Accuracy and Survival Outcomes after National Implementation of Sentinel Lymph Node Biopsy in Early Stage Endometrial Cancer.

BACKGROUND: Sentinel lymph node (SLN) biopsy has recently been accepted to evaluate nodal status in endometrial cancer at early stage, which is key to tailoring adjuvant treatments. Our aim was to evaluate the national implementation of SLN biopsy in terms of accuracy to detect nodal disease in a clinical setting and oncologic outcomes according to the volume of nodal disease. PATIENTS AND METHODS: A total of 29 Spanish centers participated in this retrospective, multicenter registry including patients with endometrial adenocarcinoma at preoperative early stage who had undergone SLN biopsy between 2015 and 2021. Each center collected data regarding demographic, clinical, histologic, therapeutic, and survival characteristics. RESULTS: A total of 892 patients were enrolled. After the surgery, 12.9% were suprastaged to FIGO 2009 stages III-IV and 108 patients (12.1%) had nodal involvement: 54.6% macrometastasis, 22.2% micrometastases, and 23.1% isolated tumor cells (ITC). Sensitivity of SLN biopsy was 93.7% and false negative rate was 6.2%. After a median follow up of 1.81 years, overall surivial and disease-free survival were significantly lower in patients who had macrometastases when compared with patients with negative nodes, micrometastases or ITC. CONCLUSIONS: In our nationwide cohort we obtained high sensitivity of SLN biopsy to detect nodal disease. The oncologic outcomes of patients with negative nodes and low-volume disease were similar after tailoring adjuvant treatments. In total, 22% of patients with macrometastasis and 50% of patients with micrometastasis were at low risk of nodal metastasis according to their preoperative risk factors, revealing the importance of SLN biopsy in the surgical management of patients with early stage EC.

Anuria como presentación anómala de himen imperforado / Anuria as anomalous presentation of imperforate hymen

El himen imperforado es un trastorno congénito en el desarrollo del aparato genital femenino. Pese a ser la más frecuente, su incidencia es alrededor del 0,1 % de las recién nacidas. La anamnesis y exploración física son útiles para el diagnóstico, aunque a menudo se requieren técnicas de imagen. La plastia o apertura del himen es el tratamiento de primera línea. A continuación, exponemos un caso de una paciente de 12 años que consultó por anuria

Imperforate hymen is a congenital disorder of the female genital tract. Despite being the most frequent, its incidence is about 0.1% in female newborns. Medical history and physical examination are useful for diagnosis, although imaging studies are often required. The hymen plasty or opening is the first-line treatment. Below, we present the case of a 12-year-old patient who consulted because of anuria