Calcified uterine leiomyoma from an 18th-century nunnery in North Italy.

OBJECTIVE: To develop a differential diagnosis of a mass retrieved alongside skeletal remains in the crypt of the church of Santissima Annunziata of Valenza (Province of Alessandria, Northern Italy). MATERIAL: A calcified mass measuring 40 × 39 mm and 17.62 × 16.3817.62 × 16.38 mm. METHOD: The analysis utilized macroscopic assessment and histologic examination (including histochemical and immunohistochemical analyses). RESULTS: Morphological traits include an irregular and spongy external surface. Holes of different sizes lead toward the inner part of the object. A section of the mass shows an "intertwined bundle" pattern, confirmed by microscopic examination. CONCLUSIONS: Differential diagnosis determined the mass to be consistent with calcified leiomyoma. SIGNIFICANCE: Identifying uterine leiomyoma adds to the paucity of paleopathological literature on the condition and to calcified tumors more broadly. It also allows for an important discussion of women's gynecological health in the past and potentially among nulliparous women. LIMITATIONS: Neither histochemical staining nor immunohistochemical analysis demonstrated the certain muscular nature of the specimens due to the rehydration and decalcification processes, for which there are no gold standards. SUGGESTIONS FOR FURTHER RESEARCH: Calcified masses are common in the clinical literature but remain rare in paleopathological literature. Careful excavation and improved recognition of apparently calcified masses are necessary to improve recognition, diagnosis, and interpretation.

Trends and age-period-cohort effects on mortality of the three major gynecologic cancers in China from 1990 to 2019: Cervical, ovarian and uterine cancer.

BACKGROUND: Gynecologic cancers seriously threaten women's life and health. This study aims to assess the long-term trends of mortality from the three major gynecologic cancers in China and to examine the age-, period-, and cohort-specific effects behind them during the period 1990 to 2019. METHODS: The mortality data of cervical, ovarian, and uterine cancer in China were obtained from the Global Burden of Disease Study 2019 and were analyzed with the age-period-cohort framework. RESULTS: It was found that the net drift for cervical cancer mortality was -0.19% (95% CI, -0.46% to 0.08%) per year, for ovarian cancer was 0.76% (95% CI, 0.57% to 0.95%) per year, and for uterine cancer was -3.09% (95% CI, -3.44% to -2.76%) per year from 1990 to 2019. During this period, while cervical cancer remained the most common cause of death among gynecologic cancers among Chinese women, ovarian cancer replaced uterine cancer as the second leading cause of death in gynecologic cancers after about 2005. Significant age, cohort, and period effects were found for the mortality trends of all three major gynecologic cancers. CONCLUSIONS: The secular trends of mortality from the three major gynecologic cancers in China and their underlying age, period, and cohort effects are likely to reflect the progress of diagnosis and treatment, rapid socio-economic transitions, and the accompanying lifestyle and behavior changes. More priorities of further epidemiology studies and efforts on the prevention and control should be given to three major gynecologic cancers.

Development and history of morcellators.

PURPOSE OF REVIEW: Controversy exists surrounding extraction of tissue in gynecologic surgery using morcellators following cases of disseminated uterine cancers discovered after the use of electromechanical morcellators. This chapter traces the history of tissue extraction in gynecology and reviews the evolving scientific data and opinions regarding the future of morcellation. RECENT FINDINGS: Since the initial Food and Drug Administration warning about morcellation in 2014, subsequent studies do not support the Food and Drug Administration's high incidence of occult uterine cancer. Current research continues, focusing on methods of contained tissue morcellation, both laparoscopically and vaginally. SUMMARY: Minimally invasive surgical techniques have revolutionized gynecology, drastically reducing the need for open procedures. To maximize patient safety while preserving the rapid recovery and low morbidity of laparoscopic and vaginal approaches, optimal methods of tissue extraction need to be developed and promulgated.

Uterine cancer in the writings of ancient Greek physicians.

In this article, we present the views on uterine cancer of the ancient Greek physicians. We emphasize on uterine's cancer aetiology according to the dominant in antiquity humoural theory, on its surgical treatment suggested by Soranus of Ephesus, and in the vivid description provided by Aretaeus of Cappadocia. During that period, uterine cancer was considered as an incurable and painful malignancy and its approach was mainly palliative.

[Historical overview and the current practice of intracavitary treatment of cervical and endometrial cancer in the Oncoradiology Center of Budapest]. / A méhtest- és méhnyakrák intrakavitális kezelésének történeti áttekintése és jelen gyakorlata a Fõvárosi Onkoradiológiai Központban.

The aims of our study were to describe the history and development of intracavitary brachytherapy in the treatment of gynecological tumors, to introduce our current practice for intracavitary brachytherapy treatments based on CT planning. Gynecological intracavitary brachytherapy has been applied in our department since the early 1930s. After a long development it has been completely renewed by 2014. In our center definitive and/or preoperative gynecological HDR-AL brachytherapy treatments were given to 25 patients (13 corpus uterine cancer patients and 12 cervical cancer patients) during the period of 01. 01. 2014-31. 01. 2015. In each case, target volumes were planned by CT images, DVH (dose volume histogram) analysis was performed in order to calculate the radiation tolerance dose of rectum and urinary bladder. Evaluation was performed by the EclipseTM 11.0.47. brachytherapy treatment planning system. During the definitive treatments of the 13 uterine cancer patients the D2cc value related to rectum tolerance was 66.3 GyEQD2 (46-91 Gy). The average D2cc value of urinary bladder tolerance was 76.5 GyEQD2 (30-112 Gy). CI was 0.72 (0.6-0.95). Average value of COIN was 0.57 (0.35-0.78). Compared to the prescribed dose D100 and D90 values were given in ratios. Compared to the volume which receives 100% of reference dose V150 and V200 values were also given in ratios. D100 and D90 were calculated to be 0.66 (0.47-0.97) and 0.91 (0.8-1.25). V150 and V200 volumes were 0.11 (0.04-0.18) and 0.06 (0.02-0.1). During the definitive treatments of 12 cervical cancer patients the D2cc value related to rectum tolerance calculated by DVH was 75.2 GyEQD2 (60-82 Gy). The average D2cc value of urinary bladder tolerance was 85 GyEQD2 based on DVH. CI was 0.66 (0.42-0.76). Average value of COIN was 0.52 (0.32-0.78). Mean value of DHI was 0.46 (0.27-0.54). D100 and D90 were calculated to be 0.72 (0.57-0.89) and 0.91 (0.84-1.11). V150 and V200 volumes were 0.057 (0.02-0.13) and 0.02 (0.002-0.06). During treatments no severe side effects were found. During gynecological intracavitary HDR therapies the calculated dose of the target volume can be given safely using the EclipseTM 11.0.47. brachytherapy planning system and CT-based planning. CT-based treatment planning provides optimal safety for organs at risk, acceptable doses for rectum and urinary bladder while the target volume receives the proper prescribed dose.

Evolução de lesões precursoras de câncer de colo uterino nas coletas de citologia realizadas nas Unidades Básicas de Saúde (UBS) da Região Norte / Secretaria Municipal da Saúde – SP no período de 2009 até 2013 / Injury evolution Precursor of Cervical Cancer in cytology samples taken in Basic Health Units (BHU) of the North / Municipal Health Region - SP from 2009 until 2013

A tendência à queda da maioria das alterações citológicas, principalmente nas de maior gravidade (LIEAG/ Ca), reforça a importância dos três pilares do Programa: educação permanente dos profissionais do nível primário e secundário, integração das UBSs com os serviços de Colposcopia, monitoramento e tratamento dos casos com alterações (AU)

Aretaeus of Cappadocia and the first accurate description of uterine carcinoma.

In our article we present the work on uterine cancer of the distinguished physician Aretaeus of Cappadocia. Uterine cancer was known since antiquity and its presence is testified in ancient Egyptian and Greek medical writings. However in the 2nd century AD Aretaeus provided the first accurate description of uterine cancer, dividing it in two forms, an ulcerated and a non ulcerated, both painful and fatal.

The great surgeon Jean-Louis Faure (1863-1944) and his contribution in the treatment of uterine cancer.

At the beginning of the 20th century, Professor Jean-Louis Faure, one of the leading surgeons of the innovative Parisian Medical School, published an exhaustive work on uterine cancer. He was the first to perform in France the procedure of total abdominal hysterectomy by median section of the uterus contributing to the evolution of cancer surgery.

"Because of their praiseworthy modesty, they consult too late": regime of hope and cancer of the womb, 1800-1910.

The birth of the "do not delay" principle in cancer treatment has often been linked with developments in late nineteenth century: the rise of histology and cellular theory of malignancy that favored the definition of cancer as a local pathology, then the development of radical surgical techniques that transformed malignant tumors into a potentially curable condition. This text seeks to nuance this view. It points out important continuities in the understanding of the natural history of uterine cancers. At its center, the wish, already present in early nineteenth century, is to detect "early," that is, small and localized malignant lesions, then to extirpate or destroy these lesions before they become fully blown cancer. The long history of this particular regime of hope helps demonstrate why it is so difficult today to promote more nuanced views of the efficacy of early detection of malignant tumors.

Uterine cancer through the works of the eccentric Auguste Joseph Lutaud (1847- 1925), famous gynaecologist, publisher and intellectual of the 19th century.

Auguste Lutaud was standing for almost half century in front of the French and International stage for his controversy and eccentric personality, his undisputed authority in gynecology, his writings and his publishing success. Thanks to his writings, he is considered as the main propagator of the prevailing ideas on uterine cancer diagnosis and treatment.

Menopause and historical constructions of cancer risk.

This paper explores the association between menopause and cancer over the past 250 years in relation to the disease model of menopause. Relying primarily upon medical literature produced in Great Britain, the United States, and Canada, it shows how this association evolved from traditional humoral theory; how it was sustained during the 19th century as part of a larger vision of female vulnerability at midlife countered, partially and temporarily, by a more optimistic outlook at the beginning of the 20th century; and how, over the past 80 years, the debate over cancer risk at menopause was intertwined with the vacillating fortunes of the disease model and its normalization of hormone replacement therapy.

Who identified endometriosis?

Although uterine adenomyoma and endometriosis were described around the turn of the 19th century, the history of the identification of endometriosis has remained controversial and continues to confuse recent literature affecting the management of the disease. Using histologic parameters of endometrial structure and activity, the first scientist to identify the condition, under the name "adenomyoma," was Thomas Cullen. John Sampson was the first to identify the pathogenesis of the condition.

[150 years since the birth of Thomas Ionescu (1860-1926)]. / Thoma Ionescu (1860-1926): 150 de ani de la mastere.

One of the most important surgeons of the 1900 period was the Romanian-born Thomas Jonnesco. He became a surgeon in Paris (1885-1890) under the guidance of D.M. Bourneville and J. Peyrot (Bicatre), P. Berger (Tenon), A. Le Dentu (St. Louis) and A. Verneuil (Pitié-Salpétrire). In 1894, he gained at the Paris Faculty of Medicine the title of professor of anatomy. In the same year he was selected by the professors Poirier, Charpy and Nicolas to be their collaborator in a treatise of anatomy, published in 1894. In 1895, he returned to Bucharest to lead the Institute of Topographic Anatomy and Experimental Surgery, especially created for him. He also accepted the Chair of the Clinical Surgery of Coltzea Hospital in Bucharest. In 1896 he founded in Paris the French periodical "Archives des Sciences Medicales'". Jonnesco was a prolific surgeon in the field of experimental surgery, especially cervical sympathectomy, general spinal anaesthesia but also in surgical oncology and genito-urinary field. He also drew clinical correlations on surgical techniques of gastrectomy for cancer, on total abdominal genital ablation as treatment for septic conditions of the uterus and the adnexa or on the large abdominal hysterectomy with complete ilio-lumbo-pelvic lymph node dissection in uterine cancer, which refined Wertheim's hysterectomy method. Thomas Jonnesco is now considered the founder of the modem Romanian school of

Migrating techniques, multiplying diagnoses: the contribution of Argentina and Brasil to early 'detection policy' in cervical cancer

This article on the early detection of cervical cancer focuses on the development of two leading diagnostic techniques - colposcopy and the Pap smear test - and their histories in Argentina and Brazil. It explores how diagnostic tools were transferred between Europe and the Americas, while examining the intersection of cultural and medical aspects and the processes of adaptation and resignification in the receiving countries. Colposcopy received little attention in the main Western medical centers until South American countries reasserted its significance in the 1950s. 'Peripheral' centers played a central role in early detection policies and the combined uses of these methods gave rise to a new stage of 'cumulative confidence' in cervical cancer diagnosis and screening.(AU)