The Role of Ultrasound in Endometrial Cancer

Endometrial cancer is the most common gynecologic malignancy in developed countries. The vast majority of cases occur after menopause, with postmenopausal bleeding being the presenting symptom in 95% of the cases. The use of transvaginal ultrasonography (TVS) is the sin e qua non in the assessment of these women. The finding of endometrial thickness of 5 mm or more is associated with increased likelihood for endometrial cancer, and should prompt further investigations. In cases with confirmed endometrial cancer, MRI and ultrasound are used to assess the depth of invasion to the myometrium and the cervical stroma. Recent studies have shown that – in experienced hands - a combination of gray-scale ultrasound with color and/or power Doppler examination has comparable results to that of MRI in the estimation of cancer invasion ≥ 50% in the myometrium or in the cervical stroma. Lack of uniformity in objective measurements is the main problem that hampers our ability to correctly predict myometrial or cervical stroma invasion with ultrasound. However, ultrasound is cheap, easy to perform and more readily available than any other imaging modality. The present article examines the use of gray-scale and Doppler ultrasound imaging in estimating the risk of endometrial cancer

Optic neuropathy following radiotherapy for Cushing's disease: Case report and literature review

Radiation-induced optic neuropathy is a rare adverse effect of radiotherapy applied for the treatment of pituitary adenomas. We report a patient with a recurrent adrenocorticotrophin secreting pituitary adenoma who received external beam irradiation after failing surgical and medical therapy. Sixteen months after radiotherapy, the patient was presented with declining visual acuity, and radiation-induced optic neuropathy was diagnosed. Despite treatment with glucocorticoids and hyperbaric oxygen, her vision did not improve. The pathophysiology, prevention and treatment of radiation-induced optic neuropathy, including the efficacy of hyperbaric oxygen therapy are reviewed

The prevalence and relevance of adrenal masses in patients with sporadic gastroenteropancreatic neuroendocrine tumours (GEP-NET)

Objective The widespread application of abdominal computerized tomography (CT) imaging has revealed that 0 center dot 984 center dot 0% of individuals harbour adrenal lesions (incidentalomas). There is, however, paucity of information regarding the prevalence of adrenal lesions in patients with gastroenteropancreatic neuroendocrine tumours (GEP-NETS). Purpose of this study was to estimate the prevalence of adrenal lesions in patients with GEP-NETS and identify their radiological features and clinical significance. Design The prevalence of adrenal lesions was estimated retrospectively in 438 patients with GEP-NETS who underwent abdominal imaging. Secretory status and changes in size were documented during subsequent follow-up. MEN-1 patients and ectopic ACTH-secreting tumours were excluded. Results Adrenal lesions were detected in 32 (8 center dot 4%) of 383 patients included. The majority (22 patients 69%) were located at the left adrenal gland and the mean size was 23 center dot 6mm. In two patients, one with a well and another with a poorly differentiated tumour, clinicopathological features suggested adrenal metastases. During a mean follow-up period of 69 center dot 5months, no subsequent growth of any adrenal lesion was observed. Endocrine evaluation documented subclinical glucocorticoid hypersecretion in 4 cases (14%). The presence of adrenal lesions did not correlate to distant metastases, however, they were observed more frequently in patients with G3 tumours. Conclusion The prevalence of adrenal lesions in patients with GEP-NETs was found to be higher than the general population and mostly represent benign adrenal adenomas (except patients with G3 tumours). Nevertheless, individualized assessment of imaging characteristics should be still considered