Gynecologic Oncology Reports最新文献

Temporary intraperitoneal breast implant spacer to facilitate safe stereotactic body radiotherapy for recurrent high-grade serous ovarian carcinoma 临时腹腔内乳房植入间隔器促进复发性高级别浆液性卵巢癌的安全立体定向放疗

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2026-02-01 DOI: 10.1016/j.gore.2026.102040

Caleigh E. Smith , Emilie K. Sandfeld , Sheen Cherian , Peter G. Rose

Background

Recurrent ovarian cancer involving the upper abdomen can be challenging to treat with radiation therapy due to the proximity of bowel. Spacer technologies have been used in other malignancies to displace radiosensitive organs, but they are not routinely employed in gynecologic oncology.

Case

We report the case of a 71-year-old woman with a germline BRCA1 mutation and recurrent high-grade serous carcinoma following secondary cytoreduction with right hepatectomy and diaphragmatic resection. Surveillance imaging demonstrated a right upper quadrant abdominal wall recurrence overlying the hepatic flexure, precluding safe stereotactic body radiation therapy (SBRT). Following multidisciplinary review, the patient underwent an exploratory laparotomy with adhesiolysis and placement of a saline-filled breast implant in the right upper quadrant to exclude bowel from the radiation field. Postoperative CT confirmed displacement of the colon, and the patient subsequently received one fraction of SBRT to the abdominal wall. The implant was removed uneventfully two days later. The patient recovered well, and subsequent imaging two months later showed the desired reduction in RUQ disease.

Conclusion

This is the first report, to our knowledge, of the use of a breast implant as a temporary spacer to facilitate safe SBRT in recurrent ovarian cancer. This removable, cost-effective approach offers a feasible solution for anatomically constrained upper abdominal recurrences in close proximity to the bowel.

背景：复发性卵巢癌累及上腹部，由于靠近肠道，放射治疗具有挑战性。间隔技术已用于其他恶性肿瘤，以取代放射性敏感器官，但在妇科肿瘤中并未常规使用。病例：我们报告一例71岁女性，BRCA1基因突变，右肝切除和膈切除术后继发性细胞减少，复发高级别浆液性癌。监测成像显示右上腹壁复发覆盖肝屈曲，排除了安全的立体定向全身放射治疗（SBRT）。在多学科回顾之后，患者接受了剖腹探查术，并在右上象限放置了一个充满盐水的乳房植入物，以将肠道排除在辐射场之外。术后CT证实结肠移位，患者随后接受一小部分SBRT至腹壁。两天后，植入物被顺利取出。患者恢复良好，两个月后的影像学显示RUQ疾病的预期减少。结论：据我们所知，这是首次报道使用乳房植入物作为临时间隔物，以促进复发性卵巢癌的安全SBRT。这种可移动的、经济有效的方法为解剖受限的靠近肠道的上腹部复发提供了可行的解决方案。

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引用次数: 0

The use of ultrasound guidance for endometrial sampling in patient populations with known or suspected cervical stenosis: A retrospective case review 在已知或怀疑宫颈狭窄的患者人群中使用超声引导子宫内膜取样：回顾性病例回顾

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2026-02-01 DOI: 10.1016/j.gore.2026.102030

Courtney Nail , Sara Moufarrij , Jennifer J. Mueller , Mario M. Leitao Jr. , Nadeem R. Abu-Rustum , Dennis S. Chi , Duan Li

Objective

To assess the safety, efficacy, and diagnostic adequacy of ultrasound-guided endometrial sampling (UGES) in patients with known or suspected cervical stenosis.

Methods

We reviewed records of patients who underwent UGES (under general anesthesia) due to cervical stenosis at our center between 1999 and 2024. Of 181 patients identified, 155 were included. Key outcomes included success rate, complication rates, and histopathological findings.

Results

The most common indications for sampling included postmenopausal bleeding (72 of 155, 46.5%), abnormal imaging findings (40 of 155, 25.8%), abnormal Papanicolaou test (16 of 155, 10.3%), and neocervix creation after treatment for cervical cancer (10 of 155, 6.5%). The overall success rate of UGES in gaining access to the endometrial canal for assessment of underlying pathology was 93.5% (145 of 155). Of 155 patients, 150 underwent UGES for histopathologic diagnosis; 131 (84.5%) provided adequate tissue for pathologic analysis, 15 (10%) had a sample obtained but had insufficient tissue for pathologic analysis, and 4 (2.7%) failed to provide a tissue sample due to inability to access the endometrial cavity. Overall, 109 of 155 samples (70.3%) were benign and 18 (11.6%) were malignant. All 5 procedures performed for therapeutic reasons were successful. Seven patients (4.5%) experienced a minor adverse event from UGES. No major complications occurred.

Conclusion(s)

UGES appears to be an effective and safe technique for patients with cervical stenosis. We observed a low complication rate and a high diagnostic yield, suggesting UGES may be a valuable alternative for endometrial evaluation in this challenging setting.

目的评价超声引导下子宫内膜取样（UGES）在已知或疑似宫颈狭窄患者中的安全性、有效性和诊断充分性。方法回顾我院1999年至2024年因颈椎狭窄行全身麻醉的患者资料。在确定的181例患者中，纳入了155例。主要结果包括成功率、并发症发生率和组织病理学结果。结果155例患者中，绝经后出血（72例，46.5%）、影像学异常（40例，25.8%）、Papanicolaou试验异常（16例，10.3%）、宫颈癌治疗后新宫颈形成（10例，6.5%）是最常见的检查指征。UGES进入子宫内膜管以评估潜在病理的总成功率为93.5%（155例中的145例）。155例患者中，150例接受了UGES进行组织病理学诊断；131例（84.5%）提供了足够的组织用于病理分析，15例（10%）获得了样本，但没有足够的组织用于病理分析，4例（2.7%）由于无法进入子宫内膜腔而未能提供组织样本。总体而言，155个样本中有109个（70.3%）为良性，18个（11.6%）为恶性。5例手术均成功。7名患者（4.5%）经历了UGES的轻微不良事件。无重大并发症发生。结论UGES是治疗颈椎病狭窄的一种安全有效的技术。我们观察到低并发症率和高诊断率，这表明UGES可能是子宫内膜评估的一个有价值的替代方案。

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引用次数: 0

Adverse childhood experiences, obesity, and endometrial cancer: A case series and scoping review 不良童年经历、肥胖和子宫内膜癌：一个病例系列和范围回顾

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2026-02-01 DOI: 10.1016/j.gore.2026.102035

Haley D. Frerichs , Jenna B. Wowdzia , Allison Sivak , Sarah Chapelsky , Christa Aubrey , Sophia Pin

Objective: To evaluate self-reported adverse childhood experiences (ACEs) in patients with endometrial cancer and class 3 obesity undergoing a preoperative weight loss protocol, and summarize the existing literature surrounding ACEs, endometrial cancer, and obesity.

Methods: We performed a retrospective chart review of 92 gynecologic oncology patients enrolled in a preoperative weight loss program from 2020 to 2022. Patients included in the case series had endometrioid carcinoma or atypical endometrial hyperplasia, class 3 obesity (body mass index ≥ 40 kg/m²), and at least one self-reported ACE. The scoping review followed PRISMA guidelines and included peer-reviewed studies evaluating ACEs in individuals with endometrial cancer or obesity.

Results: Seventeen of 92 patients (18.5%) with class 3 obesity and endometrial cancer self-disclosed a history of ACEs. The most frequent ACE types were psychological abuse (7/15, 15 46.7%), sexual abuse (6/15, 40%), and physical abuse (4/15, 26.7%). Patients had a mean of 6.4 ± 2.5 comorbidities, with 13/17 (76.5%) patients having at least one mental health disorder. The scoping review identified three studies that investigated ACEs in endometrial cancer patients and found that ACEs may negatively impact gynecologic care. Various ACE types are linked to obesity, with a stronger association between ACEs and obesity in women versus men.

Conclusion: Patients with endometrial cancer, class 3 obesity, and ACEs in our study reported a high degree of abuse and medical comorbidities. ACEs appear to increase the risk of endometrial cancer via obesity and complicate patient care, but a formal association cannot be established.

目的：评估术前接受减重方案的子宫内膜癌和3级肥胖患者自我报告的童年不良经历（ace），并总结有关ace、子宫内膜癌和肥胖的现有文献。方法：我们对2020年至2022年参加术前减肥计划的92名妇科肿瘤患者进行回顾性图表回顾。纳入病例系列的患者患有子宫内膜样癌或非典型子宫内膜增生，3级肥胖（体重指数≥40 kg/m2），并至少有一次自我报告的ACE。范围审查遵循PRISMA指南，包括同行评议的研究，评估子宫内膜癌或肥胖患者的ace。结果：92例3级肥胖合并子宫内膜癌患者中有17例（18.5%）有ace病史。最常见的ACE类型为心理虐待（7/15,15 46.7%）、性虐待（6/15,40%）和身体虐待（4/15,26.7%）。患者平均有6.4±2.5个合并症，其中13/17（76.5%）患者至少有一种精神健康障碍。该综述确定了三项研究，这些研究调查了子宫内膜癌患者的ace，并发现ace可能对妇科护理产生负面影响。各种ACE类型都与肥胖有关，与男性相比，女性ACE与肥胖之间的关联更强。结论：在我们的研究中，患有子宫内膜癌、3级肥胖和ace的患者报告了高度的滥用和医疗合并症。ace似乎通过肥胖增加了子宫内膜癌的风险，并使患者护理复杂化，但尚未建立正式的联系。

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引用次数: 0

Metastatic high-grade undifferentiated ovarian carcinoma: A case report from Sub-Saharan Africa 转移性高级别未分化卵巢癌：撒哈拉以南非洲1例报告

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2026-02-01 DOI: 10.1016/j.gore.2026.102041

John Lugata , Caleigh Smith , Fortunata Nzota , Abitalis Mayengela , Tecla Lyamuya , Albert Masenga , Eusebious Maro , Bariki Mchome , Alex Mremi

Background

Undifferentiated ovarian carcinoma (UDOC) is an exceptionally rare and highly aggressive subtype of epithelial ovarian cancer, accounting for less than 1% of cases and infrequently reported in the literature, particularly in resource-limited settings. To our knowledge, this represents the first reported case of metastatic UDOC from Sub-Saharan Africa.

Case presentation

We report a case of high-grade UDOC in a 63-year-old postmenopausal woman presenting to a tertiary referral center in Northern Tanzania with a one-year history of progressive abdominal pain, distension, early satiety, and weight loss. Imaging demonstrated a large heterogeneous pelvic mass with extensive exophytic hepatic metastases and omental involvement, consistent with advanced-stage disease. Exploratory laparotomy revealed a frozen pelvis with extensive adhesions and intraabdominal metastases, precluding optimal cytoreductive surgery. Histopathologic evaluation demonstrated sheets of poorly differentiated tumor cells with marked cytologic atypia and high mitotic activity, a high proliferative index, and negative staining for Wilms tumor 1 (WT1), estrogen receptor (ER), and epithelial membrane antigen (EMA), supporting the diagnosis of FIGO stage IVB UDOC. Multidisciplinary tumor board review recommended platinum-based chemotherapy; however, treatment was not initiated due to financial barriers, and the patient was subsequently lost to follow-up.

Conclusion

UDOC is a rare and aggressive malignancy that often presents at an advanced stage with nonspecific gastrointestinal symptoms and widespread metastases. This case highlights the intersection of aggressive tumor biology and structural healthcare barriers that continue to limit access to timely cancer diagnosis and treatment in resource-constrained settings, underscoring persistent disparities in global cancer care delivery.

无分化卵巢癌（UDOC）是一种非常罕见且高度侵袭性的上皮性卵巢癌亚型，占病例的不到1%，在文献中很少报道，特别是在资源有限的环境中。据我们所知，这是撒哈拉以南非洲首次报道的转移性UDOC病例。我们报告一个63岁的绝经后妇女在坦桑尼亚北部的三级转诊中心就诊的高级别UDOC病例，她有一年的进行性腹痛、腹胀、早期饱腹感和体重减轻的病史。影像学显示一个大的不均匀盆腔肿块伴广泛的外源性肝转移和大网膜受累，符合晚期疾病。剖腹探查发现骨盆冻结伴广泛粘连和腹腔内转移，排除最佳的细胞减少手术。组织病理学评估显示低分化肿瘤细胞具有明显的细胞学异型性和高有丝分裂活性，高增殖指数，Wilms tumor 1 (WT1)，雌激素受体（ER）和上皮膜抗原（EMA）的阴性染色，支持FIGO IVB期UDOC的诊断。多学科肿瘤委员会审查推荐铂类化疗；然而，由于经济困难，没有开始治疗，患者随后失去了随访。结论udoc是一种罕见的侵袭性恶性肿瘤，常表现为晚期非特异性胃肠道症状和广泛转移。该病例突出了侵袭性肿瘤生物学和结构性医疗障碍的交集，这些障碍继续限制了在资源有限的环境中获得及时的癌症诊断和治疗，强调了全球癌症护理服务的持续差异。

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引用次数: 0

Gynecologic oncology education for obstetrics and gynecology residents: a needs assessment 妇产科住院医师的妇科肿瘤学教育：需求评估

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2026-02-01 DOI: 10.1016/j.gore.2026.102036

Cecilia Rossi, Graham Chapman, Allison Reid, Lindsay Ferguson, Amy Armstrong

Objective

The objective of this needs assessment is to determine self-identified areas of strength and weakness in residents’ Gynecologic Oncology (GO) knowledge and elucidate gaps that may be addressed in future curricular initiatives.

Design

This was a cross-sectional survey designed to assess the effectiveness of current GO curricula at residency programs across the United States. Needs assessment surveys were distributed via a Program Director (PD) listserv to Obstetrics and Gynecology (OB/GYN) PDs in May 2024, with requests to distribute to OB/GYN residents and GO faculty. The primary outcome in this study was respondents’ overall satisfaction with their current GO curricula. Groups were compared in a pairwise fashion using Chi-squared testing for categorical variables and t test or Wilcoxon rank sum for continuous parametric and non-parametric variables, respectively. Multivariate logistic regression was used to control for confounders and to identify variables that were independently associated with participant satisfaction. As a secondary outcome, respondent scores assigned to ten key topics within GO were ranked.

Results

There were 85 survey respondents including 51 residents and 34 faculty. The primary composite outcome of satisfaction with the current curriculum was met in 30 participants (35.3%). Those who were satisfied were more likely to be part of a large residency program (43.3% vs 20.0%, p = 0.02), and reported greater numbers of annual gynecologic oncology lectures (5 + lectures, 70.0% vs 30.9%, p=<0.001). No difference was noted between groups in regard to region or setting of residency program, gender, or rate of additional graduate degrees. Satisfaction was reported in 27.4% of residents vs 47.1% of faculty (p = 0.06).On multivariate logistic regression, having 5 or more lectures per year was the only independent predictor of higher satisfaction (aOR 4.8, 95%CI 1.7–13.4, p = 0.003). Both residents and faculty reported the strongest resident knowledge was in the following 3 key domains: preoperative and postoperative care, critical care and inpatient management, and surgical principles. Residents identified lectures as their preferred educational format, and a preference for supplemental education to be offered during protected resident education time at the workplace.

Conclusions

In this survey study we aimed to assess the overall levels of satisfaction with GO educational curricula, to identify specific areas of strengths and weaknesses within curricula, and to propose strategies for improvement. Satisfaction rates with GO curricula amongst current OBGYN residents and faculty were relatively low. Our findings suggest that investing in GO-focused lectures may improve resident education curricula.

本需求评估的目的是确定住院医师在妇科肿瘤学（GO）知识方面的优势和劣势，并阐明可能在未来课程计划中解决的差距。这是一项横断面调查，旨在评估美国住院医师项目中当前GO课程的有效性。需求评估调查于2024年5月通过项目主任（PD）列表发送给妇产科（OB/GYN） PD，并要求分发给OB/GYN住院医生和GO教员。本研究的主要结果是受访者对当前GO课程的总体满意度。对分类变量采用卡方检验，对连续参数变量和非参数变量采用t检验或Wilcoxon秩和，两两比较各组。多变量逻辑回归用于控制混杂因素，并确定与参与者满意度独立相关的变量。作为次要结果，在GO中分配给十个关键主题的受访者得分被排名。结果调查对象85人，其中住院医师51人，教师34人。30名参与者（35.3%）达到了对当前课程满意的主要综合结果。那些感到满意的人更有可能成为大型住院医师计划的一部分（43.3%对20.0%,p= 0.02），并且报告了更多的年度妇科肿瘤学讲座（5 +讲座，70.0%对30.9%,p=<0.001）。在地区或住院医师项目设置、性别或额外研究生学位率方面，各组之间没有差异。27.4%的住院医师对47.1%的教师表示满意（p = 0.06）。在多变量逻辑回归中，每年有5次或更多的讲座是满意度较高的唯一独立预测因子（aOR 4.8, 95%CI 1.7-13.4, p = 0.003）。住院医生和教师都报告说，住院医生在以下三个关键领域的知识最强：术前和术后护理，重症监护和住院病人管理，以及外科原理。居民将讲座确定为他们首选的教育形式，并倾向于在受保护的居民教育时间内在工作场所提供补充教育。在这项调查研究中，我们旨在评估对GO教育课程的总体满意度，确定课程中的特定优势和劣势，并提出改进策略。目前妇产科住院医师和教师对GO课程的满意度相对较低。我们的研究结果表明，投资于以go为重点的讲座可能会改善居民教育课程。

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引用次数: 0

Assessing long-term quality of life and survivorship priorities in cervical cancer patients: a social media survey-based study 评估宫颈癌患者的长期生活质量和生存优先权：一项基于社交媒体调查的研究

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2026-02-01 DOI: 10.1016/j.gore.2026.102031

Edward A. Joseph , Manasa Mula , Muhammad Muntazir Mehdi Khan , Casey J. Allen

Background

We evaluated quality of life (QOL) and healthcare priorities among cervical cancer survivors.

Methods

We utilized the validated Short Form 12 (SF-12) survey to assess QOL (focusing on physical [P-QOL] and mental well-being [M-QOL]) and care prioritization among cervical cancer patients. Respondents were asked how they prioritize the following healthcare priorities: overall survival (OS), emotional well-being (EWB), functional independence (FI), cost of healthcare (CC), and treatment experience (TE). Kendall’s coefficient of concordance (W) assessed agreement among respondents.

Results

We received 100 survey respondents, they were 45.5 ± 13.8 years old and 88% White. The most common diagnoses included squamous cell carcinoma (57.0%) and adenocarcinoma (23.0%). With moderate consensus (W = 0.340, p < 0.001), patients considered OS (1.93 ± 1.26) the most important healthcare priority, followed by FI (2.63 ± 1.11) and EWB (2.76 ± 1.10). Patients attributed the lowest rank to TE (3.23 ± 1.17) and CC (4.41 ± 1.15). Patients who received chemotherapy were more likely to rank FI (2.59 ± 1.05 chemotherapy vs 2.72 ± 1.28 no chemotherapy, p = 0.620) above EWB (2.80 ± 1.09 chemotherapy vs 2.63 ± 1.15 no chemotherapy, p = 0.528). Respondents who underwent surgery reported better P-QOL (46.94 ± 12.64 vs. 37.57 ± 11.63, p < 0.001) compared to non-surgically managed patients. Both M-QOL and P-QOL did not vary significantly throughout survivorship (P-QOL: 40.61 ± 12.76 at < 1 year vs 35.43 ± 12.57 at > 5 years, p = 0.200; M-QOL: 35.74 ± 13.65 at < 1 year vs 39.55 ± 17.74 at > 5 years; p = 0.637), and remained below that of the general population (p < 0.050).

Conclusions

Cervical cancer survivors experience persistent deficits in both physical and mental well-being and consistently prioritized OS and FI, and less frequently cost considerations. This study emphasizes the importance of personalized survivorship care that evolves with patients’ changing priorities.

背景：我们评估宫颈癌幸存者的生活质量（QOL）和医疗保健优先级。方法采用经验证的SF-12问卷，评估宫颈癌患者的生活质量（主要关注身体[P-QOL]和心理健康[M-QOL]）和护理优先度。受访者被问及他们如何优先考虑以下医疗保健优先事项：总体生存（OS）、情绪健康（EWB）、功能独立性（FI）、医疗保健成本（CC）和治疗经验（TE）。肯德尔的一致性系数(W)评估受访者之间的协议。结果共收到100名调查对象，年龄（45.5±13.8）岁，白人占88%。最常见的诊断包括鳞状细胞癌（57.0%）和腺癌（23.0%）。中度共识（W = 0.340, p < 0.001），患者认为OS（1.93±1.26）是最重要的医疗保健优先事项，其次是FI（2.63±1.11）和EWB（2.76±1.10）。患者认为TE（3.23±1.17）和CC（4.41±1.15）排名最低。接受化疗的患者FI评分（化疗2.59±1.05 vs未化疗2.72±1.28,p = 0.620）高于EWB评分（化疗2.80±1.09 vs未化疗2.63±1.15,p = 0.528）。接受手术治疗的受访者报告的p - qol（46.94±12.64比37.57±11.63,p < 0.001）优于非手术治疗的患者。M-QOL和p - qol在整个生存期均无显著差异（p - qol: 1年时为40.61±12.76,5年时为35.43±12.57,p = 0.200； M-QOL: 1年时为35.74±13.65,5年时为39.55±17.74,p = 0.637），且仍低于一般人群（p < 0.050）。结论：宫颈癌幸存者在生理和心理健康方面持续存在缺陷，并且始终优先考虑OS和FI，而较少考虑成本。本研究强调个性化生存护理的重要性，随着患者优先事项的变化而发展。

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引用次数: 0

Dapsone-induced methemoglobinemia in gynecologic cancer patients treated with immune checkpoint Inhibitors: a case series 用免疫检查点抑制剂治疗的妇科癌症患者中氨苯砜诱导的高铁血红蛋白血症：一个病例系列

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2026-02-01 DOI: 10.1016/j.gore.2026.102039

Julia C. Sakach , Sydney Anderson , Cassidy Abdeen , Danielle Glassman , Casey M. Cosgrove , Robert T. Neff , Laura J. Chambers

Background

Immune checkpoint inhibitors (ICI) activate antitumor immunity which can lead to the development of immune-related adverse events (irAE) that often require management with high-dose corticosteroids. The dosing and duration of corticosteroid therapy necessitates antibiotic prophylaxis against Pneumocystis jirovecii pneumonia (PJP). In patients that cannot use first-line trimethoprim–sulfamethoxazole, dapsone is a common alternative. A rare, serious complication of dapsone use is methemoglobinemia. Here, we present a case series of 3 gynecologic oncology patients on PJP prophylaxis with dapsone for irAEs related to ICI therapy who developed acquired-methemoglobinemia.

Methods

This is a case series and review of literature. Patient consent was obtained prior to initiation of the series and submission to the journal.

Objective

This case series describes three gynecologic oncology patients on ICI therapy who, while receiving dapsone for PJP prophylaxis during corticosteroid treatment for irAEs, presented to care with hypoxia and nonspecific symptoms. The presence of persistent hypoxia despite oxygen supplementation increased clinical suspicion of a dyshemoglobinemia and co-oximetry confirmed methemoglobinemia. Dapsone, the offending agent, was discontinued and patients were supportively managed with one patient additionally receiving methylene blue. This series aims to highlight the diagnostic challenges, overlap with ICI pneumonitis, and key management considerations.

Conclusions

Dapsone-induced methemoglobinemia is an important diagnostic consideration in gynecologic oncology patients on ICIs, particularly when faced with refractory hypoxia despite appropriate management of presumed immune-related toxicity. Recognition of acquired methemoglobinemia’s characteristic laboratory features and timely cessation of dapsone are vital to ensuring accurate diagnosis and to optimizing patient outcomes.

免疫检查点抑制剂（ICI）激活抗肿瘤免疫，可导致免疫相关不良事件（irAE）的发生，通常需要高剂量皮质类固醇治疗。皮质类固醇治疗的剂量和持续时间需要抗生素预防对肺囊虫肺炎（PJP）。对于不能使用一线甲氧苄啶-磺胺甲恶唑的患者，氨苯砜是一种常见的替代方案。氨苯砜的一种罕见的严重并发症是高铁血红蛋白血症。在这里，我们报告了3例妇科肿瘤患者的病例系列，这些患者在接受氨苯砜预防与ICI治疗相关的irae时发生了获得性高铁血红蛋白血症。方法：这是一个病例系列和文献综述。在开始该系列研究并提交给期刊之前获得患者同意。目的：本病例系列描述了3例接受ICI治疗的妇科肿瘤患者，他们在接受皮质类固醇治疗期间接受氨苯砜预防PJP治疗，但出现缺氧和非特异性症状。尽管补充了氧气，但持续缺氧的存在增加了临床对血红蛋白异常的怀疑，共氧测定证实了高铁血红蛋白血症。停用致恶药物氨苯砜，并对患者进行支持性管理，其中一名患者额外接受亚甲基蓝治疗。本系列旨在强调诊断挑战，与ICI肺炎的重叠，以及关键的管理注意事项。结论apsone诱导的高铁血红蛋白血症是接受ICIs的妇科肿瘤患者的重要诊断考虑因素，特别是当患者面临难治性缺氧时，尽管有适当的免疫相关毒性管理。识别获得性高铁血红蛋白血症的实验室特征并及时停用氨苯砜对于确保准确诊断和优化患者预后至关重要。

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引用次数: 0

Primary lymphatic leiomyosarcoma presenting as a pelvic mass 原发性淋巴平滑肌肉瘤表现为盆腔肿块

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2026-01-19 DOI: 10.1016/j.gore.2026.102037

Bridget S. Dillon , Rayan M. Sibira , Laura Miller , Morgan Gruner , Mahmoud Khalifa , Britt K. Erickson

Introduction

Leiomyosarcoma (LMS) most commonly presents in the uterus or as a primary retroperitoneal mass. LMS metastases to the lymph nodes is exceedingly rare and to our knowledge there are no reported cases of lymphatic confined LMS.

Case Presentation.

A 72-year-old woman presented with intermittent lower abdominal cramping for about one year. Her surgical history was notable for a total abdominal hysterectomy (TAH) and bilateral salpingo-oophorectomy (BSO) for uterine fibroids, 25 years prior to presentation. She had no other notable medical history. She was found to have a 9 cm complex pelvic mass, extensive bulky pelvic and retroperitoneal lymphadenopathy and an enlarged right supraclavicular lymph node. Biopsies of the right supraclavicular lymph nodes, right para-aortic lymph nodes, and complex pelvic mass showed benign leiomyomatosis. Surgical debulking was performed including pelvic mass resection, and extensive lymphadenectomy. Final pathology confirmed metastatic LMS. The pelvic mass was found to be an enlarged obturator lymph node, positive for LMS. All visible disease was resected. She was started on an aromatase inhibitor postoperatively and has been disease free for 16 months.

Conclusion

This is a unique case of widely metastatic, yet lymphatic confined LMS in a patient with very remote history of TAH/BSO. The tumor responded well to surgical resection and aromatase inhibition. Although traditionally LMS does not involve lymphatic spread, this case demonstrates that LMS should remain in the differential when bulky lymphadenopathy is encountered. While there are rare cases of primary retroperitoneal LMS, this may be the first reported case of primary lymphatic LMS.

平滑肌肉瘤（LMS）最常见于子宫或原发性腹膜后肿块。LMS转移到淋巴结是非常罕见的，据我们所知，没有报道的病例淋巴局限性LMS。例演示。一名72岁女性，因间歇性下腹部绞痛约一年。她的手术史是值得注意的子宫肌瘤全腹子宫切除术（TAH）和双侧输卵管卵巢切除术（BSO），在25年前出现。她没有其他明显的病史。她被发现有一个9厘米的复杂盆腔肿块，广泛的盆腔和腹膜后淋巴结肿大和右侧锁骨上淋巴结肿大。右侧锁骨上淋巴结、右侧主动脉旁淋巴结及复杂盆腔肿块活检显示为良性平滑肌瘤病。手术切除包括盆腔肿块切除术和广泛淋巴结切除术。最终病理证实转移性LMS。盆腔肿块为增大的闭孔淋巴结，为LMS阳性。所有可见的疾病都切除了。术后开始使用芳香酶抑制剂，已无病16个月。结论：这是一例罕见的广泛转移，但淋巴局限的LMS患者，有非常久远的TAH/BSO病史。肿瘤对手术切除和芳香酶抑制反应良好。虽然传统上LMS不涉及淋巴扩散，但本病例表明，当遇到肿大的淋巴结病变时，LMS应保持在鉴别区。虽然有罕见的原发性腹膜后LMS病例，但这可能是首次报道的原发性淋巴LMS病例。

{"title":"Primary lymphatic leiomyosarcoma presenting as a pelvic mass","authors":"Bridget S. Dillon , Rayan M. Sibira , Laura Miller , Morgan Gruner , Mahmoud Khalifa , Britt K. Erickson","doi":"10.1016/j.gore.2026.102037","DOIUrl":"10.1016/j.gore.2026.102037","url":null,"abstract":"<div><h3>Introduction</h3><div>Leiomyosarcoma (LMS) most commonly presents in the uterus or as a primary retroperitoneal mass. LMS metastases to the lymph nodes is exceedingly rare and to our knowledge there are no reported cases of lymphatic confined LMS.</div><div>Case Presentation.</div><div>A 72-year-old woman presented with intermittent lower abdominal cramping for about one year. Her surgical history was notable for a total abdominal hysterectomy (TAH) and bilateral salpingo-oophorectomy (BSO) for uterine fibroids, 25 years prior to presentation. She had no other notable medical history. She was found to have a 9 cm complex pelvic mass, extensive bulky pelvic and retroperitoneal lymphadenopathy and an enlarged right supraclavicular lymph node. Biopsies of the right supraclavicular lymph nodes, right <em>para</em>-aortic lymph nodes, and complex pelvic mass showed benign leiomyomatosis. Surgical debulking was performed including pelvic mass resection, and extensive lymphadenectomy. Final pathology confirmed metastatic LMS. The pelvic mass was found to be an enlarged obturator lymph node, positive for LMS. All visible disease was resected. She was started on an aromatase inhibitor postoperatively and has been disease free for 16 months.</div></div><div><h3>Conclusion</h3><div>This is a unique case of widely metastatic, yet lymphatic confined LMS in a patient with very remote history of TAH/BSO. The tumor responded well to surgical resection and aromatase inhibition. Although traditionally LMS does not involve lymphatic spread, this case demonstrates that LMS should remain in the differential when bulky lymphadenopathy is encountered. While there are rare cases of primary retroperitoneal LMS, this may be the first reported case of primary lymphatic LMS.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102037"},"PeriodicalIF":1.3,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rare case of primary HPV negative vaginal cancer presenting in a young woman with normal cervix 罕见的原发HPV阴性阴道癌呈现在一个年轻的妇女正常宫颈

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2026-01-16 DOI: 10.1016/j.gore.2026.102032

Erin Carter , Teri Nguyen-Guo , Paulina Guta , Vikram Soni , Jennifer McEachron

Background

Primary vaginal cancer is defined as malignancy of the vaginal wall without coexisting cervical or vulvar pathology or history of such in the past 5 years. It is a rare diagnosis, and makes up only 1–3% of all gynecologic cancer globally. Major risk factors historically have included older age, history of high-risk HPV infection, diethylstilbestrol (DES) exposure, immunocompromise, history of tobacco smoking (Adams et al., 2025, Di Donato et al., 2012).

Case presentation

A healthy 32-year-old women, with well documented history of normal Pap smears presented with primary, HPV negative, invasive squamous cell carcinoma of the vagina. The patient was diagnosed via tissue biopsy and treated successfully according to standard chemoradiation protocol for primary vaginal cancer, despite rare presentation. The patient remains disease free at 22 months and avoided vaginectomy to preserve sexual function.

Conclusions

This case emphasizes the importance of tissue biopsy for suspicious vaginal lesions, even in the absence of major risk factors for malignancy, as well as the potential broad application of standard chemoradiation in atypical presentations of primary invasive squamous cell vaginal cancer.

背景：原发阴道癌被定义为阴道壁恶性肿瘤，在过去5年内无宫颈或外阴病理或此类病史。这是一种罕见的诊断，仅占全球所有妇科癌症的1-3%。历史上的主要危险因素包括年龄较大、高危HPV感染史、己烯雌酚（DES）暴露、免疫功能低下、吸烟史（Adams等人，2025年，Di Donato等人，2012年）。病例表现：健康32岁女性，宫颈抹片检查记录良好，原发HPV阴性，阴道浸润性鳞状细胞癌。患者通过组织活检诊断，并根据原发性阴道癌的标准放化疗方案成功治疗，尽管罕见的表现。患者22个月无疾病，避免阴道切除术以保持性功能。结论：本病例强调了组织活检对可疑阴道病变的重要性，即使没有恶性肿瘤的主要危险因素，以及标准放化疗在原发性侵袭性阴道鳞状细胞癌的非典型表现中的潜在广泛应用。

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引用次数: 0

Active surveillance of an endometriosis-related, hormone-responsive pelvic adenosarcoma during pregnancy: A case report 妊娠期间子宫内膜异位症相关的激素反应性盆腔腺肉瘤的主动监测：一例报告

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2026-01-08 DOI: 10.1016/j.gore.2026.102029

Amar Zaidan , Kelly H Bruce , Mark R Hopkins , Steven I Robinson , Carl H Rose , Wendaline M VanBuren , Carrie L Langstraat

Background

Extrauterine adenosarcomas are rare gynecologic malignancies that can arise within foci of pelvic endometriosis. They are often hormone mediated and thus are challenging to treat during pregnancy.

Case presentation

We present the case of a hormone-receptor positive extrauterine adenosarcoma arising within a known focus of pelvic endometriosis diagnosed in the second trimester of pregnancy. The posterior pelvic mass involved and completely obstructed the colon. The patient desired pregnancy continuation and was managed with surgical intestinal diversion followed by serial surveillance with MRI imaging. Indicated primary preterm cesarean delivery was performed at 30 weeks gestation, after which she was treated with dual anti-estrogen therapy followed by definitive surgical resection. Fifteen months after surgery, she remains free from disease.

Conclusion

We review salient topics including malignant transformation of endometriosis, hormone therapy for adenosarcoma without sarcomatous overgrowth, and ethical considerations of cancer management during pregnancy.

子宫内膜腺肉瘤是一种罕见的妇科恶性肿瘤，可发生在盆腔子宫内膜异位症的病灶内。它们通常是激素介导的，因此在怀孕期间治疗是具有挑战性的。我们提出的情况下，激素受体阳性的子宫外腺肉瘤出现在一个已知的焦点盆腔子宫内膜异位症诊断在妊娠中期。后盆腔肿块累及并完全阻塞了结肠。患者希望继续妊娠，并进行手术肠转移，随后进行MRI成像连续监测。在妊娠30周进行了原发性早产剖宫产，之后她接受了双重抗雌激素治疗，随后进行了明确的手术切除。手术后15个月，她仍然没有患病。结论我们回顾了子宫内膜异位症的恶性转化，无肉瘤过度生长的腺肉瘤的激素治疗，以及妊娠期间癌症治疗的伦理考虑。

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引用次数: 0