To define the clinical, histopathological features and the prognostic factors affecting survival in patients with adult granulosa cell tumors of the ovary (AGCT).
Only 2% of all breast cancers are metastatic, making them extremely uncommon. They are frequently mistaken for a primary breast tumor. Although it has been observed, metastatic spread from primary uterine cancers is extremely uncommon. In the literature, our case represents the fourth endometroid adenocarcinoma metastasis from the uterus. Clinical, pathological, and immunohistochemical examination and management of metastatic endometrioid adenocarcinoma of the uterus' extragenital organ were described in this 69-year-old patient's case. Immunohistochemical analysis was performed on a breast biopsy taken from the patient who underwent therapy and discovered a breast mass two years later. Metastatic endometrial adenocarcinoma was diagnosed with negative signs pointing to mammaglobin, GCDFP-15 and GATA3 breasts and markers indicating endometroid adenocarcinomas such as p53, PAX8 and VIMENTIN support. As a result, a thorough clinical history is needed, with special attention to diagnoses of concurrent or prior malignancies, along with clinical examination, appropriate radiological evaluation, and immunohistochemistry. This is necessary to prevent unnecessary surgery, to provide appropriate systemic treatment, to ensure correct diagnosis, and to manage treatment.
Abstract Objective: The main feature of adult granulosa cell tumours (AGCT) is their capacity to secrete hormones, with nearly all of them capable of synthesizing oestradiol. Endometrial pathology is caused granulosa cell-produced oestrogen. The primary goal of this study is to identify synchronised endometrial pathologies, particularly endometrial cancer, in AGCT patients who had undergone a hysterectomy. The secondary objective is to define the factors related to synchronised endometrial cancer in AGCT. Materials and Methods : The study cohort comprised retrospectively of 316 AGCT patients from ten tertiary gynaecological oncology centres. AGCT surgery consisted of bilateral salpingo-oophorectomy, hysterectomy, peritoneal cytology, omentectomy and the excision of any suspicious lesion. Endometrial hyperplasia was categorised as simple hyperplasia without atypia, complex hyperplasia without atypia, complex hyperplasia with atypia or endometrial intraepithelial neoplasia (EIN). The median tumour size value was used to define the relationship between tumour size and endometrial cancer. The relationship between each value and endometrial cancer was evaluated. Results: EIN or hyperplasia with complex atypia was detected in 7.7% of patients and endometrial cancer in 3.2% of patients. The relationship between tumour size and endometrial cancer was evaluated by taking the tumour size as a cut-off value of 150 mm. Four patients with a tumour size of ≤150 mm (3.2%), and four patients with a tumour size >150 mm (12.1%) had endometrial cancer. ( p =0.036). Tumour size was statistically significant in relation to endometrial cancer in menopausal AGCT patients. Conclusion: Our present study determined that 7.3% of patients had complex hyperplasia with atypia or EIN, and 3.1% of patients had endometrial carcinoma. During the menopausal period, endometrial cancer risk was 4.5%. The study revealed that the likelihood of developing endometrial cancer increased to 12% from 3.2% when the size of the tumour was >150 mm in menopausal patients.
Abstract Objective The main feature of adult granulosa cell tumors (AGCT) is their capacity to secrete hormones, with nearly all of them capable of synthesizing oestradiol. The primary goal of this study is to identify synchronized endometrial pathologies, particularly endometrial cancer, in AGCT patients who had undergone a hysterectomy. Materials and Methods The study cohort comprised retrospectively of 316 AGCT patients from 10 tertiary gynecological oncology centers. AGCT surgery consisted of bilateral salpingo‐oophorectomy, hysterectomy, peritoneal cytology, omentectomy, and the excision of any suspicious lesion. The median tumor size value was used to define the relationship between tumor size and endometrial cancer. The relationship between each value and endometrial cancer was evaluated. Results Endometrial intraepithelial neoplasia, or hyperplasia with complex atypia, was detected in 7.3% of patients, and endometrial cancer in 3.1% of patients. Age, menopausal status, tumor size, International Federation of Gynecology and Obstetrics stage, ascites, and CA‐125 level were not statistically significant factors to predict endometrial cancer. There was no endometrial cancer under the age of 40, and 97.8% of women diagnosed with endometrial hyperplasia were over the age of 40. During the menopausal period, the endometrial cancer risk was 4.5%. Developing endometrial cancer increased to 12.1% from 3.2% when the size of the tumor was >150 mm in menopausal patients ( p = 0.036). Conclusion Endometrial hyperplasia, or cancer, occurs in approximately 30% of AGCT patients. Patients diagnosed with AGCT, especially those older than 40 years, should be evaluated for endometrial pathologies. There may be a relationship between tumor size and endometrial cancer, especially in menopausal patients.
Abstract Objective: The main feature of adult granulosa cell tumors (AGCT) is their capacity to secrete hormones, with nearly all of them capable of synthesizing estradiol. Endometrial pathology is caused by granulosa cell-produced estrogen exposure. The primary goal of this study is to identify endometrial pathologies, particularly the endometrial cancer, in AGCT patients who had undergone hysterectomy. The secondary objective of the study is to define the factors that predict endometrial cancer in AGCT. Materials and Methods : The study cohort was formed with 316 AGCT patients from ten tertiary gynecological oncology centers. Surgery for AGCT consisted of bilateral salpingo-oophorectomy, hysterectomy, peritoneal cytology, omentectomy, excision of any suspicious lesion. Endometrial hyperplasia was categorized as simple hyperplasia without atypia, complex hyperplasia without atypia, complex hyperplasia with atypia or endometrial intraepithelial neoplasia (EIN). The median tumor size value was used to define the relationship between tumor size and endometrial cancer. The relationship of each value with endometrial cancer was evaluated. Results: EIN or hyperplasia with complex atypia was detected in 7.7% of patients and endometrial cancer in 3.2% of patients. The relationship between tumor size and endometrial cancer was evaluated by taking the tumor size as a cut-off value of 150 mm. Therefore, tumor size ≤150 mm four (3.2%) and >150 mm four (12.1%) patients had endometrial cancer ( p =0.036). Tumor size was statistically significant in relation to endometrial cancer in menopausal AGCT patients. Conclusion: Our present study determined that 7.3% of patients had complex hyperplasia with atypia or EIN and 3.1% of patients had endometrial carcinoma. During the menopausal period, endometrial cancer risk was 4.5%. The study revealed that, the likelihood of developing endometrial cancer increased to 12% from %3.2 when the size of the tumor was >150 mm in menopausal patients.
Minimal invaziv cerrahi, açık cerrahilere göre bir çok avantajı mevcuttur. Dünyada artan teknolojik ve inovatif gelişmeler minimal invaziv cerrahinin yaygınlaşmasına katkıda bulundu. Endoskopik cerrahideki artan gelişmeler ile jinekolojik endoskopik cerrahide de ilerlemeler sağlandı. Ülkemiz de son yıllarda hem temel endoskopik hemde advanced endoskopik cerrahide dünya literatürüne makale ve teknik anlamda bir çok katkısı olmuştur. Buna karşın, jinekolojik endoskopik cerrahideki uzun öğrenme süreci ve merkezi olmayan sağlık merkezlerinde yeterli endoskopik alet alt yapısına erişim zorluğu nedeniyle istenilen seviyeye yeterince yayılmamıştır. Ayrıca, kitap ve diğer dökümanlar konusunda dünya ve ülkemizde yeterli kaynak bulunamamaktadır. Kitabımız bu konuda kaynak ihtiyacınıkapatma amacıyla yola çıktı. Konusunda yetkin uzman ve hocalar tarafından son güncel bilgiler dikkate alınarak yazıldı. Kitabımızınmeslektaşlarımıza ve jinekolojik endoskopi camiasına verimli bir kaynak olması en büyük temmenimizdir.
Abstract Aim The aim of our study is to examine the clinical, surgical, and pathological factors of stage 1C adult granulosa cell tumor (AGCT) patients and to investigate the effects of adjuvant therapy on recurrence and survival rates in this patient group. Methods Out of a total of 415 AGCT patients treated by 10 tertiary oncology centers participating in the study, 63 (15.2%) patients with 2014 FIGO stage IC constituted the study group. The FIGO 2014 system was used for staging. Patient group who received adjuvant chemotherapy was compared with patient group who did not receive adjuvant chemotherapy in terms of disease‐free survival (DFS), and disease‐specific survival. Results The 5‐year DFS of the study cohort was 89%, and the 10‐year DFS was 85%. Those who received adjuvant chemotherapy and those who did not were similar in terms of clinical, surgical and pathological factors, except for peritoneal cytology. In the univariate analysis, none of the clinical, surgical or pathological factors were significant for DFS. Adjuvant chemotherapy and type of treatment protocol had no impact on DFS. Conclusion Adjuvant chemotherapy was not associated with improved DFS and overall survival in stage IC AGCT. Multicentric and randomized controlled studies are needed for early stage AGCT in order to confirm these results and reach accurate conclusions.
AbstractBackground: The aim of the present study was to compare colposcopic biopsy results of women in Turkey with normal cervical cytology and Atypical Squamous Cells of Undetermined Significance(ASCUS) who had human papilloma virüs(HPV) genotypes 16,18,and combined 16/18.The overarching goal was to enhance the existing body of evidence on cervical cancer screening strategies, with an ultimate aim of refining HPV testing guidelines and improving patient management. Methods:In this retrospective study, we examined the medical records of 1121 patients from a tertiary health care setting who tested positive for HPV 16,HPV 18, or both, and who exhibited ASCUS or normal Pap smear findings. A detailed review of the patients' colposcopic biopsy outcomes was conducted, with particular attention to their HPV genotype status and the impact of smoking. Results: Study involved 1121 patients , the participants were classified based on HPV genotype into three groups: HPV 16 (78.5%), HPV 18 (15.8%),and co-infection with HPV 16 & 18 (5.7%). On the basis of smear characteristics, patients were categorized as normal (81.4%) and ASCUS (18.2%). Notably, for those with normal smear results, the rate of CIN-1 biopsy was approximately 15% higher in the HPV-18 group than the HPV-16 group (59.6% vs. 45.8%; p=0.023).Smoking prevalence was significantly higher in the co-infected HPV 16/18 group (p=0.013). Conclusion:This study underscores the importance of vigilant HPV and cytology testing, especially for individuals with HPV 16/18, regardless of normal cytology findings.