The IPI influences the MAP of the second pregnancy in women with prior preeclampsia. Shorter IPI is associated with a greater reduction in MAP when compared to the longer IPI. Although there was a trend toward higher preeclampsia recurrence with longer IPI, this trend did not reach statistical significance.
We read with interest the article by Hammad et al. 1 reviewing 14 studies describing specific radiologic findings for gallbladder adenomyomatosis (GBAM) in an attempt to distinguish it from gallbladder cancer (GBCa).We would like to commend the authors for publishing an excellent summary of the imaging characteristics of GBAM. The findings will be very helpful in diagnosing GBAM and avoiding overtreatment when unfounded concern for GBCa may exist. We do, however, want to raise a concern regarding significance and management of GBAM.Although the focus of the present study was on the diagnosis of GBAM, to distinguish it from GBCa, the inherent assumption that GBAM is always benign warrants highlighting, since this assumption is not supported by the literature. Although appropriate for the study design, the intentional exclusion of series with <5 patients excluded at least five reports suggesting that GBAM could have malignant potential to become GBCa. Four of these are individual case reports, 2-5 and one, 6 a study of 3197 cholecystectomy patients that found a significant increase (P < 0.025) in the prevalence of GBCa in gallbladders with segmental type of GBAM.There may be some cases of GBAM that warrant a more extensive evaluation or resection. Although there are insufficient data to easily and accurately identify these cases, we feel that highlighting their existence is nonetheless important, lest readers of this otherwise excellent paper assume that GBAM is always benign. Perhaps such knowledge might lead to surveillance imaging that could be life-saving to select higher-risk GBAM patients.
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