Rupture of uterine serosal hematoma: delayed complication of uterine perforation.

Uterine perforation, a major complication of dilatation and curettage (D&C), is typically recognized at the time of the procedure. Large defects in the uterine wall or injury to other intraabdominal organs can result in an acute abdomen requiring immediate surgical treatment. On the other hand, small perforations usually resolve on their own without any long-term consequences. Here, the authors report a case of delayed hemoperitoneum, ten days after the D&C evacuation of an early pregnancy. Initially, intramural pregnancy was the suspected etiology. However, histopathology suggested that the inciting event was the rupture of a serosal uterine hematoma, which likely resulted from an incomplete uterine perforation during D&C. The patient did well after undergoing an uneventful laparoscopy.

Secondary missed abdominal pregnancy due to iatrogenic uterine perforation: a case report.

Abdominal pregnancy is extremely rare and can result from the reimplantation of an intrauterine pregnancy after spontaneous uterine rupture. In this report, we present the case of a secondary missed abdominal pregnancy resulting from iatrogenic uterine perforation during dilatation and curettage in an early intrauterine pregnancy and subsequently misdiagnosed as intrauterine trophoblastic disease. Transvaginal ultrasound missed the diagnosis, which was finally confirmed by computed tomography. We discuss the particulars of the case along with a review of the relevant literature.

The effects of obesity and HER-2 polymorphisms as risk factors for endometrial cancer in Korean women.

OBJECTIVE: To evaluate the relationship between single nucleotide polymorphisms (SNPs) in the HER-2 gene, body mass index (BMI) and the risk of endometrial cancer. DESIGN: Case-control study. SETTING: Medical centres in Korea. SAMPLE: DNA samples and medical histories were obtained from 125 endometrial cancer cases and 302 controls. METHODS: The genotypes evaluated in HER-2 at positions -423, -655, -776, -857, -1170, -1177, -1253 of the coding region and two SNPs located in an intron by SNP-IT assay using SNPstream Ultra-high throughput system. MAIN OUTCOME MEASURES: Odd ratio for endometrial cancer associated with HER-2 polymorphisms and BMI. RESULTS: Cases had a significantly higher BMI than controls and the obese subjects had a 2.65-fold increased risk for endometrial cancer. However, HER-2 polymorphism was not associated significantly with the risk of endometrial cancer. Subjects with BMI > or = 25 kg/m2 who carried rs1801200 AA, rs1801200 GA/GG, rs1810132 CT/CC, rs2517951 CT/TT and rs1058808 CG/GG genotype had significantly increased risk of endometrial cancer than subjects with a normal BMI (P for linear trend <0.05). However, the risk in the subjects with the variant allele for HER-2 genotypes did not differ significantly compared to those with homozygous wild-type allele within specific BMI subgroups. CONCLUSIONS: Endometrial cancer risk increased significantly in proportion to BMI. However, HER-2 polymorphism did not affect significantly on the risk of endometrial cancer.

Comparison of adjuvant chemotherapy and radiation in patients with intermediate risk factors after radical surgery in FIGO stage IB-IIA cervical cancer.

The aim of this study was to compare the outcome of chemotherapy or radiation as adjuvant therapy for patients with FIGO stage IB-IIA cervical cancer and surgically confirmed intermediate risk factors. Data were collected from patients with uterine cervical cancer FIGO stage IB-IIA who had adjuvant chemotherapy following radical hysterectomy with pelvic lymph node dissection (RHLND, cases) or adjuvant radiotherapy following RHLND (controls). The study groups consisted of 38 cases and 42 controls. Adjuvant treatment was given to the patients with a combination of intermediate risk factors including deep stromal invasion (>50%), lymphvascular space invasion, large tumor size (3-6 cm), or close vaginal resection margin (<1 cm). Comparison of the cases with the controls revealed no significant differences in variables studied including median age (P = 0.18), stage distribution (P = 0.30), histologic subtype (P = 0.93), pathologic tumor size (P = 0.46), depth of the stromal invasion (P = 0.29), lymphvascular space invasion (P = 0.50), and close vaginal resection margin (P = 0.62). The difference in disease-free survival rates was not significant (P = 0.68). However, the overall survival analysis was incomplete due to the limited number of events available at the end of the study period. The findings of this study suggest that adjuvant chemotherapy in patients with FIGO stage IB-IIA uterine cervical cancer and surgically confirmed intermediate risk factors may be effective.