Transvaginal color Doppler imaging in the detection of ovarian cancer in a large study population.

Introduction: The aim of the study was to compare the diagnostic accuracy of grayscale sonography and that of color Doppler imaging in the diagnosis of ovarian malignancy in a prospective study by the Sardinia-Navarra group.

Methods: The study was performed as a collaborative work at the 2 European university departments of obstetrics and gynecology between 1997 and 2007. A total of 2148 pelvic masses in 1997 women on whom transvaginal sonography were performed before surgical exploration were included in the study.

Different injection sites of radionuclide for sentinel lymph node detection in breast cancer: single institution experience.

Objective: The sentinel node is defined as the first lymph node in a regional basin that receives lymph flow from the primary tumor. There is still a controversy over deep versus superficial injection administration in the breast.

Study Design: From June 2006 to June 2008, 133 patients with biopsy proven breast carcinoma and clinically negative axilla have been treated with conservative surgery and a study of their axillary sentinel lymph nodes (SLN) has been conducted.

[Treatment for endometriosis].

Endometriosis is defined as the presence of endometrial-like tissue outside the uterus, which induced a chronic inflammatory reaction. Endometriosis is associated with severe dysmenorrhea, deep dyspareunia, chronic pelvic pain, ovulation pain, cyclical, or perimenstrual symptoms, with or without abnormal bleeding, infertility, and chronic fatigue. Therapies can be useful to relieve and sometimes solve the symptoms, encourage fertility, eliminate endometrial lesions, and restore the anatomy of the pelvis.

[Basic research into endometriosis. Are we going in the right direction?].

Endometriosis is a common gynaecological syndrome of unknown aetiology. The most widely accepted hypothesis for the development of endometriosis is retrograde menstruation. However, some other factor renders certain women susceptible to the implantation and growth of ectopic endometrium.

[Diagnosis of endometriosis].

There are no sufficiently sensitive and specific signs and symptoms or diagnostic tests for the clinical diagnosis of endometriosis, and no diagnostic strategy is supported by evidence of effectiveness. Pelvic and rectal examinations should be performed, although the yield of the physical examination is low. Laboratory tests and radiological examinations are usually not warranted.

Ultrasound study of the myoendometrial border.

Abnormal thickening of the Endometrial Subendometrial Myometrium Unit (ESEMy Unit, including basal endometrium and inner myometrium) has been detected on imaging and referred to as "diffuse adenomyosis" in infertile patients with proven endometriosis. However, no robust relationship exists between enlargement of the ESEMy Unit and adenomyosis proven on hysterectomy specimen examination; moreover, if any correlation exists, it lacks histological validation in women wishing to preserve fertility. While adenomyosis effects on fertility, if any, remain elusive, thickening of the ESEMy Unit have been consistently linked to fertility impairment in both experimental and clinical models.

[Proposal for a new microsurgical model for the study of induced endometriosis in Wistar rats. Preliminary results].

The current knowledge status on the patogenesis of endometriosis as well as devastating consequences of disease evolution in women's reproductive health, have promoted researchers advances in a great manner during last years. The immunologic and neangiogenesis systems implication have opened new ways of knowledge over classic theories from the beginning of the xx century. The experimental resesearch, using animal induction models.

[Angiogenesis and endometriosis].

Endometriosis is a common gynaecological disease of unknown aetiology. Angiogenesis appears to be one of the processes involved in its pathogenesis. Angiogenic factors are increased in the peritoneal fluid of patients with endometriosis (McLaren 1996 et al; Taylor et al, 2002), in peritoneal implants (Ferriani et al, 1993) and in ovarian endometriomas.

[Endometriosis].

Endometriosis is a common gynaecological disease of unknown aetiology which affects an estimated 10% to 15% of all premenopausal women. It is defined as the presence of endometrial tissue, consisting of both glandular epithelium and stroma, outside the uterine cavity. Three different clinical entities of endometriosis can be distinguished: peritoneal endometriosis, ovarian endometriosis and deep invasive endometriosis.

The value of minilaparotomy for total hysterectomy for benign uterine disease: a comparative study with conventional Pfannenstiel and laparoscopic approaches.

Background: The aim of this paper is to review and compare the results obtained using the Pfannenstiel, laparoscopy and minilaparotomy approaches for total hysterectomy procedure in relation to benign uterine diseases.

Methods: A retrospective data analysis was performed on 165 patients who underwent hysterectomy for benign uterine diseases at our centre during the period 2004 to 2006.

Findings: The minilaparotomy procedure was the fastest procedure with a mean time of 73.

Triage for surgical management of ovarian tumors in asymptomatic women: assessment of an ultrasound-based scoring system.

Objectives: To prospectively evaluate an ultrasound-based scoring system as a method for triaging asymptomatic women presenting with an adnexal mass for surgical treatment.

Methods: Two hundred and four adnexal masses in 189 asymptomatic women undergoing elective surgical treatment at our institution were included in this prospective study. Patients were evaluated by transvaginal power Doppler ultrasound imaging before surgery.

[New developments in the surgical treatment of breast cancer].

Adecuate surgical treatment is mandatory in order to achieve cure in patients with breast cancer. Breast surgeons have to choice the best surgical technique over the breast and over the axillary nodes. Two new surgical aproaches have been implemented in the last decade: oncoplastic conservative surgery and sentinel lymph node biopsy.

[Breast cancer during pregnancy].

As women in western countries delay childbearing, it has been hypothesized that the incidence of breast cancer diagnosed during pregnancy will increase. Breast carcinoma during pregnancy(BCP) put the health of the mother in conflict with that of the fetus. The aim is to give optimal treatment to the mother to maximise the chances of survival, whilst minimising the risk of harm of the fetus.

[New horizons in breast surgery. Radioguided surgery and selective sentinel node biopsy].

Although needle-wire localization is the most commonly used localization technique for nonpalpable breast lesion biopsy, the technique of radioguided occult lesion localization (ROLL), is becoming increasingly used for open-surgery diagnosis in such cases. Sentinel lymph node biopsy(SLNB) is based on the hypothesis that lymphatic drainage from a tumor reaches the sentinel node(SLN) first and that it can be identified accurately and removed. If SLN exactly reflects the lymph-node status, a negative SLN for metastasis might allow complete axillary lymph node dissection (ALDN) to be avoided.

Pregnancy associated breast cancer.

Background: Breast carcinoma during pregnancy put the health of the mother in conflict with that of the foetus. The aim is to give optimal treatment to the mother to maximise the chances of survival, whilst minimising the risk of harm of the foetus. We report the epidemiology, pathology, clinical picture, therapeutic management and foetal outcome of pregnant women with breast cancer treated in our institution.

Relationship between microvascular density and expression of vascular endothelial growth factor in patients with ovarian endometriosis.

Objective: The aim of this investigation was to assess whether a correlation exists among microvascular density (MVD), expression of endothelial growth factor, and pelvic pain in patients with ovarian endometriosis.

Methods: Sixty-five patients (mean age 33.3 years, range 20-49 years) were diagnosed as having suspected cystic ovarian endometriosis and were scheduled for surgery.

Postpartum ovarian vein thrombosis after cesarean delivery: a case report.

Introduction: Postpartum ovarian vein thrombosis is an uncommon complication; incidence varies between 0.002% and 0.05%.

Three-dimensional sonographic morphologic assessment of adnexal masses: a reproducibility study.

Objective: The purpose of this study was to assess the reproducibility of 3-dimensional (3D) sonography for classifying adnexal masses.

Methods: Eighty-two consecutive women with the diagnosis of an adnexal mass on 2-dimensional transvaginal sonography were reevaluated by 3D sonography, and 3D volume data from each mass were stored. Two different examiners (6 years and 1 year of experience in 3D sonography, respectively) reviewed 3D sonograms 1 month after the last patient was recruited and then 1 week later again.

Ovarian endometrioma vascularization in women with pelvic pain.

Objective: To assess whether a correlation exists between angiogenesis in ovarian endometrioma with the presence of pelvic pain.

Design: Prospective study.

Setting: Tertiary-care university hospital.

Vascular endothelial growth factor (VEGF) and ovarian endometriosis: correlation between VEGF serum levels, VEGF cellular expression, and pelvic pain.

Vascular endothelial growth factor (VEGF) serum levels and VEGF and cellular expression were prospectively analyzed in 60 patients (group A consisted of asymptomatic patients or patients presenting mild dysmenorrhea; 30 women comprised group B severe dysmenorrhea and/or chronic pelvic pain and/or dyspareunia) who underwent surgery for cystic ovarian endometriosis to asses whether a correlation exists among VEGF serum levels, VEGF cellular expression, and pelvic pain. No differences were found in VEGF serum levels and VEGF cellular expression between both groups. Therefore, we conclude that pain symptoms in ovarian endometriosis are not correlated with VEGF serum levels and VEGF cellular expression.

Docetaxel administered during pregnancy for inflammatory breast carcinoma.

We report the case of a 35-year-old pregnant woman with inflammatory breast carcinoma initially treated with 5-fluorouracil/doxorubicin/cyclophosphamide beginning her 13th week of pregnancy. There was no noticeable shrinkage of the axillary or breast tumors after 4 cycles, at which point the patient accepted a treatment change to docetaxel. Four cycles of docetaxel at 100 mg/m2 every 21 days were delivered from the 25th week of pregnancy with good tolerance.

Three-dimensional power Doppler vascular sampling: a new method for predicting ovarian cancer in vascularized complex adnexal masses.

Objective: The purpose of this study was to explore the role of a new concept ("vascular sampling") as a third step to discriminate benign and malignant lesions in B-mode and color Doppler sonographically suggestive adnexal masses.

Methods: Forty-five women (mean age, 52.3 years; range, 17-82 years) with the diagnosis of complex adnexal masses on B-mode sonography were evaluated using 3-dimensional power Doppler sonography.