She is currently an obstetrician-gynaecologist in Montpellier and has specialized in reproductive medicine since 2015. She carried out 12-months of clinical research in reproductive medicine at the Royal Hospital for Women in Sydney in 2018 and worked on premature ovarian insufficiency and polycystic ovary syndrome.
We aimed to evaluate the correlation between the histological grade of endometrial cancer diagnosed on endometrial biopsy or curettage, with the definitive grade and stage of lesion as determined by surgery and histopathological examination and to make recommendations about the suitability of conservative surgery based on pre-operative determination of the grade of endometrial adenocarcinoma. A retrospective review of all patients with endometrial adenocarcinoma presenting to the Queensland Centre for Gynaecological Cancer from 1 January 1996 to 31 December 1998 was undertaken. Clinical and pathological data was abstracted from medical records and case notes of 460 patients. All histological specimens were prospectively reviewed by a panel consisting of gynaecologic pathologists, gynaecologic oncologists and other doctors involved in the treatment of patients with gynaecological malignancies. The percentage of patients whose management would have been optimised by full surgical staging at the time of initial surgery was calculated. Only 60%, 71%, and 84 % of the patients with a presenting diagnosis of grade 1, 2 and 3 endometrial adenocarcinomas respectively had this confirmed on final histopathology. Furthermore, using established criteria, 30%, 46% and 100% of patients presenting with grade 1, 2 and 3 endometrial adenocarcinoma required full surgical staging at the time of their primary surgery There is poor correlation between the pre-operative grade of endometrial cancer and the grade as determined on analysis of the resected uterus. The correlation is poorest with grade 1 endometrial adenocarcinoma, where strongest consideration is given to conservative surgery and the avoidance of subspecialty referral. There is a strong argument that all patients with a diagnosis of endometrial cancer made on endometrial biopsy or curettage, regardless of grade of malignancy, should be offered surgery where the option to perform concurrent comprehensive surgical staging is available.
This paper describes a case of spinal tuberculosis diagnosed at 29 weeks' gestation in a primigravid Indian woman. The report illustrates the primary problems in suspecting disease, recognizing the diverse clinical presentations and initiating investigations to confirm the diagnosis. In most cases, M. tuberculosis, once recognized and appropriately treated, should result in an excellent prognosis.
The benefits of non-invasive, correctly-directed instrumentation coupled with an ability to predict complete evacuation of the uterus can make intraoperative ultrasound an important addition in the continued and improved care of women with a perforated uterus and retained products of conception. Two such cases are reported.
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