Synchronously occurring endometrioid carcinomas of the uterine corpus and uterine cervix preceded by different precancerous lesions: A case study and a literature review.

The incidence of two synchronous carcinomas originating from the uterine corpus and uterine cervix, both endometrioid subtypes, is exceedingly rare. Herein, we presented synchronous early stage G1 adenocarcinoma of the uterine corpus with cervical G2 endometrioid adenocarcinoma. Although both neoplasms displayed the same histological subtype, they differed significantly according to the histological grading or clinical stage of the disease. Finally, it is worth emphasizing that both tumors were preceded by different precancerous lesions, atypical endometrial hyperplasia (AEH) and foci of endometriosis localized within the uterine cervix. Although AEH is a well-known precancerous condition of endometrioid carcinoma, the mechanisms resulting in the malignant transformation of endometriosis foci to the cervical endometrioid carcinoma are still a matter of controversy. We briefly summarized the impact of different precancerous lesions on the development of synchronous female genital tract neoplasms with the same histotype.

Overactive bladder as a dysfunction of the autonomic nervous system - A narrative review.

Overactive bladder (OAB) is a common condition with increasing prevalence. However, its aetiology is not fully understood. The main symptoms are sudden urge to urinate, with or without incontinence; increased daytime frequency; and nocturia. OAB-like symptoms can be caused by a number of diseases, including urinary tract infections, neurologic and metabolic diseases, and neoplasms. The final diagnosis is made after excluding all the abovementioned factors. Autonomic nervous system (ANS) dysfunction has also been identified as a possible cause of so-called 'idiopathic OAB'. In order to check this hypothesis, many studies have measured ANS activity in patients with OAB by means of dynamic pupillometry, heart rate variability and sympathetic skin response. These non-invasive, fast and reliable tests assess ANS function - both sympathetic and parasympathetic - indirectly. ANS activity depends on many factors, such as age, gender, baseline level and a number of environmental stimuli. An imbalance between the sympathetic nervous system and the parasympathetic nervous system can lead to homeostatic disruption and the subsequent development of many diseases, including OAB. This narrative review summarizes the most important studies concerning the putative influence of the ANS on OAB symptoms.

[Selected mechanisms inducing resistance to immunotherapy in patients with ovarian cancer].

Recently, the intensive development of immunotherapies in the treatment of malignant tumors has been observed. The investigated treatment approaches including specific monoclonal antibodies, adoptive therapy and also anticancer vaccinations. The implementation of immunotherapy seems to be promising in treatment of the most malignant and fatal tumors including ovarian cancer. However, current findings have shown only a nonsignificant improvement of patients' survival. The possible cause of failure may be immunotherapy barriers that are a result of low immunogenicity level of ovarian cancer cells, mutation variability, and also the presence of a specific, immunosuppressive tumor microenvironment, which stimulates the cancer progression. The review presents the selected mechanisms of tumor resistance to immunological therapy. In order to project effective treatment approaches, it is necessary to understand both, mechanisms leading to the correct response for the treatment and causing therapeutic failures, resulting from resistance to therapy.

[The meaning of PD-1/PD-L1 pathway in ovarian cancer pathogenesis].

Ovarian cancer is a serious diagnostic and clinical issue. It belongs to the group of cancers with the highest mortality rate, that is why new, effective methods of therapy have been sought after. In recent years, researchers have been paying attention to the use of immunothetapy in the treatment of ovarian cancer. Currently, the numer of studies with the use of PD-1/PD-L1 pathway inhibitors is increasing. It has been reported that PD-1 receptor and its ligand are expressed on tumor cells and immunology system cells in patients with ovarian cancer. Increased expression of PD-1/PD-L1 is one of the inhibition mechanisms of the anti-tumor response by induction of peripheral tolerance. That seems why blocking PD-1/PD-L1 may be so important. A significant role in activation of programmed death cell-1 is attributed to tumor microenvironment (TME). In this review we have described the meaning of PD-1/PD-L1 pathway in ovarian cancer pathogenesis and current results of clinical trials using PD-1/PD-L1 inhibitors. Numerous clinical trials are focused on the effectiveness of immunotherapies as both monotherapy and combination therapy. The promising results of initial research phases are the basis for taking action on a larger scale. Perhaps this will allow in the future to use inhibitors of the PD-1/PD-L1 pathway in the treatment of ovarian cancer.