Accuracy of preoperative endometrial sampling diagnosis for predicting the final pathology grading in uterine endometrioid carcinoma

Objective: We aimed to determine the frequency of endometrial pathologies of patients who presented to our outpatient clinic with postmenopausal bleeding (PMB) and asymptomatic menopausal patients with a finding of thickened endometrium on transvaginal ultrasonography.Study Design: This study was performed at Bezmialem University Hospital. Women who presented to our clinic from January 2015 to January 2017 were analyzed. Patients were divided to two groups. All patients underwent transvaginal ultrasound with a 7.5 MHz probe. Endometrial sampling was performed by either blind D&C (dilatation & curettage) or pipelle sampling. We excluded patient specimens that were obtained by hysteroscopy.Results: Electronic records of a total of 368 patients in menopause were inspected. Out of these patients; 287 (78%) underwent endometrium sampling indicated by bleeding. Eighty-one patients (22%) were asymptomatic; however, a thickened endometrium echo on TVUSG examination (≥ 5 mm) was suspected. The median age was 57 (42-85). In both groups the two leading causes of endometrial pathology was; endometrial polyps followed by proliferative endometrium. The frequency of endometrial cancer was 9.4 % for the PMB group and 1.2 % in the asymptomatic patient groupConclusion: Evaluation of PMB as soon as possible is essential for diagnosing endometrial pathologies. Role of endometrial thickness is decisive in detecting patients at high risk for malignancy especially with comorbid conditions. Histopathological evaluation is mandatory for ruling out malignancy.

Download Full-text

THE SIGNIFICANCE OF PRE-OPERATIVE ENDOMETRIAL SAMPLING IN GRADE 1, LOW RISK ENDOMETRIAL CANCERS: IGCS-0088 Uterine Cancer, including Sarcoma

International Journal of Gynecological Cancer ◽

10.1136/00009577-201505001-00057 ◽

2015 ◽

Vol 25 (Supp 1) ◽

pp. 72-73

Author(s):

L. Singh ◽

T. Pua ◽

P. Khattar ◽

L. Han ◽

S. Tedjarati ◽

...

Keyword(s):

Uterine Cancer ◽

Low Risk ◽

Endometrial Sampling ◽

Endometrial Cancers

Download Full-text

Mixed Neuroendocrine/Non-neuroendocrine Neoplasm (MiNEN) of the Ovary Arising from Endometriosis: Molecular Pathology Analysis in Support of a Pathogenetic Paradigm

Endocrine Pathology ◽

10.1007/s12022-021-09689-8 ◽

2021 ◽

Author(s):

Roberta Maragliano ◽

Laura Libera ◽

Ileana Carnevali ◽

Valeria Pensotti ◽

Giovanna De Vecchi ◽

...

Keyword(s):

Large Cell ◽

Neuroendocrine Neoplasm ◽

Molecular Profile ◽

Neuroendocrine Neoplasms ◽

Fish Analysis ◽

Sequencing Analysis ◽

Endometrioid Carcinoma ◽

Preneoplastic Lesions ◽

Ovarian Endometriosis ◽

Neuroendocrine Carcinomas

AbstractPrimary ovarian neuroendocrine neoplasms (Ov-NENs) are infrequent and mainly represented by well-differentiated forms (neuroendocrine tumors — NETs — or carcinoids). Poorly differentiated neuroendocrine carcinomas (Ov-NECs) are exceedingly rare and only few cases have been reported in the literature. A subset of Ov-NECs are admixed with non-neuroendocrine carcinomas, as it occurs in other female genital organs, as well (mostly endometrium and uterine cervix), and may be assimilated to mixed neuroendocrine/non-neuroendocrine neoplasms (MiNENs) described in digestive and extra-digestive sites. Here, we present a case of large cell Ov-NEC admixed with an endometrioid carcinoma of the ovary, arising in the context of ovarian endometriosis, associated with a uterine endometrial atypical hyperplasia (EAH). We performed targeted next-generation sequencing analysis, along with a comprehensive immunohistochemical study and FISH analysis for TP53 locus, separately on the four morphologically distinct lesions (Ov-NEC, endometrioid carcinoma, endometriosis, and EAH). The results of our study identified molecular alterations of cancer-related genes (PIK3CA, CTNNB1, TP53, RB1, ARID1A, and p16), which were present with an increasing gradient from preneoplastic lesions to malignant proliferations, both neuroendocrine and non-neuroendocrine components. In conclusion, our findings underscored that the two neoplastic components of this Ov-MiNEN share a substantially identical molecular profile and they progress from a preexisting ovarian endometriotic lesion, in a patient with a coexisting preneoplastic proliferation of the endometrium, genotypically and phenotypically related to the ovarian neoplasm. Moreover, this study supports the inclusion of MiNEN in the spectrum ovarian and, possibly, of all gynecological NENs, among which they are currently not classified.

Download Full-text

Endometrial sampling before or after saline contrast sonohysterography in women with postmenopausal bleeding (ESPRESSO trial): A multicenter randomized controlled trial

Acta Obstetricia Et Gynecologica Scandinavica ◽

10.1111/aogs.14086 ◽

2021 ◽

Author(s):

Albertine J. Vroom ◽

Luca Aerts ◽

Marlies Y. Bongers ◽

Arianne C. Lim ◽

Bart J. Pielkenrood ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Controlled Trial ◽

Postmenopausal Bleeding ◽

Endometrial Sampling ◽

Randomized Controlled ◽

Multicenter Randomized Controlled Trial

Download Full-text

Clinical pathological characteristics and survival of high‐grade endometrioid carcinoma

Journal of Obstetrics and Gynaecology Research ◽

10.1111/jog.14839 ◽

2021 ◽

Author(s):

Shuang Liang ◽

Ying Zhang

Keyword(s):

High Grade ◽

Endometrioid Carcinoma ◽

Pathological Characteristics

Download Full-text

Naive patients with suspicious prostate cancer and positive multiparametric magnetic resonance imaging (mp-MRI): is it time for fusion target biopsy alone?

Journal of Clinical Urology ◽

10.1177/20514158211023713 ◽

2021 ◽

pp. 205141582110237

Author(s):

Enrico Checcucci ◽

Sabrina De Cillis ◽

Daniele Amparore ◽

Diletta Garrou ◽

Roberta Aimar ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Prostate Cancer ◽

Magnetic Resonance ◽

Detection Rate ◽

Resonance Imaging ◽

Fusion Biopsy ◽

Grade Group ◽

Final Pathology ◽

Multiparametric Magnetic Resonance Imaging ◽

Clinically Significant

Objectives: To determine if standard biopsy still has a role in the detection of prostate cancer or clinically significant prostate cancer in biopsy-naive patients with positive multiparametric magnetic resonance imaging. Materials and methods: We extracted, from our prospective maintained fusion biopsy database, patients from March 2014 to December 2018. The detection rate of prostate cancer and clinically significant prostate cancer and complication rate were analysed in a cohort of patients who underwent fusion biopsy alone (group A) or fusion biopsy plus standard biopsy (group B). The International Society of Urological Pathology grade group determined on prostate biopsy with the grade group determined on final pathology among patients who underwent radical prostatectomy were compared. Results: Prostate cancer was found in 249/389 (64.01%) and 215/337 (63.8%) patients in groups A and B, respectively ( P=0.98), while the clinically significant prostate cancer detection rate was 57.8% and 55.1% ( P=0.52). No significant differences in complications were found. No differences in the upgrading rate between biopsy and final pathology finding after radical prostatectomy were recorded. Conclusions: In biopsy-naive patients, with suspected prostate cancer and positive multiparametric magnetic resonance imaging the addition of standard biopsy to fusion biopsy did not increase significantly the detection rate of prostate cancer or clinically significant prostate cancer. Moreover, the rate of upgrading of the cancer grade group between biopsy and final pathology was not affected by the addition of standard biopsy. Level of evidence: Not applicable for this multicentre audit.

Download Full-text