Gynecology Oncology
Soudabeh Sabetian; Zahra Shiravani; Fatemehsadat Najib; Mahvash Alirahimi; Elham Askary; Tahereh Poordast; Nader Tanideh; Shohreh Roozmeh; Golsa Shekarkhar; Sana Atbaei; danilo porro; Claudia Cava
Articles in Press, Accepted Manuscript, Available Online from 03 September 2023
Abstract
The endometriosis treatment was critical issue due to complications associated with current drug delivery system. Present investigation compared the curative effect of Vitamin D3 (VTD3) and Omega–3 (OG3) with Diphereline during the treatment of endometriosis. Endometriosis was induced in different ...
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The endometriosis treatment was critical issue due to complications associated with current drug delivery system. Present investigation compared the curative effect of Vitamin D3 (VTD3) and Omega–3 (OG3) with Diphereline during the treatment of endometriosis. Endometriosis was induced in different groups containing 60 adult female rats. The rat model is categorized into 6 groups untreated and treated (Olive Oil (solvent), VTD3 (42 mcg/kg/day), OG3 (450 mg/kg/day), VTD3+OG3, Diphereline (3 mg/kg/day)). The suspension containing combination of Diphereline and supplements was injected and treated for 4 weeks to analyses the effect of supplements. The interleukin -6 (IL-6) and Tumor necrosis factor – alpha (TNFα) inflammatory responses were measured from the serum samples while endometrial implants was dissected and histopathological investigation was done. At the end of four weeks pathologic score was decreases significantly with simultaneous measurement of inflammation score of endometriotic lesion, size of implant area, IL-6, TNFα response and compared with untreated female rat. No significant different was observed in groups undergoing treatment of VTD3, OG3 and Diphereline. The combined effect of VTD3+OG3 has similar responses with Diphereline treated endometrial implants. In conclusion, treatment of VTD3 deficiency and making a change in dietary habits of high-risk population for endometriosis from adolescence may also play a preventative role in adulthood.
Gynecology Oncology
May Kassim Khalaf; Dr. Fadia J Alizzi; Ammar Mohammed Qassim
Articles in Press, Accepted Manuscript, Available Online from 11 September 2023
Abstract
Background: gonadotropin-releasing hormone acts on the anterior pituitary and promotes the release of both follicle-stimulating hormone (FSH) and luteinizing hormone (LH), both of great importance in the ovarian cycle.
Method: A prospective cross sectional study conducted at the High Institute for ...
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Background: gonadotropin-releasing hormone acts on the anterior pituitary and promotes the release of both follicle-stimulating hormone (FSH) and luteinizing hormone (LH), both of great importance in the ovarian cycle.
Method: A prospective cross sectional study conducted at the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies / Al-Nahrain University and Kamal Al-Sameraie hospital for infertility& in vitro fertilization, Baghdad-Iraq during the period from April 2022 to April 2023, women received rFSH in a single daily dose of (150-300 IU) for ovarian stimulation. Women in group B and C received ovarian stimulation antagonist while those in the group A were not
Results: Both clinical and ongoing pregnancy rates were measured for each Group. Positive hCG test was found in 27 (79.4%) in Group A while it was positive in 19 (55.9%) in Group B with significant difference (P=0.03), clinical pregnancy was 25 (73.5%) in Group A while it was positive in 17 (50.0%) in Group B with significant difference (P=0.04), and ongoing pregnancy was found in 24 (70.6%) in Group A while it was positive in 15 (44.1%) in Group B with significant difference (P=0.01).
Conclusion: women with LH <4 IU presented with significant increase in pregnancy rate than those with ≥4 IU, and do not need for GnRH antagonist addition as co treatment.
Gynecology Oncology
Mastaneh - Sanei; Hamidreza Dehghan; Nadereh - Behtash
Articles in Press, Accepted Manuscript, Available Online from 27 September 2023
Abstract
Non- Hodgkin lymphoma are a heterogenous group of lymphoproliferative disorders with various behaviors and responses to treatment .As a primary extranodal NHL , the disease must be confined to one location and bone marrow should not be involved .Primary uterine cervix lymphoma is a rare malignancy as ...
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Non- Hodgkin lymphoma are a heterogenous group of lymphoproliferative disorders with various behaviors and responses to treatment .As a primary extranodal NHL , the disease must be confined to one location and bone marrow should not be involved .Primary uterine cervix lymphoma is a rare malignancy as well as a rare site of extranodal lymphoma .Because of the rarity of the disease there is no standard treatment guideline for women with primary uterine cervix lymphoma.Patients mostly present with abnormal uterine bleeding vaginal discharge or pelvic pain . Typically pap smear may not show the malignant cells in the specimen . when the diagnosis is made, management may be debated due to rarity and lack of standard treatment. Surgery, chemotherapy, chemo-immunotherapy and radiotherapy either alone or in combination are the treatment options. most patients respond well to chemotherapy and radiation therapy . prognosis is usually favorable . Here we report a case of primary cervical lymphoma in a 50 year old woman who presented with abnormal vaginal bleeding. She was treated with radiotherapy and chemo-immunotherapy and remained disease free after 9 months of treatment.
Gynecology Oncology
Roya Dolatkhah; Mehrnaz Hosseinalifam; Zohreh Sanaat; Neda Dolatkhah; Saeed Dastgiri
Volume 8, Issue 5 , September and October 2023, , Pages 426-434
Abstract
Breast cancer (BC) was the most common cancer in Iran, accounting for 12.9% of all incident cancer, and was the 5th leading cause of cancer death in 2020. The latest age standardized incidence rate (ASIR) of breast cancer was 35.8 in Iran and is expected to increase to more than 70 per 100,000 by the ...
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Breast cancer (BC) was the most common cancer in Iran, accounting for 12.9% of all incident cancer, and was the 5th leading cause of cancer death in 2020. The latest age standardized incidence rate (ASIR) of breast cancer was 35.8 in Iran and is expected to increase to more than 70 per 100,000 by the end of 2030. Incidence of breast cancer had a clustering pattern in Iran, while central provinces had the highest ASIR (72 per 100,000 population), and South East provinces had the lowest ASIR (5-11 per 100,000 population). Numerous studies have shown that the peak incidence of breast cancer was occurred in the age group of 40-49 years in Iran. There has also been reported a rapid increase in the incidence in young women from different regions of the country. Known molecular and cellular processes involved in the development of breast cancer in Iranian BCs have been reported from various studies in recent decades, and the most well-known and prominent genes susceptible to breast cancer were BRCA1 and BRCA2. They acted as tumor suppressor genes and inherited mutations leading to chromosomal instability. However, non-coding RNAs, epigenetic alterations, signaling pathways, immune responses, and antioxidant-related genes are the main molecular processes associated with the progression of breast cancer among Iranian patients. While we are facing a significant increase in the incidence of breast cancer, with a lower survival rate, breast cancer is currently considered as one of the major health problems in Iran, which emphasizes the importance of providing and designing prevention and early detection program of breast cancer.
Gynecology Oncology
Batool Hossein Rashidi; Marjan Ghaemi; Ensieh Shahrokh Tehrani; Marzieh Mohebbi; Marzieh Savari
Volume 8, Issue 5 , September and October 2023, , Pages 450-460
Abstract
Background & Objective: Preserving fertility in women with cancer before therapeutic interventions is very important. This study was evaluating the 8 years’ experience of an onco-fertility center from 2013 to 2020 on fertility preservation and its outcomes in female cancer survivors.Materials ...
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Background & Objective: Preserving fertility in women with cancer before therapeutic interventions is very important. This study was evaluating the 8 years’ experience of an onco-fertility center from 2013 to 2020 on fertility preservation and its outcomes in female cancer survivors.Materials & Methods: Participants were females with an approved cancer diagnosis of reproductive ages that were referred for fertility preservation. After proper counseling by an expert team, the final decision on the fertility preservation method was made based on the patient's condition and survival expectation. The primary goal was to collect data about the fertility, clinical and survival outcomes of these women and pregnancy rate as a secondary objective that were compared between cancer types.Results: Totally 337 participants were recruited with a mean±SD age of 30.7±6.6 years. Gynecological cancers accounted for 166 (49.3%) of all cases followed by breast (107 (31.8%)) and other cancers (64 (19.0%)) respectively. Of those, 144 (42.7%) cases entered into the ovulation induction cycle and the others did not continue due to lack of correct information and late referral, and inability to postpone treatment as the major reasons. Comparing between 3 groups (gynecological, breast and other cancers), a higher rate of pregnancy otherwise not statistically different was detected in gynecological cancer survivors. In the breast cancer survivors, the chance of oocyte retrieval and fertility was not lower than in other cancers.Conclusion: Many patients and even their therapists are unfamiliar with the methods of fertility preservation, and when they consider it, the golden time is usually passed. Therefore, having a good consultation with the survivors and patient education may be the most important issue that led to a timely referral for preserving fertility in cancer patients.
Gynecology Oncology
Behnaz Nouri; Malihe Arab; Nazli Najeddin Choukan
Volume 8, Issue 5 , September and October 2023, , Pages 497-503
Abstract
Background & Objective: Endometriosis is a common and benign disease of the female genital system, which is often seen in reproductive age and leads to infertility, dysmenorrhea, and dyspareunia. The aim of this study is to investigate the anatomical location and characteristics of endometriosis ...
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Background & Objective: Endometriosis is a common and benign disease of the female genital system, which is often seen in reproductive age and leads to infertility, dysmenorrhea, and dyspareunia. The aim of this study is to investigate the anatomical location and characteristics of endometriosis lesions in laparoscopic surgery.Materials & Methods: In this cross-sectional study, 557 endometriosis patients who referred to the gynecology department of Shohadaye-Tajrish Hospital and underwent laparoscopic surgery during 2016-2021 were evaluated. Statistical analysis of data was done using SPSS software version 24.P-value less than 0.05 was considered statistically significant level.Results: The results of this study show that the highest anatomical distribution of endometriosis lesions was ovarian endometriosis, and the lowest was vagina. Also, the highest rate of surface lesions is uterus and bladder, and the lowest is superficial lesions of the cul-de-sac cyst.Conclusion: Our results demonstrate that the distribution of endometriosis lesions is asymmetric.
Gynecology Oncology
Mohammad Reza Javan; Bahareh Moghimian-Boroujeni; Hossein Ayatollahi; Amirali Ayatollahi; Nafise Amini; Elham Jafaei; Maryam Sheikhi; Narjes Soltani
Volume 8, Issue 4 , July and August 2023, , Pages 341-348
Abstract
Background & Objective: Recurrent pregnancy loss (RPL) is the occurrence of three or more miscarriages before the 20th week of pregnancy. Thrombophilia factors are one of the common causes of RPL.Materials & Methods: This retrospective study was performed on women with miscarriages. ...
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Background & Objective: Recurrent pregnancy loss (RPL) is the occurrence of three or more miscarriages before the 20th week of pregnancy. Thrombophilia factors are one of the common causes of RPL.Materials & Methods: This retrospective study was performed on women with miscarriages. 620 patients’ documents with pregnancy loss were investigated. Based on the number of pregnancy loss, the women were divided into a control group with less than three miscarriages (212) and RPL group (180). Cytogenetics analysis and thrombophilia factors polymorphism tests were performed for all patients.Results: In the analysis, none of the studied polymorphisms (MTHFR 677 C⁄T /Factor V Leiden /Prothrombin G20210A/ ACE I/D/ PAI-1) showed a significant relationship between Control and RPL groups (P-value ˃ 0.05). Cytogenetic analysis showed 2 numerical and 9 structural abnormalities among both groups. Statistical analysis indicated a significant association between the number of abortions and age (P value= 0.005, r= 0.139). We even realized that there was a significant relationship between polymorphism number and recurrent number of miscarriages (P value= 0.018, r= 0.6).Conclusion: We showed that polymorphisms analysis for thrombophilia factors is a more precious test than cytogenetics analysis (study of the banded pattern of chromosomes during metaphase of the cell cycle). We even indicated that no association was found between thrombophilia polymorphisms in the control and RPL groups. This means that screening for Factor V Leiden, prothrombin G20210A, MTHFR C677T, ACE I/D, and PAI-1 and cytogenetic analysis in patients with a history of RPL is not recommended.
Gynecology Oncology
Hossam Hassan Aly Hassan El Sokkary
Volume 8, Issue 4 , July and August 2023, , Pages 361-369
Abstract
Background & Objective: The present study compares between superficial and deep myometrial invasion in type 1 endometrial cancer in relation to regional lymph nodes metastasis, so we can answer the question to do or not do lymphadenectomy, this life-threatening procedure in both superficial ...
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Background & Objective: The present study compares between superficial and deep myometrial invasion in type 1 endometrial cancer in relation to regional lymph nodes metastasis, so we can answer the question to do or not do lymphadenectomy, this life-threatening procedure in both superficial and deep myometrial invasion with type 1, clinically and radiologically stage 1 endometrial cancer.Materials & Methods: Patients were divided into 2 groups distributed as follows: group I includes 50 patients type 1 endometrial cancer with superficial myometrial invasion and group II includes 50 patients type 1 endometrial cancer with deep myometrial invasion. Total abdominal hysterectomy with bilateral salpingo-opherectomy with pelvic and lower para-aortic lymphadenectomy to all patients included in the study from both groups. Histopathological examinations were done to all the specimen from both groups to confirm diagnosis of type 1 endometrial cancer, depth of myometrial invasion, pathological grading and metastasis to the regional lymph nodes.Results: Considering regional lymph nodes metastasis in both groups, there is a statistical difference between group I and group II in relation to regional lymph nodes metastasis as group II (cases with deep myometrial invasion) are associated with more regional lymph nodes metastasis (P= 0.0001)).Conclusion: Deep myometrial invasion in type 1 endometrial cancer is associated with significant increase in regional lymph nodes metastases.
Gynecology Oncology
Alsmadi Yaseen Mohammad Ibrahim; Saad Altimimi; Aisha Kamal Mahmoud; Muqdad Hussein Ali; Naseer Mehdi Mohammed; Ruqayah Taher Habash; Ahmed S Abed; Entsar Hachim Muhammad
Volume 8, Issue 4 , July and August 2023, , Pages 400-407
Abstract
Background & Objective: Today, the prevalence of cervical cancer in developing societies and its impacts on various body functions, mainly sexual performance, is of particular significance. In order to examine the relationship between sexual function and its domains with different stages of ...
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Background & Objective: Today, the prevalence of cervical cancer in developing societies and its impacts on various body functions, mainly sexual performance, is of particular significance. In order to examine the relationship between sexual function and its domains with different stages of cervical cancer, the present study was conducted.Materials & Methods: Examined in the current study were 284 cervical cancer patients with a history of trachelectomy surgery, referred to the Baghdad Women's Hospitals in 2020 and 2021 and selected randomly. The personal profile form and the female sexual function index (FSFI) were among the research instruments. The data were investigated by statistical software SPSS.23 and the Spearman correlation coefficient test. A P-value of less than 0.05 was deemed statistically significant.Results: The results revealed that 26.8% of women complained of low sexual desire, 43.0% did not receive adequate sexual arousal, and 39.1% experienced deficient vaginal lubrication. Additionally, 46.8% of women did not experience a proper orgasm, 27.8% were dissatisfied with their sexual satisfaction, and 37.0% reported experiencing pain during intercourse. In addition, there was an inverse correlation between the stages of cervical cancer and sexual performance (r= -0.25, P= 0.002), as well as its domains, including sexual desire (r= -0.18, P= 0.02), sexual arousal (r= -0.23, P= 0.004), vaginal lubrication (r= -0.23, P= 0.003), orgasm (r= -0.20, P= 0.009), sexual satisfaction (r= -0.21, P= 0.005), and pain during intercourse (r= -0.26, P= 0.001).Conclusion: The sexual performance of cervical cancer patients is impaired, and the more advanced stages of the disease weaken sexual performance and its domains.
Gynecology Oncology
Ghodratolah Maddah; Mohammad Ali Mohammadzadeh Rezae; Zohreh Yousefi; Helena Azimi; Leila Mousavi Seresht
Volume 8, Issue 4 , July and August 2023, , Pages 415-420
Abstract
Background & Objective: Pelvic exenteration and other types of super-radical procedures are the standard of care in the management of patients with recurrent or persistent cervical cancer. But, since the extent of surgery and possible morbidities are considered as an important challenge in low-resource ...
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Background & Objective: Pelvic exenteration and other types of super-radical procedures are the standard of care in the management of patients with recurrent or persistent cervical cancer. But, since the extent of surgery and possible morbidities are considered as an important challenge in low-resource countries, there is need to investigate the outcomes of similar patient.Materials & Methods: The present study tries to report the successful outcome of radical surgery in detailed in 7 cases in a low-economic setting.Results: Total Pelvic exenteration was performed in three but free margin could be achieved by less radical approach in others. All were alive up to 5yaers of follow-up.Conclusion: What we had noticed was the excellent survival prognosis even in curative intent. It is highly recommended, considering the psychological effect of such an extensive surgery and quality of life in these patients with advanced disease and loss of hope.
Gynecology Oncology
Soheila Aminimoghaddam; Zahra Vahedpoor; Shabnam Bozorgzadeh
Volume 8, Issue 4 , July and August 2023, , Pages 421-425
Abstract
Hereditary non polyposis colorectal cancer (HNPCC) also known as Lynch syndrome (LS), is an autosomal dominant cancer syndrome. Besides colorectal cancers, it predisposes patients to extracolonic cancers. Despite several extracolonic cancers have been reported on LS, we found a new face of it. A 43-year-old ...
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Hereditary non polyposis colorectal cancer (HNPCC) also known as Lynch syndrome (LS), is an autosomal dominant cancer syndrome. Besides colorectal cancers, it predisposes patients to extracolonic cancers. Despite several extracolonic cancers have been reported on LS, we found a new face of it. A 43-year-old G2L2 patient with chief complaint of abnormal uterine bleeding. Her endometrium biopsy showed clear cell carcinoma, and the necessary work-ups have been done. But the patient's family history demonstrated HNPCC based on the Amsterdam 2 criteria. After some years, the patient presented to our hospital for fever, shivering and abdominal LUQ pain. Spiral CT scan showed a solid cyst with heterogeneous enhancement in the spleen, and hepatosplenomegaly. In this paper, another case with endometrial cancer as a sentinel cancer of LS is reported. This fact implicate that physicians should notice the family history of malignancies in patients with gynecologic cancers and consider LS.
Gynecology Oncology
Sedigheh Ghasemian Dizajmehr; Mahsa Mohammadi Irvanlou; Afshin Mohammadi; Farzaneh Rashidi Fakari
Volume 8, Issue 3 , May and June 2023, , Pages 295-300
Abstract
Background & Objective: Ovarian mature cystic teratomas (OMCTS) are one of the most common benign ovarian tumors. Most MCTs can be diagnosed by ultrasonography (us). Due to heterogeneous composition and a variety of appearance, in some non-diagnostic imaging reports it is suggested that we evaluate ...
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Background & Objective: Ovarian mature cystic teratomas (OMCTS) are one of the most common benign ovarian tumors. Most MCTs can be diagnosed by ultrasonography (us). Due to heterogeneous composition and a variety of appearance, in some non-diagnostic imaging reports it is suggested that we evaluate some tumor markers (CA125 and CA19-9) to complement imaging modalities. According to previous investigation, a single elevated CA 19-9 is in association with specific radio-pathologic features, such as size, torsion, bronchial glands, fat and teeth components. Here we are presenting three different cases of OMCT with different characteristics.Case Presentation: Case 1: asymptomatic, non-diagnostic US, single- elevated CA19-9, smaller than in 10 cm with bronchial glands and fat component. Case 2: symptomatic, non-diagnostic U.S. normal CA19-9, larger than 10 cm with torsion and necrosis. Case 3: symptomatic, diagnostic US, single- elevated CA19-9, smaller than 10 cm, full of hair and sebaceous material. Computer tomography (CT), in all of our cases was diagnostic based on OMCT. Apologia of pathologic pathway of elevated CA19-9 in both cases 1 and 3 were in agreement with the result of previous investigations. In case 2, despite its large size and torsion, CA 19-9 level was low.Conclusion: Single- elevated CA 19-9 level in OMCTs could impact benign characteristics of this kind of tumor.
Gynecology Oncology
Giti Noghabaei; Maliheh Arab; Ghazaleh Fazli; Golnaz Fallah-Talouki; Masoomeh Raoufi; Hamed Tahmasebi; Behnaz Ghavami
Volume 8, Issue 3 , May and June 2023, , Pages 301-305
Abstract
Background & Objective: Low-grade appendiceal mucinous neoplasm (LAMN) is a very rare condition, diagnosed in 0.2-0.7% of appendectomies. The pathophysiology of the neoplasm involves accumulation of large volume of mucin in the appendiceal lumen, resulting in its obstructive dilation. Most epithelial ...
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Background & Objective: Low-grade appendiceal mucinous neoplasm (LAMN) is a very rare condition, diagnosed in 0.2-0.7% of appendectomies. The pathophysiology of the neoplasm involves accumulation of large volume of mucin in the appendiceal lumen, resulting in its obstructive dilation. Most epithelial tumors affecting the appendix are of the mucinous type and are manifested by mucin accumulation within an inflamed appendix with fibrotic and hyalinized wall.Case Presentation: A 29-year-old female presented with a history of chronic and intermittent episodes of abdominal pain and a palpable mass in the right lower abdominal quadrant. Sonography showed a 58 mm mass anterior to the uterus and adjacent to the ovary, probably a uterine myoma. Laparotomy revealed normal uterus, and ovaries with a translucent mass originating from the appendix and fixed to the cecum. Pathologic examination of the mass was reported as low grade appendiceal mucinous neoplasm.Conclusion: This is a rare case of appendiceal mucocele in a young female, mimicking a pelvic mass, which was misinterpreted by sonography as a gynecologic solid mass near the uterus. Preoperative diagnosis of appendiceal mucocele is important due to the risk of concurrent GI and ovarian malignancy associated with the condition.
Gynecology Oncology
Fereshteh Fakour; Zahra Rafiei Sorouri; Amirhossein hajizadeh Fallah; Atefeh Mousavi; maral farahmand
Volume 8, Issue 2 , March and April 2023, , Pages 173-180
Abstract
Background and objective: In Iranian women, the age of breast cancer is 10-20 years earlier than women living in developed countries. Moreover, HPV infection has increased among Iranian women and it is more common compared to European women. The purpose of the present study is to investigate the role ...
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Background and objective: In Iranian women, the age of breast cancer is 10-20 years earlier than women living in developed countries. Moreover, HPV infection has increased among Iranian women and it is more common compared to European women. The purpose of the present study is to investigate the role of HPV as a potential risk factor for breast cancer at younger ages.Results: The results showed a significant difference between the two groups of women with breast cancer and without malignancy in the age of first pregnancy and gravidity. There was a significant difference in human papillomavirus type 16 infection between the two groups with breast cancer and without malignancy. The logistic regression model examined the effect of all variables and showed that infection with human papillomavirus type 16 increased the risk of breast cancer by 4.6 times, taking into account other variables.Conclusion: The present study, independent of other studies, showed that human papillomavirus type 16 could be a risk factor for breast cancer. If the virus is found in an individual, it is recommended that the patient be monitored frequently and more detailed examinations for breast malignancies be performed.
Gynecology Oncology
Fariba Behnamfar; Fatemeh Ahmadi Solush; Tajossadat Allameh
Volume 8, Issue 1 , January and February 2023, , Pages 11-16
Abstract
Background & Objective: Cervical Cancer (CC) is a common cancer which is associated with HPV-infection. The aim of this study is to investigate the risk factors which affects HPV-clearance.Materials & Methods: This study was carried out on women with high risk HPV infection. All the patients ...
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Background & Objective: Cervical Cancer (CC) is a common cancer which is associated with HPV-infection. The aim of this study is to investigate the risk factors which affects HPV-clearance.Materials & Methods: This study was carried out on women with high risk HPV infection. All the patients underwent pap smears and cervical biopsy. Demographic data, marital status, vaccination history and consumption of tobacco, alcohol, opium and oral contraceptive pills were asked through a questionnaire. Results: The results showed that in one year follow-up, 142 (67.1%) patients showed HPV clearance. The HPV clearance decreased by increasing age (P=0.028) or higher CIN grades (P=0.017). In case of parity, there was no significant difference in univariate analysis (P=0.147), but it was significant in multiple logistic regression analysis (95% CI: 0.413-0.941, OR=0624, P= 0.024).Conclusion: It seems that age and cervical histology at the start of HPV infection are the most important factors for HPV clearance.
Gynecology Oncology
Tajossadat Allameh; Maryam Sadat Mirazimi; Fahimeh Sabet; Leila Mousavi Seresht; Fariba Behnamfar
Volume 8, Issue 1 , January and February 2023, , Pages 17-22
Abstract
In gynecological cancers, sentinel lymph node (SLN) mapping has been proposed as an alternative to complete lymph node dissection. The goal of this study was to determine sentinel lymph node mapping's sensitivity, specificity, NPV, and PPV versus gold standard surgery (complete lymph node dissection) ...
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In gynecological cancers, sentinel lymph node (SLN) mapping has been proposed as an alternative to complete lymph node dissection. The goal of this study was to determine sentinel lymph node mapping's sensitivity, specificity, NPV, and PPV versus gold standard surgery (complete lymph node dissection) in patients with metastatic illness. A total of 26 patients were prospectively enrolled from spring 2021 to winter 2022. Sentinel lymph node mapping with complete pelvic lymph node dissection was done in all of them, and para-aortic lymphadenectomy was detected in 11 (43.33%) patients. At least one sentinel lymph node was successfully mapped in 22 (84.6%) patients. Three patients (11.5%) had positive lymph nodes, with an 85.7% sensitivity (95 percent CI) to detect node positive illness, a specificity of 74.93%, an NPV of 99.6 (99.5 CI), and a PPV of 5.9% calculated. There were no serious adverse effects due to blue dye. The accuracy rate of sentinel lymph node mapping by methylene blue was 75.1%.
Gynecology Oncology
Mahdis Mohamadianamiri; Hossein Shirazi; Majid Aklamli; Kobra Tahermanesh; Shahin Keshtkar Rajabi
Volume 8, Issue 1 , January and February 2023, , Pages 29-34
Abstract
Background & Objective: There are controversial results and paucity of data regarding the role of prolactin hormone in triple negative breast cancer. Hence, this study aimed to evaluate the role of prolactin receptor as a predictive factor in patients with triple negative breast cancer.Materials ...
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Background & Objective: There are controversial results and paucity of data regarding the role of prolactin hormone in triple negative breast cancer. Hence, this study aimed to evaluate the role of prolactin receptor as a predictive factor in patients with triple negative breast cancer.Materials & Methods: This was a descriptive-analytical study. All patients referred to three referral hospitals with triple negative breast cancer (ER−, PR−, HER-2−), were assessed to be included in the study. Patients' slides and blocks were re-examined for prolactin receptor by immunohistochemistry. Moreover, the association between the tumor size and grade was examined with prolactin receptor. Clinical characteristics and pathological features were recorded in researcher made questionnaire.Results: In total, 25 patients with triple negative breast cancer (TNBC) entered the study. Mean and standard deviation (SD) of tumor size in prolactin negative and positive groups were 4.82 ± 5.05 and 3.37 ± 1.61 cm, respectively with no significant difference (P-value> 0.05). Also, there was no statistically significant association between the tumor grade and prolactin receptor status (P-value = 0.056). Moreover, there was no statistically significant association between lymph nodes involvement and prolactin receptor status using Fisher’s exact test (P-value = 0.9). However, mean ± SD of age in negative and positive prolactin groups were 45.73 ± 12.12 and 56.60 ± 9.84, respectively with a statistically significant difference (P-value = 0.026).Conclusion: We did not find any association between prolactin receptor status and tumor size or grade in TNBC. Nonetheless, there is still ambiguity regarding the role of prolactin receptor expression in development of breast cancer. The controversial results are probably due to different effects of prolactin receptor in various breast cancer subtypes, which should be assessed in further trials.
Gynecology Oncology
Afsaneh Tehranian; Akram Ghahghaei-Nezamabadi; Maryam Motiei Langeroudi; Reyhaneh Aghajani
Volume 8, Issue 1 , January and February 2023, , Pages 53-56
Abstract
Background & Objective: We compared two different methods of visual inspection of the cervix, including Visual inspection of the cervix with acetic acid (VIA) and Visual inspection of the cervix with Lugol's iodine (VILI) in terms of sensitivity and specificity in diagnosis of pre-malignant cervical ...
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Background & Objective: We compared two different methods of visual inspection of the cervix, including Visual inspection of the cervix with acetic acid (VIA) and Visual inspection of the cervix with Lugol's iodine (VILI) in terms of sensitivity and specificity in diagnosis of pre-malignant cervical lesions in comparison to colposcopy guided biopsy.Materials & Methods: In this cross-sectional study, a total number of 200 women who were referred to the colposcopy clinic of Arash women’s hospital (Tehran, Iran) for cervical cancer screening, underwent VIA, VILI, and colposcopy guided biopsy during 2018-2019.Results: The calculated sensitivity and specificity of VIA and VILI in this population were (100% and 69.5%) and (100% and 60%), respectively, whereas the sensitivity and specificity of both VIA and VILI tests in combination were 100% and 77.2%. The positive and negative predictive values were 32.7% and 100%, respectively, when combined form of VIA and VILI was applied in this population.Conclusion: VIA and VILI alone or in combination could be used as screening tests to evaluate the presence of cervical cancer and in case of positive results, supplementary tests such as colposcopy guided biopsy could be performed for definite diagnosis.
Gynecology Oncology
Hakimeh Akbari; Hossein Forouzandeh; Tooraj Reza Mirshekari; Seyed Adnan Kashfi; Mehdi Ghavamizadeh
Volume 7, Issue 6 , September and October 2022, , Pages 507-512
Abstract
Background & Objective: Breast cancer has a pivotal role in many deaths caused by malignancies. Epidermal growth factor receptor-2 (EGFR-2 or HER-2) and estrogen receptor (ER) have immense predictive values as prognostic factors. Breast cancers that have steroid receptors and respond to hormone ...
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Background & Objective: Breast cancer has a pivotal role in many deaths caused by malignancies. Epidermal growth factor receptor-2 (EGFR-2 or HER-2) and estrogen receptor (ER) have immense predictive values as prognostic factors. Breast cancers that have steroid receptors and respond to hormone therapy show a better prognosis than cancers without steroid receptors.Materials & Methods: A retrospective cross-sectional study was performed on 500 pathology blocks of women with breast cancer sent to the pathology department of Amir-al-Momenin medical and educational center, Gerash, Iran, from 2016 to 2019. Data were analyzed by SPSS software (Version-16) via ANOVA test followed by Chi-square and t-tests. P-value <0.05 was considered as significant.Results: The utmost type of malignancy was invasive ductal carcinoma (IDC) at 35.03%. Among ER-positive patients 59.67% were HER-2-positive. Nonetheless, among the PR-positive patients 54.74% were HER-2-positive. ER-positive patients were correlated with p53 receptor, distant metastasis and HER-2 significantly (P < /i><0.01). However, PR-positive patients just correlated with p53 receptor significantly (P < /i><0.01).Conclusion: Investigated samples were more ER-negative and less PR-positive compared to similar studies. Meanwhile, ER-positive patients were HER-2-positive. Regarding the correlation with prognosis of breast cancer, especially in HER-2-positive patients, there is a need to perform profound screening programs for HER-2 in breast cancer patients, especially with histopathological characteristics of invasive ductal carcinoma.
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
Soheila Aminimoghaddam; Nima Azh; Somayyeh Noei Teymoordash; Firouzeh Ghaffari
Volume 7, Issue 5 , July and August 2022, , Pages 362-373
Abstract
Uterine cancer affects more than 1.28 million people worldwide; considering current world trends in obesity and aging, a +52.7% growth by 2040 is foreseen. Around 5% of endometrial cancer patients are less than 40 years old, meaning that conventional oncologic approaches would result in fertility loss; ...
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Uterine cancer affects more than 1.28 million people worldwide; considering current world trends in obesity and aging, a +52.7% growth by 2040 is foreseen. Around 5% of endometrial cancer patients are less than 40 years old, meaning that conventional oncologic approaches would result in fertility loss; thus, it is essential to consult patients regarding their fertility and family planning.Owing to developments of oncofertility, patients are now able to preserve their fertility and complete their childbearing, drafting from the standard of care in endometrial cancer. Strict criteria should be applied to make sure of selecting patients who benefit most from the fertility preservation approach. Furthermore, careful selection of patients increases the possibility of successful treatment.Most candidates for fertility preservation have risk factors in common with infertility, including polycystic ovarian syndrome, obesity, increasing of age and irregular menses; therefore, Advanced Reproductive Technology (ART) can improve their chances for pregnancy.Current applied knowledge towards the fertility preservation approach in patients with endometrial cancer is reviewed in this article.
Gynecology Oncology
Mohammad Pouryasin; Azam-Sadat Mousavi; Jalil Pakravesh; Delaram Zare Kamel; Shahla Nooriardabili; Shakiba Khodadad; Soheila Aminimoghaddam; Mehran Ghazimoghadam; Yasaman Farbod; Ali Pouryasin
Volume 7, Issue 5 , July and August 2022, , Pages 405-413
Abstract
Background & Objective: Persistent infection with some types of Human papillomavirus (HPV), which are high-risk genotypes, can lead the patients toward cervical cancer and, finally, death. Recent studies showed HPV co-infection with non-HPV sexually transmitted infections (non-HPV STIs) could increase ...
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Background & Objective: Persistent infection with some types of Human papillomavirus (HPV), which are high-risk genotypes, can lead the patients toward cervical cancer and, finally, death. Recent studies showed HPV co-infection with non-HPV sexually transmitted infections (non-HPV STIs) could increase the persistency rate of HPV infections. This study aimed to estimate the prevalence of STIs and assess the association of HPV/non-HPV STIs co-infection on cervical cell changes based on cytological findings.Materials & Methods: In this cross-sectional study, in addition to the routine cervical screening, including HPV testing and cytological assessment, non-HPV STI testing was performed on 1065 Iranian women. To assess the HPV and non-HPV STIs, commercial kits were used.Results: 964 (90.5%) women had normal cytology (NILM) results. The overall prevalence of HPV and non-HPV STIs were 39.1% and 68.5%, respectively. HPV-53 (6.5%), -16 (6.1%) and -31 (5.5%) were found as the most prevalent genotypes. Ureaplasma Parvum (UP) (42.7%), Group B Streptococcus (GBS) (23.7%), Candida Species (CS) (23.6%), Ureaplasma Urealyticum (UU) (9.6%), and Mycoplasma Hominis (MH) (7.1%) were found as the most prevalent non-HPV STIs. The co-infection of HPV with GBS played an important role in developing the cervical lesion (P < /i><0.05). Conclusion: In the present study, the STIs, including HPV, UP, GBS, CS, UU, and MH, were prevalent among the study participant, and it was found that the HPV/GBS co-infection played a significant role in the development of LSIL or worse cytological grades. To clarify this issue, further studies will be conducted.
Gynecology Oncology
Behnaz Nouri; Mohadese Alemi; Ahmad Reza Baghestani
Volume 7, Issue 5 , July and August 2022, , Pages 429-436
Abstract
Background & Objective: Endometriosis is associated with the increased risk of coronary heart disease and immune alterations, which may be attributed to the altered lipid profile and decreased serum level of 25–hydroxyl vitamin D (25(OH)D). The present study aimed to evaluate the effect of ...
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Background & Objective: Endometriosis is associated with the increased risk of coronary heart disease and immune alterations, which may be attributed to the altered lipid profile and decreased serum level of 25–hydroxyl vitamin D (25(OH)D). The present study aimed to evaluate the effect of radical laparoscopic surgery of endometriosis on serum lipid profile and 25(OH)D.Materials & Methods: This cross-sectional study was performed on 47 women aged 15 to 45, with body mass index <30kg/m2, who were referred to Shohaday-eTajrish Hospital, from May 2018 until Jan 2020, for surgical treatment of endometriosis and did not have a systemic disease and did not use oral contraceptives and/or other hormonal therapies three months before surgery were enrolled into the study. The serum lipid profile and 25(OH)D levels of patients two months after surgery were compared with presurgical levels. The results were analyzed by using paired t-test.Results: A total of 47 patients completed the study (mean age: 32.8±7.5years). About half had no pregnancies (49.1%). Comparing the serum lipid profile of patients before and two months after surgery showed a significant decrease in triglyceride from 108.4±46.2 to 86.4±51.1 mg/dL (P < /i>=0.001), ], total cholesterol from 172.5±26.5 to 160.0±28.3mg/dl (P < /i>=0.002), and low-density lipoprotein levels from 97±28.3 to 89.8±26.1 mg/dL (P < /i>=.003); however, high-density lipoprotein and 25(OH)D levels did not show a significant difference (P < /i>>0.05). Conclusion: the results of the current study showed that laparoscopic resection of endometriotic lesions resulted in a significant reduction of the unfavorable lipid profile after two months, but not 25(OH)D levels.
Gynecology Oncology
Tajossadat Alameh; Leila Mousavi Seresht; Noshin Afshar; Behnoosh Mohamadi Jazi
Volume 7, Issue 5 , July and August 2022, , Pages 452-457
Abstract
Background & Objective: Primary lymphoma of the cervix is rare and can be misdiagnosed most of the time. On the other hand, there is no consensus on the best treatment and follow-up strategy for this type of cervical malignancy. The present study aimed to present a misdiagnosed primary cervical lymphoma ...
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Background & Objective: Primary lymphoma of the cervix is rare and can be misdiagnosed most of the time. On the other hand, there is no consensus on the best treatment and follow-up strategy for this type of cervical malignancy. The present study aimed to present a misdiagnosed primary cervical lymphoma due to its confusing presentation and rarity.Case Report: A 41-year-old woman presented with abnormal vaginal discharge and dyspareunia complaints. Unfortunately, the patient was not examined, and cervicitis was reported on biopsy. Therefore, the patient was treated for vaginitis for a long time. Due to a lack of response to antibiotic therapy, an ultrasound was performed, which showed a huge mass in the cervix. Patient was referred to the oncology department of obstetrics and gynecology center, Beheshti Hospital, Isphahan, Iran, in July 2013. Diffuse large B-cell lymphomas was diagnosed on a CT-guided biopsy of the presacral mass. Fortunately, despite the delay in diagnosis, 5 years after the last R-CHOP chemotherapic session (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone), the patient has good quality of life with no sign of recurrences.Conclusion: Due to the rarity of uterine cervix lymphoma, the diagnosis of genital lymphoma could be missed if the clinician does not consider this malignancy. High suspicion, rapid diagnosis and proper communication between clinician and pathologist lead to an excellent prognosis.
