Pub Date : 2026-02-01DOI: 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.
{"title":"Temporary intraperitoneal breast implant spacer to facilitate safe stereotactic body radiotherapy for recurrent high-grade serous ovarian carcinoma","authors":"Caleigh E. Smith , Emilie K. Sandfeld , Sheen Cherian , Peter G. Rose","doi":"10.1016/j.gore.2026.102040","DOIUrl":"10.1016/j.gore.2026.102040","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Case</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102040"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146073631","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}
Pub Date : 2026-02-01DOI: 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.
{"title":"The use of ultrasound guidance for endometrial sampling in patient populations with known or suspected cervical stenosis: A retrospective case review","authors":"Courtney Nail , Sara Moufarrij , Jennifer J. Mueller , Mario M. Leitao Jr. , Nadeem R. Abu-Rustum , Dennis S. Chi , Duan Li","doi":"10.1016/j.gore.2026.102030","DOIUrl":"10.1016/j.gore.2026.102030","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the safety, efficacy, and diagnostic adequacy of ultrasound-guided endometrial sampling (UGES) in patients with known or suspected cervical stenosis.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion(s)</h3><div>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.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102030"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146170266","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}
Pub Date : 2026-02-01DOI: 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.
{"title":"Adverse childhood experiences, obesity, and endometrial cancer: A case series and scoping review","authors":"Haley D. Frerichs , Jenna B. Wowdzia , Allison Sivak , Sarah Chapelsky , Christa Aubrey , Sophia Pin","doi":"10.1016/j.gore.2026.102035","DOIUrl":"10.1016/j.gore.2026.102035","url":null,"abstract":"<div><div>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.</div><div>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/m<sup>2</sup>), 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.</div><div>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.</div><div>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.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102035"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146170165","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}
Pub Date : 2026-02-01DOI: 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.
{"title":"Metastatic high-grade undifferentiated ovarian carcinoma: A case report from Sub-Saharan Africa","authors":"John Lugata , Caleigh Smith , Fortunata Nzota , Abitalis Mayengela , Tecla Lyamuya , Albert Masenga , Eusebious Maro , Bariki Mchome , Alex Mremi","doi":"10.1016/j.gore.2026.102041","DOIUrl":"10.1016/j.gore.2026.102041","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Case presentation</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102041"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146170247","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}
Pub Date : 2026-02-01DOI: 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.
{"title":"Gynecologic oncology education for obstetrics and gynecology residents: a needs assessment","authors":"Cecilia Rossi, Graham Chapman, Allison Reid, Lindsay Ferguson, Amy Armstrong","doi":"10.1016/j.gore.2026.102036","DOIUrl":"10.1016/j.gore.2026.102036","url":null,"abstract":"<div><h3>Objective</h3><div>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.</div></div><div><h3>Design</h3><div>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 <em>t</em> 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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102036"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146073634","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}
Pub Date : 2026-02-01DOI: 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.
{"title":"Assessing long-term quality of life and survivorship priorities in cervical cancer patients: a social media survey-based study","authors":"Edward A. Joseph , Manasa Mula , Muhammad Muntazir Mehdi Khan , Casey J. Allen","doi":"10.1016/j.gore.2026.102031","DOIUrl":"10.1016/j.gore.2026.102031","url":null,"abstract":"<div><h3>Background</h3><div>We evaluated quality of life (QOL) and healthcare priorities among cervical cancer survivors.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102031"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146073633","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}
Pub Date : 2026-02-01DOI: 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.
{"title":"Dapsone-induced methemoglobinemia in gynecologic cancer patients treated with immune checkpoint Inhibitors: a case series","authors":"Julia C. Sakach , Sydney Anderson , Cassidy Abdeen , Danielle Glassman , Casey M. Cosgrove , Robert T. Neff , Laura J. Chambers","doi":"10.1016/j.gore.2026.102039","DOIUrl":"10.1016/j.gore.2026.102039","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>This is a case series and review of literature. Patient consent was obtained prior to initiation of the series and submission to the journal.</div></div><div><h3>Objective</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102039"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146170248","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}
Pub Date : 2026-01-19DOI: 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.
{"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}
Pub Date : 2026-01-16DOI: 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.
{"title":"Rare case of primary HPV negative vaginal cancer presenting in a young woman with normal cervix","authors":"Erin Carter , Teri Nguyen-Guo , Paulina Guta , Vikram Soni , Jennifer McEachron","doi":"10.1016/j.gore.2026.102032","DOIUrl":"10.1016/j.gore.2026.102032","url":null,"abstract":"<div><h3>Background</h3><div>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 (<span><span>Adams et al., 2025</span></span>, <span><span>Di Donato et al., 2012</span></span>).</div></div><div><h3>Case presentation</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102032"},"PeriodicalIF":1.3,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022727","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}
Pub Date : 2026-01-08DOI: 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.
{"title":"Active surveillance of an endometriosis-related, hormone-responsive pelvic adenosarcoma during pregnancy: A case report","authors":"Amar Zaidan , Kelly H Bruce , Mark R Hopkins , Steven I Robinson , Carl H Rose , Wendaline M VanBuren , Carrie L Langstraat","doi":"10.1016/j.gore.2026.102029","DOIUrl":"10.1016/j.gore.2026.102029","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Case presentation</h3><div>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.</div></div><div><h3>Conclusion</h3><div>We review salient topics including malignant transformation of endometriosis, hormone therapy for adenosarcoma without sarcomatous overgrowth, and ethical considerations of cancer management during pregnancy.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102029"},"PeriodicalIF":1.3,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921638","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}