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  • Relato de Caso

    A borderline ovarian tumor in inguinal canal: case report

    Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(6):293-297

    Summary

    Relato de Caso

    A borderline ovarian tumor in inguinal canal: case report

    Revista Brasileira de Ginecologia e Obstetrícia. 2010;32(6):293-297

    DOI 10.1590/S0100-72032010000600007

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    The symptoms of ovarian tumor are not specific and a rare presentation of the tumor is as the content of an inguinal hernia. We reported a case of an 82-year-old woman, diagnosed with breast cancer and with a concomitant hypoecoic adnexal mass at the ecographic exam. The patient was treated with conservative breast surgery and laparotomy. A cystic-solid ovarian lesion was found inside the right inguinal canal. Frozen-section examination was negative for malignancy, and the anatomopathological analysis revealed a borderline ovarian tumor.

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    A borderline ovarian tumor in inguinal canal: case report
  • Artigos Originais

    High-grade intraepithelial cervical lesions: evaluation of the factors determining an unfavorable outcome after conization

    Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(11):334-340

    Summary

    Artigos Originais

    High-grade intraepithelial cervical lesions: evaluation of the factors determining an unfavorable outcome after conization

    Revista Brasileira de Ginecologia e Obstetrícia. 2011;33(11):334-340

    DOI 10.1590/S0100-72032011001100003

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    PURPOSE: To evaluate the ability of various factors related to the conization process in cytological/histological cervical intraepithelial neoplasias (CIN), after therapeutic conization. METHODS: A retrospective review was conducted of patients who had undergone conization due to CIN 2 and 3, from January 1999 to January 2006. They were divided into two groups: case group (residual disease or recurrence) and control group (without residual disease or recurrence), during 18 months of follow up. Univariate and multivariate analysis were used to define the predictive factors of disease recurrence. The c2 test or Fisher exact test was used for statistical analysis, with the level of significance set at p£0.05. RESULTS: Forty-eight patients showed recurrence/progression of CIN (case group) and 65 showed no recurrence/progression of disease (control group). Age and parity were similar in the two groups, as determined by calculation of the mean and standard deviation. There was no difference in smoking habits or in the use of contraceptive methods. The recurrence rate was 14.6%. Only conization positive margins were predictors of recurrence/progression (p<0.001). The conization techinique, the surgeon, CIN grade, gland involvement, and size of the uterine volume removed were not related to the evolution of disease after surgery. CONCLUSION: The recurrence of CIN 2 and 3 was related to positive margins in the product of conization.

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    High-grade intraepithelial cervical lesions: evaluation of the factors determining an unfavorable outcome after conization
  • Original Article

    Cervical Intraepithelial Neoplasia: Analyzing the Disease Present Exclusively in the Endocervical Canal

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):385-390

    Summary

    Original Article

    Cervical Intraepithelial Neoplasia: Analyzing the Disease Present Exclusively in the Endocervical Canal

    Revista Brasileira de Ginecologia e Obstetrícia. 2022;44(4):385-390

    DOI 10.1055/s-0042-1743102

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    Abstract

    Objective

    To evaluate the role of cervical cytology (Pap smear) in the diagnosis of cervical intraepithelial neoplasia 2 or greater (CIN2+), presented exclusively in the endocervical canal, the clinical-epidemiological characteristics of this lesion, the necessary length of canal to be removed to treat, and the rate of invasive lesion hidden in the endocervical canal.

    Methods

    Cross-sectional study, by database analysis, of patients with abnormal cytology (high-grade squamous intraepithelial lesion [HSIL]), without visible colposcopy lesion, submitted to loop electrosurgical procedure (LEEP) to evaluate the association of cytology results with the histological product of the conization, to identify the epidemiological characteristics of endocervical lesion and clinical evolution, using a pvalue< 0.05 and 95% CI.

    Results

    In 444 cases, the Pap smear sensitivity for CIN2+ diagnosis was 75% (95% CI: 69.8-79.7), specificity was 40% (95% CI: 30.2-49.5), and the prevalence rate of histological lesion was 73% (95% CI: 70.1-78.7). There was a higher prevalence of CIN2+ in women over 42 years old and invasive cancer in those over 56 years old (p<0.001), and it was necessary to remove 2.6 cm in length of the canal to reduce the chance of recurrence (p<0.006). The rate of invasive cancer was 2.7%.

    Conclusion

    Cytology was related to a high prevalence to histological lesion (73%) in the diagnosis of CIN2+ in the endocervical disease; older patients presented a higher relationship with histological lesions in the canal disease, and it was necessary to remove an average of 2.6 cm in length of the endocervical canal to avoid the persistence and progression of CIN. The rate of occult neoplasia in the endocervical canal was 2.7%.

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  • Artigos Originais

    High-grade cervical intraepithelial neoplasia during pregnancy: experience in a service in southern Brazil

    Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(12):604-608

    Summary

    Artigos Originais

    High-grade cervical intraepithelial neoplasia during pregnancy: experience in a service in southern Brazil

    Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(12):604-608

    DOI 10.1590/S0100-72032009001200005

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    PURPOSE: to evaluate the results of treatment to which patients with high grade intraepithelial cervical neoplasia (HSIL) are submitted, as well as their follow-up during pregnancy. METHODS: retrospective study based on the review of the medical report of 30 patients with diagnosis of high-grade squamous intraepithelial lesions (HSIL) during pregnancy and attended to at a tertiary hospital in southern Brazil from 1990 to 2002. Diagnosis was performed by colposcopy and biopsy, with repetition of the colposcopy during the pregnancy and after delivery. The diagnoses of regression and progression of lesions were evaluated. RESULTS: from 30 patients, 3 were excluded of the sample because the diagnosis of high-grade squamous intraepithelial lesions (HSIL) was not confirmed by the colposcopy with biopsia. Four patients were submitted to treatment during pregnancy, and one of them presented preterm delivery at the 32nd week. Twenty-three patients were submitted to expectant treatment, underwent a new colposcopy and biopsy, and then were submitted to conisation surgery at about the 11th week after the end of pregnancy. In 7.4% of the cases, there was lesion regression in the surgical specimen. CONCLUSIONS: all patients with diagnosis should be submitted to colposcopy and biopsy to exclude the possibility of invasive lesion. The expectant procedure for intraepithelial lesions is the most widely chosen and safe due to the possibility of regression in the postpartum period.

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