Hysteroscopic Endomyometrial Resection of Three Uterine Sarcomas

Vilos, George A.; Harding, Paul G.R.; Sugimoto, Akira; Ettler, Helen C.; Bernier, Mark

doi:10.1016/s1074-3804(05)60619-6

Cited by 30 publications

(8 citation statements)

References 24 publications

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“…Several studies have attempted to correlate various clinicopathological features with patient outcome . Patients with ESNs have an excellent prognosis and are cured by hysterectomy or, on occasion, by local excision with negative margins and close monitoring in younger patients who wish to preserve fertility . Although low‐grade ESSs are indolent malignant tumours that also have a favourable prognosis if they are Stage I (98 and 89% 5‐ and 10‐year survival, respectively), the 5‐year survival drops significantly to 38% and 50% for Stages III and IV tumours, respectively .…”

Section: Endometrial Stromal Tumoursmentioning

confidence: 99%

Recent developments in uterine mesenchymal neoplasms

Chiang

Oliva

2012

Histopathology

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Smooth muscle and endometrial stromal tumours represent the two most common uterine mesenchymal neoplasms that may present diagnostic dilemmas for the practising surgical pathologist. Recent changes in morphological and staging criteria, as well as the discovery of new immunohistochemical markers, have improved the diagnosis and classification of these tumours. We highlight the difficulty in distinguishing tumour cell necrosis from infarct-type necrosis and the limited utility of p16 immunohistochemical expression in the diagnosis of leiomyosarcoma. We also discuss the controversial use of mitotic activity and necrosis as prognostic factors in endometrial stromal sarcomas. Emerging genetic information has also greatly expanded our understanding of 'sarcomagenesis' in both tumour types and may provide insight into potential therapeutic targets for the treatment of leiomyosarcoma and endometrial stromal sarcomas, harboring MED12 (mediator complex subunit 12) mutations and recurrent gene rearrangements, respectively. In this review, we discuss the core updates in the diagnosis and classification of uterine leiomyosarcomas and endometrial stromal sarcomas, highlighting new and important molecular genetic findings that may drive pathogenesis.

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Section: Endometrial Stromal Tumoursmentioning

confidence: 99%

Recent developments in uterine mesenchymal neoplasms

Chiang

Oliva

2012

Histopathology

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“…No evidence of disease recurrence was noted [49]. Other similar case reports followed [50,51]. Whether this method is more effective than hormonal therapy only is unclear.…”

Section: Resection Of Endometrium As a Treatment For Endometrial Cancermentioning

confidence: 85%

The role of hysteroscopy in diagnosis and management of endometrial cancer

2010

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Endometrial sampling for histopathology examination is essential to diagnose endometrial cancer. There are many ways to obtain the specimen including endometrial biopsy or hysteroscopy. Hysteroscopy provides an accurate evaluation of the endometrial cavity and allows directed sampling of suspected lesion. However, there have been concerns that endometrial cells could be flushed into the fallopian tubes and the peritoneal cavity. We performed a literature search using the key words "endometrial cancer," "endometrial sampling," "dilation and curettage" (D&C), "hysteroscopy," and "cancer cells dissemination" and conducted the search in the Medline, EMBASE, and the Cochrane of Database of systematic reviews. Endometrial cell dissemination could occur after hysteroscopy as well as after endometrial biopsy and D&C. Hysteroscopic distension media and intrauterine pressure play a role in endometrial cell dissemination. Hysteroscopy is an additional tool in the diagnosis of endometrial cancer. However, its use in the initial workup is still controversial. In order to minimize the small risk of cancer dissemination, hysteroscopy should be performed with an intrauterine pressure of less than 80 mmHg, and the duration of the procedure should be as short as possible.

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“…For patients at high risk for hysterectomy, especially older patients, complete hysteroscopic endomyometrial resection is feasible and may be offered as diagnostic and palliative therapy (6). However, what about surgical options for young patients?…”

Section: Discussionmentioning

confidence: 99%