Abnormal uterine bleeding as a presenting sign of metastasis to the endometrium in a patient with a history of cutaneous malignant melanoma

BackgroundThe aim of the study was to compare the accuracy of hydrosonography with that of transvaginal ultrasonography in detection of intracavitary pathologies in patients with history of abnormal uterine bleeding.Study designProspective, randomized, and unblinded study.Material and methodsA total of 197 women (n = 130 premenopausal and n = 67 postmenopausal) aged between 23 and 71 years (mean age 45.7 ± 8.9) presenting with a history of abnormal uterine bleeding were included into the study. Hydrosonography was carried out by experienced gynecologists, on the same setting in an outpatient clinic immediately after the performance of transvaginal sonography. The finally obtained surgical-pathologic findings were compared with the results obtained from transvaginal sonography and hydrosonography. Sensitivity, specificity, positive, and negative predictive values were calculated for each procedure.ResultsThe surgical-pathologic examination confirmed normal physiologic endometrium in 50 (48%) of 104 women who were said to have normal endometrium on transvaginal sonography. Seventy (75%) of 93 women diagnosed of intracavitary pathologies on transvaginal sonography were confirmed by surgical-pathologic findings. The sensitivity, specificity, positive predictive value, and negative predictive value of transvaginal sonography in the detection of intracavitary pathology were 56, 68, 75, and 48%, respectively. Surgical-pathologic results revealed intracavitary pathologies in 23 (30%) of 76 women who were said to have normal endometrium on hydrosonography. Among 121 women diagnosed of intracavitary pathologies on hydrosonography, 101 (81%) women were confirmed after histological evaluation of the surgical specimens. The sensitivity, specificity, positive predictive value, and negative predictive value of hydrosonography in the detection of intracavitary pathology were 81, 73, 83, and 70%, respectively. Sensitivity and negative predictive value were significantly higher with hydrosonography. There were five cases of endometrial malignancy in which one of the case of malignancy was on polyp and two cases of endometrial hyperplasia with atypia which were not stated on sonographic results.ConclusionHydrosonography is more accurate than transvaginal ultrasography in the detection of intracavitary pathologies in women with abnormal uterine bleeding.

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Cutaneous malignant melanoma in women is uncommonly associated with a family history of melanoma in first-degree relatives: a case-control study

Melanoma Research ◽

10.1097/00008390-199612000-00005 ◽

1996 ◽

Vol 6 (6) ◽

pp. 435-440 ◽

Cited By ~ 12

Author(s):

C Cutler ◽

W D Foulkes ◽

J S Brunet ◽

T Y Flanders ◽

H Shibata ◽

...

Keyword(s):

Family History ◽

Malignant Melanoma ◽

Case Control Study ◽

Case Control ◽

Cutaneous Malignant Melanoma ◽

First Degree Relatives ◽

History Of ◽

Control Study

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The Influence of Pregnancy on the Recurrence of Cutaneous Malignant Melanoma in Women

Dermatology Research and Practice ◽

10.1155/2010/214745 ◽

2010 ◽

Vol 2010 ◽

pp. 1-5 ◽

Cited By ~ 5

Author(s):

M. Albersen ◽

V. I. Westerling ◽

P. A. M. van Leeuwen

Keyword(s):

Malignant Melanoma ◽

Disease Free Survival ◽

Recurrence Risk ◽

Cutaneous Malignant Melanoma ◽

Stage I ◽

Free Survival ◽

Medical Databases ◽

Significant Difference ◽

History Of ◽

Disease Free

Objective. The aim of this study was to determine whether pregnancy increases the recurrence risk of cutaneous malignant melanoma (CMM) in women with a history of stage I CMM.Methods. The electronic medical databases of Medline and Embase were explored. All 1084 obtained articles were screened on title and abstract using predetermined inclusion and exclusion criteria. A critical appraisal of relevance and validity was conducted on the remaining full text available articles.Results. Two studies were selected. Both studies revealed no significant difference in disease-free survival between women with stage I CMM and the control population.Conclusion. Pregnancy does not increase the recurrence risk of CMM in women with a history of stage I CMM.

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Natural history of cutaneous malignant melanoma

Plastic & Reconstructive Surgery ◽

10.1097/00006534-198011000-00112 ◽

1980 ◽

Vol 66 (5) ◽

pp. 808

Author(s):

Mark A. Mandel

Keyword(s):

Malignant Melanoma ◽

Natural History ◽

Cutaneous Malignant Melanoma ◽

History Of

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ECTOPIC PREGNANCY : A MAJOR CAUSE OF MATERNAL MORTALITY?

Journal of Nepal Medical Association ◽

10.31729/jnma.823 ◽

2003 ◽

Vol 42 (147) ◽

pp. 151-155

Author(s):

Rajshree Jha ◽

M Singh ◽

A Rana ◽

A Singh ◽

S Bastola

Keyword(s):

Risk Factors ◽

Ectopic Pregnancy ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Pelvic Surgery ◽

Transvaginal Sonography ◽

Pregnancy Risk ◽

Abdominal Tenderness ◽

Presenting Symptoms ◽

History Of

ABSTRACTSeventyeight cases of ectopic pregnancy were studied retrospectively at Tribhuvan University TeachingHospital during April 1993 - December 1996. The overall incidence of etopic pregnancy was 0.86% livebirths. Grandmultipara were found to be at a low risk for ectopic pregnancy. A history of infertility andprevious pelvic surgery were positive risk factors. The most common presenting symptoms were abdominalpain (90%), history of amenorrhoea (46%), abnormal uterine bleeding (40%). On examination adenexaltenderness (72%), abdominal tenderness (68%), pallor (53%) and cervical excitation (33%) were the mostfrequent findings. Adenexal mass was noted in 22% cases and in 35 % cases the size of the uterus could notbe assessed. Ultrasonography and transvaginal sonography proved to be valuable diagnostic aids. Twomaternal deaths (2.6 %) due to ectopic pregnancy occurred in the hospital during this period.Key Words: Ectopic pregnancy, risk factors, sonography.

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Natural history of cutaneous malignant melanoma

World Journal of Surgery ◽

10.1007/bf01556570 ◽

1979 ◽

Vol 3 (3) ◽

pp. 255-267 ◽

Cited By ~ 7

Author(s):

Henry A. Briele ◽

T. K. Das Gupta

Keyword(s):

Malignant Melanoma ◽

Natural History ◽

Cutaneous Malignant Melanoma ◽

History Of

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Clinical Factors Associated With Anxiety and Depression in Korean Women With Abnormal Uterine Bleeding

10.21203/rs.3.rs-74801/v1 ◽

2020 ◽

Author(s):

Hae Nam Lee ◽

Ji Min Seo ◽

Gi Soo Um ◽

Min Jeong Kim

Keyword(s):

Depressive Disorders ◽

Health Management ◽

Premenopausal Women ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

University Hospital ◽

Menstrual Bleeding ◽

Anxiety And Depression ◽

Korean Women ◽

History Of

Abstract Background: Abnormal uterine bleeding (AUB) is defined as an abnormality in menstrual bleeding and is common gynecological problem in premenopausal women. Anxiety and depressive disorders were frequently observed in patients with AUB. This study was conducted to investigate the prevalence and the relationship of anxiety and depression in Korean women with AUB.Methods: The study was a questionnaire study of 124 Korean women aged 15–55 who admitted a single university hospital due to AUB between September 2015 and December 2019. Anxiety, depression were assessed using the Korean Beck Anxiety Inventory (K-BAI), the Korean Beck Depression Inventory-II (K-BDI-II). The obstetrical and clinical data were analyzed to assess the association of anxiety and depression with AUB.Results: Out of 124 patients, 47 (37.9%) met the criteria for anxiety, and 24 (19.5%) met the criteria for depression. The most common menstrual problems seen were heavy menstrual bleeding (80.7%), followed by irregular bleeding (62.9%), dysmenorrhea (55.7%), and irregular menstrual cycles (33.9%). More women with AUB in our study had anxiety as measured by the K-BAI and depression as measured by the K-BDI-II. A history of abortion and cesarean section were related with anxiety, whereas a history of minor surgery was related to depression. Anxiety and depression (r = 0.629, p < 0.001) were correlated with AUB.Conclusions: Anxiety and depression are underdiagnosed and undertreated in Korean women with AUB symptoms. Screening and appropriate mental health management are needed for women with AUB for women’s health.

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Association of thyroid dysfunction with abnormal uterine bleeding

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20182355 ◽

2018 ◽

Vol 7 (6) ◽

pp. 2388

Author(s):

Lakshmi Manjeera M. ◽

Prabhneet Kaur

Keyword(s):

Thyroid Dysfunction ◽

Endometrial Thickness ◽

Abnormal Uterine Bleeding ◽

Uterine Bleeding ◽

Thyroid Function Tests ◽

Medical College ◽

History Of ◽

Hormonal Steroids ◽

Thyroid Abnormalities ◽

Rule Out

Background: Abnormal uterine bleeding is a common complaint for women being referred to the gynaecologist and is associated with an array of symptoms. The objective of this study was to detect association of thyroid dysfunction in patients with menstrual irregularitiesMethods: This non-interventional prospective study was done over a period of one and half years in a private medical college in Mangalore. All patients in age group of 15-55 years who presented with history of menstrual disturbances were enrolled and evaluated in the study. Patients with structural causes of AUB or using IUCDs or hormonal steroids were excluded. Total of 85 patients were hence evaluated. These 85 patients were subjected to routine investigations like Hb, BT, CT and platelets (to rule out coagulation defects) along with TSH, T3, T4 estimation. Ultrasound abdomen and pelvis with endometrial thickness was done to rule out structural causes.Results: The most common menstrual disturbance was menorrhagia (47 patients: 55.3%). Thyroid abnormalities were found in 29 of the 85 patients with AUB (34.11%). Of the 29 patients with thyroid dysfunction, 24 were hypothyroid and 5 patients were found to be hyperthyroid.Conclusions: Thyroid abnormalities are frequently associated with menstrual irregularities. Hence Thyroid Function Tests are extremely valuable in patients with provisional diagnosis of AUB and should be made mandatory to avoid unnecessary hormonal or surgical treatment in such patients.

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