Gynecologic Oncology Reports最新文献_第5页

Ovarian carcinoid tumor with carcinoid heart syndrome: A case report and literature review 类卵巢癌合并类癌性心脏综合征1例报告并文献复习

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-12-01 Epub Date: 2025-11-24 DOI: 10.1016/j.gore.2025.101997

Minyoung Jang , Lakeisha Mulugeta-Gordon , Joseph Carver , Natalie Tupper , Julie Barbera , Lauren Schwartz , Nawar Latif

Background

Primary ovarian carcinoid tumors are rare neuroendocrine neoplasms comprising <0.1% of ovarian tumors and 1% of all carcinoid tumors. Up to 30% present with carcinoid syndrome, and approximately one-quarter of these develop carcinoid heart syndrome. Unlike gastrointestinal carcinoid tumors, ovarian lesions can cause carcinoid syndrome without hepatic metastases due to direct venous drainage into the systemic circulation.

Case

A 46-year-old woman presented with abdominal discomfort, new onset hypertension, and lower extremity edema. Imaging revealed a 16.8 cm right adnexal mass with mixed solid and cystic components. Echocardiography demonstrated torrential tricuspid regurgitation related to thickened, immobile leaflets, consistent with carcinoid heart syndrome. Serum serotonin and chromogranin A were markedly elevated. She underwent exploratory laparotomy, total abdominal hysterectomy, bilateral salpingo-oophorectomy, right pelvic and para-aortic lymphadenectomy, and omental biopsy. Pathology showed a carcinoid tumor arising in a mature cystic teratoma, confined to the right ovary (FIGO stage IA). Immunohistochemistry confirmed neuroendocrine differentiation (synaptophysin, chromogranin positive). Postoperatively, chromogranin A normalized, serotonin decreased, and proBNP improved. Three months later, she underwent successful bioprosthetic tricuspid valve replacement with ongoing Cardiology follow up.

Discussion

This case illustrates that ovarian carcinoid tumors may present with minimal symptoms despite significant cardiac involvement. Early cardiac evaluation is warranted in suspected carcinoid tumors to identify carcinoid heart syndrome. Overall survival is generally favorable for early stage ovarian carcinoid tumors. Long-term cardiac prognosis is determined by right ventricular function and presence of residual tumor after resection. Management requires individualized and multidisciplinary surgical planning, balancing tumor resection with timely cardiac intervention.

原发性卵巢类癌是一种罕见的神经内分泌肿瘤，占卵巢肿瘤的0.1%，占所有类癌的1%。高达30%的人表现为类癌综合征，其中约四分之一的人发展为类癌心脏综合征。与胃肠道类癌不同，卵巢病变由于静脉直接引流进入体循环，可引起无肝转移的类癌综合征。病例1:46岁女性，腹部不适，新发高血压，下肢水肿。影像显示右侧附件16.8 cm肿块，有实性和囊性混合成分。超声心动图显示剧烈的三尖瓣反流与增厚、不动的小叶有关，符合类癌心脏综合征。血清5 -羟色胺和嗜铬粒蛋白A明显升高。她接受了剖腹探查、全腹子宫切除术、双侧输卵管卵巢切除术、右侧骨盆和主动脉旁淋巴结切除术和大网膜活检。病理显示成熟囊性畸胎瘤的类癌，局限于右侧卵巢（FIGO IA期）。免疫组化证实神经内分泌分化（synaptophysin， chromogranin阳性）。术后，色粒蛋白A正常化，血清素降低，proBNP改善。三个月后，她成功接受了生物假体三尖瓣置换术，并进行了心脏病学随访。本病例表明，尽管严重累及心脏，但卵巢类癌可能表现为轻微症状。对于疑似类癌肿瘤，早期心脏评估是必要的，以确定类癌心脏综合征。早期类卵巢肿瘤的总体生存率通常是有利的。长期心脏预后是由右心室功能和肿瘤切除后是否存在残余肿瘤决定的。治疗需要个体化和多学科的手术计划，平衡肿瘤切除和及时的心脏介入治疗。

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引用次数: 0

MECOM amplified endometrial cancer, a novel subset of copy number high tumors associated with poor prognosis MECOM扩增子宫内膜癌，一个新的亚群的拷贝数高的肿瘤相关的不良预后

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-12-01 Epub Date: 2025-11-16 DOI: 10.1016/j.gore.2025.101993

Shariska P. Harrington , Jacqueline Romani , Aminah Jatoi , S.John Weroha , Andrea Mariani , William A. Cliby , Jamie N. Bakkum-Gamez , Dineo Khabele , Alexandre Gaspar-Maia

Objective

Copy number high (CNH) endometrial cancer (EC) is an aggressive molecular subgroup characterized by TP53 mutations and relative chemoresistance. CNH EC with cyclin E1 gene (CCNE1) amplification and erythroblastic oncogene B (ERBB2) amplification are associated with poor clinical outcomes. MECOM, a complex locus of MDS1 (myelodysplasia syndrome 1) and EVI1 (ecotropic virus integration site 1), has recently been associated with poor prognosis in ovarian cancer. Our objective was to evaluate clinical outcomes of MECOM, CCNE1 and ERBB2 amplified ECs and to provide a literature review on the role of MECOM in gynecologic cancers.

Methods

Copy number variation and molecular subtype classification were extracted from The Cancer Genome Atlas for 529 ECs. Amplification status was determined for MECOM, CCNE1 and ERBB2. Measured clinical outcomes were overall and progression-free survival, covariates included race, stage at diagnosis, and tumor histology. A comprehensive search of peer-reviewed articles was undertaken to summarize evidence on the role of MECOM in gynecologic cancers.

Results

Of all ECs profiled, MECOM was the most frequently amplified gene. Notably, 35% of CNH ECs were MECOM amplified. In multivariate analysis, MECOM amplification without co-amplification of CCNE1 or ERBB2 was associated with an increased risk of death and recurrence, HR 2.3 [1.17–4.62], p = 0.0163 and HR 2.07 [1.08–3.98], p = 0.0282, respectively. The literature review identified 19 relevant studies with inconsistent evidence on MECOM’s role in carcinogenesis.

Conclusions

ECs with MECOM amplification are associated with poor clinical outcomes, even in the absence of CCNE1 or ERBB2 amplification. The current literature is limited, and further studies are warranted to determine the role of MECOM amplification in ECs.

目的高拷贝数（CNH）子宫内膜癌（EC）是一种以TP53突变和相对化疗耐药为特征的侵袭性分子亚群。伴有细胞周期蛋白E1基因（CCNE1）扩增和红母细胞癌基因B （ERBB2）扩增的CNH EC与较差的临床结果相关。MECOM是MDS1（骨髓增生异常综合征1）和EVI1（亲生态病毒整合位点1）的复杂位点，最近发现与卵巢癌预后不良相关。我们的目的是评估MECOM、CCNE1和ERBB2扩增的ECs的临床结果，并对MECOM在妇科癌症中的作用进行文献综述。方法从肿瘤基因组图谱中提取529例ECs的数量变异和分子亚型分类。测定MECOM、CCNE1和ERBB2的扩增情况。测量的临床结果是总生存期和无进展生存期，协变量包括种族、诊断阶段和肿瘤组织学。我们对同行评议的文章进行了全面检索，总结了MECOM在妇科癌症中作用的证据。结果在所分析的ECs中，MECOM是扩增频率最高的基因。值得注意的是，35%的CNH ec是MECOM扩增的。在多因素分析中，MECOM扩增而不同时扩增CCNE1或ERBB2与死亡和复发风险增加相关，HR分别为2.3 [1.17-4.62],p = 0.0163； HR为2.07 [1.08-3.98],p = 0.0282。文献综述确定了19项有关MECOM在致癌作用方面证据不一致的相关研究。结论即使没有CCNE1或ERBB2扩增，伴有MECOM扩增的sc也与较差的临床结果相关。目前的文献是有限的，需要进一步的研究来确定MECOM扩增在ECs中的作用。

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引用次数: 0

HPV profiles in Botswana: An analysis of healthy women, cervical intraepithelial neoplasia, and invasive cervical cancer 博茨瓦纳的HPV概况：健康妇女、宫颈上皮内瘤变和浸润性宫颈癌的分析

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-12-01 Epub Date: 2025-10-17 DOI: 10.1016/j.gore.2025.101971

Caroline Kernell , Emily MacDuffie , Xiang Lin , Le Gao , Doreen Ramogola-Masire , Surbhi Grover , Erle Robertson

Purpose/Objective(s)

High prevalence of HPV and HIV contribute to the high rate of cervical cancer (CaCx) in Botswana. HPV subtypes in healthy, unvaccinated students (Cohort 1), women with CIN II/III (Cohort 2), and women with invasive CaCx (Cohort 3) were compared.

Materials/Methods

The Ipabalele study in Gaborone, Botswana enrolled patients between 2016–2020. Demographics, clinical characteristics, and HPV cervical swabs were collected. PathoChip quantified prevalence of HPV subtypes.

Results

Overall 414 patients enrolled. Cohort 1: 43; Cohort 2; 212; Cohort 3: 159. Median age was 19, 39, and 46 years. Women living with HIV (WLWH) accounted for 0 %, 76 %, and 72 %. High-risk (HR) HPV prevalence in Cohort 1 increased 34 % to 57 % over 20 months. HPV profiles did not differ by HIV status. The prevalence of all HR HPV subtypes in Cohorts 2 and 3 is increased compared to Cohort 1. The prevalence of HPV HR subtypes except for HPV 53 is increased in Cohort 3 compared to Cohort 2. Among WLWH, Cohort 3 had a higher prevalence of HPV 16, 18, and 34 compared to Cohort 2. Among women without HIV, Cohort 3 had a higher prevalence of HPV 16 and 18 compared to Cohort 2.

Conclusions

Compared to healthy women, HPV subtype representation is higher among women with CIN and CaCx. This suggests the presence of multiple HR HPV strains may impact transformation from pre-cancerous lesions to CaCx, highlighting the importance of CIN detection and primary prevention of HR HPV to decrease the incidence of CaCx in Botswana.

目的/目标：人乳头瘤病毒和艾滋病毒的高流行率导致博茨瓦纳宫颈癌（CaCx）的高发病率。比较未接种疫苗的健康学生（队列1）、CIN II/III女性（队列2）和侵袭性CaCx女性（队列3）的HPV亚型。材料/方法在2016-2020年期间，博茨瓦纳哈博罗内的Ipabalele研究纳入了患者。收集人口统计学、临床特征和HPV宫颈拭子。病理芯片量化了HPV亚型的患病率。结果共纳入414例患者。队列1:43；队列2;212年;队列3:159。中位年龄分别为19岁、39岁和46岁。感染艾滋病毒的妇女（WLWH）分别占0%、76%和72%。在20个月内，队列1的高危（HR） HPV患病率增加了34%至57%。人乳头瘤病毒的特征没有因HIV感染状况而异。与队列1相比，队列2和3中所有HR HPV亚型的患病率增加。与队列2相比，队列3中除HPV 53外的HPV HR亚型的患病率有所增加。在WLWH中，队列3的HPV 16、18和34的患病率高于队列2。在未感染艾滋病毒的妇女中，队列3的HPV 16和18的患病率高于队列2。结论与健康女性相比，CIN和CaCx女性的HPV亚型代表性更高。这表明多种HR HPV毒株的存在可能影响癌前病变向CaCx的转化，强调了CIN检测和HR HPV一级预防对于降低博茨瓦纳CaCx发病率的重要性。

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引用次数: 0

A fast-progressing orthotopic ovarian cancer model reveals synergistic antitumor effects of AXL-targeting nanobodies and Olaparib 一个快速进展的原位卵巢癌模型揭示了靶向axl的纳米体和奥拉帕尼的协同抗肿瘤作用

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-12-01 Epub Date: 2025-11-25 DOI: 10.1016/j.gore.2025.101998

Aarushi A. Caro , Alícia Gordún Peiró , Eva Hadadi , Yani Berckmans , Yvon Elkrim , Ayla Debraekeleer , Gisèle Mateu Cabrera , Kim De Veirman , An Coosemans , Damya Laoui

Objective

Ovarian cancer (OC) is the deadliest gynecological malignancy, with patients experiencing late diagnosis and high recurrence. AXL is highly expressed in OC and correlates with worse prognosis. We aim to evaluate the use of AXL-targeting nanobodies as a novel therapeutic modality to inhibit the AXL-GAS6 axis in OC.

Methods

ID8-fLuc cells were in vivo passaged three times to obtain the fast-progressing P3 ID8 Thy1.1 cell line. The expression of AXL in ID8 lines was assessed by flow cytometry and immunofluorescence, while serum GAS6 levels in tumor-bearing and naïve mice were measured by ELISA. Using in silico analyses, we correlated AXL and GAS6 expression with OC patient outcomes and assessed AXL expression in different tissues and patient cohorts. Orthotopic ovarian tumors were processed to a single cell suspension and treated in vitro with the nanobody (AXL-Fc), a PARP inhibitor (Olaparib), or controls (PBS or DMSO) for 24 h or 72 h, followed by flow cytometry to assess stages of cell death and cancer cell proliferation.

Results

In vivo passaging of ID8-fLuc cells resulted in a faster-progressing P3 ID8 Thy1.1 cell line that recapitulates stages I-III observed in OC patients. In OC patients, AXL and GAS6 genes are highly expressed in primary and metastatic tumors, and enriched in platinum-resistant patients. AXL-Fc induces necrosis in OC cells from orthotopic ovarian tumors. AXL-Fc synergizes with Olaparib, resulting in decreased OC cell proliferation.

Conclusions

Leveraging the synergistic effects of AXL-Fc with Olaparib, we propose a new AXL-targeting treatment approach for OC that warrants further investigation.

目的卵巢癌是最致命的妇科恶性肿瘤，诊断晚，复发率高。AXL在OC中高表达，预后较差。我们的目的是评估使用靶向axl的纳米体作为一种新的治疗方式来抑制OC中的AXL-GAS6轴。方法sid8 - fluc细胞在体内传代3次，获得快速进展的P3 ID8 Thy1.1细胞系。采用流式细胞术和免疫荧光法检测ID8细胞系中AXL的表达，ELISA法检测荷瘤小鼠和naïve小鼠血清中GAS6的表达。通过计算机分析，我们将AXL和GAS6的表达与OC患者的预后相关联，并评估了AXL在不同组织和患者队列中的表达。将原位卵巢肿瘤处理成单细胞悬液，用纳米体（AXL-Fc）、PARP抑制剂（Olaparib）或对照组（PBS或DMSO）在体外处理24小时或72小时，然后用流式细胞术评估细胞死亡和癌细胞增殖的阶段。结果ID8- fluc细胞的体内传代导致P3 - ID8 Thy1.1细胞系进展更快，重现了在OC患者中观察到的I-III期。在OC患者中，AXL和GAS6基因在原发和转移性肿瘤中高表达，在铂耐药患者中富集。AXL-Fc诱导原位卵巢肿瘤OC细胞坏死。AXL-Fc与奥拉帕尼协同作用，导致OC细胞增殖下降。结论利用AXL-Fc与奥拉帕尼的协同作用，我们提出了一种新的靶向axl治疗OC的方法，值得进一步研究。

{"title":"A fast-progressing orthotopic ovarian cancer model reveals synergistic antitumor effects of AXL-targeting nanobodies and Olaparib","authors":"Aarushi A. Caro , Alícia Gordún Peiró , Eva Hadadi , Yani Berckmans , Yvon Elkrim , Ayla Debraekeleer , Gisèle Mateu Cabrera , Kim De Veirman , An Coosemans , Damya Laoui","doi":"10.1016/j.gore.2025.101998","DOIUrl":"10.1016/j.gore.2025.101998","url":null,"abstract":"<div><h3>Objective</h3><div>Ovarian cancer (OC) is the deadliest gynecological malignancy, with patients experiencing late diagnosis and high recurrence. AXL is highly expressed in OC and correlates with worse prognosis. We aim to evaluate the use of AXL-targeting nanobodies as a novel therapeutic modality to inhibit the AXL-GAS6 axis in OC.</div></div><div><h3>Methods</h3><div>ID8-fLuc cells were <em>in vivo</em> passaged three times to obtain the fast-progressing P3 ID8 Thy1.1 cell line. The expression of AXL in ID8 lines was assessed by flow cytometry and immunofluorescence, while serum GAS6 levels in tumor-bearing and naïve mice were measured by ELISA. Using <em>in silico</em> analyses, we correlated AXL and GAS6 expression with OC patient outcomes and assessed AXL expression in different tissues and patient cohorts. Orthotopic ovarian tumors were processed to a single cell suspension and treated <em>in vitro</em> with the nanobody (AXL-Fc), a PARP inhibitor (Olaparib), or controls (PBS or DMSO) for 24 h or 72 h, followed by flow cytometry to assess stages of cell death and cancer cell proliferation.</div></div><div><h3>Results</h3><div><em>In vivo</em> passaging of ID8-fLuc cells resulted in a faster-progressing P3 ID8 Thy1.1 cell line that recapitulates stages I-III observed in OC patients. In OC patients, <em>AXL</em> and <em>GAS6</em> genes are highly expressed in primary and metastatic tumors, and enriched in platinum-resistant patients. AXL-Fc induces necrosis in OC cells from orthotopic ovarian tumors. AXL-Fc synergizes with Olaparib, resulting in decreased OC cell proliferation.</div></div><div><h3>Conclusions</h3><div>Leveraging the synergistic effects of AXL-Fc with Olaparib, we propose a new AXL-targeting treatment approach for OC that warrants further investigation.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"62 ","pages":"Article 101998"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145620213","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

From intractable hiccups to optic neuritis: paraneoplastic neuromyelitis optica with leptomeningeal carcinomatosis in the setting of immature ovarian teratoma 从顽固性呃逆到视神经炎：未成熟卵巢畸胎瘤伴轻脑膜癌的副肿瘤性视神经脊髓炎

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-12-01 Epub Date: 2025-11-13 DOI: 10.1016/j.gore.2025.101990

Shannon Zhou , Julie Szczygielski , Boris Winterhoff , Jordan Mattson

Background

Paraneoplastic syndromes are associated with 10% of ovarian cancers. Neuromyelitis optica spectrum disorders (NMOSD), which can present with vision changes, paraplegia, vomiting, and/or intractable hiccups, are rarely associated with ovarian cancers. We present the first recorded case of NMOSD in the setting of malignant immature ovarian teratoma, with concurrent leptomeningeal carcinomatosis contributing to clinical presentation.

Case

We describe a 27-year-old patient with Stage IVB Immature Ovarian Teratoma complicated by leptomeningeal carcinomatosis, who initially presented with intractable hiccups, nausea, and vomiting, and eventually developed attenuated vision. Neurological workup revealed AQP4-IgG antibodies, suggesting neuromyelitis optica (NMO) as a paraneoplastic syndrome (PNS). The patient’s cancer was treated with tumor resection, BEP (bleomycin, etoposide, cisplatin) therapy, maintenance bevacizumab, and brain radiation. While symptoms suspicious for NMO presented early on, it was not until after tumor resection and the development of double vision that NMO was diagnosed. NMO was promptly treated with plasma exchange and high dose steroids. While therapies did lead to disease stabilization, she was left with residual neurologic deficits requiring gait assistance.

Conclusion

Early symptoms such as intractable hiccups, nausea, or vomiting may precede optic neuritis or myelitis and serve as initial warning signs of NMOSD. Clinicians should maintain a high index of suspicion and low threshold for neurology consultation and AQP4-IgG antibody titers, especially when neurologic symptoms are not fully explained by metastatic disease.

研究背景：10%的卵巢癌与副肿瘤综合征有关。视神经脊髓炎谱系障碍（NMOSD）可表现为视力改变、截瘫、呕吐和/或顽固性打嗝，很少与卵巢癌相关。我们提出了第一例记录在案的NMOSD在恶性未成熟卵巢畸胎瘤的背景下，并发轻脑膜癌导致临床表现。我们描述了一位27岁的IVB期未成熟卵巢畸胎瘤合并脑膜轻癌的患者，他最初表现为顽固性打嗝、恶心和呕吐，最终发展为视力减弱。神经学检查显示AQP4-IgG抗体，提示视神经脊髓炎（NMO）为副肿瘤综合征（PNS）。患者的癌症接受肿瘤切除、BEP（博来霉素、依托泊苷、顺铂）治疗、维持贝伐单抗和脑放疗。虽然早期出现了疑似NMO的症状，但直到肿瘤切除并出现复视后才被诊断为NMO。NMO立即接受血浆置换和大剂量类固醇治疗。虽然治疗确实导致疾病稳定，但她留下了残余的神经功能缺陷，需要步态辅助。结论顽固性呃逆、恶心、呕吐等早期症状可能是视神经炎或脊髓炎的前兆，是NMOSD的早期预警信号。临床医生对神经内科会诊和AQP4-IgG抗体滴度应保持高怀疑指数和低阈值，特别是当转移性疾病不能完全解释神经内科症状时。

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引用次数: 0

Exploratory study of a long-term hospital-based cervical cancer screening program in a high HIV prevalence area of rural Malawi 马拉维农村艾滋病毒高发地区长期医院宫颈癌筛查方案的探索性研究

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-12-01 Epub Date: 2025-11-08 DOI: 10.1016/j.gore.2025.101986

Nora Badiner , Laurel Guthrie , Emily Stevenson , Andrew Folkerts , Joseph Mkandawire , Roslyn YX Ghui , Cassandra Graybill , Ryan Hayton , Moses Kasumba , Linda Hong , Sharon Lum , Mark Reeves , Yevgeniya Ioffe

Introduction

Malawi has the second-highest incidence and highest cervical cancer-attributed mortality worldwide. National HIV prevalence is 7.7%. Malawi implemented the Cervical Cancer Control Plan in 1999. We conducted an exploratory study of a non-government, hospital-based cervical cancer screening program established in the Southern Region.

Methods

We performed a retrospective review of outcomes from a cervical cancer screening program at a 275-bed rural mission hospital from 1/2016 – 12/2021. Female patients 18 years and older presenting for cervical cancer screening were included. Outcomes included trends in screening modality, return screening rates, abnormal screening rates, and the COVID pandemic impact. Data abstracted included demographics, HIV status, screening modality, and follow-up information.

Results

15,432 patients were screened for cervical cancer during the study period, with an overall increase in annual number of patients screened, despite the COVID-19 pandemic. Screening was initially performed via Pap testing; Visual inspection with acetic acid became the most common screening modality in 2019 (69.4%).

HIV prevalence among screened patients increased over the study period to 82.0% in 2021 and was higher among return screening patients (89.0%). 4.3% of HIV-negative and 7.2% of HIV-positive women demonstrated abnormal screening results.

Conclusion

Despite the COVID-19 pandemic, the number of patients screened for cervical cancer annually increased over the study period. HIV prevalence in this study was much higher than the national prevalence. These results emphasize the successful collaboration between a national program, private hospital, and HIV treatment centers, and highlight the need to increase screening among healthy women in the community.

马拉维是世界上宫颈癌发病率和死亡率第二高的国家。全国艾滋病毒感染率为7.7%。马拉维于1999年实施了子宫颈癌控制计划。我们对南方地区建立的一个非政府的、以医院为基础的宫颈癌筛查项目进行了探索性研究。方法回顾性分析2016年1月至2021年12月在一家拥有275个床位的农村教会医院开展的宫颈癌筛查项目的结果。包括18岁及以上的女性宫颈癌筛查患者。结果包括筛查方式、返回筛查率、异常筛查率和COVID大流行影响的趋势。提取的数据包括人口统计数据、艾滋病毒状况、筛查方式和随访信息。结果在研究期间，15432例患者接受了宫颈癌筛查，尽管2019冠状病毒病大流行，但每年筛查的患者总数仍在增加。筛查最初是通过巴氏试验进行的；醋酸目视检查成为2019年最常见的筛查方式（69.4%）。在研究期间，接受筛查的患者的艾滋病毒感染率在2021年增加到82.0%，在返回筛查的患者中更高（89.0%）。4.3%的hiv阴性妇女和7.2%的hiv阳性妇女表现出筛查结果异常。结论尽管2019冠状病毒病大流行，但在研究期间，每年接受宫颈癌筛查的患者人数有所增加。在这项研究中，艾滋病毒的流行率远远高于全国的流行率。这些结果强调了国家计划、私立医院和艾滋病毒治疗中心之间的成功合作，并强调了在社区健康妇女中增加筛查的必要性。

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引用次数: 0

Low-grade endometrial stromal sarcoma arising from extrauterine deep infiltrating endometriosis: a rare, but important differential diagnosis and short review of the literature 由子宫外深浸润性子宫内膜异位症引起的低级别子宫内膜间质肉瘤：一种罕见但重要的鉴别诊断和简短的文献回顾

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-12-01 Epub Date: 2025-11-05 DOI: 10.1016/j.gore.2025.101985

Lina Judit Schiestl , Simin Schadmand-Fischer , Evangelos Tagkalos , Udo Raab , Pia-Elisabeth Baqué , Nadja Hamscho , Friedrich Kommoss , Dennis Jung , Valerie Linz , Marcus Schmidt , Annette Hasenburg , Roxana Schwab

Background

Low-grade endometrial stroma sarcoma is a very rare mesenchymal neoplasm, that is usually found inside the uterine corpus. It is very uncommon that LG-ESS arises from extrauterine foci.

Case presentation

We report the case of a 31-year-old patient diagnosed with extrauterine LG-ESS arising from deep infiltrating endometriosis. Primary symptoms, diagnostic workflow, operating method, and the outcome will be described, as well as a short review of the current literature about the optimal treatment for young LG-ESS patients within the reproductive window.

Conclusions

Long-term surveillance is imperative for patients with LG-ESS given the potential for late recurrences. Although extrauterine LG-ESS represents an exceedingly rare gynecologic malignancy, establishing standardized treatment approaches is critical to optimize therapeutic efficacy and improve patient outcomes.

背景：低级别子宫内膜间质肉瘤是一种非常罕见的间质肿瘤，通常发生在子宫体内。由子宫外灶引起的lgs是非常罕见的。我们报告一例31岁的患者，被诊断为由深浸润性子宫内膜异位症引起的子宫外LG-ESS。主要症状，诊断工作流程，操作方法和结果将被描述，以及简短回顾目前的文献关于最佳治疗年轻LG-ESS患者在生殖窗口。结论考虑到晚期复发的可能性，长期监测对于LG-ESS患者是必要的。尽管宫外LG-ESS是一种极为罕见的妇科恶性肿瘤，但建立标准化的治疗方法对于优化治疗效果和改善患者预后至关重要。

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引用次数: 0

Alectinib as salvage therapy for metastatic UIMT following misdiagnosis: A case enabling definitive surgery and prolonged remission 阿勒替尼作为转移性UIMT误诊后的补救性治疗：一例使最终手术和延长缓解

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-12-01 Epub Date: 2025-11-15 DOI: 10.1016/j.gore.2025.101994

Ting Shuang , Xiao lin Wang , Yuanyuan Wang , Bao li Jun

Background

Uterine inflammatory myofibroblastic tumor (UIMT) is a rare, aggressive tumor often mistaken for uterine fibroids. This case report discusses managing advanced UIMT after a misdiagnosis and assesses the effectiveness of the anaplastic lymphoma kinase (ALK) inhibitor, alectinib, as a targeted treatment.

Case presentation

A 29-year-old woman had a laparoscopic myomectomy for presumed uterine fibroids. Three months later, she developed abdominal distension, vaginal bleeding, and fever. Pathological evaluation confirmed a diagnosis of UIMT with aggressive behavior, and imaging showed extensive abdominal metastases. She received supportive therapies including hepatoprotection, infection control, and hemostasis. Due to the substantial tumor burden and malnutrition, targeted therapy with the ALK inhibitor alectinib was initiated, informed by ALK-p80 positivity on IHC. Her symptoms relieved significantly, and pelvic masses reduced by 53.9 % after two treatment cycles. She subsequently underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and resection of pelvic and abdominal lesions. Post-surgery, she continued alectinib with no recurrence for over 10 months till now. Next-generation sequencing (NGS) revealed an FN1-ALK fusion and a novel MTAP-CDKN2A fusion.

Conclusions

This case highlights the significant efficacy and safety of alectinib in the management of advanced, recurrent, and aggressive UIMT, while also emphasizing the essential role of multidisciplinary management. It provides valuable insights and serves as a reference for the management of similar rare cases.

背景：原发性炎性肌纤维母细胞瘤是一种罕见的侵袭性肿瘤，常被误认为是子宫肌瘤。本病例报告讨论了误诊后晚期UIMT的管理，并评估了间变性淋巴瘤激酶（ALK）抑制剂阿勒替尼作为靶向治疗的有效性。病例介绍：一名29岁女性因推测子宫肌瘤行腹腔镜子宫肌瘤切除术。3个月后，患者出现腹胀、阴道出血和发热。病理评估证实了UIMT的诊断，并伴有侵袭性行为，影像学显示广泛的腹部转移。患者接受保肝、控制感染和止血等支持性治疗。由于严重的肿瘤负担和营养不良，在IHC上ALK-p80阳性的通知下，开始了ALK抑制剂alectinib的靶向治疗。两个治疗周期后，患者症状明显缓解，盆腔肿块减少53.9%。随后，她接受了腹部全子宫切除术、双侧输卵管-卵巢切除术、网膜切除术以及盆腔和腹部病变切除术。术后继续使用阿勒替尼治疗，10个多月无复发。新一代测序（NGS）揭示了FN1-ALK融合和MTAP-CDKN2A融合。结论该病例强调了alectinib在晚期、复发性和侵袭性UIMT治疗中的显著有效性和安全性，同时也强调了多学科治疗的重要作用。为类似罕见病例的管理提供了有价值的见解和参考。

{"title":"Alectinib as salvage therapy for metastatic UIMT following misdiagnosis: A case enabling definitive surgery and prolonged remission","authors":"Ting Shuang , Xiao lin Wang , Yuanyuan Wang , Bao li Jun","doi":"10.1016/j.gore.2025.101994","DOIUrl":"10.1016/j.gore.2025.101994","url":null,"abstract":"<div><h3>Background</h3><div>Uterine inflammatory myofibroblastic tumor (UIMT) is a rare, aggressive tumor often mistaken for uterine fibroids. This case report discusses managing advanced UIMT after a misdiagnosis and assesses the effectiveness of the anaplastic lymphoma kinase (ALK) inhibitor, alectinib, as a targeted treatment.</div><div>Case presentation</div><div>A 29-year-old woman had a laparoscopic myomectomy for presumed uterine fibroids. Three months later, she developed abdominal distension, vaginal bleeding, and fever. Pathological evaluation confirmed a diagnosis of UIMT with aggressive behavior, and imaging showed extensive abdominal metastases. She received supportive therapies including hepatoprotection, infection control, and hemostasis. Due to the substantial tumor burden and malnutrition, targeted therapy with the ALK inhibitor alectinib was initiated, informed by ALK-p80 positivity on IHC. Her symptoms relieved significantly, and pelvic masses reduced by 53.9 % after two treatment cycles. She subsequently underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and resection of pelvic and abdominal lesions. Post-surgery, she continued alectinib with no recurrence for over 10 months till now. Next-generation sequencing (NGS) revealed an FN1-ALK fusion and a novel MTAP-CDKN2A fusion.</div></div><div><h3>Conclusions</h3><div>This case highlights the significant efficacy and safety of alectinib in the management of advanced, recurrent, and aggressive UIMT, while also emphasizing the essential role of multidisciplinary management. It provides valuable insights and serves as a reference for the management of similar rare cases.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"62 ","pages":"Article 101994"},"PeriodicalIF":1.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145576517","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

Homologous recombination status drives disease-free survival in patients with advanced ovarian cancer undergoing hyperthermic intraperitoneal chemotherapy at the time of interval debulking surgery 同源重组状态驱动晚期卵巢癌患者在间歇减容手术时接受高温腹腔化疗的无病生存

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-12-01 Epub Date: 2025-10-28 DOI: 10.1016/j.gore.2025.101981

Khrystyna Levytska , SeungYong Han , Allison E. Axtell , Malaika W. Amneus , Brandon Ing , Scott E. Lentz

Objective

Describe surgical outcomes of patients undergoing HIPEC with cisplatin (C) alone or cisplatin/paclitaxel (CP), compared to interval debulking surgery (IDS) without HIPEC, and stratify disease-free survival (DFS) by treatment and homologous recombination (HR) status.

Methods

Retrospective chart review of patients with advanced ovarian cancer undergoing IDS with and without HIPEC between 2018–2024. DFS was compared using a log rank test. Cox proportional hazards model was used to test association between treatment group and recurrence.

Results

74 patients were included: 20 in no HIPEC, 28 in HIPEC-C, and 26 in HIPEC-CP groups. Duration of surgery was shortest in no HIPEC group (159 ± 64 min vs HIPEC-C 377 ± 54 min vs HIPEC-CP 400 ± 48 min, p < 0.0001). Post-operatively, there was no difference in days to return of bowel function (p = 0.17) or Grade II-IV complications (p = 0.39). HIPEC-C group had longest time to discharge (4.5 ± 1.2 post-operative days vs no HIPEC 3.8 ± 1.9 vs HIPEC-CP 3.6 ± 0.9, p = 0.002). Twenty-nine (39.2 %) patients were HR deficient (HRD). Median DFS did not differ between treatment groups (no HIPEC 17.0 months vs HIPEC-C 13.87 months vs HIPEC-CP 19.25 months, p = 0.853). Median DFS was higher in HRD vs HRP (HR proficient) patients (40.5 months vs 11.4 months, HR 0.32 (95 % CI: 0.19–0.57, p = 0.0001).

Conclusions

Addition of paclitaxel to cisplatin at the time of IDS with HIPEC had no effect on peri-operative morbidity. No differences in DFS were seen between treatment groups. HRD group had a significantly longer DFS, when compared to HRP. Tumor genetics and HR status likely drive response to treatment in advanced ovarian cancer.

目的描述HIPEC患者单用顺铂(C)或顺铂/紫杉醇（CP）的手术结果，与不使用HIPEC的间隔减压手术（IDS）进行比较，并通过治疗和同源重组（HR）状态对无病生存（DFS）进行分层。方法回顾性分析2018-2024年晚期卵巢癌合并和不合并HIPEC的IDS患者。DFS采用对数秩检验进行比较。采用Cox比例风险模型检验治疗组与复发率的相关性。结果74例患者：无HIPEC组20例，HIPEC- c组28例，HIPEC- cp组26例。无HIPEC组手术时间最短（159±64 min vs . HIPEC- c 377±54 min vs . HIPEC- cp 400±48 min, p < 0.0001）。术后肠功能恢复天数（p = 0.17）和II-IV级并发症（p = 0.39）无差异。HIPEC- c组出院时间最长（术后4.5±1.2天vs未HIPEC组3.8±1.9天vs HIPEC- cp组3.6±0.9天，p = 0.002）。29例（39.2%）患者为HR缺陷（HRD）。治疗组间的中位DFS无差异（无HIPEC 17.0个月vs HIPEC- c 13.87个月vs HIPEC- cp 19.25个月，p = 0.853）。HRD患者的中位DFS高于HRP （HR精通）患者(40.5个月vs 11.4个月，HR 0.32 （95% CI: 0.19-0.57, p = 0.0001）。结论在IDS合并HIPEC时顺铂加用紫杉醇对围手术期发病率无影响。治疗组间DFS无差异。与HRP相比，HRD组的DFS明显更长。肿瘤遗传学和HR状态可能驱动对晚期卵巢癌治疗的反应。

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引用次数: 0

Unmet needs after prevention: a model for managing premature surgical menopause post-risk-reducing bilateral salpingo-oophorectomy 预防后未满足的需求：降低风险的双侧输卵管-卵巢切除术后管理过早手术绝经的模型

IF 1.3 Q3 OBSTETRICS & GYNECOLOGY

Gynecologic Oncology Reports

Pub Date : 2025-12-01 Epub Date: 2025-10-05 DOI: 10.1016/j.gore.2025.101963

Sara Perelmuter , Laura Keenahan , Alicia Mecklai , Panagiota Andreopoulou , Sangeeta Kashyap , Jamieson Greenwald , Lisa Mosconi , Michael Battista , Ravi N. Sharaf , Melissa K. Frey

Risk-reducing bilateral salpingo-oophorectomy (rrBSO) is a standard of care for individuals with BRCA1/2 pathogenic variants and other hereditary ovarian cancer syndromes. While the oncologic benefits are clear, the abrupt estrogen deprivation of premature surgical menopause confers increased risks of cardiovascular disease, osteoporosis, and cognitive decline—yet long-term preventive care remains inconsistently provided. This commentary presents a multidisciplinary pilot model developed at a major academic center to bridge this gap.

Eligible patients seen in a gynecologic oncology clinic received an educational flyer summarizing chronic disease risks and evidence-based prevention strategies. Referral algorithms were created to streamline access to cardiology, endocrinology, and neurology.

From December 2023 to October 2024, 49 patients (median age 49 years, range 27–61) engaged with the program. All patients accepted the flyers, and at one-month follow-up (47 reached), 98% reported positive feedback, 94% found the material accessible, and 23% noted increased motivation for preventive care. The most frequent comment was that the flyers were easily understandable (70%). Eight patients were referred to preventive cardiology (6 scheduled), and six to endocrinology for low bone density (5 scheduled).

These preliminary findings suggest that patients with premature surgical menopause are highly motivated to engage in chronic disease prevention when provided with accessible education and a clear pathway to care. Integrating survivorship-focused preventive strategies into routine gynecologic oncology visits is feasible, well-received, and addresses a pressing unmet need. As cancer prevention improves, the next frontier must include structured care for long-term health after premature surgical menopause.

降低风险的双侧输卵管卵巢切除术（rrBSO）是BRCA1/2致病性变异和其他遗传性卵巢癌综合征患者的标准治疗方法。虽然肿瘤方面的益处是明确的，但过早手术绝经的突然雌激素剥夺会增加心血管疾病、骨质疏松症和认知能力下降的风险，但长期预防保健仍然不一致。本评论介绍了在一个主要学术中心开发的多学科试点模型，以弥合这一差距。在妇科肿瘤诊所就诊的符合条件的患者收到了一份概述慢性病风险和循证预防策略的教育传单。创建了转诊算法，以简化心脏病学、内分泌学和神经学的访问。从2023年12月到2024年10月，49名患者（中位年龄49岁，范围27-61岁）参与了该项目。所有患者都接受了传单，在一个月的随访中（达到47人），98%的患者报告了积极的反馈，94%的患者认为材料可获得，23%的患者注意到预防保健的动机增加。最常见的评论是传单很容易理解（70%）。8例患者转至预防心脏病科（6例），6例患者转至内分泌科（5例）。这些初步研究结果表明，当提供可获得的教育和明确的护理途径时，手术提前绝经的患者非常有动力参与慢性疾病预防。将以生存为中心的预防策略整合到常规妇科肿瘤就诊中是可行的，受到好评，并解决了迫切的未满足的需求。随着癌症预防的改善，下一个前沿必须包括对手术提前绝经后长期健康的结构化护理。

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引用次数: 0