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 342-349
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 357-365
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 396-403
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 411-416
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 417-421
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 & 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 ...
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Background & 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.Materials & Methods: This study is a case-control study that was performed on 46 specimens of breast cancer tissue and 46 samples of normal breast tissue with no malignancy. In coordination with the pathology laboratory of Poursina Hospital (Rasht, Iran), samples of breast cancer pathology templates that were available in the laboratory archives were selected after a preliminary examination of the accuracy of tissue diagnosis. After that, a tissue incision was prepared with H&E staining and the cancer diagnosis was again confirmed by a pathologist. Samples were cut with a microtome with disposable blades. Then the tissue sample was deparaffinized and its DNA was extracted. The data were analyzed by SPSS software version 21 (IBM SPSS, Armonk, NY, USA) using Chi-square, T-test, variance analysis and logistic regression.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.
Gynecology Oncology
Maryam Rahimi; Setareh Talebi Kakroodi; Mansoureh Tajvidi
Volume 7, Issue 4 , March and April 2022, , Pages 258-271
Abstract
Receptor tyrosine kinase (RTK) signaling is a crucial pathway in the development of many cancers. KIT, PI3K, and AKT are the major genes in this pathway. KIT RTK functions in cell signal transduction in various cell types, such as cancer cells. A central element of RTK signaling is phosphatidylinositol-4, ...
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Receptor tyrosine kinase (RTK) signaling is a crucial pathway in the development of many cancers. KIT, PI3K, and AKT are the major genes in this pathway. KIT RTK functions in cell signal transduction in various cell types, such as cancer cells. A central element of RTK signaling is phosphatidylinositol-4, 5-bisphosphate 3-kinase catalytic subunit A (PIK3CA), involved in cell proliferation, survival, and growth. AKT is a serine/threonine-specific protein kinase that has an important role in several processes, such as apoptosis and cell proliferation. The importance of mutations and overexpression of KIT, PI3K, and AKT genes in breast cancer has been previously demonstrated. This review investigated the relationship between gene mutations and overexpression and clinicopathological variable of KIT, PI3K, and AKT in breast cancer. Finally, the role of inhibitor drugs of these genes in breast cancer treatment. These data were collected from PubMed and Google Scholar databases from 2000 to 2021. The expression of KIT, PI3K, and AKT genes in normal breast tissues has been observed. However, mutations and overexpression of these genes are associated with malignancies. The mutations in KIT, PI3K, and AKT genes are different from those found in other malignancies. Also, most of the drugs that inhibit the RTK signaling are being tested in clinical trials for the treatment of breast cancer. Monitoring and timely management of adverse effects are critical to minimize toxicities and optimize the efficacy of this targeted therapy. Therefore, further development of predictive biomarkers can better select patients who will benefit from RTK inhibitors.
Gynecology Oncology
Shahrzad Sheikhhasani; Mohades Peydayesh; Narges Zamani; Somayeh Nikfar; Mona Mohseni
Volume 7, Issue 4 , March and April 2022, , Pages 348-350
Abstract
Perivascular epithelioid cell tumors (PEComas) are a group of mesenchymal neoplasms with different biological presentations from benign to malignant types. Hence, we report the first description of PEComa presenting with an acute surgical abdomen. Her definite diagnoses were made based on the histomorphology ...
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Perivascular epithelioid cell tumors (PEComas) are a group of mesenchymal neoplasms with different biological presentations from benign to malignant types. Hence, we report the first description of PEComa presenting with an acute surgical abdomen. Her definite diagnoses were made based on the histomorphology results at Imam Khomeini Hospital, Tehran University of Medical Sciences, in 2020.Considering different clinical presentations, unknown characteristics of imaging, and rarity of PEComa, preoperative diagnosis of it seems impossible. However, IHC can play an important role in its diagnosis.
Gynecology Oncology
Behnaz Nouri; Sara Sarani; Maliheh Arab; Mina Bakhshali-Bakhtiari; Fereshte Sarbazi; Anita Karimi
Volume 7, Issue 4 , March and April 2022, , Pages 361-361
Abstract
CORRIGENDUM : In the version of this article initially published, the name of author Mina Bakhshali-Bakhtiari was incorrectly written as Mina Bakhtiari.[J. Obstet. Gynecol. Cancer Res. 2022;7(3):230-234] published article with the doi of http://dx.doi.org/10.30699/jogcr.7.3.230
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CORRIGENDUM : In the version of this article initially published, the name of author Mina Bakhshali-Bakhtiari was incorrectly written as Mina Bakhtiari.[J. Obstet. Gynecol. Cancer Res. 2022;7(3):230-234] published article with the doi of http://dx.doi.org/10.30699/jogcr.7.3.230
Gynecology Oncology
Azam-Sadat Mousavi; Setareh Akhavan; Fareideh Sabzi shahrbabaki; Narges Izadi-mood; Fariba Yarandi; Mehran Ghazimoghadam; Mohammad Pouryasin; Saina Nassiri; Mamak Shariat; Ali Pouryasin
Volume 7, Issue 3 , January and February 2022, , Pages 151-157
Abstract
Background & Objective: Recent advances in molecular testing for human papillomavirus (HPV) has increased the accuracy of cervical screening programs. This study intended to estimate the diagnostic value of high-risk (HR) HPV DNA- and E6/E7 mRNA-based methods for triage of Iranian women with ...
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Background & Objective: Recent advances in molecular testing for human papillomavirus (HPV) has increased the accuracy of cervical screening programs. This study intended to estimate the diagnostic value of high-risk (HR) HPV DNA- and E6/E7 mRNA-based methods for triage of Iranian women with abnormal cytological results regarding the histopathological cut-off.Materials & Methods: In this cross-sectional study, 360 non-pregnant women (≥ 21 years) who had faced abnormal cytological findings (ASC-US and LSIL) were enrolled and referred for further diagnostic tests. The INNO-LiPA® HPV Genotyping Extra-II and Aptima HPV assay kits were used in DNA- and E6/E7 mRNA-based methods for detection of HR-HPV. Regarding the CIN-2+ histopathological cut-off, the diagnostic value of each molecular-based assay was calculated.Results: Among the study participants, 260 cases had ASC-US, and 100 had LSIL. The overall positivity rate for DNA- and mRNA-based methods was 74.4% (268/360) and 64.2% (231/360), respectively. Fifty-nine (16.4%) individuals showed CIN-2+. The DNA-based test showed higher sensitivity (100%) than the mRNA-based method (93.2%), while the mRNA-based method revealed greater clinical specificity (41.5%) compared to the DNA-based test (30.6%).Conclusion: Our results revealed appropriate clinical sensitivity of the molecular-based methods for triage of Iranian women with abnormal cytological results; however, the mRNA-based method showed greater specificity for detection of CIN-2+.
Gynecology Oncology
Seyyed Mohammad Tabatabaei; Moslem Taheri Soodejani; Hamid Reza Shoraka; Marzieh Mahmoudimanesh; Saeid Eslami; Azimeh Ghaderi
Volume 7, Issue 3 , January and February 2022, , Pages 200-205
Abstract
Background and Objective: Breast cancer is a malignant lesion caused by abnormal changes and growth in breast tissue epithelial cells, including glands, lobules, and larynx. Therefore, the current study's objective was to estimate the incidence of breast and cervical intraepithelial lesions in Iran. ...
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Background and Objective: Breast cancer is a malignant lesion caused by abnormal changes and growth in breast tissue epithelial cells, including glands, lobules, and larynx. Therefore, the current study's objective was to estimate the incidence of breast and cervical intraepithelial lesions in Iran. This study is based on results from a screening program implemented in the province of Isfahan, Iran.Methods: Two stages of cancer screening were performed in the study on over 250000 women in 2018.Results: As a result of this study, it was determined that in 2018, there was an incidence of 422 benign breast tumors per 100 000 women (95% CI: 393-450). Also, the incidence of breast cancer was 65 (95% CI: 54-76) per 100 000 women, and that of Cervical intraepithelial lesions was 45 (95% CI: 27-63) per 100 000 women in 2018.Conclusion: This study revealed that breast cancer and cervical intraepithelial lesions are increasing in Isfahan province. Moreover, it was found that screening for these 2 cancers leads to early detection of patients, which results in early treatment and an increase in the 5-year survival rate in these patients.
Gynecology Oncology
Haleh Ayatollahi; Samira Jahangard; Siamak Naji; Zahra Yekta
Volume 7, Issue 3 , January and February 2022, , Pages 206-212
Abstract
Background and Objective: Cervical cancer is a common neoplasm in women, and the role of the HPV virus in the development of precancerous and cancerous cells has been established. There exist different strains of the HPV virus with varied functions. In the high-risk HPV strains, the p16 and ki67 proteins ...
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Background and Objective: Cervical cancer is a common neoplasm in women, and the role of the HPV virus in the development of precancerous and cancerous cells has been established. There exist different strains of the HPV virus with varied functions. In the high-risk HPV strains, the p16 and ki67 proteins play a crucial role in regulating the cell cycle leading to cell proliferation and progression. P16 and ki67 proteins are positive in almost all lesions and indicate a high degree of malignancy. This study aims to investigate the predictive effect of p16 and ki67 on the progression of low-grade intraepithelial lesions to high-grade malignancy.Methods: P16 and ki67 were measured on CIN1 lesions, and during the average two-year follow-up period, the outcome of positive cases was investigated. A total of 106 referred patients between the age of 15 to 75 years were examined from April 2015 to March 2019.Results: Among the patients with progression of CIN1 to CIN2 and other severe lesions, p16 was positive in 14 cases (60.9%), and a significant difference between groups with positive and negative markers in the progression or regression of lesions was noticed. Ki67 frequently occurs in CIN2 and other severe lesions.Conclusion: The use of p16 and ki67 as predictive markers is still under debate. In countries like the United States, these are not yet used separately for prediction but are being used in combination together. The authors of this study strongly recommend the conduction of further studies to assess the role of p16 in association with other markers and within a larger population so as to apply the functional role of p16 and ki67 in the clinical setting thereby effectively preventing it.
