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Uterine Cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Claudia von Arx, Hani Gabra, Christina Fotopoulou
Pelvic/peritoneal washing cytology: Pelvic/peritoneal washing cytology is a way of assessing microscopic peritoneal spread. The role of peritoneal cytology as a strong independent prognostic factor has failed to be established, especially after diagnostic hysteroscopy, and is therefore not included in the new Federation Internationale de Gynecologie et d’Obstetrique (FIGO) classification of uterine cancers and does not influence indication for adjuvant treatment. In only a minority of patients, positive washings are the only evidence of neoplasm outside the endometrium. However, most clinicians will not change management based on positive peritoneal washings. It has not been established that positive cytology without other evidence of extra-uterine disease or other high risk factors indicates an increased risk of recurrence.25
Endometrial malignant lesions
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
Peritoneal washing status is no longer part of endometrial cancer staging. However, positive washing is considered a poor prognostic factor for non-endometrioid and high-grade endometrioid carcinomas.42 This situation sometimes is seen in those high-grade cancers with or without myometrial invasion. It is believed that cases like these largely metastasize through the trans-tubal route. Based on our own practice, we are able to identify free-floating cancer cells in tubal lumen in about 20% of the cases after completely examining both fallopian tubes (Figure 9.20). We therefore recommend that both fallopian tubes should be entirely submitted for microscopic examination in this situation.
Endometrial cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2014
Christina Fotopoulou, Hani Gabra
Pelvic/peritoneal washing cytology – Pelvic/peritoneal washing cytology is a way of assessing microscopic peritoneal spread. The role of peritoneal cytology as a strong independent prognostic factor has failed to be established, especially after diagnostic hysteroscopy and is therefore not included into the new Federation Internationale de Gynecologie et d’Obstetrique (FIGO) classification of uterine cancers and does not influence indication for adjuvant treatment. In only a minority of patients, positive washings are the only evidence of neoplasm outside the endometrium. It is thought that such spread is due to retrograde migration of neoplastic cells through the fallopian tube; however, most clinicians will not change management based on positive peritoneal washings. It has not been established that positive cytology without other evidence of extra-uterine disease or other high risk factors indicates an increased risk of recurrence.17
Laparoscopic treatment of ovarian granulosa cells tumor developed in the pelvic anterior preperitoneal space 20 years after laparotomic salpingo-oophorectomy: case report and review of literature
Published in Gynecological Endocrinology, 2020
Raffaele Tinelli, Massimo Stomati, Giuseppe Trojano, Stefano Uccella, Francesco Cosentino, Ettore Cicinelli, Stefano Angioni
Pneumoperitoneum was induced by infraombelical insertion of a Veress needle (Auto-Suture™, Norwalk, CT). After placing optic and three ancillary trocars, the abdomical and pelvic structures were inspected. Surprisingly, uterus and right adnexa were normal; however, a bulging, with smooth surface, brown colored, structure developing under the peritoneum of the anterior pelvic wall near the right inguinal canal was observed. Peritoneal washing for cytological examination was performed. After opening the peritoneal leaf, the 6 cm cyst, yellowish-brown, friable developing under the right anterior peritoneum without a clear cleavage plan from the adipose tissue was observed (Figure 2). By using blunt dissection, the mass was isolated and removed. The specimen was sent to histological evaluation. Unexpectedly, the pathologist diagnosed an ovarian GC tumor. By considering that the right ovary was normal, and that the woman had left adnexectomy due to ovarian cysts, we hypothesized that even small part of the cyst could drop or remain entrapped into the abdominal wound during the closure of laparotomy 20 years before.
Ovarian steroid cell tumor as an example of severe hyperandrogenism in 45-year-old woman
Published in Gynecological Endocrinology, 2020
Anna Szeliga, Aleksandra Zysnarska, Agnieszka Podfigurna, Marzena Maciejewska-Jeske, Rafał Moszyński, Stefan Sajdak, Piotr Jasiński, Andrzej Frankowski, Andrea R. Genazzani, Błażej Męczekalski
The patient was readmitted to the hospital in January 2019. The total serum T rose to 3.75 ng/ml. During laparotomy, left salpingo-oophorectomy with removal of the tumor was performed. Laparotomy showed 6 cm in the diameter encapsulated tumor with solid structure, yellow and swollen in the cross-section (Figure 3). The capsule with hemorrhages was not abrupted. The cytologic smears from peritoneal surfaces were also taken. During the intraoperative histopathological examination, SCT was initially diagnosed. Further histopathological examination revealed positive staining for sex cord-stromal markers, inhibin, calretinin, Melan A, and about 5% Ki67-positive cells (Figure 4). There was neither atypia nor mitotic figures; mitotic index: 0–1 mitoses/10 HPF. The peritoneal washing was negative. The final histopathological conclusion was the benign SCT of the ovary. In postoperative hormonal evaluation, serum T decreased to 0.74 ng/ml one day after the surgery and to 0.13 ng/ml three days after the surgical procedure (Table 2).
The therapeutic effects of coenzyme Q10 on surgically induced endometriosis in Sprague Dawley rats
Published in Journal of Obstetrics and Gynaecology, 2022
Saadet Özen Akarca-Dizakar, Mürşide Ayşe Demirel, Neslihan Coşkun Akçay, Mehmet Sipahi, Lale Karakoç Sökmensüer, Hakan Boyunaga, Ayse Köylü, Suna Ömeroğlu
The peritoneal cavity was washed with 2 mL warm sterile saline 3 times at the first and second stages of the experimental procedure. Peritoneal washing fluid was carefully collected using a Pasteur pipette without causing tissue and vascular damage (Demirel et al. 2014). The fluid was collected by centrifuge tubes and the samples were stored until analysis at −80°C. The levels of TNF-α and VEGF in the peritoneal fluid were quantitatively assessed by enzyme-linked immunosorbent assay (ELISA) (VersaMax™ ELISA Microplate Reader) using a commercial rat kit. The results between pre- and post-treatment were compared and statistically evaluated.