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Endometriosis can be associated with adverse pregnancy outcomes. We report six cases of endometriosisrelated spontaneous hemoperitoneum diagnosed in pregnant and postpartum women over 13 years. Spontaneous hemoperitoneum in pregnancy mainly occurred in the second half of gestation. All women presented with acute abdominal pain; four of them needed an emergent surgery, two were managed expectantly. The median estimated blood loss was 4250 ml, four women required massive transfusion. Three out of six women had a known history of endometriosis, all of them had histologically confirmed endometriosis after surgery. No maternal or perinatal deaths occurred. In one case, reticence to perform a computed tomography scan led to delayed diagnosis. Since delay can lead to lethal consequences, high levels of suspicion for spontaneous hemoperitoneum should be maintained in cases of severe abdominal pain, even with a woman's negative history of endometriosis. Improved knowledge and regular interdisciplinary meetings are pivotal to ameliorate outcomes.

Our study, covering an 18-year period, shows a substantial low risk of occult cancer among a high-risk population of women undergoing RRSO. Our data still support the indication for RRSO in higher-risk patients. An endometrial biopsy should also be routinely obtained as it raises the chances of detecting occult endometrial cancers that may be otherwise missed.

Background: Squamous cell carcinoma of the vulva is a rare malignancy that affects elderly women. About one-third of vulvar cancers are diagnosed in an advanced stage, requiring extensive surgery. Neoadjuvant chemotherapy (NACT) has been introduced to reduce local tumor burden. In this retrospective study, we analyze the efficacy and toxicity of NACT followed by radical surgery. Methods: Patients with locally advanced vulvar cancer (LAVC) treated at our institution with neoadjuvant platinum and paclitaxel-based chemotherapy ± ifosfamide followed by surgery at our institution were retrospectively identified. Results: Fourteen patients (93%) completed NACT with tolerable toxicities (G3–G4 toxicity: 30%). Thirteen patients (87%) underwent surgery. The overall clinical response rate on vulvar disease was 66% (20% complete response, 46% partial response), confirmed by histopathologic analysis, while on inguinal lymph nodes it was 69% (23% complete response, 46% partial response). At the pathologic examination, all patients had negative surgical margins. Three out of 9 patients (33%) with lesions infiltrating the urethral meatus and 4 patients out of 7 (57%) with anal involvement did not require urethral amputation or colostomy, respectively, after NACT. No severe postoperative complications were described. Overall survival at 5 years was 60%, and median overall survival was 76 months. Conclusion: NACT followed by surgery in locally advanced vulvar cancer is well tolerated and allows surgical modulation.

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Methods During our research, we examined 100 sexually active women 25-35 years old (29,1±1.25) with precancer cervical lesions and chronic recurrent bacterial vaginosis who were separated in two groups according to cervical human papillomavirus (HPV) infection presence. We used liquid PAPP test, PCR, tissue biopsy histology, proliferation cells proteins lab tests. Results 50 women of group I with 100% HPV highly oncogenic types showed: PAP test -ASCUS -36 women (72%), LSIL -7(14%), HSIL -7(14%); HPV of 16-18 types -39 women (78%); the histology verified HSILin all 50 women (100%), of which CIN II -21(42%), CIN II-III -22(44%), CIN III -18 patients (36%); p16 protein was determined in specimens of 36 women (72%), Ki-67 protein -in 23 samples (46%). From group II of 50 women with HPV absence we revealed: NILM -in 10 women (20%), ASCUS -in 24(48%), LSIL -in 16 patients (32%); the histology showed parakeratosis, acanthosisin 34 patients (68%), LSIL (CINI)in 16 samples (32%). Conclusions Chronic recurrent bacterial vaginosis leads to the toxic nitrosamines release, which causes the epithelial cells neogenesis generation, leads to cellular immunity decrease and favorable conditions for the HPV more advanced stage of CIN II-III development. p16 and Ki-67 proteins determine the dysplasia genesis and disease prognosis. We consider that chronic recurrent bacterial vaginosis timely treatment is obligable in precancer cervix uterine diseases progression prevention.

Endometrial carcinoma is the most common gynecological cancer in Europe, with 130,000 new cases per year, and the incidence has been rising with aging and increased obesity of the population. Most women with endometrial cancer will present with early-stage disease, with a tumor confined to the uterus and without metastasis, and the first approach is surgery. Approximately 10% to 15% of these patients have a metastatic nodal disease, which is why guidelines have always emphasized the importance of lymphadenectomy to stratify the risk and tailor adjuvant treatment. However, comprehensive lymphadenectomy is related to significant morbidity and seems not to improve either progression-free or overall survival in these patients. Lymphatic mapping with sentinel lymph node biopsy has emerged as an alternative and an optimal compromise instead of systematic lymphadenectomy. This review presents the current evidence supporting sentinel lymph node biopsy in patients with endometrial cancer.

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