RESUMO
A 59-year-old post-menopausal female presented with complaints of per vaginal spotting for 3 months. Histopathological examination of contents of dilation and curettage revealed endometrial carcinoma (FIGO stage I), along with benign endocervical polyps. MRI also showed presence of left-sided structure indicative of ectopic pelvic kidney. The patient underwent laparoscopic radical hysterectomy, bilateral salpingo-oophorectomy and bilateral ilio-obturator lymph node dissection. Dissection was started along the left pelvic plane. The left pelvic kidney was seen, and left ureter was located and confirmed below the uterus. The patient withstood the procedure well. Anomalies of pelvic anatomy, such as a malpresentation of the kidney and ureter, may prove as surgical challenges while performing open and laparoscopic surgery. However, in depth preoperative imaging, meticulous intraoperative dissection and proper identification of surrounding structures reduces the risk of such complications.
RESUMO
Neoadjuvant chemotherapy (NACT) in breast cancer has undergone continuous evolution over the last few decades to establish its role in the combined modality management of these tumors. The process of evolution is still far from over. Many questions are still lurking in the minds of oncologists treating breast cancer. This review analyzes the evidence from metaanlyses, major multiinstitutional prospective trials, retrospective institutional series and systematic reviews in breast cancer to determine the current standards and controversies in NACT. The most effective drugs, their advantages, issues and controversies in delivery as well as the criteria for response are reviewed. A summary of evidence-based consensus is presented and unresolved aspects are discussed.
