Although it is known that breast cancer can metastasize to many organ sites, metastasis to the uterus is uncommon and usually occurs during widespread metastatic disease. Lobular carcinoma is not the most common histological subtypes of breast carcinoma, but it is the most frequent histologic type that causes gastrointestinal, gynecological and peritoneal metastases. The main symptoms of the uterine metastasis depend on the anatomic involvement site. Abnormal uterine bleeding is by far the most important symptom.We highlight the importance of the follow up of patient with breast cancer. A rapid endometrial sampling for confirmation of the diagnosis, should be performed when the routine gynecological follow-up revealed any abnormality. We report two original observations of endometrium metastases of invasive lobular carcinoma of the breast which we detected during follow-up.
En dépit des progrès obstétricaux et pédiatriques, les grossesses gémellaires représentent une situation à haut risque aussi bien pour le déroulement de la grossesse que pour l´accouchement et reste encore une situation angoissante pour l´équipe obstétricale. Le but de cette étude était de décrire la pratique des accouchements des grossesses gémellaires au service de gynécologie obstétrique de Sousse, de décrire le pronostic maternel et fœtal et d´analyser les facteurs pouvant l´influencer. Nous avons réalisé une étude descriptive, rétrospective portant sur les accouchements des grossesses gémellaires sur une période de deux ans. Ont été incluses dans l´étude les grossesses gémellaires ayant atteint au moins 28 semaines d´aménorrhée (SA) et les femmes ayants une grossesse gémellaire compliquée d'une mort fœtale in utéro. Ont été exclues les femmes ayant une grossesse gémellaire et ayant accouchés avant 28 SA. Les grossesses bi-choriales bi-amniotiques représentaient 67% des cas, contre seulement 11,5% de grossesses mono-choriales bi-amniotiques et 3% de grossesses mono-choriale mono-amniotique. Nous avons recensé 52 césariennes programmées. Le travail a été spontané dans 304 cas. Il a été déclenché dans 43 cas. Au total 178 parturientes ont accouché par voie basse (44,6%), contre 215 par voie haute (53,9%). Le taux de césarienne pour le deuxième jumeau était de 1,5%. Quand l'accouchement était par voie basse, 19 cas de complications ont été observés (10,7%). Nous avons analysé le score d'Apgar du premier jumeau et du deuxième jumeau en fonction du mode d'accouchement. Il n'y a pas eu de différence statistiquement significative du score d'Apgar entre les deux voies d'accouchement. La morbi-mortalité périnatale est plus importante pour le deuxième jumeau que pour le premier jumeau. La morbidité maternelle en cas d´accouchement par voie basse était supérieur à la morbidité en cas d´accouchement par césarienne. Il n´y a pas de différences significatives dans le score d´Apgar selon que les enfants sont nés par voie basse ou par césarienne.
Backgrounds and aims Breast cancer is a major public health problem. In Tunisia, breast cancer is the first leading cause of cancer-related deaths. Different organizations and professionals advise women to learn how to perform breast self-examination (BSE) so that they can detect the slightest change as soon as it intervenes. Objective This study aims to determine the prevalence of women performing breast self-examination and to evaluate their practices. Materials and Methods A cross-sectional descriptive study was performed about women's knowledge, attitude and practice of breast cancer screening and breast self-examination. The study was conducted in the Reproductive Health Center of Sousse spread over a period of 2 months (February, March 2018). Self administered questionnaires were distributed to women. Results The mean age of the participants was 34 years with extremes ranging from 18 to 64 years. 47% of women surveyed have already performed breast self examination at least once during the last year. 14% of participants practiced breast cancer screening less than once a year. The first source of learning for breast cancer screening was health professionals in 27% of cases. The score of the practice of women surveyed was average; mostly, women have intermediate results for the technique of self-examination breast. No woman had a score of 15/15. Conclusions A better education of the practice of self-examination is essential in order to improve the screening program for breast cancer. The role of the gynecologist, general practitioner or midwife is therefore essential in education and training. Key messages A better education of the practice of self-examination is essential in order to improve the screening program for breast cancer. The role of the gynecologist, general practitioner or midwife is therefore essential in education and training.
Introduction. Sister Mary Joseph’s nodule (SMJN) is a rare illness characterized by an umbilical mass caused by tumor metastases in the abdomen or pelvis. The most common main site of SMJN in women is ovarian cancer. Case Presentation. A 73-year-old woman with no pathological history came to our emergency room with a one-month history of umbilicus enlargement. A 9-centimeter uncomfortable umbilical swelling with hard consistency was discovered during a clinical examination. An ovarian tumor with several local expansions was seen on an abdominal CT scan. It was linked to peritoneal metastases, one of which extends via a supraumbilical hernial orifice and into intestinal tissues in the same hernia sac. The umbilical tumor was removed from the patient. A moderately differentiated serous carcinoma with ovarian origin was identified in a periumbilical site on histological testing. Conclusion. The presence of an SMJN is a rare but significant issue that clinicians must examine because it is associated with a bad prognosis. Early detection and diagnosis of the original lesion can lead to more effective treatment and a higher rate of survival.
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