Madalina Piron, L. Pop, B. Danciu, N. Bacalbaşa, I. Bălescu, Ioan Dumitru Suciu
Female genital malformations mostly affect women`s reproductive health. Vaginal septa are rare conditions that occur secondary to defectuous fusion or canalization of the Mullerian ducts. There are longitudinal and transverse septa. Transverse septa can be found in the upper, middle or lower vagina and the main symptom is primary amenorrhea in the presence of cyclic pelvic pain. Imaging discoveries can reveal urological, anorectal and uterine abnormalities that accompany the vaginal abnormalities.
{"title":"Transverse vaginal septum evaluation","authors":"Madalina Piron, L. Pop, B. Danciu, N. Bacalbaşa, I. Bălescu, Ioan Dumitru Suciu","doi":"10.37897/rmj.2022.s4.15","DOIUrl":"https://doi.org/10.37897/rmj.2022.s4.15","url":null,"abstract":"Female genital malformations mostly affect women`s reproductive health. Vaginal septa are rare conditions that occur secondary to defectuous fusion or canalization of the Mullerian ducts. There are longitudinal and transverse septa. Transverse septa can be found in the upper, middle or lower vagina and the main symptom is primary amenorrhea in the presence of cyclic pelvic pain. Imaging discoveries can reveal urological, anorectal and uterine abnormalities that accompany the vaginal abnormalities.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83040004","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}
N. Bacalbaşa, I. Bălescu, V. Varlas, Cristina Martac, Ileana Pantea, Mihaela Vîlcu, I. Brezean, A. Ciulcu
Laparoscopic surgery has been widely implemented in the field of surgical oncology due to the numerous benefits such as rapid recovery and low level of traumatism at the level of the abdominal wall. Therefore, oncological patients will be referred to the oncology services and will be submitted to adjuvant therapies after a shorter period of time. However, in certain cases it has been stipulated that the laparoscopic approach might be associated with higher rates of adverse events such as port site metastases especially in cases presenting massive contamination such as peritoneal carcinomatosis from ovarian cancer. The aim of the current paper is to analyze whether in cases with cervical cancer there is a higher risk of port site metastases after laparoscopic approach.
{"title":"Port site metastases after surgically treated cervical cancer","authors":"N. Bacalbaşa, I. Bălescu, V. Varlas, Cristina Martac, Ileana Pantea, Mihaela Vîlcu, I. Brezean, A. Ciulcu","doi":"10.37897/rmj.2022.s4.14","DOIUrl":"https://doi.org/10.37897/rmj.2022.s4.14","url":null,"abstract":"Laparoscopic surgery has been widely implemented in the field of surgical oncology due to the numerous benefits such as rapid recovery and low level of traumatism at the level of the abdominal wall. Therefore, oncological patients will be referred to the oncology services and will be submitted to adjuvant therapies after a shorter period of time. However, in certain cases it has been stipulated that the laparoscopic approach might be associated with higher rates of adverse events such as port site metastases especially in cases presenting massive contamination such as peritoneal carcinomatosis from ovarian cancer. The aim of the current paper is to analyze whether in cases with cervical cancer there is a higher risk of port site metastases after laparoscopic approach.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"176 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73959437","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}
N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean, C. Grigoriu
Ovarian transposition has been imagined for young women diagnosed with pelvic malignancies who are submitted to surgery, who are further candidates for irradiation and who deserve fertility preservation. The most commonly indication for this procedure are represented by rectal and hematological malignancies; in certain cases diagnosed with gynecological malignancies in early stages such as cervical cancer ovarian preservation can be also taken in consideration in order to preserve fertility; however, ovarian transposition should be taken in consideration in order to remove the ovaries from the radiation field. The aim of the current paper is to report the case of a 31 year old patient diagnosed with a stage IIA cervical cancer in whom a total radical hysterectomy en bloc with right adnexectomy and pelvic lymph node dissection was performed; meanwhile the left ovary was transposed at the level of the left lumbar area, 2 cm above the left iliac crest and metallic clips were placed at the inferior margins in order to be easily identified when performing adjuvant radiation therapy.
{"title":"Ovarian transposition in order to preserve fertility before irradiation in a young patient with cervical cancer","authors":"N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean, C. Grigoriu","doi":"10.37897/rmj.2022.s3.17","DOIUrl":"https://doi.org/10.37897/rmj.2022.s3.17","url":null,"abstract":"Ovarian transposition has been imagined for young women diagnosed with pelvic malignancies who are submitted to surgery, who are further candidates for irradiation and who deserve fertility preservation. The most commonly indication for this procedure are represented by rectal and hematological malignancies; in certain cases diagnosed with gynecological malignancies in early stages such as cervical cancer ovarian preservation can be also taken in consideration in order to preserve fertility; however, ovarian transposition should be taken in consideration in order to remove the ovaries from the radiation field. The aim of the current paper is to report the case of a 31 year old patient diagnosed with a stage IIA cervical cancer in whom a total radical hysterectomy en bloc with right adnexectomy and pelvic lymph node dissection was performed; meanwhile the left ovary was transposed at the level of the left lumbar area, 2 cm above the left iliac crest and metallic clips were placed at the inferior margins in order to be easily identified when performing adjuvant radiation therapy.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"39 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75715408","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}
N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean, C. Grigoriu
Pulmonary cancer is commonly associated with the development of distant metastases at the level of liver, bones, adrenal glands and even brain. However, in certain cases other metastatic sites might be encountered such as the ovaries; however, these situations have been rarely encountered. The aim of the current paper is to present the case of a 39 year old patient with previous history of pulmonary neuroendocrine tumor, submitted to palliative radio-chemotherapy who was diagnosed with two large ovarian tumors and high volume of ascites which impaired even more the respiratory function. The patient was submitted to hysterectomy and bilateral adnexectomy, the histopathological studies demonstrating the metastatic origin of the tumors.
{"title":"Bilateral ovarian metastases from pulmonary neuroendocrine tumor. A case report and literature review","authors":"N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean, C. Grigoriu","doi":"10.37897/rmj.2022.s4.2","DOIUrl":"https://doi.org/10.37897/rmj.2022.s4.2","url":null,"abstract":"Pulmonary cancer is commonly associated with the development of distant metastases at the level of liver, bones, adrenal glands and even brain. However, in certain cases other metastatic sites might be encountered such as the ovaries; however, these situations have been rarely encountered. The aim of the current paper is to present the case of a 39 year old patient with previous history of pulmonary neuroendocrine tumor, submitted to palliative radio-chemotherapy who was diagnosed with two large ovarian tumors and high volume of ascites which impaired even more the respiratory function. The patient was submitted to hysterectomy and bilateral adnexectomy, the histopathological studies demonstrating the metastatic origin of the tumors.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76075035","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}
N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean
Omental cake represents a common finding in advanced stage ovarian cancer and is characterized by the complete omental transformation. Most often it is associated with subjacent invasion of the enteral segments and needs multiple resections in order to achieve radical cytoreductive surgery. Meanwhile, in other cases different visceral invasions are encountered necessitating other visceral resections. The aim of the current paper is to report the case of a 55 year old patient diagnosed with stage IIIC ovarian cancer in whom intraoperatively omental cake transformation invading the urinary bladder was encountered.
{"title":"Omental cake invading the urinary bladder – a case report and literature review","authors":"N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean","doi":"10.37897/rmj.2022.s4.10","DOIUrl":"https://doi.org/10.37897/rmj.2022.s4.10","url":null,"abstract":"Omental cake represents a common finding in advanced stage ovarian cancer and is characterized by the complete omental transformation. Most often it is associated with subjacent invasion of the enteral segments and needs multiple resections in order to achieve radical cytoreductive surgery. Meanwhile, in other cases different visceral invasions are encountered necessitating other visceral resections. The aim of the current paper is to report the case of a 55 year old patient diagnosed with stage IIIC ovarian cancer in whom intraoperatively omental cake transformation invading the urinary bladder was encountered.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"344 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77200405","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}
N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean, C. Grigoriu
Endometrial cancer represents one of the most commonly encountered gynecological malignancies affecting women worldwide which is usually treated by surgery followed by adjuvant chemo-radiotherapy. Even if curative intent treatment is performed, in certain cases recurrent disease might develop; in such cases, depending to the extent of the disease different therapeutic strategies might be taken in consideration. As expected, cases diagnosed with solitary, isolated recurrences are rather candidates for surgery, improved outcomes being expected in such patients. When it comes to cases diagnosed with isolated adenopathic masses, complex surgical procedures including vascular resections have been reported in order to achieve negative resection margins. This is a literature review of the most significant papers reporting complex vascular resections for isolated adenopathic masses with endometrial origin.
{"title":"Vascular resections as part of debulking surgery for isolated adenopathies after surgically treated endometrial cancer","authors":"N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean, C. Grigoriu","doi":"10.37897/rmj.2022.s4.20","DOIUrl":"https://doi.org/10.37897/rmj.2022.s4.20","url":null,"abstract":"Endometrial cancer represents one of the most commonly encountered gynecological malignancies affecting women worldwide which is usually treated by surgery followed by adjuvant chemo-radiotherapy. Even if curative intent treatment is performed, in certain cases recurrent disease might develop; in such cases, depending to the extent of the disease different therapeutic strategies might be taken in consideration. As expected, cases diagnosed with solitary, isolated recurrences are rather candidates for surgery, improved outcomes being expected in such patients. When it comes to cases diagnosed with isolated adenopathic masses, complex surgical procedures including vascular resections have been reported in order to achieve negative resection margins. This is a literature review of the most significant papers reporting complex vascular resections for isolated adenopathic masses with endometrial origin.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74564526","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}
N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean
Due to the anatomical location of the ovaries, in the close proximity of the rectosigmoidian loop, local invasion of this segment is frequently encountered especially in cases presenting peritoneal carcinomatosis of the Douglas pouch. The aim of the current paper is to report a case series of 16 patients diagnosed with ovarian cancer and rectosigmoidian invasion submitted to surgery with curative intent. In all cases resection to no residual disease was achieved. Due to the advanced level of rectal invasion, anastomosis was not performed, in all cases the continuity of the digestive tract being reestablished through left colostomy. In conclusion in certain cases presenting locally invasion of the nodules of peritoneal carcinomatosis, modified posterior exenteration might be needed.
{"title":"Posterior pelvic exenteration in advanced stage ovarian cancer – a case series","authors":"N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean","doi":"10.37897/rmj.2022.s3.18","DOIUrl":"https://doi.org/10.37897/rmj.2022.s3.18","url":null,"abstract":"Due to the anatomical location of the ovaries, in the close proximity of the rectosigmoidian loop, local invasion of this segment is frequently encountered especially in cases presenting peritoneal carcinomatosis of the Douglas pouch. The aim of the current paper is to report a case series of 16 patients diagnosed with ovarian cancer and rectosigmoidian invasion submitted to surgery with curative intent. In all cases resection to no residual disease was achieved. Due to the advanced level of rectal invasion, anastomosis was not performed, in all cases the continuity of the digestive tract being reestablished through left colostomy. In conclusion in certain cases presenting locally invasion of the nodules of peritoneal carcinomatosis, modified posterior exenteration might be needed.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80614059","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}
N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean
Although endometrial cancer is usually diagnosed in early stages of the disease due to the frequent association of worrisome symptoms such as postmenopausal bleeding, in certain cases the patients are diagnosed when metastatic lesions are already present. In such cases, a multidisciplinary approach is needed in order to achieve a maximum benefit in terms of survival. The aim of the current paper is to report a 62 year old patient diagnosed with endometrial cancer with bone and pulmonary metastases in whom a complex oncological and surgical therapeutic strategy was performed with good results.
{"title":"Debulking surgery for metastatic endometrial cancer – a case report and literature review","authors":"N. Bacalbaşa, I. Bălescu, C. Stoica, Cristina Martac, V. Varlas, Andrei Voichitoiu, L. Pop, S. Petrea, Mihaela Vîlcu, I. Brezean","doi":"10.37897/rmj.2022.s4.6","DOIUrl":"https://doi.org/10.37897/rmj.2022.s4.6","url":null,"abstract":"Although endometrial cancer is usually diagnosed in early stages of the disease due to the frequent association of worrisome symptoms such as postmenopausal bleeding, in certain cases the patients are diagnosed when metastatic lesions are already present. In such cases, a multidisciplinary approach is needed in order to achieve a maximum benefit in terms of survival. The aim of the current paper is to report a 62 year old patient diagnosed with endometrial cancer with bone and pulmonary metastases in whom a complex oncological and surgical therapeutic strategy was performed with good results.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90205804","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}
N. Bacalbaşa, I. Bălescu, V. Varlas, Cristina Martac, Ileana Pantea, Mihaela Vîlcu, I. Brezean, A. Ciulcu
Once the techniques of minimally invasive surgery improved and the benefits in terms of early postoperative recovery have been widely demonstrated, minimally invasive surgical procedures have been widely implemented in the setting of surgical oncology. However, in cases in which peritoneal contamination already exists, attention was focused on identifying the risk factors of developing port site metastases and, in the meantime, on preventing this event. The aim of the current paper is to analyze these risk factors and to discuss about the possibilities to prevent this event.
{"title":"Port site metastases after laparoscopic treatment of ovarian cancer","authors":"N. Bacalbaşa, I. Bălescu, V. Varlas, Cristina Martac, Ileana Pantea, Mihaela Vîlcu, I. Brezean, A. Ciulcu","doi":"10.37897/rmj.2022.s4.13","DOIUrl":"https://doi.org/10.37897/rmj.2022.s4.13","url":null,"abstract":"Once the techniques of minimally invasive surgery improved and the benefits in terms of early postoperative recovery have been widely demonstrated, minimally invasive surgical procedures have been widely implemented in the setting of surgical oncology. However, in cases in which peritoneal contamination already exists, attention was focused on identifying the risk factors of developing port site metastases and, in the meantime, on preventing this event. The aim of the current paper is to analyze these risk factors and to discuss about the possibilities to prevent this event.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88947176","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}
N. Bacalbaşa, I. Bălescu, V. Varlas, Cristina Martac, Ileana Pantea, Mihaela Vîlcu, I. Brezean, A. Ciulcu
Pancreatic metastases represent rare eventualities, being more frequently encountered in colorectal, ovarian or breast cancer, other primaries being usually reported more often in autopsy studies. When it comes to cervical cancer, it usually is responsible for the development of local recurrences, lymphatic recurrences or hematogenous metastases in lungs. The aim if the current paper is to discuss about the possibility of developing pancreatic metastases from cervical cancer and to analyze the most efficient therapeutic strategies in such cases.
{"title":"Pancreatic metastases from uterine cervix tumors – diagnostic challenge and therapeutic options","authors":"N. Bacalbaşa, I. Bălescu, V. Varlas, Cristina Martac, Ileana Pantea, Mihaela Vîlcu, I. Brezean, A. Ciulcu","doi":"10.37897/rmj.2022.s4.11","DOIUrl":"https://doi.org/10.37897/rmj.2022.s4.11","url":null,"abstract":"Pancreatic metastases represent rare eventualities, being more frequently encountered in colorectal, ovarian or breast cancer, other primaries being usually reported more often in autopsy studies. When it comes to cervical cancer, it usually is responsible for the development of local recurrences, lymphatic recurrences or hematogenous metastases in lungs. The aim if the current paper is to discuss about the possibility of developing pancreatic metastases from cervical cancer and to analyze the most efficient therapeutic strategies in such cases.","PeriodicalId":21278,"journal":{"name":"Romanian Medical Journal","volume":"98 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81043393","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}
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