. On physical exam, recto-vaginal tender nodularity was palpated. Vaginal ultrasound and magnetic resonance imaging confirmed the presence of the nodular formation extending up to the rectum. In-office vaginoscopy revealed a perforated bulge on the uterine cervix, mimicking a double cervix. A biopsy of the nodule confirmed the presence of endometrial tissue, confirming the diagnosis of endometriosis. Patient underwent total hysterectomy with excision of deep infiltrating endometriosis which required segmental bowel resection with diverting loop colostomy. The final pathology confirmed the diagnosis of deep infiltrating endometriosis

Novel diagnostic approaches to intrauterine neoplasm in fertile age: sonography and hysteroscopy

Endometrial carcinoma (EC) is the most common gynecological malignancy in the world. It is mostly detected in postmenopausal women, but it can also occur in women of fertile age who need fertility-sparing therapy. An early diagnosis is the main objective for the correct management of these patients, making it possible to use a fertility-sparing treatment approach without exposing the patients to the risk of cancer progression. In this review, we discuss the role of sonography and hysteroscopy in the detection of intrauterine neoplasm in women of childbearing ag