BMC Women's Health最新文献

Background: Granulosa cell tumors (GCT) are a distinct type of sex cord-stromal tumor with low-grade malignancy. It frequently recurs due to pelvic dissemination or direct spread, whereas liver metastasis rarely occurs. Here, we report a rare case of a GCT in which recurrence with liver metastasis occurred 14 years later. We also discuss the imaging findings, histological features, and therapeutic approaches, and conducted a review of similar reported cases.

Case presentation: A 61-year-old female with recurrent ovarian GCT presented with a hepatic mass measuring approximately 8 cm in diameter. After surgical resection, histopathological examination revealed tumor cells nuclei with characteristic longitudinal grooves, a key diagnostic feature of GCT. Additionally, eosinophilic, unstructured Call-Exner bodies were observed. Immunohistochemical staining confirmed positive immunoreactivity for inhibin α, CD99 and CD56 markers. Based on these findings, the tumor was diagnosed as a liver metastasis of an ovarian GCT. The patient remained recurrence-free for 7 years following hepatectomy.

Conclusions: This case highlights the potential of ovarian GCT for late recurrence- even decades after primary treatment. A literature review revealed that, to date, only 21 cases of GCT with liver metastasis have been reported, with the interval between the diagnosis of the primary tumor and the development of liver metastasis ranging from 6 to 40 years. Close long-term follow-up is essential to detect recurrence early and optimize patient outcomes.

Background: This study investigates the social impact of menstrual stigma in Spain. Whilst menstruation is a biological process, it is shaped by cultural norms that influence how it is perceived, experienced, and managed.

Methods: A nationwide cross-sectional mixed-methods survey was conducted with 4,028 participants aged 14 years and older. Quantitative items were analysed using descriptive statistics, while qualitative open-ended responses were thematically analysed through a constructivist lens to explore social perceptions, behavioural responses, and institutional dynamics related to menstruation.

Results: Menstruation affects participation in everyday activities, particularly those involving physical exposure such as sports, swimming, or wearing certain types of clothing. While some respondents reported avoiding activities due to physical symptoms, others cited anxiety, fear of leakage, or social discomfort, reflecting internalised stigma. In professional and educational settings, participants described presenteeism, reluctance to take leave, and a sense of pressure to minimise or conceal menstrual needs. Experiences of exclusion, whether from religious rituals, traditional roles, or interpersonal interactions, were also reported. Despite these challenges, the study highlights the positive role of supportive social environments. Solidarity, peer empathy, and institutional flexibility were identified as protective factors that help counter the effects of stigma. However, gaps in menstrual education and limited integration of menstrual health in clinical contexts continue to pose barriers to well-being and equity.

Conclusion: The findings underscore the need to recognise menstruation as a relevant factor in public health, education, and workplace inclusion. Addressing menstrual stigma requires structural attention and a shift from individual responsibility to collective and institutional support.

Background: Lymphocytic mastopathy (also known as diabetic mastopathy, fibrotic mastopathy, or sclerosing lymphocytic lobulitis) is a rare benign fibroinflammatory breast disease that clinically and radiologically mimics breast carcinoma. It is most commonly associated with long-standing diabetes mellitus and autoimmune disorders.

Case presentation: We report the case of a 63-year-old woman with a 6-month history of a gradually enlarging, painless right breast lump. The patient was a known type 2 diabetic for 15 years on oral hypoglycaemic agents. Mammography and ultrasonography revealed an ill-defined hypoechoic lesion with marked posterior acoustic shadowing (BIRADS IV). Core needle biopsy was inconclusive. Excision biopsy demonstrated dense keloid-like fibrosis with periductal and perilobular lymphocytic infiltration without atypia, consistent with lymphocytic mastopathy.

Conclusion: Awareness of lymphocytic mastopathy is essential to prevent misdiagnosis as malignancy and avoid unwarranted surgical interventions. Although rare in non-insulin dependent diabetics, this condition should be included in the differential diagnosis of breast lump that mimic carcinoma on clinical examination and imaging.

Background: Self-collection of HPV DNA samples is recommended as a cervical cancer screening method in areas with high barriers to clinical examination, such as Ethiopia. Self-collected sample adequacy in clinical settings is high compared to clinician collection, but less is known about self-collected sample adequacy in community settings. We evaluated sample adequacy differences when samples were taken at women's homes, a local health post, or a primary care health center in rural Ethiopia.

Methods: Women either self-collected vaginal samples for HPV DNA at home (Arm 1, n = 100), at a health post (Arm 2, n = 100), or at a health center (Arm 3, n = 200). Women received identical sample collection kits and illustrated instruction pamphlets; all samples were treated the same way once collected. HPV DNA testing was performed using Ampfire Multiplex High-Risk HPV (Atila, Mountain View, California).

Results: Thirty-two (8%) of the 399 samples were inadequate (negative β-globin gene). Sample inadequacy frequency was highest in Arm 1-Home (15%) compared to Arm 2-Health Post (7%) and Arm 3-Health Center (5%) (p < 0.05)). Arm 1 had significantly higher odds of inadequacy than Arm 3 (aOR: 2.8, 95% CI 1.2-6.8, p = 0.02) when adjusted for age, education, and marital status. There was no difference in adequacy between Arms 2 and 3. HPV prevalence was lowest in Arm 1 (6%) and significantly higher in Arms 2 and 3 (20.4% and 15.9%, respectively, p = 0.02). More women in Arm 2 reported positive views of self-sampling, and fewer reported embarrassment when using the self-test compared to Arm 1.

Conclusions: Collecting self-samples at home yielded more inadequate samples than collecting at a health center; however, self-samples collected at the health post were not significantly different from those collected at the health center. In rural areas, self-sampling at locations proximal to women's residences but providing privacy may increase screening campaigns' success. While more work is needed to confirm this finding, home sampling may miss women who should be referred for diagnostic testing.