Endocannabinoid system expression in ovarian epithelial tumors according to the dualistic model of ovarian carcinogenesis.

Objective: Our study aimed to confirm the expression of the endocannabinoid system in the human epithelial ovarian tumors, assessing the immunohistochemical expression of Cannabinoid Receptor Type 1 and Fatty Acid Amide Hydrolase in benign, borderline and malignant tumors.

Materials And Methods: Cannabinoid Receptor Type 1 and Fatty Acid Amide Hydrolase immunohistochemical expression was determined in 118 epithelial ovarian tumors sequentially treated during the last decade in our department: 36 benign, 34 borderline and 48 malignant neoplasms. Cannabinoid Receptor type 1 and Fatty Acid Amide Hydrolase expression resulted predominantly weak-moderate in the benign and borderline forms.

A partial molar pregnancy associated with a fetus with intrauterine growth restriction delivered at 31 weeks: a case report.

Introduction: Molar pregnancies belong to a group of diseases classified as gestational trophoblastic diseases, which result from an altered fertilization. Partial molar pregnancy with a live fetus is a very rare condition, occurring in 0.005 to 0.

Outcomes of monopolar versus bipolar endometrial ablation on uterine bleeding and psychophysical wellbeing.

Background: To compare outcomes of endometrial ablation with monopolar versus bipolar resection on uterine bleeding and psychophysical wellbeing.

Methods: In a prospective randomized study, 100 perimenopausal patients, without desire of pregnancy and with no response to pharmacological treatment, underwent endometrial ablation from 2012 to 2014. They were randomly divided in two groups: 50 patients treated with monopolar electrode resection loop (group A) and 50 patients treated with bipolar electrode resection loop (group B).

Resectoscope versus small diameter hysteroscopy for endometrial polypectomy in patients with "unfavorable" cervix.

Background: The aim of this study was to compare resectoscopic and small-diameter hysteroscopic techniques for endometrial polypectomy in patients with "unfavorable" cervix.

Methods: Eighty women with a single 2-4 cm sized endometrial polyp, with unfavorable cervical anatomical conditions were enrolled in the study. Forty patients were treated with a 26F resectoscope requiring cervical dilatation (group A), forty patients were treated with a 5-mm hysteroscope requiring vaginoscopic approach (group B).

Conservative Resectoscopic Surgery, Successful Delivery, and 60 Months of Follow-Up in a Patient with Endometrial Stromal Tumor with Sex-Cord-Like Differentiation.

Uterine tumors with sex-cord-like differentiation are extremely rare types of uterine stromal neoplasm. These tumors were classified into two groups with considerable practical relevance because clinical behaviour of uterine tumor resembling ovarian sex cord tumor (UTROSCT) differs widely from its closely related endometrial stromal tumors with sex-cord-like elements (ESTSCLE). Treatment and prognosis of these tumors are unresolved issues because of the exiguous number of reported cases.

Ovarian fibrosarcoma: case report and latest trends in diagnostic and therapeutic management.

The authors describe a rare case of primary ovarian fibrosarcoma and the latest trends in diagnosis and therapy. The rarity of this dis-ease and the scarce number of reported cases pose serious problems in differentiating it from other fibrous forms. A 58-year-old woman presented intermittent pelvic pain and a demarcated, mobile, and solid lump in the right adnexa.

Fertility-sparing management of low-grade endometrial stromal sarcoma: analysis of an institutional series and review of the literature.

Objective: Low-grade endometrial stromal sarcoma (LG-ESS) is a rare malignancy, often occurring before menopause. There is no consensus regarding its optimal management. Total hysterectomy and bilateral salpingo-oophorectomy precludes future fertility and may thus be undesirable by women wishing to maintain their reproductive potential.

Vaginal angiomatosis: differential diagnosis of a rare case.

Vaginal angiomatosis is regarded as part of a very rare entity of benign vascular tumors of the female genital tract. The incidence of these tumors is extremely low. The rarity of this disease and lack of distinctive features poses a problem of differential diagnosis.

Surgical management of early endometrial cancer: an update and proposal of a therapeutic algorithm.

In the last few years technical improvements have produced a dramatic shift from traditional open surgery towards a minimally invasive approach for the management of early endometrial cancer. Advancement in minimally invasive surgical approaches has allowed extensive staging procedures to be performed with significantly reduced patient morbidity. Debate is ongoing regarding the choice of a minimally invasive approach that has the most effective benefit for the patients, the surgeon, and the healthcare system as a whole.

Cannabinoid receptor type 1 immunoreactivity and disease severity in human epithelial ovarian tumors.

Objective: In light of recent findings indicating that endocannabinoid system has antitumor actions, our study aimed to localize it in the human epithelial ovarian tumors, highlighting the differences among benign, borderline, and invasive forms and correlating cannabinoid receptor type 1 (CB1R) expression with disease severity.

Study Design: We determined CB1R immunohistochemical expression in 66 epithelial ovarian tumors treated in the Department of Woman, Child, and General and Specialized Surgery, Second University of Naples, at S. Maria del Popolo degli Incurabili Hospital (Naples): 36 borderline ovarian tumors, the main target of interest being intermediate forms, 15 benign and 15 invasive ovarian tumors.

The possible role of zinc in the etiopathogenesis of endometriosis.

Purpose Of Investigation: Aim of the study was to evaluate the possible involvement of zinc in the complex pathogenic process behind the onset and perpetuation of endometriotic lesions. To study the level of zinc serum between a group of patients affected by endometriosis and a group of healthy patients.

Materials And Methods: The study included 86 women: 42 patients whose histodiagnosis had revealed pelvic endometriosis and 44 healthy patients.

Arterial hypertension and female sexual dysfunction in postmenopausal women.

Purpose: To evaluate female sexual dysfunction in hypertensive postmenopausal women and the effects of antihypertensive therapy.

Materials And Methods: Female sexual dysfunction was assessed by the Female Sexual Function Index (FSFI) in three groups of postmenopausal patients: normotensive women (group A: 240 women), hypertensive women without therapy (group B: 220 women), hypertensive women on therapy (group C: 80 women).

Results: The incidence of female sexual dysfunction was increased in group B compared to groups A and C.

Borderline ovarian tumors: features and controversial aspects.

Objective: To investigate features and controversial aspects of the borderline ovarian tumor (BOT), a neoplasm with favorable prognosis representing 10-15% of epithelial ovarian tumors.

Study Design: : We retrospectively studied all patients treated at our institution from 2000 to 2010 taking into account the age, the stage, the type of surgery, the tumor size, the symptoms, the pre- and post-intervention tumor marker levels (CA125, CA19.9, CA15.

An apparently benign vulvar mass: possibly a rare malignancy.

Background: Vulvar dermatofibrosarcoma is a rare fibrous tumor of intermediate grade malignancy, with a tendency for local recurrence, and rarely metastasizes. Management should be multidisciplinary. This is a report of an apparently benign vulvar mass with delayed diagnosis of vulvar dermatofibrosarcoma.

Perineal ultrasound evaluation of urethral mobility after the TVT-O procedure.

Aims: The aim of study was to assess, by means of perineal ultrasound (US), women treated with the trans-obturator suburethral sling procedure for urinary stress incontinence (USI).

Methods: Twelve women with USI and urethral hypermobility were enrolled. Static and dynamic perineal US of urethral mobility was performed before and after tension-free vaginal tape opturator (TVT-O) procedure: US parameters evaluated were pubis-urethra distance and inclination angle of the urethral axis.

Long-term safety and efficacy of raloxifene in the prevention and treatment of postmenopausal osteoporosis: an update.

The integrity of bone tissue and its remodeling that occurs throughout life requires a coordinated activity of osteoblasts and osteoclasts. The decreased estrogen circulating level during postmenopausal transition, with a prevalence of osteoclastic activity over osteoblastic activity, represents the main cause of bone loss and osteoporosis. Osteoporosis is a chronic disease requiring long-term therapy and it is important to evaluate the efficacy and safety of treatments over several years, as the fear of health risks is a common reason for discontinuing therapy.

Surgical approach to appendiceal mucocele mimicking an adnexal complex mass: case report.

Mucocele of the vermiform appendix is a rare disease of the appendix caused by mucoid substance retention in its lumen, due to obstruction or hyperproduction due to appendiceal retention cysts, mucosal hyperplasia, mucinous cystadenomas and cystadenocarcinomas. Therefore, also appendiceal malignancy can be the underlying cause, making accurate preoperative diagnosis imperative, even if this disease is often asymptomatic and an early diagnosis still remains very difficult on imaging studies. In women, appendiceal mucoceles can sometimes present on clinical and instrumental findings as a right adnexal mass mimicking an ovarian neoplasm.

A rare case of female pelvic mass: angioleiomyoma of the broad ligament.

Angioleiomyoma is a benign mesenchymal neoplasm composed of smooth muscle cells and thick-walled vessels. It is usually found in the skin of the lower extremities. Angioleiomyoma is a very rare tumor among the ever-expanding repertoire of growth variants described in benign uterine leiomyoma.

Therapeutic alternatives in Behçet's syndrome.

Behçet's Syndrome (BD) is a chronic, relapsing, recurrent systemic vasculitis with an unknown cause. The disease affects all organs of the body concurrently or consecutively. Its various clinical manifestations result from ubiquitous small-vessel vasculitis, which is the underlying pathology.

A new approach to vulvar squamous cell carcinoma: two-year follow-up of a case report.

Background: Vulvar carcinoma is relatively rare gynaecologic malignancy. The most prevalent vulvar cancer is squamous cell carcinoma. It is not uncommon for patients to delay seeking medical attention or for physicians to delay diagnosing the condition.

A therapeutic algorithm for early-stage endometrial cancer: indications, patient selection, and feasibility.

Endometrial cancer is the most widely spread gynaecologic neoplasm in industrial countries. Mode of spread includes direct extension, lymphatic and haematic diffusion. Lymphatic involvement, particularly, is a topic of wide debate due to the strong therapeutic implications associated with it.

Third stage ovarian carcinoma--case report: the necessity of a multidisciplinary approach to treatment.

Ovarian carcinoma, part of a heterogeneous group of tumours, is the main cause of death by gynaecological neoplasms. The diagnosis, in general, is delayed. Multiorgan diffusion, the necessity of a surgical operation and strong chemotherapy, and the eventual pathology due to patient age are all factors that require a multidisciplinary approach.

Raloxifene therapy interacts with serum osteoprotegerin in postmenopausal women.

Objectives: Osteoprotegerin (OPG) is a protein expressed by osteoblasts that, linking the receptor activator of nuclear factor kappaB (RANK) ligand (RANKL), produced by osteoblasts, blocks the process of osteoclastic differentiation and modulates osteoclastic apoptosis. Raloxifene (RAL) stimulates the production of OPG from osteoblasts, as demonstrated in vitro, carring out their antiresorption activity, at least in part, as means of the OPG/RANK/RANKL system. The aim of this study was to evaluate in vivo if the RAL treatment of postmenopausal women was associated to changes in serum OPG; moreover, to evaluate the serum changes of bone turnover modulators interleukin-6 (IL-6) and C-telopeptides of type-1 collagen (CrossLaps).

Local estrogen replacement therapy in postmenopausal atrophic vaginitis: efficacy and safety of low dose 17beta-estradiol vaginal tablets.

Purpose Of Investigation: To verify the effectiveness and safety of low-dose 17beta-estradiol vaginal tablets in the treatment of the postmenopausal atrophic vaginitis.

Patients And Methods: 325 postmenopausal women with atrophic vaginitis in estrogenic replacement therapy with 0.025 mg 17beta-estradiol vaginal tablets, one application each day for two weeks, and a single application two times a week for the following 22 weeks (total treatment period: 24 weeks).