scholarly journals Fertility preservation in patients with uterus didelphys and endometrial carcinoma: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jiao Yu ◽  
Jing Shang ◽  
Hongwu Wen ◽  
Yang Xu
Keyword(s):  
Endometrial Cancer ◽  
Case Report ◽  
Endometrial Carcinoma ◽  
Fertility Preservation ◽  
High Efficiency ◽  
Young Patients ◽  
Uterine Endometrium ◽  
Uterus Didelphys ◽  
Child Bearing

Abstract Background Endometrial cancer combining uterus didelphys is quite rare clinically which partially explains that there is no discussion about young patients’ fertility preservation and follow up of tumor outcome. Case presentation In this article, we report a case of unilateral endometrial carcinoma found in a young patient with uterus didelphys who was treated with high-efficiency progesterone due to unfinished child-bearing. During the follow-up, the affected uterine endometrium was not reversed by progesterone. So, the patient underwent the abdominal surgery with the left uterus and left fallopian tube resection. We performed three consecutive immunohistochemical studies of the contralateral uterine endometrium to verify the safety of preserving the contralateral uterus and its appendages which preserved her fertility. Conclusions Endometrial cancer occurring in patients with uterus didelphys is quite rare in child-bearing age. In this case report, we preserved the patient’s contralateral uterus based on patient’s strong needs and negative IHC analysis of the preserved side uterine endometrium. However, the tumor and fertility outcome require more follow-up.

scholarly journals Systemic recurrence of endometrial cancer more than 10 years after hysterectomy: a report of two cases and a brief review of the literature

2020 ◽  
Vol 32 (1) ◽  
Author(s):  
Leonardo Muratori ◽  
Paola Sperone ◽  
Gabriella Gorzegno ◽  
Anna La Salvia ◽  
Giorgio Vittorio Scagliotti
Keyword(s):  
Endometrial Cancer ◽  
Case Report ◽  
Endometrial Carcinoma ◽  
Developed Countries ◽  
Disease Stage ◽  
Prior History ◽  
Disease Relapse ◽  
Review Of The Literature ◽  
Radical Treatment ◽  
Risk Of Disease

Abstract Background Endometrial carcinoma is one of the most common female cancers in developed countries. Disease stage is associated with the risk of disease relapse after radical treatment. Typically, the risk of disease relapse peaks at 3 years from local radical treatment and then diminishes over time, so that late relapses (i.e., from year 5 afterward) are extremely infrequent. Here, we report two cases of women with endometrial cancer who developed a disease relapse more than 15 years after radical treatment. A review of the literature revealed other seven reports of women with relapse from endometrial cancer occurring more than 10 years after radical treatment. Case presentation Case report 1 is a 56-year-old woman with an endometrioid cancer who underwent a hysterectomy with bilateral salpingo-oophorectomy in 1998. She relapsed in the lung in 2014, 16 years from radical surgery. Case report 2, a 75-year-old woman, with an endometrioid cancer, was treated by hysterectomy with bilateral salpingo-oophorectomy and adjuvant radiotherapy. The disease relapse in the lung was detected in 2019, 22 years from radical treatment. Conclusion Although guidelines do not support oncological follow-up beyond 5 years from surgery, oncologists should consider late recurrence of endometrial carcinoma in the differential diagnosis of women presenting with metastases of uncertain origin and prior history of this disease.

Is there a role for CA-125 in monitoring patients with early endometrial cancer?

1991 ◽  
Vol 1 (4) ◽  
pp. 169-172
Author(s):  
M. Prefontaine ◽  
G. J. O'Connell ◽  
E. Ryan ◽  
K. J. Murphy
Keyword(s):  
Endometrial Cancer ◽  
Positive Predictive Value ◽  
Endometrial Carcinoma ◽  
Predictive Value ◽  
Clinical Status ◽  
Statistical Correlation ◽  
Ca 125 ◽  
Recurrent Malignancy ◽  
Low Prevalence

Elevated CA-125 levels have been reported in some women with endometrial carcinoma. Current follow-up policy for these patients does not involve the use of tumor markers. CA-125 measurements were performed in 28 patients with a diagnosis of endometrial cancer, 14 clinically free of disease and 14 with known disease. Based on the sensitivity (0.64) and specificity (0.93) observed we constructed a model to estimate the predictive value of the assay as a marker in the follow-up of patients who have completed treatment. This model would involve a CA-125 assay every six months for five years in 100 patients with stage I and II disease. Despite the high statistical correlation between the clinical status of the patient and the CA-125 value observed in our study, the positive predictive value would be approximately 24% in such a follow-up protocol where a low prevalence of recurrent malignancy is expected.

Why Routine Clinical Follow-up for Patients With Early Stage Endometrial Cancer Is Not Always Necessary: A Study on Women in South Wales

2014 ◽  
Vol 24 (3) ◽  
pp. 556-563 ◽  
Author(s):  
Lilly Aung ◽  
Robert E.J. Howells ◽  
Kenneth C.K. Lim ◽  
Emma Hudson ◽  
Peter W. Jones
Keyword(s):  
Endometrial Cancer ◽  
Confidence Interval ◽  
Endometrial Carcinoma ◽  
Early Stage ◽  
Progression Free Survival ◽  
Disease Recurrence ◽  
Hazard Ratio ◽  
Free Survival ◽  
South Wales

ObjectiveThis study aimed to examine the existing methods of follow-up in women who have undergone treatment of early endometrial carcinoma in South Wales and to assess if they are appropriate.DesignThis study used a retrospective analysis of follow-up data.SettingThis study was performed in the Virtual Gynaecological Oncology Centre, South Wales, United Kingdom.SampleThis study sample is composed of 552 women.MethodsData regarding follow-up were collected retrospectively from patient case notes and computerized data systems. Data were analyzed using the Pearson χ2 test, Cox proportional hazard regression analysis, and Kaplan-Meier curves.Main Outcome MeasuresThis study aimed to determine whether routine follow-up was beneficial in detecting disease recurrence and whether outcome was influenced by routine follow-up.ResultsBetween January 1, 2000, and December 31, 2010, 552 women were treated for early stage endometrial carcinoma. The 5-year survival was 81%, and the 5-year progression-free survival was 77%. Of these 552 women, 81 (15%) developed a disease recurrence; the majority (61/81 [75%]) recurred within 3 years. The median survival was 35 months compared with 47 months in patients who did not develop a recurrence. Of the 81 patients, 73 (90%) were symptomatic and only 5 patients were truly asymptomatic at follow-up. The most important and significant prognostic factor was “recurrent disease” with overall survival (hazard ratio, 2.20; P < 0.001; 95% confidence interval, 1.75–2.65) and progression-free survival (hazard ratio, 2.52; P < 0.001; 95% confidence interval, 2.09–2.95). “Asymptomatic recurrence” was not an independent predictor of outcome.ConclusionsRoutine follow-up for early endometrial cancer is not beneficial for patients because most were symptomatic at the time of detection. It does not significantly improve the outcome. We propose altering the follow-up time regimen and adopting alternative follow-up strategies for women in South Wales.

Young patients with endometrial carcinoma selected for conservative treatment: A need for vigilance for synchronous ovarian carcinomas, case report and literature review

2007 ◽  
Vol 104 (3) ◽  
pp. 757-760 ◽  
Author(s):  
Alireza A. Shamshirsaz ◽  
Matthew Withiam-Leitch ◽  
Kunle Odunsi ◽  
Trudy Baker ◽  
Peter J. Frederick ◽  
...  
Keyword(s):  
Case Report ◽  
Conservative Treatment ◽  
Literature Review ◽  
Endometrial Carcinoma ◽  
Young Patients ◽  
Ovarian Carcinomas

scholarly journals Fertility-Sparing Methods in Adolescents Affected by Endometrial Cancer: A Comprehensive Review

2021 ◽  
Vol 10 (5) ◽  
pp. 1020
Author(s):  
Krzysztof Gałczyński ◽  
Piotr Olcha ◽  
Katarzyna Romanek-Piva ◽  
Maciej Jóźwik ◽  
Andrzej Semczuk
Keyword(s):  
Endometrial Cancer ◽  
World Literature ◽  
Young Patients ◽  
Developed Countries ◽  
Type I ◽  
Genetic Syndromes ◽  
Patient Death ◽  
Future Fertility ◽  
Fertility Sparing

Although in developed countries endometrial cancer (EC) is the most common gynecological malignancy, its occurrence in adolescents is exceedingly rare. The increasing rate of obesity in children and adolescents is held responsible for the increasing prevalence of EC in younger cohorts of patients. The diagnosis of this malignancy can have devastating consequences for future fertility because standard treatment protocols for EC include hysterectomy. Here, we present the first detailed review of the world literature on EC in subjects aged 21 years or younger (n = 19). The mean age at diagnosis was 16.7 ± 0.6 years. One patient (5.3%) had a Type II (high-risk) disease. No communication retrieved from the search reported on patient death; however, two (10.5%) patients were lost to follow-up. There was also a high proportion (five subjects, or 26.3%) of cases with genetic background (Cowden syndrome and Turner syndrome), therefore genetic screening or a direct genetic study should be considered in very young patients with EC. The current fertility-sparing options, limited to Type I (low-risk) disease, are presented and discussed. Such information, obtained from studies on older women, translates well to adolescent girls and very young women. Careful anatomopathological monitoring at follow-up is essential for the safety of a conservative approach. Improved survival in very young EC patients makes the preservation of fertility a central survivorship issue, therefore both patients and caregivers should undergo counseling regarding available options. Moreover, our study suggests that genetic syndromes other than Lynch syndrome may be associated with EC more frequently than previously thought.

2Fibulin-5 Inhibits Proliferation of Endometrial Carcinoma Ishikawa Cells by Down-Regulating β-Catenin

2020 ◽  
Vol 10 (2) ◽  
pp. 189-194
Author(s):  
Jing Chu ◽  
Zhichao Tong ◽  
Xiaolan Zhou ◽  
Teng Li
Keyword(s):  
Endometrial Cancer ◽  
Cell Viability ◽  
Endometrial Carcinoma ◽  
Cancer Cell Proliferation ◽  
Ishikawa Cells ◽  
Cancer Tissues ◽  
Related Pathway ◽  
Tissue Cancer

Endometrial cancer is a malignance in the uterus. The incidence of endometrial cancer is increasing recent years. Fibulin-5 participates in tissue homeostasis. The exact role of Fibulin-5 in endometrial cancer, such as becoming a sensitive tumor marker for endometrial cancer for diagnosis and follow-up, remains to be determined. 30 cases of endometrial tissue cancer specimens and adjacent tissues were collected for analysis of the expression of Fibulin-5 by western blot. Endometrial carcinoma Ishikawa cells (ECICs) were cultured and the level of Fibulin-5 was regulated via transfection. β-catenin level was measured followed by analysis of cell viability by MTT assay or BrdU staining. Results showed that Fibulin-5 in endometrial carcinoma tissues was significantly downregulated compared to para cancer tissues. Overexpression of Fibulin-5 decreased cell viability of endometrial carcinoma Ishikawa cells (ECICs) whereas downregulation increased cell viability. Meanwhile, Fibulin-5 overexpression significantly downregulated β-catenin and β-catenin knockdown blocked the proliferation effect caused by Fibulin-5 on ECICs. In conclusion, Fibulin-5 could inhibit cancer cell proliferation possibly via β-catenin related pathway.

scholarly journals Poland Syndrome: Use of Vertical Expandable Prosthetic Titanium Rib System before Walking Age—A Case Report

2016 ◽  
Vol 02 (03) ◽  
pp. e91-e95
Author(s):  
Rosen Drebov ◽  
Atanas Katsarov
Keyword(s):  
Case Report ◽  
Vertebral Column ◽  
Young Patients ◽  
Late Complications ◽  
Poland Syndrome ◽  
Paradoxical Breathing ◽  
Choice Of Treatment ◽  
Walking Age ◽  
Left Scapula

Aim To present a new therapy for Poland syndrome (PS) using a novel surgical approach: the vertical expandable prosthetic titanium rib (VEPTR) system. Methods The VEPTR system rib-to-rib variant was used to enhance the chest wall and vertebral column support in a young patient before walking age. Case Report We present a 12-month-old infant diagnosed with left-sided PS at the age of 6 months associated with missing ribs, scoliosis, and absence of the left pectoral muscles. Because of four missing ribs, paradoxical breathing was present. In addition, the left scapula was protruding into the chest due to the missing rib support. Scoliosis was caused by a left-sided nonsegmented bar of the thoracic spine. Results We decided to use the VEPTR system before the patient reached walking age to prevent progression of column deformation and future pulmonary problems. To improve the spinal deformity, to stabilize the thorax, and to improve thoracic function, we performed the operation at 1 year of age. At 10-month follow-up, the patient was reevaluated. The construction was still stable and scoliosis had not deteriorated. Conclusion The VEPTR system is a choice of treatment in young patients with PS to prevent late complications after a child reaches walking age.

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