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, 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. 2009;31(8):411-414
DOI 10.1590/S0100-72032009000800007
Benign metastazing leiomyomatosis (BML) is a rare disease in which the lung is the most affected extra-uterine organ. The BML histology is compatible with benignity and similar to that found in the myometrial leiomyoma. A history of surgically treated uterine myomatosis is reported by most of the patients with metastatic disease. We report the cases of two patients with uterine metastazing leiomyomatosis. In the first case, a 55-year-old patient presented lung nodes over 20 years after being submitted to hysterectomy due to uterine leiomyoma. The histological and immunohistochemical studies from the lung node revealed that it was an implant of benign leiomyoma. The second patient, a 65-years-old woman, presented lung and retroperitoneal nodes 20 years after being submitted to a hysterectomy due to uterine leiomyoma.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(8):411-414
DOI 10.1590/S0100-72032009000800007
Benign metastazing leiomyomatosis (BML) is a rare disease in which the lung is the most affected extra-uterine organ. The BML histology is compatible with benignity and similar to that found in the myometrial leiomyoma. A history of surgically treated uterine myomatosis is reported by most of the patients with metastatic disease. We report the cases of two patients with uterine metastazing leiomyomatosis. In the first case, a 55-year-old patient presented lung nodes over 20 years after being submitted to hysterectomy due to uterine leiomyoma. The histological and immunohistochemical studies from the lung node revealed that it was an implant of benign leiomyoma. The second patient, a 65-years-old woman, presented lung and retroperitoneal nodes 20 years after being submitted to a hysterectomy due to uterine leiomyoma.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(1):22-27
DOI 10.1590/S0100-72032009000100005
PURPOSE: to analyze complications, morbidity, mortality and survival rate in a group of patients with cervical cancer with central pelvic relapse after primary radiotherapy treatment. METHODS: retrospective study of a series of 16 cases of pelvic exenteration after primary radiotherapy treatment. Descriptive statistics, survival curve through Kaplan-Meier's method, and regression analysis to evaluate prognosis were performed. RESULTS: sixteen patients have undergone pelvic exenteration. Epidermoid carcinoma, IIb stage and undifferentiated grade were the most frequent conditions. Post-operatory tumor relapse occurred in half the cases. Eleven patients presented peri or post-surgical complications, the most frequent being pelvic infection, that of the surgical wound, and urinary fistulae. Global survival rate was 64.3%, with average follow-up of 11 months. Regression analysis did not detect any significant prognosis factor for the patient survival. CONCLUSIONS: the survival rate was 64.3%. No particular factor associated to poor prognosis has been found in the present series of cases.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(1):22-27
DOI 10.1590/S0100-72032009000100005
PURPOSE: to analyze complications, morbidity, mortality and survival rate in a group of patients with cervical cancer with central pelvic relapse after primary radiotherapy treatment. METHODS: retrospective study of a series of 16 cases of pelvic exenteration after primary radiotherapy treatment. Descriptive statistics, survival curve through Kaplan-Meier's method, and regression analysis to evaluate prognosis were performed. RESULTS: sixteen patients have undergone pelvic exenteration. Epidermoid carcinoma, IIb stage and undifferentiated grade were the most frequent conditions. Post-operatory tumor relapse occurred in half the cases. Eleven patients presented peri or post-surgical complications, the most frequent being pelvic infection, that of the surgical wound, and urinary fistulae. Global survival rate was 64.3%, with average follow-up of 11 months. Regression analysis did not detect any significant prognosis factor for the patient survival. CONCLUSIONS: the survival rate was 64.3%. No particular factor associated to poor prognosis has been found in the present series of cases.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(9):446-451
DOI 10.1590/S0100-72032007000900002
PURPOSE: to evaluate the clinical and epidemiological characteristics of patients with the diagnosis of phantom breast syndrome or with phantom phenomena lonely. METHODS: it was conducted an observational, descriptive and sectional study enrolling 98 patients treated for breast cancer at Hospital São Marcos, Teresina (PI), Brazil. A standardized questionnaire was applied. RESULTS: the phantom breast syndrome was observed in 11.2% of the patients and phantom sensation alone was observed in 30% of the patients. The mean age of the patients was 54 years. Fifty-nine patients were married (60%) and 79.5% were analphabetic or had not concluded the high school. Emotional alterations were present in 67.4%, even though in 66.7% the libido was not changed after surgical procedure. As a relief factor of phantom pain, resting was cited by 90.9% of the patients, while physical exercises were mentioned to exacerbate the symptoms in 63.6% of the cases. The mean grade attributed to the pain in a 0 to 10 scale was 3, ranging from 1 to 7. Only 3% of the patients knew about the existence of this syndrome before the interviews. CONCLUSIONS: phantom phenomena are frequent in mastectomized patients, being necessary more studies to know about its characteristics and effects in these women's quality of life.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(9):446-451
DOI 10.1590/S0100-72032007000900002
PURPOSE: to evaluate the clinical and epidemiological characteristics of patients with the diagnosis of phantom breast syndrome or with phantom phenomena lonely. METHODS: it was conducted an observational, descriptive and sectional study enrolling 98 patients treated for breast cancer at Hospital São Marcos, Teresina (PI), Brazil. A standardized questionnaire was applied. RESULTS: the phantom breast syndrome was observed in 11.2% of the patients and phantom sensation alone was observed in 30% of the patients. The mean age of the patients was 54 years. Fifty-nine patients were married (60%) and 79.5% were analphabetic or had not concluded the high school. Emotional alterations were present in 67.4%, even though in 66.7% the libido was not changed after surgical procedure. As a relief factor of phantom pain, resting was cited by 90.9% of the patients, while physical exercises were mentioned to exacerbate the symptoms in 63.6% of the cases. The mean grade attributed to the pain in a 0 to 10 scale was 3, ranging from 1 to 7. Only 3% of the patients knew about the existence of this syndrome before the interviews. CONCLUSIONS: phantom phenomena are frequent in mastectomized patients, being necessary more studies to know about its characteristics and effects in these women's quality of life.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(8):609-611
DOI 10.1590/S0100-72032003000800011
Carcinoma of the uterine cervix is a common neoplasm; however skin metastasis from carcinoma of the uterine cervix is a very rare occurrence, varying from 0.1% to 2%. The common primary sites in patients with skin metastasis are the breast, lung, large intestine and ovary. The interval between the diagnosis of cervical cancer and skin lesions ranges from 0 to 69 months, and they present as nodules in 86,7%. Skin metastasis represents a late manifestation of advanced disease with poor prognosis. We present a case of scalp metastasis from carcinoma of the uterine cervix . The patient was 43 years old, had a diagnosis of undifferentiated epidermoid carcinoma of the uterine cervix. Six months after radical surgery she presented with vaginal recurrence, being treated with pelvic radiotherapy. Four months later three painless metastatic nodules appeared at the scalp. The patient underwent chemotherapy with total regression of the scalp lesions.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(8):609-611
DOI 10.1590/S0100-72032003000800011
Carcinoma of the uterine cervix is a common neoplasm; however skin metastasis from carcinoma of the uterine cervix is a very rare occurrence, varying from 0.1% to 2%. The common primary sites in patients with skin metastasis are the breast, lung, large intestine and ovary. The interval between the diagnosis of cervical cancer and skin lesions ranges from 0 to 69 months, and they present as nodules in 86,7%. Skin metastasis represents a late manifestation of advanced disease with poor prognosis. We present a case of scalp metastasis from carcinoma of the uterine cervix . The patient was 43 years old, had a diagnosis of undifferentiated epidermoid carcinoma of the uterine cervix. Six months after radical surgery she presented with vaginal recurrence, being treated with pelvic radiotherapy. Four months later three painless metastatic nodules appeared at the scalp. The patient underwent chemotherapy with total regression of the scalp lesions.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(3):215-215
DOI 10.1590/S0100-72032003000300012
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2003;25(3):215-215
DOI 10.1590/S0100-72032003000300012
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(10):681-684
DOI 10.1590/S0100-72032002001000008
PURPOSE: to assess ovarian function in patients with cervical cancer following radical hysterectomy with ovarian preservation. METHODS: we retrospectively analyzed patients with cervical carcinoma, submitted to radical hysterectomy with ovarian preservation at the Gynecologic Clinic of the São Marcos Hospital-SPCC, from April 1998 to October 2001, with evaluation of symptoms of estrogenic deprivation (flushing, dry vagina) and the measurement of FSH levels after surgery. All data were analyzed using the Pearson test. RESULTS: FSH levels were measured in 42 patients; of these, 33 (78.5%) patients had normal FSH levels (below 30 mU/mL). The median level was 21.05 mU/mL (range 1.2-132.44 mU/mL). Five (55.6%) of the nine patients with high FSH levels had received postoperative radiotherapy (p<0.0001). There was no correlation between postoperative FSH levels and age over 40 years (p=0.33). Benign ovarian cysts occurred in four patients (7.7%). One patient presented recurrence of the lesion in the vaginal dome and metastasis to the scalp, and died. CONCLUSION: in 78.5% of the patients, ovarian function was preserved. Ovarian transposition was inadequate to preserve ovarian function in patients who underwent postoperative radiotherapy. There was no correlation between age and postoperative FSH levels.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2002;24(10):681-684
DOI 10.1590/S0100-72032002001000008
PURPOSE: to assess ovarian function in patients with cervical cancer following radical hysterectomy with ovarian preservation. METHODS: we retrospectively analyzed patients with cervical carcinoma, submitted to radical hysterectomy with ovarian preservation at the Gynecologic Clinic of the São Marcos Hospital-SPCC, from April 1998 to October 2001, with evaluation of symptoms of estrogenic deprivation (flushing, dry vagina) and the measurement of FSH levels after surgery. All data were analyzed using the Pearson test. RESULTS: FSH levels were measured in 42 patients; of these, 33 (78.5%) patients had normal FSH levels (below 30 mU/mL). The median level was 21.05 mU/mL (range 1.2-132.44 mU/mL). Five (55.6%) of the nine patients with high FSH levels had received postoperative radiotherapy (p<0.0001). There was no correlation between postoperative FSH levels and age over 40 years (p=0.33). Benign ovarian cysts occurred in four patients (7.7%). One patient presented recurrence of the lesion in the vaginal dome and metastasis to the scalp, and died. CONCLUSION: in 78.5% of the patients, ovarian function was preserved. Ovarian transposition was inadequate to preserve ovarian function in patients who underwent postoperative radiotherapy. There was no correlation between age and postoperative FSH levels.