scholarly journals Development of an Algorithm To Differentiate Uterine Sarcoma From Fibroid Using MRI and LDH Levels

2021 ◽  
Author(s):  
Ayako Suzuki ◽  
Aki Kido ◽  
Mitsuru Matsuki ◽  
Yasushi Kotani ◽  
Kosuke Murakami ◽  
...  
Keyword(s):  
Uterine Fibroid ◽  
Poor Prognosis ◽  
Evaluation Method ◽  
Uterine Fibroids ◽  
Uterine Sarcoma ◽  
Test Set ◽  
Ldh Value

Abstract This study aimed to establish an evaluation method for detecting uterine sarcoma with 100% sensitivity using MRI and serum LDH levels. One evaluator reviewed the MRI images and LDH values of a total of 1801 cases, including 36 cases of uterine sarcoma and 1765 cases of uterine fibroids. The reproducibility of the algorithm was also examined using a test set of 61 cases, including 14 cases of uterine sarcoma, by four evaluators with different imaging experience and abilities. From the MRI images and LDH values of 1801 cases of uterine sarcoma and uterine fibroid, we found that all sarcomas were included in the group with high T2WI and either high T1WI, unclear margin, or high LDH value. In addition, when cases with DWI were examined, all sarcomas had high DWI. Among the 36 sarcoma cases, the group with positive findings in T2WI, T1WI, margin, and serum LDH levels all had a poor prognosis (p = 0.015). The reproducibility of the algorithm was examined by four evaluators, and the sensitivity of sarcoma detection ranged from 71–93%. We established an algorithm that is not uterine sarcoma if tumors in the myometrium with low T2WI and DWI.

scholarly journals Tissue Extraction and Morcellation: The Menace of Unexpected Malignancy

2017 ◽  
Vol 1 (1) ◽  
pp. 1-4
Author(s):  
Khulkar Abdusattarova
Keyword(s):  
Uterine Fibroid ◽  
Histopathological Examination ◽  
Uterine Fibroids ◽  
Endometrial Stromal Sarcoma ◽  
Uterine Sarcoma ◽  
Preoperative Imaging ◽  
Tissue Extraction ◽  
Stromal Sarcoma ◽  
Power Morcellation ◽  
Symptomatic Uterine Fibroid

ABSTRACT Uterine fibroids are a common indication for hysterectomy or myomectomy. Even with optimal preoperative imaging, unexpected uterine sarcoma can be detected in histopathology after uterine fibroid surgery. In case of inadvertent morcellation of an unexpected uterine sarcoma the clinical outcomes, due to the rapid intraperitoneal dissemination of malignant tissue during the procedure can be negatively influenced. The purpose of this study was to determine the prevalence of uterine sarcoma in women undergoing hysterectomy or myomectomy for benign uterine fibroids. We performed retrospective study (2003-2014 years). The total number of women operated for uterine fibroids was 2297. Of this, 938 (42.5%) women had myomectomies and 1269 (57.5%) women had hysterectomies. In myomectomies the most frequently used surgical method was laparoscopic myomectomy in 591(63%) cases, followed by hysteroscopy myomectomy in 306 (32.62%) cases, and laparotomic myomectomy only in 41 (4.37%) cases. In hysterectomies, laparoscopic approaches significantly dominated in 1163 (61.1%) cases, showing laparotomic approaches in 491(25.82%) cases and vaginal approaches in 247 (12.99) cases. Only one patient with endometrial stromal sarcoma (ESS) was not preoperatively diagnosed and treated as symptomatic uterine fibroid; this patient underwent laparoscopic supracervical hysterectomy. In the post-operative histopathological examination ESS was detected. Thus, our incidence of sarcomas among women who underwent benign uterine fibroid surgery is 1/2297 (0,043%). Laparoscopic power morcellation should be performed only in cases with no suspicion of malignancy Patients, who undergo laparoscopic surgery with power morcellation should be informed about the possible risks of morcellation in cases of rare not suspected malignant disease. How to cite this article Mettler L, Abdusattarova K. Tissue Extraction and Morcellation: The Menace of Unexpected Malignancy. Int J Gynecol Endsc 2017;1(1):1-4.

scholarly journals PREVALENCE OF LEIOMYOSARCOMA OF UTERUS: A THREE YEAR RETROSPECTIVE STUDY

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Saket Sarswat ◽  
D. P. Soni ◽  
Saurabh Soni ◽  
Vimlesh . ◽  
Qadir Fatima
Keyword(s):  
Retrospective Study ◽  
Uterine Fibroid ◽  
Poor Prognosis ◽  
Malignant Tumors ◽  
Uterine Fibroids ◽  
Uterine Leiomyosarcoma ◽  
Appropriate Treatment ◽  
Relative Rarity ◽  
Optimum Management ◽  
Rule Out

Background: leiomyosarcoma of uterus are notorious for their aggressive nature and poor prognosis. The relative rarity of uterine leiomyosarcomas, as well as their pathological diversity, hinders studies aimed at improving understanding of the disease and makes it difficult to define the optimum management. Methods: This retrospective study is conducted over a period of three year from January 2017 to December 2020. All the hysterectomy specimens received at the Department of Pathology were processed and included in the study during the study period. We report here the Prevalence of leiomyosarcoma of uterus at Bikaner region. Results: We received a total of 952 hysterectomy specimens at Department of Pathology during the study period. Out of which 546 were operated and sent with the clinical diagnosis of uterine fibroid. Two patients were diagnosed with histopathological features of leiomyosarcoma which is 0.37% of all uterine fibroids and 0.21% of all hysterectomies at Bikaner region. Conclusion: Uterine leiomyosarcomas are rare but highly malignant tumors which are difficult to diagnose preoperatively and mostly mimic clinical features of benign uterine fibroids. The leiomyosarcomas show poor prognosis. This makes it important to investigate uterine malignancies histopathologically to rule out leiomyosarcomas so that appropriate treatment can be started early. Keywords: Uterine leiomyosarcoma, uterine fibroid.

scholarly journals Transcriptome Analyses of Myometrium from Fibroid Patients Reveals Phenotypic Differences Compared to Non-Diseased Myometrium

2021 ◽  
Vol 22 (7) ◽  
pp. 3618
Author(s):  
Emmanuel N. Paul ◽  
Gregory W. Burns ◽  
Tyler J. Carpenter ◽  
Joshua A. Grey ◽  
Asgerally T. Fazleabas ◽  
...  
Keyword(s):  
Uterine Fibroid ◽  
Three Dimensional ◽  
Uterine Fibroids ◽  
Principal Component ◽  
Leading Edge ◽  
Gene Set Enrichment ◽  
Phenotypic Differences ◽  
False Discovery ◽  
Gene Sets ◽  
High Concordance

Uterine fibroid tissues are often compared to their matched myometrium in an effort to understand their pathophysiology, but it is not clear whether the myometria of uterine fibroid patients represent truly non-disease control tissues. We analyzed the transcriptomes of myometrial samples from non-fibroid patients (M) and compared them with fibroid (F) and matched myometrial (MF) samples to determine whether there is a phenotypic difference between fibroid and non-fibroid myometria. Multidimensional scaling plots revealed that M samples clustered separately from both MF and F samples. A total of 1169 differentially expressed genes (DEGs) (false discovery rate < 0.05) were observed in the MF comparison with M. Overrepresented Gene Ontology terms showed a high concordance of upregulated gene sets in MF compared to M, particularly extracellular matrix and structure organization. Gene set enrichment analyses showed that the leading-edge genes from the TGFβ signaling and inflammatory response gene sets were significantly enriched in MF. Overall comparison of the three tissues by three-dimensional principal component analyses showed that M, MF, and F samples clustered separately from each other and that a total of 732 DEGs from F vs. M were not found in the F vs. MF, which are likely understudied in the pathogenesis of uterine fibroids and could be key genes for future investigation. These results suggest that the transcriptome of fibroid-associated myometrium is different from that of non-diseased myometrium and that fibroid studies should consider using both matched myometrium and non-diseased myometrium as controls.

scholarly journals TO THE QUESTION ON UTERINE FIBROIDS DURING PREGNANCY

2021 ◽  
pp. 54-59
Author(s):  
T. F. TATARCHUK ◽  
N. V. KOSEY ◽  
S. I. REGEDA ◽  
O. V. ZANKO ◽  
K. D. PLAKSIIEVA
Keyword(s):  
Statistical Analysis ◽  
Cesarean Section ◽  
Live Birth ◽  
Uterine Fibroid ◽  
Postpartum Period ◽  
Uterine Fibroids ◽  
Premature Delivery ◽  
Pelvic Ultrasound ◽  
Natural Childbirth ◽  
Increased Risk

Uterine fibroids is an extremely common tumor of the female reproductive system, among whose manifestations are infertility, spontaneous abortions, incorrect fetal position, placenta previa, premature delivery, bleeding during and after delivery, and an increased risk of cesarean section. According to the literature, myomas are changing in size during pregnancy and in the postpartum period. Aim of the study. To assess the dynamics of uterine fibroid size change during pregnancy and the effect of an existing uterine fibroid on the course of pregnancy and labor. Materials and methods. Outpatient records of patients aged 24 to 45 years (mean age 33.36 ± 4.63 years) who were diagnosed with Pregnancy and uterine fibroids from 2016 to 2021 at Verum Medical Center were evaluated (n = 57). The size of the fibroids (volume and diameter) before, during (I or II prenatal screening) and after pregnancy (first pelvic ultrasound after delivery) was used for statistical analysis. Forty-one of the 57 patients had pelvic ultrasound before, during, and after pregnancy and were included in the statistical analysis of changes in uterine myoma size. Results. Among the patients included in the statistical analysis, uterine fibroids increased in volume by 194.38% ± 86.9 (40.98% ± 18.4 in diameter) during pregnancy, and decreased by 53.98% ± 14.93 in diameter and by 54.28% ± 29.62 of baseline in the postpartum period. A significant number of fibroids (39.47%) did undergo involutionary changes and were not visualized in the first postpartum ultrasound. The live birth rate was high at 90% (64% of deliveries were through natural childbirth and 26% through cesarean section). Conclusions. There was no effect of intramural, intramural-subserosal, and subserosal uterine fibroids with an average diameter of £20 mm on pregnancy and live birth in women. A great amount of uterine fibroids nearly triple in size during pregnancy, but after delivery they return to their original size and even halve in size. This can be regarded as a confirmation of the absence of a negative effect of pregnancy, or, possibly, a positive effect on uterine fibroid size, which requires further investigation.

scholarly journals Concept of Granthi with reference to uterine fibroid: An Ayurveda review

2021 ◽  
Vol 9 (02) ◽  
Author(s):  
Jaya Umate ◽  
Soudamini Chaudhari
Keyword(s):  
Life Span ◽  
Uterine Fibroid ◽  
Uterine Fibroids ◽  
Modern Science ◽  
Reproductive Age ◽  
Significant Morbidity ◽  
Reproductive Life ◽  
Reproductive Life Span ◽  
Gynecological Disease ◽  
Reproductive Age Group

Uterine fibroids are the commonest benign tumor of the uterus and also the commonest benign solid tumor in the female. It can cause significant morbidity in women of a reproductive life span. The exact cause of uterine fibroid is unknown. Prevalence of uterine fibroid 5 -20 % of women in the reproductive age group. It can cause significant morbidity in women of a reproductive life span. Not all fibroids cause symptoms. 50% of women are asymptomatic. Fibroids mainly cause symptoms like menorrhagia, dysmenorrhea and cause pressure symptoms on adjacent viscera i. e. bladder, uterus, rectum which affects the everyday activities of women. In Ayurveda all gynecological disease explained under the term yonivyapad. It can be explained as the anatomical and functional abnormalities of the female reproductive system. In Ayurveda granthi can be correlated with the uterine fibroid. In modern science uterine fibroid treats medically, surgically. But it is challenging to establish a satisfactory conservatory medical treatment to date. so in Ayurveda the main purpose is the management of granthi by samprapti vighatan by use of medicine.

scholarly journals Uterine Fibroid Embolisation for Symptomatic Uterine Fibroids: A Survey of Clinical Practice in Europe

2010 ◽  
Vol 34 (4) ◽  
pp. 765-773 ◽  
Author(s):  
Marianne J. Voogt ◽  
Mark J. Arntz ◽  
Paul N. M. Lohle ◽  
Willem P. Th. M. Mali ◽  
Leo E. H. Lampmann
Keyword(s):  
Clinical Practice ◽  
Uterine Fibroid ◽  
Uterine Fibroids ◽  
Uterine Fibroid Embolisation

A Novel predictive probability algorithm to determine risk for malignancy between uterine fibroids versus uterine sarcoma.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e18098-e18098
Author(s):  
Alexandra Michelle Blackman ◽  
Alexandra Samborski ◽  
Michael Craig Miller ◽  
Rakesh Singh ◽  
Kyu Kwang Kim ◽  
...  
Keyword(s):  
Prospective Trial ◽  
Uterine Fibroids ◽  
Pelvic Mass ◽  
Risk Groups ◽  
Uterine Sarcoma ◽  
Low Risk ◽  
Ca 125 ◽  
Logistics Regression ◽  
Predictive Probability ◽  
Risk Of Malignancy

e18098 Background: The combination of HE4 and CA125 can be used as a predictive probability algorithm to determine the risk of malignancy in women with a uterine mass. Many studies have been done looking at ways to differentiate between benign fibroids and uterine sarcomas with limited success. This study examined the utility of using a logistics regression algorithm containing biomarkers HE4 and CA 125 to predict risk of malignancy of a uterine mass. Methods: This was an IRB retrospective study using de-identified data form 5 pelvic mass studies. Patients were included if they were diagnosed with either uterine fibroids or uterine sarcoma on final pathology. Pre-operative serum levels of HE4 and CA125 were obtained for each patient. A logistics regression analysis was performed in a prior pelvic mass prospective trial and utilized in this analysis. The predictive probability algorithm was used to classify patients into high and low risk groups for sarcoma. Wilson’s score interval was used to determine confidence intervals. Results: There were 71 patients identified with a uterine mass. The mean age of study participants was 54 (range 22-85). There were 10 (14.1%) sarcomas and 61 fibroids (85.9%) identified. Six of the sarcomas were leiomyosarcomas (60.0%). There was 1 adenosarcoma (10%), 1 mixed sarcoma (10%) and 2 sarcomas which were not further characterized. A threshold of 13.1% was used to classify masses as low or high risk. The predictive probability algorithm was found to have a sensitivity of 90.9% (CI 55.5-99.7%), specificity of 60.7% (CI 47.3-72.9%), PPV of 27.3% (13.3-45.5%), and NPV of 97.4% (86.2-99.9%). An elevated risk of malignancy was noted in 9 (90%) sarcomas and 24 (39%) of fibroids. Conclusions: A predictive probability algorithm using HE4 and CA 125 had a high sensitivity for determining high and low risk of malignancy in patients with presumed uterine fibroids with a sensitivity of 90.9% for detecting sarcoma. This algorithm will be validated in a prospective clinical trial.

scholarly journals Aberrant expression and regulation of NR2F2 and CTNNB1 in uterine fibroids

Reproduction ◽  
2013 ◽  
Vol 146 (2) ◽  
pp. 91-102 ◽  
Author(s):  
Marina Zaitseva ◽  
Sarah J Holdsworth-Carson ◽  
Luke Waldrip ◽  
Julia Nevzorova ◽  
Luciano Martelotto ◽  
...  
Keyword(s):  
Uterine Fibroid ◽  
Molecular Mechanisms ◽  
Primary Cultures ◽  
Uterine Fibroids ◽  
Reproductive Age ◽  
Causal Role ◽  
Aberrant Expression ◽  
Regulatory Pathways ◽  
Shh Pathway ◽  
Common Benign Tumour

Uterine fibroids are the most common benign tumour afflicting women of reproductive age. Despite the large healthcare burden caused by fibroids, there is only limited understanding of the molecular mechanisms that drive fibroid pathophysiology. Although a large number of genes are differentially expressed in fibroids compared with myometrium, it is likely that most of these differences are a consequence of the fibroid presence and are not causal. The aim of this study was to investigate the expression and regulation of NR2F2 and CTNNB1 based on their potential causal role in uterine fibroid pathophysiology. We used real-time quantitative RT-PCR, western blotting and immunohistochemistry to describe the expression of NR2F2 and CTNNB1 in matched human uterine fibroid and myometrial tissues. Primary myometrial and fibroid smooth muscle cell cultures were treated with progesterone and/or retinoic acid (RA) and sonic hedgehog (SHH) conditioned media to investigate regulatory pathways for these proteins. We showed that NR2F2 and CTNNB1 are aberrantly expressed in fibroid tissue compared with matched myometrium, with strong blood vessel-specific localisation. Although the SHH pathway was shown to be active in myometrial and fibroid primary cultures, it did not regulateNR2F2orCTNNB1mRNA expression. However, progesterone and RA combined regulatedNR2F2mRNA, but notCTNNB1, in myometrial but not fibroid primary cultures. In conclusion, we demonstrate aberrant expression and regulation of NR2F2 and CTNNB1 in uterine fibroids compared with normal myometrium, consistent with the hypothesis that these factors may play a causal role uterine fibroid development.

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