Gynecology Oncology
Tahereh Ashrafganjoei; nooshin amjadi; Robabeh Taheripanah; Hamed talayeh; maryam Talayeh; Nasim Noorinasab
Articles in Press, Accepted Manuscript, Available Online from 26 April 2024
Abstract
Introduction: The administration of tamoxifen to post-menopausal patients with breast cancer may lead to vaginal bleeding, necessitating a thorough understanding of associated factors. Our objective was to investigate sonographic, hysteroscopic, and pathologic findings in breast cancer patients experiencing ...
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Introduction: The administration of tamoxifen to post-menopausal patients with breast cancer may lead to vaginal bleeding, necessitating a thorough understanding of associated factors. Our objective was to investigate sonographic, hysteroscopic, and pathologic findings in breast cancer patients experiencing vaginal bleeding following tamoxifen use.Methods: In this cross-sectional study, we evaluated women with post-menopausal breast cancer reporting vaginal bleeding while undergoing tamoxifen treatment for more than six months. Data collection involved a checklist encompassing ultrasonographic, hysteroscopic, and pathologic findings.Results: The study included 100 patients with a mean age of 56.2 ± 2.9 years and a mean endometrial thickness of 14.5 ± 3.4 mm. Notably, 25% of the patients exhibited abnormally large uterine size. Ultrasonography revealed polyps and myomas in 36% and 15% of cases, respectively. Positive hysteroscopy findings were observed in 72%, comprising polyps in 36%, hyperplasia in 32%, and atrophy in 4%. Pathological assessment identified abnormal features in 31% as polyps, 34% as hyperplasia, 4% as atrophy, and 5% as cancerous lesions.Conclusion: Patients who received tamoxifen had high endometrial thickness due to endometrial polyp, it seems that clinicians can consider using hysteroscopy with dilation and curettage in these patients.
Gynecology Oncology
Maryam Talayeh; Maliheh Arab; Somayyeh Noei Teymoordash; Noushin Afsharmoghadam; Masoomeh Raoufi; Behnaz Ghavami; Mahsa Asghari
Volume 7, Issue 6 , September and October 2022, , Pages 569-573
Abstract
Endometrial stromal sarcoma is a rare condition, constituting nearly 0.2% of all reproductive tract malignancies. The condition mainly affects the peri-menopausal population; however, it can occasionally be found in younger women and adolescents. Here, this is a case of a 20-year-old primiparous ...
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Endometrial stromal sarcoma is a rare condition, constituting nearly 0.2% of all reproductive tract malignancies. The condition mainly affects the peri-menopausal population; however, it can occasionally be found in younger women and adolescents. Here, this is a case of a 20-year-old primiparous female who was referred to us with the main complaint of vaginal bleeding (menometrorrhagia), ongoing for 6 months after delivery. Her sonography report indicated a 5 cm intra-cavitary mass suspicious for myoma or placental polyp. Given the pathology report of low-grade endometrial stromal sarcoma (LGESS) on samples obtained through hysteroscopy and D&C, she underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH+BSO). Endometrial stromal sarcoma is a rare uterine malignancy of mesenchymal origin that should be considered, even in very young patients.
Gynecology Oncology
Tahereh Ashraf Ganjoei; Maryam Talayeh; Noushin Afsharmoghadam; Ali Reza Norouzi; Somayyeh Noei Teymoordash
Volume 7, Issue 6 , September and October 2022, , Pages 583-586
Abstract
Paratubal cysts account for 5-20% of all adnexal lesions. Malignant modifications seldom arise in the paratubal cysts that are usually known as primary carcinomas of fallopian tube. Paratubal borderline tumors are very infrequent conditions and until now only sixteen cases of primary paratubal borderline ...
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Paratubal cysts account for 5-20% of all adnexal lesions. Malignant modifications seldom arise in the paratubal cysts that are usually known as primary carcinomas of fallopian tube. Paratubal borderline tumors are very infrequent conditions and until now only sixteen cases of primary paratubal borderline tumors have been previously reported in the literature. Herein, we describe a rare paratubal serous borderline tumor occurring in a woman of reproductive age and provide insights into its management. A 32-year-old woman referred to Imam Hussein Hospital, Tehran with chief complaint of amenorrhea for the last year and transvaginal sonography (TVS) report indicating a 68×74 mm persistent right adnexal cyst from 10 months ago. The patient was candidate for laparotomy and due to the report of paratubal serous borderline tumor in frozen section she underwent right total salpingectomy and infracolic omentectomy. No evidence of recurrence or metastasis was observed after 3 years of follow up. Persistent adnexal cysts need to be evaluated precisely even in young women in order to rule out the malignancy of fallopian tubes.
Gynecology Oncology
Tahereh Ashrafganjoei; Maryam Talayeh; Somayeh Noei Teymoordash; Mohammad Hashemi Bahremani; Hamed talayeh
Volume 7, Issue 1 , September and October 2021, , Pages 59-62
Abstract
Uterine adenosarcoma (UA) is an infrequent malignancy which contains the epithelium of benign glands and malignant mesenchymal elements. Low-grade adenosarcoma has a sarcomatous part that is uniformly low grade. Uterine adenosarcoma includes 8% of all uterine sarcomas and less than 0.2% of uterine neoplasms. ...
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Uterine adenosarcoma (UA) is an infrequent malignancy which contains the epithelium of benign glands and malignant mesenchymal elements. Low-grade adenosarcoma has a sarcomatous part that is uniformly low grade. Uterine adenosarcoma includes 8% of all uterine sarcomas and less than 0.2% of uterine neoplasms. It is more common in perimenopausal or postmenopausal women. Due to the rarity of uterine adenosarcoma, limited information is available to help guide treatment.A 33-year-old woman, who had one child referred to ???? with a complaint of abnormal uterine bleeding for one year; the sonography reported a polyp in fundal cavity of uterus. The patient underwent hysteroscopy and curettage. The pathology examination revealed uterine adenosarcoma which led to a total hysterectomy and bilateral salpingo-oophorectomy.Abnormal uterine bleeding is the most common symptom of UA. At a young age there is a possibility of misdiagnosis. Hysteroscopy should also be performed if symptomatic or enlarge polypoid lesions are diagnosed preoperatively.
Maternal Fetal Medicine
Ali Reza Norouzi; Mahsa Siavashi; Fatemeh Norouzi; Maryam Talayeh; Somayyeh Noei Teymoordash
Volume 6, Issue 4 , August 2021, , Pages 217-223
Abstract
Background & Objective: Gestational diabetes mellitus (GDM) is the most prevalent disorder during pregnancy, which is the result of insulin resistance and hyperinsulinemia due to the secretion of placental diabetogenic hormones. This study aimed to investigate the utility of glycated hemoglobin ...
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Background & Objective: Gestational diabetes mellitus (GDM) is the most prevalent disorder during pregnancy, which is the result of insulin resistance and hyperinsulinemia due to the secretion of placental diabetogenic hormones. This study aimed to investigate the utility of glycated hemoglobin A1c (HbA1c) alone and in combination with hematocrit for early detection of gestational diabetes mellitus.Materials & Methods: In this prospective cohort research, 373 pregnant women who referred to prenatal clinics were included. Hematocrit and HbA1c were determined at gestational age of 12 to 16 weeks and compared with the oral glucose tolerance test (OGTT) results at gestational age of 24-28 weeks.Results: The best cut-off hematocrit for determining pregnancy diabetes mellitus was 37.3. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 70.15%, 64.12%, 32.71 %, and 89.51% respectively.In terms of HbA1c, the best cut-off value to determine GDM in pregnant women was 5, with a sensitivity of 98.51%, specificity rate of 99.02%, PPV of 95.07%, and NPV of 99.49%. In terms of diagnosing GDM, the area under the ROC curve (AUC) for HbA1c was equal to 0.985 which was higher than the AUC for the combination of HbA1c with HCT.Conclusion: Measuring HbA1c can be useful as a screening test for GDM, which is an inexpensive and available test. The combined evaluation of HbA1c and hematocrit did not improve the diagnostic value of HbA1c in GDM screening compared to exclusive evaluation of HbA1c.
Obstetrics and Gynecology
Tahereh Ashrafganjoei; Atyeh Bahman; Somayyeh Noei Teymoordash; Soheila Aminimoghaddam; Abdolali Ebrahimi; Maryam Talayeh
Volume 6, Issue 3 , June 2021, , Pages 105-109
Abstract
Background & Objective: Endometrial carcinoma is the most common malignancy of the female genital tract, which most often affects postmenopausal women. The ovaries may be active when a patient has endometrial cancer, so removing an ovary can worsen a patient's quality of life. On the other hand, ...
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Background & Objective: Endometrial carcinoma is the most common malignancy of the female genital tract, which most often affects postmenopausal women. The ovaries may be active when a patient has endometrial cancer, so removing an ovary can worsen a patient's quality of life. On the other hand, a complete surgical staging in endometrial cancer includes oophorectomy since 1988. There has been some research to assess whether an oophorectomy should be performed and in which cases, ovaries can be preserved.Materials & Methods: Aim of this study was to evaluate the coexistence of ovarian involvement in endometrioid endometrial carcinoma. In this study, we evaluated 180 patients with endometrioid endometrial cancer patients who were surgically staged at Imam Hossein Hospital between 2004 and 2017.Results: Mean age of subjects of the study was 56.78 ±10.59. Forty-six of patients (25.6 %) were less than 50 years old and 74.4 % (134) were older than 50. Twenty out of 180 (11.1 %) of them had ovarian involvement (one of them had simultaneous ovarian tumor) and 11 (55%) of these cases were less than 50 years old. In 55 % (11) patients, the involved ovaries were less than 5 cm with grossly normal appearance, lymph nodes metastases were detected in 3 out of 20 (15 %) of them although their ovarian size were 4, 4.5 and 6.5 cm. In 10 (50 %) of them, deep myometrial invasion was detected.Conclusion: In endometrial cancer staging, ovarian preservation could be a challenging decision and a real controversy which needs more researches.
Gynecology Oncology
Somayyeh Noei Teymoordash; Maliheh Arab; Maryam Talayeh; Masoomeh Raoufi; Behnaz Ghavami; Behnaz Nouri
Volume 6, Issue 2 , March 2021, , Pages 99-104
Abstract
Background: A variety of presentations may be manifested by retained sponge, including intestinal obstruction, intestinal fistula, malabsorption syndrome and chronic pain from adhesions; in some cases, it may have an asymptomatic clinical course.Case report: In a 41-year-old female, gravida 4 para 4, ...
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Background: A variety of presentations may be manifested by retained sponge, including intestinal obstruction, intestinal fistula, malabsorption syndrome and chronic pain from adhesions; in some cases, it may have an asymptomatic clinical course.Case report: In a 41-year-old female, gravida 4 para 4, with a history of laparotomy performed for an ovarian adenocarcinoma three years prior to her referral, a gossypiboma was incidentally detected on follow up imaging. The gossypiboma was safely excised by a midline laparotomy.Conclusion: Asymptomatic gossypiboma should be considered in patients presenting with a mass, who have undergone laparotomy in the past.