The Importance of Uterine Tumors in the Day-to-Day Practice of the General Surgery Department of Ignace Deen National Hospital

Introduction: Uterine tumors are all abnormal cell proliferations developed at the expense of one or more tissue types, which may be located in any uterine segment and have anatomopathological characteristics of benignity or malignancy. The aim of this study was to report on the management of uterine tumors in the general surgery department of Ignace Deen Hospital in Conakry. Methodology: This was a retrospective study lasting five (5) years, from January 1, 2011 to December 31, 2015: All complete records of patients with the diagnosis of a uterine tumor managed in the department were included. Our results are presented in tables and figures. Results: 3200 patients underwent surgery. Among them, 82 cases concerned uterine tumors, i.e. 2% of the department’s overall activity. The average age of our patients was 38.5 years, with extremes of 18 and 59 years. The age group most affected was 41 - 50, with a rate of 39.02%. Housewives and married civil servants were the socio-professional strata most affected, with a predominance of married women. We estimated an increasing proportion of patients admitted to the department during the study period, proving that our study site plays a significant role in the management of uterine tumors. Conclusion: The management of uterine tumors is a major public health problem. Information, communication and education of all socio-professional groups seem necessary.

Uterine tumor resembling an ovarian sex cord tumor:A case report and review of literature

BACKGROUND Endometrial stromal tumors originate from the endometrial stroma and account for<2%of all uterine tumors.Uterine tumor resembling an ovarian sex cord tumor(UTROSCT)is a rare histological class of endometrial stromal and related tumors according to the latest World Health Organization classification of female genital tumors.Here,we report a case of UTROSCT in a 51-year-old woman.CASE SUMMARY A 51-year-old woman had irregular menses for 6 mo.The patient visited a local hospital for vaginal bleeding.Pelvic computed tomography(CT)showed a mass in the pelvic cavity.Five days later,she came to our hospital for further diagnosis.The results of contrast-enhanced CT and pelvic ultrasound at our hospital suggested a malignant pelvic tumor.She then underwent total removal of the uterus with bilateral salpingectomy.Postoperative histological examination showed that the tumor cells had abundant cytoplasm,ovoid and spindle-shaped nuclei,fine chromatin,a high nucleoplasm ratio,and a lamellar distribution.The findings were consistent with UTROSCT,and the results of immunohistochemical analysis supported that diagnosis.The tumor was International Federation of Gynecology and Obstetrics stage IB.No adjuvant therapy was administered after radical surgery.The patient was followed up for 58 mo,and no recurrence was found.CONCLUSION We report a case of UTROSCT with abnormal menstruation as a symptom,which is one of the most common symptoms.In patients with vaginal bleeding,ultrasonography can be used as a screening test because of its convenience,speed,and lack of radiation exposure.For patients with long-term tamoxifen use,routine monitoring of the endometrium is recommended.As UTROSCT may have low malignant potential,surgery remains the primary management strategy.Additionally,fertility preservation in patients of childbearing age is a vital consideration.

Detecting benign uterine tumors by autofuorescence lifetime imaging microscopy through adjacent healthy cervical tissues

The endogenous fluorophores such as reduced nicotinarmide adenine dinucleotide(phosphate)(NAD(P)H)and favin adenine dinucleotide(FAD)in cells and tissues can be imaged by fuo-rescence lifetime imaging microscopy(FLIM)to show the tisute morphology features,as well as the biomolecular changes in microenvironment.The two important coenzymes in cellular metabolism,NAD(P)H and FAD,can be used to monitor the cellular metabolic status.This work proposed a novel method to study the uterine metabolism at the adjacent site of healthy cervix.It was found that the benign uterine tumors such as leiomyomas and adenomyosis with abnormal cell growth can be detected by measuring the fluorescence lifetime of NAD(P)H and FAD in adjacent healthy cervical tisues.This method opened a novel strategy for alicted women to undergo the cervical biopsies instead of hysterectomies for detecting tumors,which can preserve the fertility of patients.The FLIM studying on NAD(P)H and FAD indicated the correlation between metabolism and some diseases,including diabetes,hyperthyroidism and obesity.It was also suggested that the metabolic level might be quite different for a patient with a malignant tumnor history.

Uterine epithelioid trophoblastic tumor with the main manifestation of increased human chorionic gonadotropin:A case report

BACKGROUND Epithelioid trophoblastic tumor(ETT)is an extremely rare malignant gestational trophoblastic neoplasm commonly presenting with abnormal vaginal bleeding,abdominal pain,and increased human chorionic gonadotropin(hCG).This study reported a case of uterine ETT with the main manifestation being increased hCG.CASE SUMMARY A 39-year-old female was referred to the Ningbo Maternal and Child Hospital of China in December 2022,complaining of increased hCG levels for 1 month.Magnetic resonance imaging revealed gestational trophoblastic tumor,and hysteroscopic electrotomy and curettage of intrauterine hyperplasia were performed.The patient was diagnosed with uterine ETT through postoperative pathological examination and immunohistochemical results.Total laparoscopic hysterectomy and bilateral salpingectomy were performed,and hCG levels returned to normal.The patient was without recurrence during the postoperative 3-month follow-up.CONCLUSION This study reported a case of uterine ETT with the main manifestation being increased hCG,highlighting that ETT should be considered in the presence of abnormal hCG.A total laparoscopic hysterectomy is recommended.

Clinicopathological analysis of mullerian adenosarcoma of the uterus

Uterine mullerian adenosareoma is a very rate tumor clinically. Shi et al 1 has reported 9 uterine adenosarcomas among 116 uterine sarcomas during 11 years in West China Second Hospital.It consists of benign or atypical neoplastic glands within a sarcomatous stroma and represents only 8% of uterine sarcomas.