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2.
BMC Gastroenterol ; 21(1): 365, 2021 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-34620107

RESUMO

OBJECTIVE: To determine the accuracy of endoscopic ultrasonography (EUS) in the diagnosis of upper gastrointestinal submucosal lesions (SMLs). METHODS: This was a retrospective study involving patients diagnosed with SMLs using EUS and confirmed by histopathology from November 2014 to December 2020 at The Third Xiangya Hospital of Central South University. RESULTS: A total of 231 patients with SMLs were examined by EUS. Histologically, 107 lesions were stromal tumors, and 75 lesions were leiomyomas. Stromal tumors were mainly located in the stomach (89.7%), and leiomyomas were predominantly seen in the esophagus (69.3%). The diagnostic accuracy of EUS for stromal tumors and leiomyomas was 80.4% and 68.0%, respectively. The diagnostic accuracy was highest for lesions located in the muscularis mucosa. The mean diameter of stromal tumors measured using EUS was significantly larger than that of leiomyomas (21.89 mm vs. 12.35 mm, p < 0.001). Stromal tumors and leiomyomas originated mainly from the muscularis propria (94.4%) and the muscularis mucosa (56.0%), respectively. Compared with the very low-risk and low-risk groups of stromal tumors according to the National Institute of Health guidelines, the intermediate-risk and high-risk groups were more likely to have a lesion > 3 cm (p < 0.001) and a surface ulcer (p < 0.01) identified by EUS. CONCLUSIONS: EUS has good diagnostic value for the diagnosis of upper gastrointestinal SMLs based on the lesion size and the muscle layer of origin. The diagnostic accuracy of EUS lesions is related to the origin, and the diagnostic accuracy is greatest in the mucosal muscularis layer. Stromal tumors > 3 cm and a surface ulcer on EUS are likely to be intermediate or high risk for invasion.


Assuntos
Leiomioma , Trato Gastrointestinal Superior , Diagnóstico Diferencial , Endossonografia , Humanos , Leiomioma/diagnóstico por imagem , Estudos Retrospectivos
3.
J Coll Physicians Surg Pak ; 31(10): 1234-1236, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34601849

RESUMO

We present a case of a 49-year Turkish woman who had synchronous renal leiomyoma and breast cancer. The patient was evaluated for a suspicious breast mass; and renal mass was detected incidentally by contrast-enhanced computed tomography (CT). Diagnostic tru-cut biopsy was performed for both masses. Breast mass biopsy was reported as invasive ductal carcinoma (IDC) while renal biopsy was described as benign mesenchymal tumour. According to the biopsy results, the renal mass was followed for six months. For breast cancer, segmental mastectomy and concomitant sentinel lymph node biopsy was performed. Histologically, the tumour was reported as IDC and low-grade cribriform ductal carcinoma in situ (less than 1%). Six months later, renal mass was excised by laparoscopic approach. Histopathological examination was consistent with renal leiomyoma. For both tumours, no recurrence within one year was found on follow-up. Key Words: Renal leiomyoma, Breast cancer, Laparoscopy.


Assuntos
Neoplasias da Mama , Leiomioma , Neoplasias da Mama/cirurgia , Feminino , Humanos , Leiomioma/diagnóstico por imagem , Leiomioma/cirurgia , Mastectomia , Recidiva Local de Neoplasia , Biópsia de Linfonodo Sentinela
4.
Mymensingh Med J ; 30(4): 907-912, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605455

RESUMO

Uterine leiomyoma is a common gynecological problem throughout the world. As 50% hysterectomies in black and 40% in Australians are performed due to fibroid, in our country also it is assumed that about 40%-50% hysterectomies are done due to fibroid uterus. Thus leiomyoma constitute a major public health cost to the community in terms of outpatient attendance and hospital cost for surgery. This is a descriptive type of cross sectional study among 50 patients having leiomyoma of uterus in the department of Obs and Gynae, BSMMU hospital from March 2011 to August 2011. The objective of the study is to find out the risk associated with leiomyoma, to find out the common presenting features of uterine leiomyoma and to find out best options for management. Study results showed that 62% patients were in the age group 36-45 years, 48%patients were in para1-2 group, 32% patients used combined oral contraceptive pill for contraception. Sixty percent (60%) patients presented with progressive menorrhagia and palpable mass was found in 62% cases. About 46% patients had associated medical conditions like hypertension, diabetes, obesity. Total abdominal hysterectomy was done in 32% cases. TAH with unilateral or bilateral salpingoophorectomy was done in 40% cases. Myomectomy was done in 20% cases. There is a scope for large scale study about risk factors of uterine leiomyoma like obesity, diabetes mellitus, hypertension, use of hormonal contraceptive, racial differences, different treatment modalities etc. Treatment should be individualized. However in this connection a good referral system and good communication has got a tremendous contribution in the proper management of such problems.


Assuntos
Leiomioma , Neoplasias Uterinas , Adulto , Austrália , Estudos Transversais , Feminino , Humanos , Histerectomia , Leiomioma/diagnóstico , Leiomioma/epidemiologia , Leiomioma/cirurgia , Pessoa de Meia-Idade , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/epidemiologia , Neoplasias Uterinas/cirurgia , Útero
5.
Medicine (Baltimore) ; 100(40): e27520, 2021 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-34622886

RESUMO

ABSTRACT: There is no practical predictive model for the diagnosis of gastrointestinal stromal tumors (GISTs). To establish a practical predictive model for the diagnosis of subepithelial lesions in the stomach, we reviewed patients with GISTs (n = 89), schwannomas (n = 7), and leiomyomas (n = 28).The tumor was more frequently found along the gastric cardia in the leiomyoma group (57.1%) than in the GIST/schwannoma group (2.1%, P < .01). Contrast enhancement (57.3% vs 0%, P < .01) and intra-tumoral necrosis (34.4% vs 0.0%, P < .01) were more frequently observed in the GIST/schwannoma group than in the leiomyoma group. On endoscopic ultrasonography, 58.3% of GISTs/schwannomas showed uneven echogenicity, whereas the echogenicity was uneven in 21.4% of leiomyomas (P < .01). There were no differences between the tumor color and the presence or absence of ulcer formation, tumor bleeding, irregularity of the tumor margin, cystic spaces, and hyperechoic spots between the 2 groups. Based on these results, we developed a 2-step diagnostic algorithm for GISTs/schwannomas. The first step comprises 1 endoscopic feature: a cardiac or non-cardiac location. Tumors with a cardiac location were judged as leiomyomas and those with a non-cardiac location were judged as GISTs/schwannomas, with 96.9% sensitivity and 57.1% specificity for GIST/schwannoma diagnosis. The second step comprises a combination of endoscopic (non-cardiac location), radiologic (positive contrast enhancement and intra-tumoral necrosis), and endosonographic (uneven echogenicity) features for a total of 4 points. We assigned 1 point to each feature. Tumors with scores of 2 to 4 were judged as GISTs/schwannomas, with 81.3% sensitivity and 92.9% specificity for GIST/schwannoma diagnosis.Our predictive model will be a practical guide for the management of gastric subepithelial lesions.


Assuntos
Neoplasias Gastrointestinais/patologia , Tumores do Estroma Gastrointestinal/patologia , Leiomioma/patologia , Neurilemoma/patologia , Algoritmos , Cárdia/patologia , Diagnóstico Diferencial , Endossonografia , Neoplasias Gastrointestinais/diagnóstico por imagem , Tumores do Estroma Gastrointestinal/diagnóstico por imagem , Humanos , Leiomioma/diagnóstico por imagem , Neurilemoma/diagnóstico por imagem
6.
Am J Case Rep ; 22: e932430, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34653118

RESUMO

BACKGROUND Benign esophageal neoplasms are uncommon, representing less than 10% of esophageal tumors. Esophageal leiomyomas are benign mesenchymal esophageal tumors, typically involving the distal two-thirds of the esophagus. However, upper esophageal leiomyoma is unusual. Signs and symptoms are nonspecific and similar to any esophageal lesion. The role of radiologic imaging in the diagnosis of leiomyoma is vital. Enucleation is the preferred surgical method for treatment of esophageal leiomyoma. In our patient, the presence of a large tumor necessitated esophageal resection and reconstruction. CASE REPORT A previously healthy 55-year-old woman presented with a chronic productive cough, which did not improve with symptomatic treatment and was not associated with shortness of breath, fever, anorexia, or weight loss. A chest radiograph revealed a superiorly located posterior mediastinal mass, measuring 9.6×4.8×4.6 cm in maximum dimensions. The mass was further evaluated by contrast-enhanced computed tomography, which demonstrated a mass with stippled calcifications, consistent with esophageal leiomyoma. Surgical resection was successfully performed, and the patient had complete resolution of her symptoms. A follow-up visit revealed a postoperative complication of left vocal cord palsy. Speech-language therapy was recommended. CONCLUSIONS Esophageal leiomyoma can present solely with respiratory symptoms without any gastrointestinal involvement and can be misdiagnosed because of atypical symptoms, uncommon location, or atypical imaging features. Recognizing the imaging features and pathologic basis of esophageal leiomyoma is essential for detection, early diagnosis, and management. Endoscopic and radiologic tests are critical to differentiate esophageal leiomyoma from other esophageal lesions and to eliminate the risk of malignancy.


Assuntos
Neoplasias Esofágicas , Leiomioma , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/cirurgia , Feminino , Humanos , Leiomioma/diagnóstico por imagem , Leiomioma/cirurgia , Mediastino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
7.
BMJ Case Rep ; 14(10)2021 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-34607815

RESUMO

This is a case of a 47-year-old woman with a spontaneous haemoperitoneum secondary to uterine leiomyomas (fibroids), an important differential diagnosis in patients with uterine fibroids and hypovolaemic shock. Uterine fibroids are very common in women of reproductive age, yet little is taught about their potential to cause hypovolaemic shock. Although it is a rare complication, given the prevalence of fibroids, it is important to bear this life-threatening differential in mind to optimise the care for these women. Presentation typically involves abdominal pain, syncope, haemodynamic instability and an intra-abdominal mass. CT of the abdomen and pelvis can be helpful in identifying the source of the haemoperitoneum, but should not delay surgery, which is the definitive management.


Assuntos
Leiomioma , Choque , Neoplasias Uterinas , Diagnóstico Diferencial , Feminino , Hemoperitônio/diagnóstico por imagem , Hemoperitônio/etiologia , Hemoperitônio/cirurgia , Humanos , Leiomioma/complicações , Leiomioma/diagnóstico por imagem , Leiomioma/cirurgia , Pessoa de Meia-Idade , Choque/etiologia , Neoplasias Uterinas/complicações , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/cirurgia
8.
Ann Palliat Med ; 10(8): 8772-8786, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34488366

RESUMO

BACKGROUND: To evaluate the efficacy and safety of the controversial Chinese herbal prescriptions containing Ejiao or Velvet antler (VA) in the treatment of uterine fibroids. METHODS: We searched 4 famous Chinese databases, the Chinese Clinical Trial Registry, PubMed, Cochrane Central, Google Scholar, Embase, and J-STAGE up to July 2019. We included all eligible randomized controlled trials (RCTs) which compared Chinese herbal prescriptions containing Ejiao or VA (E/VA) with placebo, pharmaceutical intervention, surgery, or other traditional Chinese medicines (TCMs) for uterine fibroids and assessed the risk of bias according to the Cochrane Collaboration's tool. The software Review Manager (RevMan) 5.1 was used for data analysis. RESULTS: A total of 9 RCTs involving 844 patients were identified. Meta-analyses demonstrated that TCM (E/VA) plus mifepristone reduced the volume of uterine fibroids to a greater degree than mifepristone alone [standardized mean difference (SMD): 0.59, 95% CI: 0.33 to 0.85, P<0.00001, I2=50%]; TCM (E/VA) did not enlarge the volume of fibroids when menopausal hormone therapy (MHT) significantly increased the volume (SMD: 1.06, 95% CI: 0.73 to 1.38, P<0.00001, I2=0. The uterine volume change difference was larger via combination therapy of TCM (E/VA) and mifepristone than that of mifepristone (SMD: 0.29, 95% CI: 0.09 to 0.49, P=0.005, I2=0%). The TCM (E/VA) group of had an advantage over the control group in the improvement of fibroid-related symptoms [relative risk (RR): 1.24, 95% CI: 1.15 to 1.35, P<0.00001, I2=0%]. It was found that TCM (E/VA) plus mifepristone could lower estradiol (E2) levels to a greater degree than mifepristone alone (SMD: 1.63, 95% CI: 0.42 to 2.83, P=0.008, I2=97%), as well as progesterone (P) level (SMD: 0.79, 95% CI: 0.55 to 1.04, P<0.00001, I2=43%) in non-menopausal women. A total of 5 studies reported adverse events (AEs), the TCM (E/VA) group was potentially safer than the control group, with lower incidence of AEs (RR: 0.24, 95% CI: 0.15 to 0.40, P<0.00001, I2=25.8%). DISCUSSION: TCM prescriptions containing E/VA seemed superior to the control group in shrinking the volume of uterine fibroids and uterus, improving related symptoms, and reducing non-menopausal women's E2 and P levels, with lower incidence of AEs.


Assuntos
Chifres de Veado , Leiomioma , Animais , China , Feminino , Gelatina , Humanos , Leiomioma/tratamento farmacológico , Prescrições , Ensaios Clínicos Controlados Aleatórios como Assunto
9.
Rev Assoc Med Bras (1992) ; 67(3): 426-430, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34468609

RESUMO

OBJECTIVE: To determine if there is a difference between uterine incision techniques (vertical vs. transversal) in terms of clinical results. METHODS: All women with leiomyomas who underwent open abdominal myomectomy (n=61) between March and August 2016 at the Gynecology and Obstetrics Clinic at the Women's Health Research and Training Hospital Zekai Tahir Burak were included, and the clinical results were included and prospectively reviewed. RESULTS: The estimated blood loss during myomectomy increased in the transversal group compared with the vertical group (809.33±483.34 versus 405.32±180.95 mL, p<0.001). The average operation duration was 60 min, and the patients got discharged on the second day after surgery. No intergroup statistical differences were observed in the surgical procedure. CONCLUSIONS: Surgeons should give preference to the most viable incision depending on the size and location of the leiomyoma.


Assuntos
Laparoscopia , Leiomioma , Miomectomia Uterina , Neoplasias Uterinas , Perda Sanguínea Cirúrgica/prevenção & controle , Feminino , Hemorragia , Humanos , Histerectomia , Leiomioma/cirurgia , Gravidez , Miomectomia Uterina/efeitos adversos , Neoplasias Uterinas/cirurgia
10.
Int J Hyperthermia ; 38(1): 1349-1358, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34486913

RESUMO

OBJECTIVES: To develop and assess nonenhanced MRI-based radiomics model for the preoperative prediction of nonperfused volume (NPV) ratio of uterine leiomyomas after high-intensity focused ultrasound (HIFU) treatment. METHODS: Two hundred and five patients with uterine leiomyomas treated by HIFU were enrolled and allocated to training (N =164) and testing cohorts (N = 41). Pyradiomics was used to extract radiomics features from T2-weighted images and apparent diffusion coefficient (ADC) map generated from diffusion-weighted imaging (DWI). The clinico-radiological model, radiomics model, and radiomics-clinical model which combined the selected radiomics features and clinical parameters were used to predict technical outcomes determined by NPV ratios where three classification groups were created (NPV ratio ≤ 50%, 50-80% or ≥ 80%). The receiver operating characteristic (ROC) curve, area under the curve (AUC), and calibration and decision curve analyses were performed to illustrate the prediction performance and clinical usefulness of model in the training and testing cohorts. RESULTS: The multi-parametric MRI-based radiomics model outperformed T2-weighted imaging (T2WI)-based radiomics model, which achieved an average AUC of 0.769 (95% confidence interval [CI], 0.701-0.842), and showed satisfactory prediction performance for NPV ratio classification. The radiomics-clinical model demonstrated best prediction performance for HIFU treatment outcome, with an average AUC of 0.802 (95% CI, 0.796-0.850) and an accuracy of 0.762 (95% CI, 0.698-0.815) in the testing cohort, compared to the clinico-radiological and radiomics models. The decision curve also indicated favorable clinical usefulness of the radiomics-clinical model. CONCLUSIONS: Nonenhanced MRI-based radiomics has potential in the preoperative prediction of NPV ratio for HIFU ablation of uterine leiomyomas.


Assuntos
Ablação por Ultrassom Focalizado de Alta Intensidade , Leiomioma , Imagem de Difusão por Ressonância Magnética , Humanos , Leiomioma/diagnóstico por imagem , Leiomioma/cirurgia , Imageamento por Ressonância Magnética , Curva ROC , Estudos Retrospectivos
11.
Int J Hyperthermia ; 38(1): 1341-1348, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34486914

RESUMO

OBJECTIVE: To assess the long-term outcomes and the factors affecting local recurrence of uterine fibroids after ultrasound-guided high-intensity focused ultrasound (USgHIFU) ablation. MATERIALS AND METHODS: 629 patients with a solitary uterine fibroid smaller than 10 cm in diameter treated with USgHIFU at our institutes between January 2011 and December 2016 were retrospectively analyzed. The patients were requested to take pre-HIFU and one day post-HIFU MRI. The patients were asked to return to the hospital every 3 months until January 2020, for imaging evaluation and to check on improvement in symptoms. RESULTS: Five hundred and thirty-six patients completed follow-up according to our protocol. The median follow-up time was 69 (interquartile range: 48 to 89) months. Among them, local recurrence was detected in 110 patients. 18 (16.4%) patients required additional treatment between 12 and 24 months after USgHIFU treatment, 59 (53.6%) patients required additional treatment 24 months after USgHIFU. Therefore, in total, 77 patients required additional treatment, of which 32 received USgHIFU and 45 underwent myomectomy. The median non-perfused volume (NPV) ratio in patients with recurrence was 73%, compared to 89% among patients without recurrence. Multivariate analysis showed that NPV ratio, maximum fibroid diameter and fibroid enhancement type were the independent factors affecting the recurrence of fibroids after USgHIFU treatment. CONCLUSIONS: Achievement of NPV ratio higher than 70% has led to acceptable re-intervention rate during the follow-up period after USgHIFU. NPV ratio, maximum fibroid diameter, and fibroid enhancement type were the independent factors affecting the recurrence of fibroids after USgHIFU treatment.


Assuntos
Ablação por Ultrassom Focalizado de Alta Intensidade , Leiomioma , Neoplasias Uterinas , Feminino , Humanos , Leiomioma/diagnóstico por imagem , Leiomioma/cirurgia , Recidiva Local de Neoplasia/diagnóstico por imagem , Estudos Retrospectivos , Resultado do Tratamento , Ultrassonografia de Intervenção , Neoplasias Uterinas/diagnóstico por imagem , Neoplasias Uterinas/cirurgia
12.
JNMA J Nepal Med Assoc ; 59(238): 601-603, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34508403

RESUMO

Paraurethral vaginal leiomyoma is the infrequent case to be described. Approximately 300 cases have been described so far. Imaging modalities aid in identifying the morphological, structural characteristics of the mass and its relationship to the surrounding structures. Thirty-six years old married women presented with a vulvar mass of (3x5) cm2. Her associated complaints were left shift of the urinary stream and dyspareunia. Ultrasonography and cystography revealed a mass with no relationship with bladder or uterine structure. Surgical excision was performed. The histopathological report confirmed the diagnosis of paraurethral vaginal leiomyoma. Surgical excision is the treatment of choice and diagnosis is confirmed by histopathological examination.


Assuntos
Leiomioma , Neoplasias Vaginais , Adulto , Feminino , Humanos , Leiomioma/diagnóstico por imagem , Leiomioma/cirurgia , Útero , Neoplasias Vaginais/diagnóstico , Neoplasias Vaginais/cirurgia
13.
JNMA J Nepal Med Assoc ; 59(237): 504-505, 2021 May 25.
Artigo em Inglês | MEDLINE | ID: mdl-34508428

RESUMO

Leiomyomas are common benign tumors of the uterus, affecting 20-30% of women of reproductive age group. But vaginal leiomyomas remain an uncommon entity with only about 300 reported cases. The first case was described in 1733. Only a few cases have been reported in Nepal to date. Tumors are thought to arise from Mullerian smooth muscle cells in the sub-epithelium of the vagina. Vaginal leiomyomas are usually situated in the anterior vaginal wall. Here, we report a case of a 48-year old multipara who presented the outpatient department with the ultrasonographic report showing multiple uterine fibroids but was asymptomatic. A physical examination showed a mass in the right vaginal wall. Pervaginal removal of the tumor was performed and subsequent histopathology revealed a vaginal leiomyoma. Removal of the tumor by the vaginal route, wherever possible, with the subsequent histopathological examination, appears to be the optimum management plan.


Assuntos
Leiomioma , Neoplasias Uterinas , Feminino , Humanos , Leiomioma/diagnóstico por imagem , Leiomioma/cirurgia , Pessoa de Meia-Idade , Nepal , Neoplasias Uterinas/diagnóstico por imagem , Neoplasias Uterinas/cirurgia , Vagina/cirurgia
14.
JNMA J Nepal Med Assoc ; 59(234): 204-206, 2021 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-34506464

RESUMO

Colon carcinoma spreads locally around the intestine wall and can undergo distant metastasis via the hematogenous or lymphatic spread. It rarely metastasizes to the female genital tract and is not fully reported to involve a uterine leiomyoma. Herein we report such an unusual case of a 27 years female a known case of sigmoid colon adenocarcinoma who presented with abdominal pain with bilateral adnexal mass and per vaginal bleeding. Exploratory laparotomy with bilateral resection of ovaries with subsequent polypectomy was done, which on histopathology, it revealed metastatic adenocarcinoma in bilateral ovaries and submucosal leiomyoma. Hence, a lesion with dimorphic histomorphology should be carefully evaluated to rule out the possibility of malignant-to-benign tumor-to-tumor metastasis.


Assuntos
Adenocarcinoma , Leiomioma , Neoplasias do Colo Sigmoide , Adenocarcinoma/cirurgia , Adulto , Feminino , Humanos , Laparotomia , Leiomioma/cirurgia , Neoplasias do Colo Sigmoide/cirurgia
16.
Nat Commun ; 12(1): 5448, 2021 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-34521855

RESUMO

Mechanical forces in a constrained cellular environment were recently established as a facilitator of chromosomal damage. Whether this could contribute to tumorigenesis is not known. Uterine leiomyomas are common neoplasms that display relatively few chromosomal aberrations. We hypothesized that if mechanical forces contribute to chromosomal damage, signs of this could be seen in uterine leiomyomas from parous women. We examined the karyotypes of 1946 tumors, and found a striking overrepresentation of chromosomal damage associated with parity. We then subjected myometrial cells to physiological forces similar to those encountered during pregnancy, and found this to cause DNA breaks and a DNA repair response. While mechanical forces acting in constrained cellular environments may thus contribute to neoplastic degeneration, and genesis of uterine leiomyoma, further studies are needed to prove possible causality of the observed association. No evidence for progression to malignancy was found.


Assuntos
Aberrações Cromossômicas , Reparo do DNA , Leiomioma/genética , Complexo Mediador/genética , Paridade , Neoplasias Uterinas/genética , Adulto , Fenômenos Biomecânicos , Quebras de DNA de Cadeia Dupla , Feminino , Expressão Gênica , Humanos , Histerectomia , Cariótipo , Leiomioma/etiologia , Leiomioma/patologia , Leiomioma/cirurgia , Mutação , Miócitos de Músculo Liso/metabolismo , Miócitos de Músculo Liso/patologia , Miométrio/metabolismo , Miométrio/patologia , Gravidez , Cultura Primária de Células , Estudos Prospectivos , Neoplasias Uterinas/etiologia , Neoplasias Uterinas/patologia , Neoplasias Uterinas/cirurgia
18.
Acta Biomed ; 92(S5): e2021403, 2021 09 10.
Artigo em Inglês | MEDLINE | ID: mdl-34505842

RESUMO

First applications of high focused ultrasound as intracranial ablative therapy were firstly described in early 50'. Since then, the technological innovations have shown an increasingly safe and effective face of this technique. And in the last few years, Magnetic Resonance (MR) guided Focused Ultrasound (gFUS) has become a valid minimally invasive technique in the treatment of several diseases, from bone tumors to symptomatic uterine fibroids or essential tremors. MR guidance, through the tomographic view, offers the advantage of an accurate target detection and treatment planning. Moreover, real-time monitoring sequences allow to avoid non-target ablation. An adequate knowledge of FUS is essential to understand its clinical effectiveness. Therefore, this brief review aims to debate the physical characteristics of US and the main fields of clinical application.


Assuntos
Ablação por Ultrassom Focalizado de Alta Intensidade , Leiomioma , Humanos , Imageamento por Ressonância Magnética , Espectroscopia de Ressonância Magnética , Resultado do Tratamento
19.
BMC Cancer ; 21(1): 1047, 2021 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-34556086

RESUMO

BACKGROUND: The differential diagnosis of endometrial stromal tumor (EST) and uterine cellular leiomyoma (CL) remains a challenge in clinical practice, especially low grade endometrial stromal sarcoma (ESS) and CL, suggesting the need for novel immunomarkers panels for differential diagnosis. Interferon-induced transmembrane protein 1 (IFITM1) is a novel immunomarker for endometrial stromal cells, h-caldesmon is an immunomarker for smooth muscle cells and has a higher specificity than smooth muscle actin (SMA). So this study aimed to evaluate whether IFITM1, cluster of differentiation 10(CD10), SMA, and h-caldesmon are useful biomarker combinations for the differential diagnosis of EST and CL. METHODS: Tissue microarrays were used to detect IFITM1, CD10, SMA, and h-caldesmon immunohistochemical staining in 30 EST and 33 CL cases. RESULTS: The expressions of IFITM1 and CD10 were high in EST (86.7 and 63.3%, respectively) but low in CL (18.2 and 21.2%), whereas those of h-caldesmon and SMA were high in CL (87.9 and 100%) and low in EST (6.9 and 40%). In diagnosing EST, IFITM1 shows better sensitivity and specificity (86.7 and 81.8%, respectively) than CD10 (63.3 and 78.8%). The specificity of h-caldesmon in diagnosing CL was significantly higher (93.1%) than that of SMA (60%). When all four antibodies were combined for the differential diagnosis, the area-under-the-curve (AUC) predictive value was 0.995. The best combination for diagnosing EST was IFITM1 (+) or CD10 (+) and h-caldesmon (-) (sensitivity 86.7%, specificity 93.9%). CONCLUSION: The best combination for diagnosing CL were h-caldesmon (+) and SMA (+) (sensitivity 87.9%, specificity 100%). IFITM1, CD10, SMA, and h-caldesmon are a good combination for the differential diagnosis of EST and CL.


Assuntos
Biomarcadores Tumorais/análise , Neoplasias do Endométrio/diagnóstico , Tumores do Estroma Endometrial/diagnóstico , Leiomioma/diagnóstico , Neoplasias Uterinas/diagnóstico , Actinas/análise , Adulto , Idoso , Antígenos de Diferenciação/análise , Antígenos de Neoplasias/análise , Área Sob a Curva , Proteínas de Ligação a Calmodulina/análise , Diagnóstico Diferencial , Neoplasias do Endométrio/química , Tumores do Estroma Endometrial/química , Feminino , Humanos , Imuno-Histoquímica , Leiomioma/química , Pessoa de Meia-Idade , Músculo Liso/química , Neprilisina/análise , Sensibilidade e Especificidade , Neoplasias Uterinas/química
20.
Laryngorhinootologie ; 100(9): 754-757, 2021 09.
Artigo em Alemão | MEDLINE | ID: mdl-34461657
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