Effects of long-term intermittent pharmacological therapy with ulipristal acetate on reducing the volume of uterine fibroids and relieving symptoms.

BACKGROUND: The aim of this study was to compare the effects of a 12-week course and four repeated 12-week courses of daily 5 mg ulipristal acetate (UPA) on reducing the volume and relieving symptoms of uterine fibroids. METHODS: From 2016 to 2019, 287 female patients with uterine fibroids diagnosed using ultrasonography were recruited. The patients received four 12-week course treatments of daily UPA administration in the first and fourth sessions, respectively. During the first and fourth courses of UPA, we measured the volume of the fibroids using ultrasonography to study the effect on volume reduction. The measured outcomes included symptomatic relief and adverse effects. RESULTS: After the first UPA treatment course, menorrhagia was improved in 82.2% of patients. A total of 59.5% of patients were responsive to treatment, and the volume of the three largest fibroids decreased from 160.9 cm3 to 104.6 cm3. After the fourth treatment course, 87.4% of patients reported decreased bleeding. A total of 67.2% of patients were responsive to treatment, and the volume of the three largest fibroids decreased from 171.7 cm3 to 106.5 cm3. In 64 (38.1%) patients in group A and 36 (30.3%) in group B, the fibroid volume increased. Among them, 72% of patients showed improved symptoms. CONCLUSIONS: Uterine bleeding, pain, and reduced fibroid volume were adequately regulated in patients with symptomatic fibroids with four repeated 12-week courses of daily UPA.

A rare case of squamous cell carcinoma in situ arising in mature cystic teratoma.

Mature cystic teratoma (MCT) is the most common ovarian tumor. Secondary malignant tumors rarely arise in MCTs, and squamous cell carcinoma (SCC) is the most common form of such tumors. MCT-derived SCC in situ (CIS) is mostly found together with invasive SCC; it is seldom detected alone. A 44-year-old woman with breast cancer was found to have a left ovarian cyst (size >8 cm) before treatment. She underwent bilateral salpingo-oophorectomy, and frozen biopsy showed MCT with focal proliferation of squamous epithelium and mild atypism. However, definitive pathologic diagnosis confirmed CIS arising in MCT. In addition, germline BRCA 1/2 test and human papillomavirus test of tumor tissue yielded negative results. This report is the first case of its kind in Korea. Our report can aid in clinical decision making and serve as a basis for follow-up studies on this rare type of CIS arising in MCT.

Lack of Association between Epstein-Barr Virus and Epithelial Malignancies Developed after Kidney Transplantation / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: Organ transplant recipients are at high risk of developing malignancies due to immunosuppressive regimens. Unlike post-transplant lymphoproliferative diseases (PTLDs), where Epstein-Barr virus (EBV) plays an etiological role, there are conflicting data regarding the association of EBV with post-transplant epithelial malignancies. In order to clarify the role of EBV in carcinomas that develop after solid-organ transplantation, the presence of EBV infection in the carcinomas of post-kidney transplant patients was examined. MATERIALS AND METHODS: The presence of EBV infection in skin carcinoma (PTSC), gastric carcinoma (PTGC) and urothelial carcinoma (PTUC), which developed in the patients under an immune suppression regime following kidney transplantation, was examined. Tumors from the patients without organ transplantation were also used as a comparison in the study. The study group included five nasopharyngeal carcinomas (NPCs), one Hodgkin's disease (HD), one B-cell non-Hodgkin's malignant lymphoma (NHL) and one hypopharynx (HPC) tumor. RESULTS: Immunofluorescence assay and Western blot analysis, using sera from the same patients, confirmed that all of the tested patients were previously infected with EBV. From in situ hybridization, no EBER positive cells were detected in any of the tumor tissues obtained from the three kidney transplant recipients (PTSC, PTGC and PTUC) or in the NHL and HPC tissues. In contrast, all five of the NPC and HD tissues showed strong EBER positivity. CONCLUSION: These results suggest that there is a strong association of EBV with NPC and HD as previously reported, while no such strong association of EBV was found with epithelial malignancies that developed after kidney transplantation.