Brain Archives - Revista Brasileira de Ginecologia e Obstetrícia
, Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(4):264-267
, Most endometrial cancers (75%) are diagnosed in early stages (stages I and II), in which abnormal uterine bleeding is the most frequent clinical sign.When the diagnosis is performed in stage IV, the most common sites of metastasis are the lungs, liver and bones. Central nervous system (CNS)metastasis is a rare condition. The aim of this study is to describe a case of uterine papillary serous adenocarcinoma of the endometrium that progressed to brain and bone metastases.
We present the case of a 56-year-old woman with abnormal uterine bleeding and endometrial thickened echo (1.8 cm). A hysteroscopy with biopsy was performed, which identified poor differentiated serous adenocarcinoma of the endometrium. A total abdominal hysterectomy, with pelvic and para-aortic lymphadenectomy, was performed. Analysis of the surgical specimen revealed a grade III uterine papillary serous adenocarcinoma. Adjuvant radio/chemotherapy (carboplatin and paclitaxel-six cycles) was indicated. Sixteen months after the surgery, the patient began to complain of headaches. Brain magnetic resonance imaging demonstrated an expansile mass in the right parietal lobe, suggesting a secondary hematogenous implant subsequently confirmed by biopsy. She underwent surgery for treatment of brain metastasis, followed by radiotherapy. She died 12 months after the brain metastasis diagnosis due to disease progression.
Uterine papillary serous adenocarcinoma of the endometrium has a low propensity to metastasize to the brain. To the best of our knowledge, this is the fifth documented case of uterine papillary serous adenocarcinoma of the endometrium with metastasis to the CNS.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2019;41(4):264-267
, Most endometrial cancers (75%) are diagnosed in early stages (stages I and II), in which abnormal uterine bleeding is the most frequent clinical sign.When the diagnosis is performed in stage IV, the most common sites of metastasis are the lungs, liver and bones. Central nervous system (CNS)metastasis is a rare condition. The aim of this study is to describe a case of uterine papillary serous adenocarcinoma of the endometrium that progressed to brain and bone metastases.
We present the case of a 56-year-old woman with abnormal uterine bleeding and endometrial thickened echo (1.8 cm). A hysteroscopy with biopsy was performed, which identified poor differentiated serous adenocarcinoma of the endometrium. A total abdominal hysterectomy, with pelvic and para-aortic lymphadenectomy, was performed. Analysis of the surgical specimen revealed a grade III uterine papillary serous adenocarcinoma. Adjuvant radio/chemotherapy (carboplatin and paclitaxel-six cycles) was indicated. Sixteen months after the surgery, the patient began to complain of headaches. Brain magnetic resonance imaging demonstrated an expansile mass in the right parietal lobe, suggesting a secondary hematogenous implant subsequently confirmed by biopsy. She underwent surgery for treatment of brain metastasis, followed by radiotherapy. She died 12 months after the brain metastasis diagnosis due to disease progression.
Uterine papillary serous adenocarcinoma of the endometrium has a low propensity to metastasize to the brain. To the best of our knowledge, this is the fifth documented case of uterine papillary serous adenocarcinoma of the endometrium with metastasis to the CNS.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(3):111-117
DOI 10.1590/S0100-72032011000300002
PURPOSE: to assess the distance of the fetal cerebral fissures from the inner edge of the skull by three-dimensional ultrasonography (3DUS). METHODS: this cross-sectional study included 80 women with normal pregnancies between 21st and 34th weeks. The distances between the Sylvian, parieto-occiptal, hippocampus and calcarine fissures and the internal surface of the fetal skull were measured. For the evaluation of the distance of the first three fissures, an axial three-dimensional scan was obtained (at the level of the lateral ventricles). To obtain the calcarine fissure measurement, a coronal scan was used (at the level of the occipital lobes). First degree regressions were performed to assess the correlation between fissure measurements and gestational age, using the determination coefficient (R²) for adjustment. The 5th, 50th and 95th percentiles were calculated for each fissure measurement. Pearson's correlation coefficient (r) was used to assess the correlation between fissure measurements and the biparietal diameter (BPD) and head circumference (HC). RESULTS: all fissure measurements were linearly correlated with gestational age (Sylvian: R²=0.5; parieto-occiptal: R²= 0.7; hippocampus: R²= 0.3 and calcarine: R²= 0.3). Mean fissure measurement ranged from 7.0 to 14.0 mm, 15.9 to 28.7 mm, 15.4 to 25.4 mm and 15.7 to 24.8 mm for the Sylvian, parieto-occiptal, hippocampus and calcarine fissures, respectively. The Sylvian and parieto-occiptal fissure measurements had the highest correlations with the BPD (r=0.8 and 0.7, respectively) and HC (r=0.7 and 0.8, respectively). CONCLUSION: the distance from the fetal cerebral fissures to the inner edge of the skull measured by 3DUS was positively correlated with gestational age.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(3):111-117
DOI 10.1590/S0100-72032011000300002
PURPOSE: to assess the distance of the fetal cerebral fissures from the inner edge of the skull by three-dimensional ultrasonography (3DUS). METHODS: this cross-sectional study included 80 women with normal pregnancies between 21st and 34th weeks. The distances between the Sylvian, parieto-occiptal, hippocampus and calcarine fissures and the internal surface of the fetal skull were measured. For the evaluation of the distance of the first three fissures, an axial three-dimensional scan was obtained (at the level of the lateral ventricles). To obtain the calcarine fissure measurement, a coronal scan was used (at the level of the occipital lobes). First degree regressions were performed to assess the correlation between fissure measurements and gestational age, using the determination coefficient (R²) for adjustment. The 5th, 50th and 95th percentiles were calculated for each fissure measurement. Pearson's correlation coefficient (r) was used to assess the correlation between fissure measurements and the biparietal diameter (BPD) and head circumference (HC). RESULTS: all fissure measurements were linearly correlated with gestational age (Sylvian: R²=0.5; parieto-occiptal: R²= 0.7; hippocampus: R²= 0.3 and calcarine: R²= 0.3). Mean fissure measurement ranged from 7.0 to 14.0 mm, 15.9 to 28.7 mm, 15.4 to 25.4 mm and 15.7 to 24.8 mm for the Sylvian, parieto-occiptal, hippocampus and calcarine fissures, respectively. The Sylvian and parieto-occiptal fissure measurements had the highest correlations with the BPD (r=0.8 and 0.7, respectively) and HC (r=0.7 and 0.8, respectively). CONCLUSION: the distance from the fetal cerebral fissures to the inner edge of the skull measured by 3DUS was positively correlated with gestational age.
