Hiperplasia endotelial papilar intravascular (tumor Masson) de localización ginecológica

Intravascular papillary endothelial hyperplasia or Masson's tumour is a non-neoplastic vascular lesion of reactive character. It is a rare diagnosis, clinically non-specific and with diverse locations. It is essential to take it into consideration and make a differential diagnosis with malignant vascular tumours such as angiosarcoma. Pathological study is fundamental for diagnosis. Treatment consists of complete resection of the tumour, including sufficiently wide margins to avoid recurrence.The case reported is an exceptional event, because of the pelvic location of the Masson's tumour that was diagnosed as part of the surgical staging of an ovarian cancer.     

女性盆腔肿块的MRI诊断与鉴别诊断

目的:探讨MRI在女性盆腔肿块中的诊断与鉴别诊断价值。方法:回顾性分析139个(75例)经术后病理证实的盆腔肿块的MRI征象。结果:MRI检出病灶共129个(129/139,92.8%),其中子宫病变67个(67/69,97.1%),卵巢病变62个(62/70,88.6%),2个子宫肌瘤、5个卵巢冠囊肿、3个黄体囊肿漏诊(10/139,7.2%)。MRI检出的129个病灶中,128个病灶部位均符合手术所见,准确性为99.2%。子宫病变主要表现为实质性肿块影或子宫内膜增厚;卵巢病变表现为囊性、囊实性或实性肿块影。MRI诊断为良性病变108个,恶性病变21个;病理诊断为良性病变116个,恶性病变23个,MRI诊断出恶性病变的灵敏度为91.3%(21/23),阳性预测值为100%。结论:MRI判断盆腔病灶的起源具有很高的准确性,在判断良恶性肿瘤方面亦具有较高的准确性,但是区分恶性肿瘤的细胞类型难度较大。     

Developing research priorities for nurses working in the gynaecology setting in Western Australia

Background

Nurses working in clinical settings are instrumental to translating research into practice. The Delphi approach has been used by clinicians worldwide to set research agendas relevant to their clinical work.

妇科肥胖患者腹腔镜手术的临床研究

目的探讨妇科肥胖患者腹腔镜手术的安全性和临床应用价值。方法回顾性分析2010年7月~2013年7月在我院行腹腔镜手术的20例肥胖患者的临床资料,与同期行开腹手术的20例肥胖患者及行腹腔镜手术的20例非肥胖患者进行比较。结果肥胖腹腔镜组手术时间、出血量、排气时间、导尿时间,下床活动时间、住院时间均较肥胖开腹组明显缩短(<0.05)。而肥胖腹腔镜组与非肥胖腹腔镜组相比较,除住院时间稍延长外,其余均无显著性差异。结论腹腔镜手术对于妇科肥胖患者是安全有效的,较开腹手术对患者更有益,值得推广。     

Coexistent squamous cell carcinoma and adenocarcinoma of the uterine cervix

The clinical and pathological features of 20 patients with coexistent squamous cell carcinoma and adenocarcinoma of the uterine cervix have been analyzed. Various combinations of in situ and invasive carcinomas were found. Located adjacent to each other and at times intermingling, these lesions probably originated from the subcolumnar reserve cells of the transformation zone. They are early lesions and may be precursors of adenosquamous and mucoepidermoid carcinomas of the cervix. The diagnosis of these double carcinomas depends upon being aware that the two entities may coexist in the same cervix. Treatment is conventional, and the prognosis is not worsened by the presence of the two types of neoplasms.     

Carcinoma in situ of the vagina

A review was made of 136 cases of carcinoma in situ of the vagina seen over a 30-year period, 1953 to 1982. The patients ranged in age from 17 to 77 years, with a mean age of 55 years. One hundred sixteen patients (85%) presented with an abnormal Papanicolaou smear. Colposcopically directed biopsies were used for diagnosis in 62% of the patients. The upper one third of the vagina was the most common site of disease, with 54% of patients having unifocal lesions. A previous hysterectomy had been performed in 71% of patients, 35% of whom had undergone operation for benign disease. A concomitant, subsequent, or prior neoplasm of the lower genital tract or pelvis was noted in 109 patients. Surgical intervention in the form of either wide local excision or partial or total vaginectomy was the most frequently used method of treatment. Radiotherapy, usually in the form of a vaginal mold, was the second most commonly used method of treatment, and it was used in 27 patients. Radiotherapy and more extensive surgical treatment methods gave the best results. Four patients subsequently developed invasive carcinoma of the vagina.     

Steroid production and responsiveness to gonadotropin in isolated stromal tissue of human postmenopausal ovaries

Specimens from the ovarian cortical stroma of 15 postmenopausal women were examined histologically and were incubated for 4 hours in Krebs' bicarbonate buffer containing 5.5 mM glucose and 1% bovine serum albumin. Specimens of normal postmenopausal stroma produced measurable amounts of androstenedione, estradiol, and progesterone in vitro. Specimens with stromal hyperplasia produced larger amounts of androstenedione and estradiol than those with normal stroma. Androstenedione was the predominant steroid produced in both groups. The nonnegligible formation of estradiol indicated an aromatizing capacity of the stromal tissue. The addition of hCG elicited a significant increase in cyclic AMP formation in specimens from ovaries with stromal hyperplasia, indicating a preserved responsiveness to gonadotropin in this type of ovaries.     

Use of oral VP16-213 as primary chemotherapeutic agent in treatment of gestational trophoblastic disease

Thirty-seven patients with persistent or metastatic gestational trophoblastic disease were treated with oral etoposide (VP16-213). All responded well and achieved permanent remission. The hematologic toxicity was mild. Alopecia was present in all patients. Etoposide is an effective drug against trophoblastic disease. In patients who have received chemotherapy for long periods oral etoposide would eliminate the problem of venous access.