Cervical cancer in women under 25 years of age in Queensland, Australia: To what extent is the diagnosis made by screening cytology?

Introduction: The current Australian National Cervical Screening Program (NCSP) involves biennial, cytology-based screening of women from the age of 18 years. From December, 2017 this will change to a five-yearly human papilloma virus-based screening commencing at age 25. There is some concern that the new program may delay the opportunistic detection of cervical cancers in women under 25 years.

Comparison of proliferation indices in primary adult-type granulosa cell tumors of the ovary and their corresponding metastases: an analysis of 14 cases.

Adult-type granulosa cell tumors (GCTs) of the ovary are generally low-grade malignancies, but late metastases are relatively common. Limited data suggest that recurrent GCTs may exhibit altered morphology and/or biologic behavior, but few studies have directly compared primary and recurrent tumors in individual patients. Fourteen GCTs in which histologic material was available from both the primary tumor and one or more metastases were reviewed, and the mitotic index (MI) and Ki-67 labelling index (KI) were evaluated using carefully specified methodology.

Intraoperative assessment of clear cell carcinoma of the ovary.

Frozen section is a reliable technique in gynecologic pathology and is widely used to guide intraoperative management in patients presenting with ovarian masses. However, there are limited data regarding the diagnostic accuracy of frozen section in specific subtypes of ovarian neoplasia. Our impression that primary clear cell carcinoma (CCC) causes disproportionate diagnostic difficulty led us to review the intraoperative and final histopathologic reports from a consecutive series of 44 CCC that were subject to frozen-section assessment and to compare the results with a similar number of primary serous and endometrioid carcinomas.

Ovarian mucinous tumour arising in mature cystic teratoma and associated with pseudomyxoma peritonei: report of two cases and comparison with ovarian involvement by low-grade appendiceal mucinous tumour.

Aims: It is currently accepted that primary ovarian tumours rarely, if ever, give rise to mucinous ascites/pseudomyxoma peritonei (PMP) which most commonly results from the intra-abdominal spread of an appendiceal mucinous neoplasm. However, primary ovarian mucinous tumours of appendiceal type arising within mature cystic teratomas appear to represent an exception to this rule. In this report two further examples of this rare tumour are described, and the immunohistological phenotype including expression of MUC proteins is compared with secondary ovarian involvement by low-grade appendiceal mucinous neoplasm.

Intraoperative assessment of ovarian tumors: a 5-year review with assessment of discrepant diagnostic cases.

Frozen section is often requested in the intraoperative assessment of patients, presenting with ovarian masses, to provide guidance for appropriate surgical management. To assess the accuracy of frozen section and identify causes of diagnostic error, we reviewed 914 consecutive ovarian frozen sections performed over a 5-year period in 2 laboratories; one of which provides a general surgical pathology service and, the other, a specialist gynecologic pathology service. Cases, in which there were significant diagnostic discrepancies between the intraoperative and the final histological diagnoses, were reviewed.

Accuracy of frozen section in distinguishing primary ovarian neoplasia from tumors metastatic to the ovary.

Frozen section is widely used in the intra-operative assessment of patients with ovarian tumors. The diagnosis of malignancy is usually straightforward but in some cases it may be difficult to distinguish whether tumors are of ovarian origin or represent matastases from other sites. Recently, Seidman and colleagues presented a simple algorithm based on tumor size and unilateral versus bilateral involvement to aid in intra-operative assessment of ovarian mucinous neoplasms.

The control of severe intraoperative bleeding using an overlay autogenous tissue (OAT) patch: case reports.

Background: Severe intraoperative bleeding cannot always be controlled by standard surgical techniques. We recently reported a new technique to repair serious vascular injury using a free graft of omentum or rectus abdominus fascia as an overlay autogenous tissue (OAT) patch in the experimental sheep model. We now describe the successful clinical use of this patch in three patients.

The overlay autogenous tissue (OAT) patch to control major intraoperative vascular injury in an ovine model.

Objective: Iatrogenic surgical injury to large blood vessels in the abdomen or pelvis is a rare adverse event but may be lethal. We present a new technique to repair serious vascular injury using a free graft of omentum or fascia as an overlay autogenous tissue (OAT) patch.

Methods: Repair to venous and arterial defects was made using an OAT patch of omentum or rectus abdominis sheath sutured through the patch and the adventitia of the injured vessel at four sites.

The freshly killed pig: a model for surgical training in gynaecological oncology.

Background: Surgical training in gynaecological oncology is complex and alternatives to the 'apprenticeship' model are being explored. Animate and inanimate simulation may be useful, allowing trainees to gain experience without the risk of harm to patients. Live animal models and ex vivo isolated material is commonly used.

Total laparoscopic hysterectomy for endometrial cancer: patterns of recurrence and survival.

Objective: The impact of laparoscopic surgery on the patterns of recurrence and on prognosis in patients with endometrial cancer remains unclear. The objective of the current study was to evaluate the effect of the laparoscopic approach on patterns of recurrence, disease-free (DFS), and overall survival (OS) in patients with endometrial cancer.

Methods: A retrospective review of patients presenting with stages 1-4 endometrial cancer who had a hysterectomy, bilateral salpingo-oophorectomy with or without surgical staging was performed.