B-Lynch technique appears to be an effective procedure with a relatively low morbidity to control persistent severe PPH following a failure of vessel ligation before considering hysterectomy.

The concept of cancer as a cell-autonomous disease has been challenged by the wealth of knowledge gathered in the past decades on the importance of tumor microenvironment (TM) in cancer progression and metastasis. The significance of endothelial cells (ECs) in this scenario was initially attributed to their role in vasculogenesis and angiogenesis that is critical for tumor initiation and growth. Nevertheless, the identification of endothelial-derived angiocrine factors illustrated an alternative non-angiogenic function of ECs contributing to both physiological and pathological tissue development. Gene expression profiling studies have demonstrated distinctive expression patterns in tumorassociated endothelial cells that imply a bilateral crosstalk between tumor and its endothelium. Recently, some of the molecular determinants of this reciprocal interaction have been identified which are considered as potential targets for developing novel anti-angiocrine therapeutic strategies.

Aim: We report a case of a mixed clear cell and endometrioid carcinoma arising in parietal endometriosis. Methods: A 46-year-old woman presented a second recurrence of parietal endometriosis. An extensive surgical resection of the tumor was then carried out. Results: Histological analysis revealed heterogeneous tissues including clear cell and endometrioid carcinoma fields arising from a large benign endometriosis lesion. Despite chemotherapy, the patient died 6 months after the diagnosis. Conclusions: Clear cell carcinoma and endometrioid carcinoma have been rarely found in parietal endometriosis. Clinicians should learn to suspect a cancerous transformation of a parietal endometriosis, when rapid recurrence and extensive development are observed.

Background: Prosthetic reconstruction in previously irradiated breasts has been associated with a higher risk of complications. Here we describe the surgical and cosmetic outcome of our breast reconstruction process based on primary fat grafting combined with prosthetic placement. Methods: In this multicenter retrospective study, 136 patients who underwent mastectomy and external chest wall radiotherapy between 2014 and 2018 were benefited from chest wall lipofilling and silicone implant placement were chosen. Patients were assessed for skin trophicity, thickness, and mobility and were allowed to undergo several lipofilling sessions before implant placement, if required. No patient had >3 lipofilling sessions. Cosmetic outcome was evaluated by the patient, surgeon, and nurse, using a Likert-type ordinal scale. Results: We included 136 patients: 79 patients (58%) received only 1 session of lipofilling before implant placement, 33 (24.6%) had 2 sessions, and 24 (17.4%) had 3 sessions. The volume of the third lipofilling was significantly higher and the volume of the prosthesis of these patients was significantly lower than those of patients undergoing 1 or 2 lipofillings. Reconstruction failure rate was 2.2% (3 patients had explantation); however, all benefited from prosthesis reconstruction a year after the initial procedures. The average satisfaction score was 4.7 out of 5 as evaluated by patients, 4.8 out of 5 by surgeons, and 4.8 out of 5 by nurses. Conclusions: Primary lipofilling combined with prosthesis placement after radiotherapy is a reconstructive method that yields a satisfactory cosmetic outcome with a low complication rate. Such minimally invasive breast reconstruction approach can be an alternative to flap-based reconstruction.