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Ovarian cancer
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Stephanie Nougaret, Helen Addley, Evis Sala, Anju Sahdev
Malignant granulosa cell tumours account for about 70% of all malignant SCSTs and 3%–5% of all ovarian neoplasms. They are divided into adult (95%) and juvenile (5%) types. The adult type manifests mostly in perimenopausal women (median age: 50–54 years), whereas the juvenile type predominates in prepubertal girls (median age: 13 years) (52,53). MRI features of granulosa cell tumours vary, but certain findings may point to the correct diagnosis. In addition to clinical information including perimenopausal status, menometrorrhagia, and elevated inhibin level, suggestive MR features are high SI on T1WI (intralesional haemorrhage), ‘sponge-like’ or ‘Swiss cheese’ appearance on T2WI (multiple cysts interspersed within a solid mass), and enhancing solid components (Figure 19.9). Findings indicative of juvenile granulosa cell tumour are age <30 years, isosexual precocious puberty, an elevated inhibin level, and MRI appearances similar to adult type. Rarely, juvenile granulosa cell tumours may manifest as intermediate-to-high SI solid masses or a predominantly cystic lesion with a solid component. Peritoneal metastases and associated endometrial hyperplasia or carcinoma should be excluded on imaging (Figures 19.10 and 19.11) (54,55).
The Hematologic System and its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Chronic posthemorrhagic anemia, however, is microcytic and hypochromic; i.e., the RBCs are small and pale. A prolonged loss of blood causes the marrow to become hyperactive as it attempts to replace the loss rapidly. Additionally, the loss of blood causes a loss of iron since about two-thirds of the body's iron stores are in hemoglobin. The result is the release of cells that are smaller and less mature and that contain reduced amounts of hemoglobin. Chronic posthemorrhagic anemia may be caused by any prolonged excessive blood loss, including bleeding ulcers, bleeding hemorrhoids, or menometrorrhagia (excessive uterine bleeding).
Functional abnormal uterine bleeding
Published in T. Yee Khong, Annie N. Y. Cheung, Wenxin Zheng, Richard Wing-Cheuk Wong, Hao Chen, Diagnostic Endometrial Pathology, 2019
T. Yee Khong, Annie N. Y. Cheung, Wenxin Zheng
In the FIGO definition, uterine bleeding is described as being normal or abnormal based on frequency (normal being every 24–38 days, and abnormal as being absent (amenorrhea), frequent being occurring every less than 24 days, or infrequent being occurring every more than 38 days); duration (normal being up to 8 days, and abnormal being prolonged beyond 8 days); regularity (normal being a variation between shortest and longest period of less than 9 days, and abnormal as a variation being more than 9 days) and flow volume (where abnormal is either light or heavy). These descriptive terms replace previous terms that were poorly defined such as menorrhagia, metrorrhagia, polymenorrhea, menometrorrhagia and dysfunctional uterine bleeding (Table 5.1).
Ulipristal acetate on quality of life and sexual function of women with uterine fibromatosis
Published in Gynecological Endocrinology, 2020
Antonella Biscione, Valeria Barra, Emma Bellone, Filiberto Maria Severi, Stefano Luisi
We analyzed the change of BMI of patients before and after treatment with UPA and it was not statistically significant (p .08); therefore, we concluded that weight variation could not affect the responses to the questionnaires. Regarding clinical manifestations at the time of filling in the questionnaires, only 11 patients (15.5%) reported being asymptomatic, while the remaining 60 patients (84.5%) reported being symptomatic for bleeding and pain. In particular, 44 patients (73.3%) complained metrorrhagia or menometrorrhagia as the main symptom, 39 patients (65%) reported mainly pain. Sometimes bleeding and pain coexisted in the same patient (33.8%). Considering the various manifestations of pain symptoms, 6 patients (15.4%) reported chronic pelvic pain, 30 patients (76.9%) dysmenorrhea, 9 patients (23.1%) dyspareunia, 1 patient (2.6%) dysuria. In some cases, there was overlap of different painful symptoms (20.5%).
How noninvasive treatment of uterine fibroids affects endometrial receptivity: a prospective cohort study
Published in Gynecological Endocrinology, 2020
Oxana Melkozerova, Irina Shchedrina, Anastasia Gryshkina, Nadezhda Bashmakova, Galina Malgina, Anna Michelson, Guzel Chistyakova
The average age of the patients did not significantly differ and amounted to 37.50 ± 1.33 years in the main group and 35.85 ± 1.43 years in the control group (p > .05).Patients did not have significant differences in anthropometric indices; average growth and weight parameters were observed. BMI in the main group was 24.64 ± 3.06 kg/cm2, in the control group 23.04 ± 1.86 kg/cm2; p > .05. The main clinical manifestations in patients of the main group were menometrorrhagia (40.63%) and pain (53.13%). The frequency of infertility as a clinical manifestation of uterine fibroids was 37.5%, where in primary infertility among women of the main group accounted for 15.63%, secondary infertility – for 21.87% of women with uterine fibroids.
Treatment options and reproductive outcome for adenomyosis-associated infertility
Published in Current Medical Research and Opinion, 2018
Ilaria Soave, Jean-Marie Wenger, Nicola Pluchino, Roberto Marci
The first live birth after MRgFUS for focal adenomyosis was reported in 200665. Rabinovici et al. published a case report of a 36 year old patient with secondary infertility due to a symptomatic focal adenomyosis. The patient underwent MRgFUS with an improvement in menometrorrhagia and a significant reduction in lesion size. Three menstrual cycles later she conceived spontaneously with the delivery at term of a healthy baby. So far, the role of HIFU as a treatment option for adenomyosis associated infertility has not yet been sufficiently clarified and there is limited data concerning its potential impact on fertility and pregnancy outcomes, although some general considerations on side-effects could be made. Permanent amenorrhea resulting in early menopause due to an accidental direct sonication of the ovaries could be a serious complication of any interventional treatment with HIFU. Indeed, an ultrasonic beam accidentally focused on the ovaries could lead to a permanent loss of ovarian function90, although so far there are no studies on endocrine changes or on anti-Müllerian hormone levels alterations after inadvertent ovary sonication during HIFU treatment for adenomyosis. Concerning the endometrium, it has been reported that its selective sonication is associated with well known morphological abnormalities91, but the possibility that accidental sonication of adjacent endometrial tissue could impair endometrial function and consequently the implantation process has not yet been demonstrated. Moreover, the change in myometrial architecture after the degeneration of the lesion and the potential presence of post-treatment intracavitary adhesions may lead to a further loss of uterine functionality, introducing an additional risk factor for uterine sterility.