scholarly journals Forgotten Lippes Loop associated with Endometrial Carcinoma

2011 ◽  
Vol 3 (3) ◽  
pp. 147-148
Author(s):  
Smiti Nanda ◽  
Savita Rani Singhal ◽  
Seema Madan
Keyword(s):  
Endometrial Carcinoma ◽  
Vaginal Bleeding ◽  
Intrauterine Device ◽  
Endometrial Adenocarcinoma ◽  
Postmenopausal Bleeding ◽  
Endometrial Sampling

ABSTRACT Patients with a forgotten intrauterine device (IUD) present most often with irregular vaginal bleeding or postmenopausal bleeding. We report a case of nonmedicated IUD (Lippes loop) associated with endometrial adenocarcinoma in a woman who presented with postmenopausal bleeding and a forgotten IUD. Although the occurrence of endometrial adenocarcinoma with IUD is almost unknown, yet given the serious nature of the disease, endometrial sampling is indicated in any patient with postmenopausal bleeding and IUD in situ.

A case of endometrial carcinoma in a long-term Levonorgestrel Intrauterine System (LNG 52 mg-IUS) user

2017 ◽  
Vol 23 (1) ◽  
pp. 13-14 ◽  
Author(s):  
Melisa Thomas ◽  
Paula Briggs
Keyword(s):  
Endometrial Carcinoma ◽  
Vaginal Bleeding ◽  
Endometrioid Carcinoma ◽  
Stage 1

This report describes a 50-year-old woman who presented to a community gynaecology clinic complaining of persistent heavy vaginal bleeding with an LNG 52 mg-IUS in situ. She was subsequently found to have stage 1 grade 1a endometrioid carcinoma. From the literature, we have identified five similar cases. This case highlights the possibility of endometrial carcinoma despite treatment with an LNG 52 mg-IUS and reinforces the importance of investigating women who present with unusual persistent or heavy vaginal bleeding.

Detection of chromosomal anomalies in uterine endometrial carcinoma using fluorescence in situ hybridization (UteroFISH)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5533-5533
Author(s):  
J. Qian ◽  
D. Weber ◽  
R. Cochran ◽  
D. Hossain ◽  
D. G. Bostwick
Keyword(s):  
In Situ Hybridization ◽  
Fluorescence In Situ Hybridization ◽  
Endometrial Carcinoma ◽  
Endometrial Adenocarcinoma ◽  
Atypical Hyperplasia ◽  
Chromosome 1 ◽  
Chromosomal Anomalies ◽  
Tissue Samples ◽  
Gynecological Malignancy

5533 Background: Endometrial cancer is the most common pelvic gynecological malignancy. The diagnosis of well-differentiated endometrial adenocarcinoma, atypical hyperplasia, and marked hyperplasia is often challenging. We sought to investigate the utility of chromosomal anomalies for the detection of uterine endometrial carcinoma using multitarget fluorescence in situ hybridization (FISH). Methods: Samples were collected by endometrial brush and processed by liquid-based thin-layer cytological preparation protocol. For study, we collected cytology slides from consecutive cases to include 50 benign, 50 hyperplasia without atypia, 50 atypical hyperplasia, and 50 endometrial cancers. Each was hybridized using fluorescence labeled DNA probes to chromosomes 1, 8, and 10 (UteroFISH). The FISH signals were enumerated in 100 cells per case, and the chromosomal anomalies were correlated with pathologic findings, including histologic diagnoses on endometrial tissue samples. Results: Numeric chromosomal anomalies were found in 0% (0/50) of benign, 20% (10/50) of hyperplasia, 76% of atypical hyperplasia (38/50), and 86% (43/50) of carcinoma specimens. The mean percentage of cells with chromosomal changes was 54% in cancer specimens, significantly higher than that in hyperplasia without atypia (13%, p< 0.0001) and atypical hyperplasia (34%, p< 0.0001). The most frequent chromosomal anomaly was gain of chromosome 1. FISH anomalies had an overall sensitivity of 81% and specificity of 90% for the detection of atypical hyperplasia and/or endometrial carcinoma. There was no association with grade of endometrial carcinoma. Conclusions: Multi-target UteroFISH appeared to be useful for the differential diagnosis of reactive hyperplasia, atypical hyperplasia, and endometrial adenocarcinoma, with a high level of sensitivity and specificity. Endometrial hyperplasia with FISH-detected chromosomal anomalies may require close clinical follow-up. No significant financial relationships to disclose.

scholarly journals Postmenopausal Bleeding: An Update

2021 ◽  
Vol 3 (1) ◽  
pp. 28-33
Author(s):  
Shaikh Zinnat Ara Nasreen ◽  
Nusrat Mahjabeen ◽  
Safinaz Shahreen
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Carcinoma ◽  
Endometrial Hyperplasia ◽  
Hormone Replacement ◽  
Treatment Modalities ◽  
Clinical Approach ◽  
Postmenopausal Bleeding ◽  
Endometrial Sampling ◽  
Unopposed Estrogen ◽  
Endometrial Intraepithelial Neoplasia

The clinical approach to postmenopausal bleeding requires prompt and efficient evaluation to exclude or diagnose endometrial carcinoma and endometrial intraepithelial neoplasia and to find out the real source. Postmenopausal bleeding is ‘endometrial cancer until proven otherwise’, although only 1-14% of such patients will actually have cancer. Clinical risk factors of endometrial carcinoma such as obesity, unopposed estrogen use, polycystic ovary syndrome, diabetes mellitus and family history of gynaecologic malignancy also should be considered during evaluation. Postmenopausal bleeding usually attributed to an intrauterine source, but it may arise from the cervix, vagina, vulva or fallopian tubes & ovaries. The origin of bleeding can also involve non-gynaecologic sites, such as the urethra, bladder, anus/rectum/bowel, or perineum. Meticulous history and thorough physical examination are must. Initial evaluation is by TVS, if endometrial thickness (ET) is <4mm no further evaluation is required but follow up consultation must. If ET is> 4mm, hysteroscopic evaluation and endometrial sampling is recommended Blind endometrial sampling is not accurate as only reveals when endometrial cancer exceeds more than 50% of the endometrial surface area so may be done if hysteroscopic evaluation is not possible. Higher dose of progesterone may be required for endometrial protection when higher doses of estradiol as hormone replacement therapy are used, or in women with high BMI. Unopposed estrogen therapy is associated with a duration and dose-related increase in risk of endometrial hyperplasia and cancer. Endometrial protection requires an adequate dose and duration of progestogen. Endometrial hyperplasia with atypia has much malignant potential but endometrial hyperplasia without atypia may be managed medically with 3 monthly endometrial sampling, if no regression or further progression hysterectomy is the choice of treatment. Finally, patient counseling with discussion of risks /benefits of different options of treatment modalities is the cornerstone of success of addressing postmenopausal bleeding.

scholarly journals Synergistic approach in diagnosing endometrial disease in women with postmenopausal bleeding

2017 ◽  
Vol 6 (9) ◽  
pp. 4081
Author(s):  
Jiten Sharma ◽  
Bhishan Dhiman ◽  
Nishi Sud ◽  
Anupriya Kaushik
Keyword(s):  
Endometrial Carcinoma ◽  
Postmenopausal Women ◽  
Histopathological Examination ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Uterine Bleeding ◽  
Postmenopausal Bleeding ◽  
Endometrial Sampling ◽  
Combined Use ◽  
Vaginal Ultrasonography

Background: All women with postmenopausal uterine bleeding mandate examination for endometrial diseases especially endometrial carcinoma. In current scenario, hysteroscopy has replaced traditional Dilatation and Curettage as diagnostic procedure of choice. However, office endometrial sampling with pipelle combined with vaginal ultrasonography being easier and less expensive is recommended. Aim and objectives of the study was to evaluate the combined use of vaginal ultrasonography and office endometrial sampling for the diagnosis of endometrial disease in postmenopausal women with uterine bleeding.Methods: One hundred consecutive postmenopausal women presenting with uterine bleeding were enrolled in the study. Vaginal ultrasonography was used to measure the endometrial thickness. Endometrial sampling was done using endometrial biopsy pipelle, as office procedure, in the OPD examination room. The sample was sent for Histopathological Examination (HPE), The accuracy of vaginal ultrasound and pipelle was measured.Results: In 21% patients, endometrial carcinoma was found, endometrial hyperplasia in 26%, atrophic endometrium in 18%, endometrial polyp in 10% and no specific pathology in 20%. Endometrial thickness measured by Transvaginal ultrasound ranged from 1mm to 28mm with mean of 10.16mm and median of 11.5mm. The mean endometrial thickness in subgroup without disease was 5.26±3.8mm, with benign disease 12.8±3.1mm and in carcinoma 16.97±5.6mm. All cases with carcinoma had endometrial thickness exceeding 5mm (range 5.7mm to 28mm).Conclusions: The study illustrates that by combined use of Trans Vaginal Sonography (TVS) and office endometrial sampling, sufficient diagnostic information was obtained for women with postmenopausal bleeding, obviating the need for more invasive diagnostic procedures.

Immunocytochemical localization of β1-4 galactosyltransferase in endometrial carcinoma cells

1990 ◽  
Vol 48 (3) ◽  
pp. 944-945
Author(s):  
Ichiro Yamamoto ◽  
Toshiaki Tachibana ◽  
Hiroko Maruyama ◽  
Noriyuki Komatsu ◽  
Hiroyuki Kuramoto ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Cell Lines ◽  
Endometrial Adenocarcinoma ◽  
Protein A ◽  
Rabbit Antiserum ◽  
Carcinoma Cells ◽  
Affinity Column ◽  
Antibody Technique ◽  
Galactosyl Transferase ◽  
C Terminus

We have paid attention to the alteration of glycosyltransferase in carcinoma cells, because it might be related to the malignancy of the cells. In this connection, localization of β1-4 galactosyl transferase (β1-4 Gal T) in human endometrial carcinoma cells was examined immunocytochemically using two kinds of cell lines, each of which showed different degree of differentiation.An antibody was purified from the rabbit antiserum against the synthetic peptide, IFNRLVFRGMSC (W89) of human β1-4 Gal T coupled with KLH (keyhole limpet hemocyanine) by protein A column and peptide-affinity column chromatography. The anti-W89 serum reacts to the C-terminus of human β 1-4 Gal T and to both membrane-bound and soluble forms of the enzyme. Cell line of well differentiated endometrial adenocarcinoma (I) and that of poorly differentiated endometrial adenocarcinoma (50B) were cultivated respectively in MEM medium containing 15% FCS and 2 mM glutamine for 4 d at 37°C under 5% CO2. The cells were fixed in a mixture of 4% paraformaldehyde and 0.1% glutaraldehyde in 0.1 M Soerensen’s phosphate buffer (pH 7.4) at 4°C for 30 min, washed with PBS, then freezed and thawed. The indirect method of the peroxidase- labeled antibody technique was used for immunocytochemistry of both LM and TEM on the cell lines. The cells were dehydrated in ethanol and embedded in TAAB 812. Ultrathin sections were observed under a TEM, JEM-100S.

PROGESTERONE AND PROGESTATIONAL COMPOUNDS IN THE TREATMENT OF ADVANCED ENDOMETRIAL CARCINOMA

1965 ◽  
Vol 49 (3) ◽  
pp. 412-426 ◽  
Author(s):  
Per Bergsjö
Keyword(s):  
Endometrial Carcinoma ◽  
Lung Metastases ◽  
Endometrial Adenocarcinoma ◽  
Cervical Adenocarcinoma ◽  
Tumour Tissue ◽  
Pelvic Tumour ◽  
Histological Alterations

ABSTRACT Various doses of progesterone in oil and of two progestational compounds (17α-hydroxy-19-nor-progesterone caproate and 17α-hydroxyprogesterone p-butoxyphenyl propionate) have been given to 15 patients with recurrent and/or metastatic endometrial adenocarcinoma and to one patient with metastatic cervical adenocarcinoma, for periods of up to 27 weeks. Regression of lung metastases was noted in 4 of 13 patients, softening of pelvic tumour in 2 of 4, and histological alterations of tumour tissue in 4 of 5 patients. In the patient with metastases from a cervical adenocarcinoma, the disease progressed during the treatment. The significance of the observations is discussed.

A Clinico-pathological Study of Transvaginal Endometrial Thickness Measurement in Asymptomatic Postmenopausal Patients and Patients with Postmenopausal Bleeding

2019 ◽  
pp. 1
Author(s):  
Ayse Filiz Gokmen Karasu ◽  
Seda Ates ◽  
Tugba Gurbuz ◽  
Nurhan Sahin ◽  
Taha Takmaz ◽  
...  
Keyword(s):  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Thickness Measurement ◽  
University Hospital ◽  
Postmenopausal Bleeding ◽  
Pathological Study ◽  
Endometrial Polyps ◽  
Endometrial Sampling ◽  
Proliferative Endometrium

<p><strong>Objective:</strong> 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.</p><p><strong>Study Design:</strong> 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&amp;C (dilatation &amp; curettage) or pipelle sampling. We excluded patient specimens that were obtained by hysteroscopy.</p><p><strong>Results:</strong> 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 group</p><p><strong>Conclusion:</strong> 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.</p>

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