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 Mcl-1 Expression Is Up-Regulated in Malignancies of the Parotid Gland

2011 ◽  
Vol 30 (5) ◽  
pp. 229-233 ◽  
Author(s):  
Gregor Heiduschka ◽  
Boban M. Erovic ◽  
Johannes Pammer ◽  
Ulana Kotowski ◽  
Alexandra Kaider ◽  
...  
Keyword(s):  
Overall Survival ◽  
Retrospective Study ◽  
Statistical Analysis ◽  
Parotid Gland ◽  
Poor Prognosis ◽  
Malignant Tumors ◽  
Gland Tumor ◽  
Parotid Gland Tumor ◽  
Apoptotic Protein ◽  
Pleomorphic Adenomas

The anti-apoptotic protein Mcl-1 is highly expressed in various types of malignant tumors. Overexpression is reported to correlate with poor prognosis and disease progression. We report the expression levels of Mcl-1 in tumor samples of the parotid gland. A retrospective study containing 108 patients was performed. A tissue microarray of six malignancies of the parotid gland and pleomorphic adenoma as control was constructed. Parotid gland tumor samples were immunohistochemically stained for Mcl-1 and expression intensities were assessed. Statistical analysis included correlation to patients' clinical data and comparison of malignancies to the adenoma.All malignancies had significantly higher expression of Mcl-1 than the pleomorphic adenomas. The intensity, however, had no significant correlation to overall survival.Our immunohistochemical findings indicate that parotid gland malignancies produce high levels of Mcl-1 protein. Therefore, Mcl-1 might serve as a predictive co-marker in tumors of the parotid gland.

scholarly journals Population-Based Survival Analysis of Patients With Limb Rhabdomyosarcoma and Metastasis at Diagnosis

2021 ◽  
Vol 8 ◽  
Author(s):  
Chunying Yang ◽  
Haiqing Wang ◽  
Feng Niu ◽  
Lufeng Yao
Keyword(s):  
Poor Prognosis ◽  
Population Based ◽  
Tumor Subtype ◽  
Male Predominance ◽  
Cox Proportional Hazard ◽  
Kaplan Meier ◽  
Appropriate Treatment ◽  
Younger Age ◽  
Relative Rarity ◽  
Cox Proportional Hazard Regression

Purpose: Given the poor prognosis and the relative rarity of patients diagnosed with limb rhabdomyosarcoma (LRMS) and metastasis at diagnosis, we performed this study to reveal distinctive clinical features and evaluated prognostic factors of this special population in order to provide appropriate treatment.Patients and Methods: We carried out retrospective research of patients diagnosed with LRMS and metastasis from 1975 to 2016 using the Surveillance, Epidemiology, and End Results (SEER) program database. Survival curves were generated by applying the Kaplan–Meier method. In terms of evaluating and determining independent predictors of survival, we conducted univariate and multivariate survival analyses using the Cox proportional hazard regression model.Results: This retrospective analysis contained a series of 245 patients with metastatic LRMS, with male predominance (male vs. female, 1.6:1). Nearly half of the patients were diagnosed with alveolar rhabdomyosarcoma (44.9%). According to the results of the univariate and multivariate analyses, younger age, tumor subtype, and radiotherapy were found to be significantly associated with improved overall survival (OS) and cause-specific survival (CSS).Conclusions: Patients with LRMS and metastasis at diagnosis experienced a quite poor prognosis. Age at diagnosis, tumor subtype, and radiotherapy can help clinicians to better estimate the prognosis. This study indicated that local radiotherapy can provide a survival benefit.

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 The effects of a preoperative multidisciplinary conference on outcomes for high-risk patients with challenging surgical treatment options: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masayoshi Koike ◽  
Mie Yoshimura ◽  
Yasushi Mio ◽  
Shoichi Uezono
Keyword(s):  
Patient Safety ◽  
Retrospective Study ◽  
High Risk ◽  
Treatment Plan ◽  
Treatment Options ◽  
High Risk Patients ◽  
Appropriate Treatment ◽  
Risk Patients ◽  
Treatment Plans ◽  
Multidisciplinary Conference

Abstract Background Surgical options for patients vary with age and comorbidities, advances in medical technology and patients’ wishes. This complexity can make it difficult for surgeons to determine appropriate treatment plans independently. At our institution, final decisions regarding treatment for patients are made at multidisciplinary meetings, termed High-Risk Conferences, led by the Patient Safety Committee. Methods In this retrospective study, we assessed the reasons for convening High-Risk Conferences, the final decisions made and treatment outcomes using conference records and patient medical records for conferences conducted at our institution from April 2010 to March 2018. Results A total of 410 High-Risk Conferences were conducted for 406 patients during the study period. The department with the most conferences was cardiovascular surgery (24%), and the reasons for convening conferences included the presence of severe comorbidities (51%), highly difficult surgeries (41%) and nonmedical/personal issues (8%). Treatment changes were made for 49 patients (12%), including surgical modifications for 20 patients and surgery cancellation for 29. The most common surgical modification was procedure reduction (16 patients); 4 deaths were reported. Follow-up was available for 21 patients for whom surgery was cancelled, with 11 deaths reported. Conclusions Given that some change to the treatment plan was made for 12% of the patients discussed at the High-Risk Conferences, we conclude that participants of these conferences did not always agree with the original surgical plan and that the multidisciplinary decision-making process of the conferences served to allow for modifications. Many of the modifications involved reductions in procedures to reflect a more conservative approach, which might have decreased perioperative mortality and the incidence of complications as well as unnecessary surgeries. High-risk patients have complex issues, and it is difficult to verify statistically whether outcomes are associated with changes in course of treatment. Nevertheless, these conferences might be useful from a patient safety perspective and minimize the potential for legal disputes.

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 Clinicopathological study of soft tissue sarcoma-retrospective study of tertiary cancer institute in eastern India

2020 ◽  
Vol 8 (11) ◽  
pp. 4075
Author(s):  
Kunhi Mohammed K. P. ◽  
Snehasis Pradhan ◽  
Supratim Bhattacharyya ◽  
Prafulla Kumar Das ◽  
Muhammed Navas N. K.
Keyword(s):  
Retrospective Study ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Malignant Tumors ◽  
Soft Tissue Sarcomas ◽  
The Body ◽  
Female Ratio ◽  
Pleomorphic Sarcoma ◽  
Frequent Variety ◽  
Male To Female

Background: Soft tissue sarcomas are a rare and heterogeneous group of malignant tumors of mesenchymal origin that comprise less than 1 percent of all adult malignancies. Although they occur anywhere in the body, they involve most commonly in extremities, trunk, retroperitoneum and head and neck. The aim of the study was to analyze clinical and histopathological features of various soft tissue sarcomas.Methods: This was a retrospective study, conducted in tertiary cancer centre in Odisha during the period 2015 to 2018. We collected clinical parameters like age, sex, site of swelling, any associated pain and biopsy reports and these variables were correlated with final histopathology reports.Results: A total of 107 patients were included in the study, with male to female ratio of 2:1(71 and 36) and average age of 43.45 years. All of them presented with a swelling. The lower extremities were the most common sites i.e. 44.62%. Pleomorphic sarcoma was the most frequent histologic variety comprising 43% and less frequent variety were angiosarcoma, and myxoid sarcoma.Conclusions: Soft tissue sarcoma are predominant in males and middle aged population are frequently affected. Most common affected site is lower extremity and pleomorphic sarcoma is the prominent histologic type.

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 Treatment-Resistant Hypercalcemia Secondary to Ectopic PTH Hypersecretion From Disseminated Ovarian Cancer

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A228-A229
Author(s):  
Alexander M Balinski ◽  
Neil J Khatter ◽  
Jeffrey M Gold ◽  
Krishna S Pothugunta ◽  
Vamshi K Garlapaty ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Early Detection ◽  
Serum Calcium ◽  
Poor Prognosis ◽  
Malignant Tumors ◽  
Ovarian Adenocarcinoma ◽  
Hypercalcemia Of Malignancy ◽  
Organ System Failure ◽  
Sestamibi Scan ◽  
Total Body

Abstract Background: Hypercalcemia of malignancy (HCM) can present secondary to hypersecretion of parathyroid hormone (PTH)-related protein (PTHrP) from malignant tumors, but rare cases of HCM have also been documented due to inappropriate PTH secretion from ectopic neoplasms. Here, we report an unusual case of HCM due to hypersecretion of PTH from a disseminated mucinous ovarian adenocarcinoma. Case Presentation: A 45-year-old female presented with confusion, constipation, fatigue, and abdominal pain two weeks after total abdominal hysterectomy with bilateral salpingo-oophorectomy and suboptimal debulking of a newly discovered left ovarian mucinous adenocarcinoma with metastasis to the bladder, parametrium, vagina, right ovary, and rectosigmoid. Subsequent CT revealed numerous bilateral pulmonary nodules, hilar adenopathy, liver lesions, and abdominal adenopathy. On exam, she was tachycardic and hypertensive with diaphoresis, dry mucous membranes, respiratory distress, guarded abdominal tenderness, and altered mental status. Her labs were significant for a serum calcium of 21.7 mg/dL, creatinine of 1.93 mg/dL, ferritin of 2,379 ng/mL, leukocytosis of 21.9 bil/L, PTH of 1,061 pg/mL, and PTHrP of 29 pmol/L. Ectopic PTH secretion was highly suspected after negative parathyroid ultrasound. Pamidronate (60 mg IV), calcitonin (200 U IM), and fluid resuscitation were unable to normalize her serum calcium, resulting in the need for dialysis and subsequent continuous renal replacement therapy. Further intervention with denosumab (120 mg SQ), etelcalcetide (5 mg IV), and cinacalcet (60 mg PO) was also attempted. Serum calcium began to decline, but repeat PTH resulted greater than 2,500 pg/mL. Unfortunately, the patient died just one week into her hospital course from septic shock and multi-organ system failure. Discussion: Hypercalcemia of malignancy typically arises from tumor secretion of PTHrP, cytokine release from osteolytic metastases, or tumor production of calcitriol. In cases of hypercalcemia due to excess PTH secretion, primary parathyroid etiologies are typically considered while ectopic PTH-secreting tumors are rare. PTH staining of biopsy specimens and total body sestamibi scan may prove useful in the early detection and treatment of these tumors, but HCM offers a poor prognosis with mean survival of 2 to 3 months and in-hospital mortality of 6.8%. Currently, there are only three cases in the reported literature of ectopic PTH-induced hypercalcemia related to ovarian cancer. To our knowledge, this is the fourth reported case. Conclusion: Ectopic PTH-secreting tumors carry a poor prognosis and should be considered in cancer patients presenting with PTH-associated hypercalcemia. Biopsy staining for PTH and total body sestamibi scan may assist in the early detection of these tumors, but current treatment strategies offer suboptimal outcomes.

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 Alternative Therapeutic Approach in the Treatment of Oral Pyogenic Granuloma

2015 ◽  
Vol 8 (3) ◽  
pp. 493-497 ◽  
Author(s):  
Amr Bugshan ◽  
Harsh Patel ◽  
Karen Garber ◽  
Timothy F. Meiller
Keyword(s):  
Oral Cavity ◽  
Malignant Tumors ◽  
Surgical Excision ◽  
Pyogenic Granuloma ◽  
Hormonal Imbalance ◽  
Choice Of Treatment ◽  
Chronic Irritation ◽  
Multiple Recurrences ◽  
And Behavior ◽  
Rule Out

Pyogenic granulomas (PGs) in the oral cavity present as an inflammatory hyperplasia usually caused by trauma, hormonal imbalance, chronic irritation, or as the response to a wide variety of drugs. PGs with atypical presentation and behavior may clinically mimic malignant tumors. Thus, histological examination is required to rule out cancer development. Lesions in the oral cavity have been described to be either an isolated entity or present in multiple forms and with multiple recurrences. Conservative surgical excision is the standard choice of treatment in almost every scenario. However, the severity of the lesions and the affected sites often challenge surgical treatment. In this report, we describe the clinical scenario of a recurrent PG, where surgical excision of the lesion was questioned. As an alternative, we describe a noninvasive approach with lesional steroid injections.

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