This document discusses carcinoma endometrium, also known as endometrial cancer. It is the most common gynecologic cancer in western countries. Risk factors include unsupervised hormone replacement therapy, hyperestrogenic states, familial predisposition, and tamoxifen use. Symptoms include abnormal bleeding. Diagnosis involves endometrial biopsy and imaging. Treatment depends on staging and may include surgery, radiation, chemotherapy, and hormone therapy. Prognosis ranges from 75% 5-year survival for stage I to 10% for stage IV.
Seminar presentation by student under supervision of endocrinology specialist from HRPZ. References as mentioned in the slides. Mostly from Malaysia CPG.
Uterine fibroid - Case scenarios and DiscussionHaynes Raja
This presentation is prepared to meet out the undergraduate medical student needs especially to understand the practical aspects of uterine fibroid and to rapidly revise some important viva questions.
Dedicated to my Great Teachers in the Dept. of Obstetrics & Gynaecology Dr. Lavanya Kumari and Dr. Sangeereni, Inspiring Friends Dr. Paulin Benedict, Dr. Jeyakumar Meyyappan and Dr. Hannah Jane and our REVELLIONZ 08’ batch.
India is the highest TB burden country accounting for more than one-fourth of the global incidence .Genital TB is found in 5-10% of women with infertility problems, with low rates in Australia (1%) and high rates of up to 19% in India (ICMR,2011)
Seminar presentation by student under supervision of endocrinology specialist from HRPZ. References as mentioned in the slides. Mostly from Malaysia CPG.
Uterine fibroid - Case scenarios and DiscussionHaynes Raja
This presentation is prepared to meet out the undergraduate medical student needs especially to understand the practical aspects of uterine fibroid and to rapidly revise some important viva questions.
Dedicated to my Great Teachers in the Dept. of Obstetrics & Gynaecology Dr. Lavanya Kumari and Dr. Sangeereni, Inspiring Friends Dr. Paulin Benedict, Dr. Jeyakumar Meyyappan and Dr. Hannah Jane and our REVELLIONZ 08’ batch.
India is the highest TB burden country accounting for more than one-fourth of the global incidence .Genital TB is found in 5-10% of women with infertility problems, with low rates in Australia (1%) and high rates of up to 19% in India (ICMR,2011)
Ca ovary staging(AJCC 8th Edition& FIGO 2014) and classificationDr.Bhavin Vadodariya
Pathological classification of ovary in details.
Principles of Staging in Ca Ovary.
Staging according to AJCC 8th edition & Figo 2014.
Summary of changes in 8th Edition AJCC
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Phone Us ❤85270-49040❤ #ℂall #gIRLS In Surat By Surat @ℂall @Girls Hotel With...
Carcinoma endometrium Dr. M.C.Bansal
1. CARCINOMA ENDOMETRIUM
Prof. M.C.Bansal
MBBS,MS,MICOG,FICOG
Professor OBGY
Ex-Principal & Controller
Jhalawar Medical College & Hospital
Mahatma Gandhi Medical College, Jaipur.
2. INTRODUCTION
Most frequently encountered gynaecologic
cancer in west because of decline in Ca Cx
Account for 7.0%of all cancer in women
Peak incidence is in the age group of 55 to
69 years.
Over three-fourth of these women are
diagnosed when the disease is still localized and
surgery offers satisfactory results.
3. PREDISPOSING FACTORS
1. Unsupervised administration of ERT in
menopausal women.
2. Women suffering from Hyperestrogenic
states i.e. Endometrial hyperplasia as cases
of DUB.
3. Familial predisposition to it and may be due
to genetic factors or dietary habits.
4. Tamoxifen prescribed to women with breast
cancer.
4. CONTN..
5. OCPs containing only estrogen while OCPs
with E & P have protective effect.
6. Obesity, HT, Diabetes, Infertility, nulliparity
are associated with endometrial cancer in
30% cases.
7. PCOD patients are more prone to this
disease.
5. PATHOLOGY
Uterus is enlarged and Endometrial cancer may
be localized or diffuse.
Localized form may appear as a nodule or polyp
or localized carcinomatous patch.
Diffuse form may be involving the entire uterine
cavity stopping short of internal os.
It may infiltrate uterine myometrium and remain
restricted to its boundaries for a long time.
In advanced stages growth may directly spread
beyond uterine body to cervix, vagina, adnexa
and may metastesize into nodes and distant
sites.
6. THIS ADENOCARCINOMA OF THE ENDOMETRIUM IS MORE OBVIOUS. IRREGULAR
MASSES OF WHITE TUMOR ARE SEEN OVER THE SURFACE OF THIS UTERUS THAT
HAS BEEN OPENED ANTERIORLY. THE CERVIX IS AT THE BOTTOM OF THE PICTURE.
THIS ENLARGED UTERUS WAS NO DOUBT PALPABLE ON PHYSICAL EXAMINATION.
SUCH A NEOPLASM OFTEN PRESENT WITH ABNORMAL BLEEDING.
7. THE ENDOMETRIAL ADENOCARCINOMA IS PRESENT ON THE LUMENAL
SURFACE OF THIS CROSS SECTION OF UTERUS. NOTE THAT THE
NEOPLASM IS SUPERFICIALLY INVASIVE. THE CERVIX IS AT THE RIGHT.
8. This uterus is not enlarged, but there is an irregular mass in the upper
fundus that proved to be endometrial adenocarcinoma on biopsy.
Such carcinomas are more likely to occur in postmenopausal women.
Thus, any postmenopausal bleeding should make you suspect that
this lesion may be present.
9. HISTOPATHOLOGY
It is adeno carcinoma
Grading of these tumors is based on
differentiation and ability to maintain gland
formation, morphology and anaplasia of the
tumour lining cells and presence of infiltration
in stroma
Tumor grading affects the prognosis of the
disease in any individual case
10.
11.
12. THE ENDOMETRIAL ADENOCARCINOMA IN THE POLYP AT THE LEFT
IS MODERATELY DIFFERENTIATED, AS A GLANDULAR STRUCTURE
CAN STILL BE DISCERNED. NOTE THE HYPERCHROMATISM AND
PLEOMORPHISM OF THE CELLS, COMPARED TO THE UNDERLYING
ENDOMETRIUM WITH CYSTIC ATROPHY AT THE RIGHT.
13. THIS IS ENDOMETRIAL ADENOCARCINOMA WHICH CAN BE SEEN INVADING
INTO THE SMOOTH MUSCLE BUNDLES OF THE MYOMETRIAL WALL OF THE
UTERUS. THIS NEOPLASM HAS A HIGHER STAGE THAN A NEOPLASM THAT
IS JUST CONFINED TO THE ENDOMETRIUM OR IS SUPERFICIALLY INVASIVE.
14. SYMPTOMS
1. May be asymptomatic to begin with.
2. Menometrorrhagia in perimenopausal
women
3. Post menopausal bleeding.
15. SIGNS
1. Per vaginal examination: may or may not
reveal a bulky uterus.
2. Enlarged uterus may be associated with Ca
endometrium along with fibroid or pyometra
3. Sub-urethral Vaginal metastatic growth may be
noted in advanced cases.
4. When adnexa is involved in late stages
enlarged uterus with unilateral or bilateral
adnexal enlargement and fixed nodules in
Pouch of Douglas may be present.
16. INVESTIGATIONS
1. Routine Haematogram and blood chemistry, urine
examination, X-ray chest and ECG should be done.
2. USG- often reveals thickened and hyperplastic,
polyp in uterine cavity.
Post menopausal endometrial thickness >4mm is
abnormal
3. Endometrial cell sampling by aspiration cytology.
4. Diagnostic hysteroscopy followed by selective
biopsy of suspected area.
5. Fractional curettage and histopathological
examination- this will help in differentiating whether
Ca endometrium is involving cervical canal or not.
6. CT/MRI help in defining the extent of disease into
the myometrium , nodes and distant organs.
17. DIFFERENTIAL DIAGNOSIS
1. Senile endometritis
2. Genital tuberculosis
3. Atypical endometrial hyperplasia
4. Any other cause of post menopausal
bleeding like senile vaginitis, foreign body,
ERT abuse, cervical polyp, urethral
caruncle, Ca cervix and ovarian carcinoma
etc
18. SCREENING OF ENDOMETRIAL CARCINOMA
1. Routine screening of all asymptomatic
women on HRT and tamoxifen therapy
2. Perimenopausal women with
menometrorrhagia should be investigated
and screened to exclude endometrial
carcinoma.
3. All women with postmenopausal bleeding
should be screened by pv examination,
TVS, Pipelle aspiration cytology.
4. Fractional curettage along with diagnostic
hysteroscopy.
19. • Local and/or regional spread
• 3A-Tumor involves serosa, spreads to adnexae,
positive peritoneal cytology.
3 • 3B- Presence of vaginal metastasis
• 3C- Node metastasis to pelvis and para aortic
nodes.
• Tumour Widespread
• 4A Tumor involves bladder and /or
4 bowel mucosa
• 4B Tumor shows distant metastasis (
intra-abdominal and inguinal nodes)
20. STAGE • DESCRIPTION
• Cancer confined to corpus uteri
• 1A- Tumor limited to endometrium
1 • 1B- Tumor involving half or less than half the
myometrial thickness
• 1C – Tumor involves more than half the
myometrial thickness
• Tumor involves cervix but does not extend
beyond uterus
2 • 2A- Endocervical gland involvement only.
• 2B- Cervical stromal invasion
21. TREATMENT
cases of simple hyperplasia develop in
malignancy in 10-20%
60-70% cases of atypical hyperplasia
develop into malignancy.
Stage 0-(Endometrial hyperplasia)-
Abdominal Pan Hysterectomy is the ideal
treatment.
Young women may be kept under
observation and 30-40 mg
medroxyprogesterone daily therapy may be
offered for 6-12 months.
22. RX CONTN..
Stage IA: (low risk Grade 1 and 2of
endometrium HPR) TAH and BSO is
sufficient because involvement of nodes is
seen in only 2% cases while myometrial
invasion is only 4%.
Stage IB- High risk > 50% myometrium
involved and HPR shows grade 3 tumor or
there is presence of lymphatic involvement
then chances of lymph node metastasis is
10-40% therefore TAH and BSO followed by
23. RX: CONTN..
Stage II- Pre operative radiotherapy followed by
TAH and BSO, or Wertheims Hysterectomy as
done for Ca cervix.
Post operative radiotherapy is needed
if lymph nodes are Ca positive.
Stage III- Advanced disease not suitable for
surgery. Chemotherapy plus Radiotherapy plus
weekly injection of Medroxy progesterone.
Stage IV- Palliative Radiotherapy, chemotherapy
and hormonal therapy using large dose of
progesterone. Progesterone helps in regression
of lung metastasis in 30% cases.
26. SARCOMA OF THE UTERUS
Introduction:
These are rare tumors comprising 4.5% of all
malignant growths of the uterus.
About 0.5% of myomas undergo sarcomatous
changes at menopausal age.
Common in the age of 40-60 yrs.
Rare before 30 yrs.
8% of sarcomas occur in women who have
received radiation for Ca cervix 8-10 yrs ago.
27. VARIETIES OF UTERINE SARCOMAS
1. Intramural- arise in the myometrium
2. Mucosal- Develops from endometrium.
3. Sarcomatous changes in pre-existing myoma.
4. Grape like sarcoma of the cervix.
Intramural is most common . Histologically
tumour may be round cell, spindle-celled,
mixed cell or giant cell type.
Spindle- cell type is most common and called
leiomyosarcoma.
28. GROSS APPEARANCE
Cut surface: is hemorrhagic and irregular
without whorled appearance like myoma. It is
friable and soft. Margins are not clear and
invasion into surrounding myometrium is
common. There is no definite capsule.
Mucosal form- projects in cavity like polyp or
spreads around the cavity of the uterus to
produce uniform enlargement.
29. THIS IS A LEIOMYOSARCOMA PROTRUDING FROM MYOMETRIUM INTO
THE ENDOMETRIAL CAVITY OF THIS UTERUS THAT HAS BEEN OPENED
LATERALLY SO THAT THE HALVES OF THE CERVIX APPEAR AT RIGHT
AND LEFT. FALLOPIAN TUBES AND OVARIES PROJECT FROM TOP AND
BOTTOM. THE IRREGULAR NATURE OF THIS MASS SUGGESTS THAT IS
NOT JUST AN ORDINARY LEIOMYOMA.
30. HERE IS THE MICROSCOPIC APPEARANCE OF A LEIOMYOSARCOMA. IT IS
MUCH MORE CELLULAR AND THE CELLS HAVE MUCH MORE
PLEOMORPHISM AND HYPERCHROMATISM THAN THE BENIGN
LEIOMYOMA. AN IRREGULAR MITOSIS IS SEEN IN THE CENTER.
31. SARCOMAS, INCLUDING LEIOMYOSARCOMAS, OFTEN HAVE VERY
LARGE BIZARRE GIANT CELLS ALONG WITH THE SPINDLE CELLS.
A COUPLE OF MITOTIC FIGURES APPEAR AT THE LEFT AND
LOWER LEFT.
32. METASTASES
Relatively earlier, occurs via blood stream,
lymphatics, direct spread and by
implantation.
Lymphatic nodes-35% cases in stage I and II
and Para-aortic lymph nodes in 15% cases.
Direct spread in the peritoneum leads to
multiple metastasis leading to ascites and
omental cake.
33. SYMPTOMS AND SIGNS
Profuse and irregular vaginal bleeding which
is often painful.
60% patients have fever due to degeneration
and infection of the tumour.
Rapid enlargement of the tumour usually
occurs due to sarcoma.
34. TREATMENT
Pan Hysterectomy, omentectomy and
debulking of metastasis foci is done.
Followed by radiation therapy.
Chemotherapy of VAC combination reduces
the recurrence rate.
5 yr cure rate is <30% and largely depends
on the type of growth, being worst in
endometrial sarcoma i.e. round cell type.
35. BOTRYOID AND GRAPE-LIKE SARCOMA
Pathologically the tumour is mesodermal
mixed tumour as the often contain cartilage,
striated muscle fibres, glands and fat.
Stroma is embryonic in type.
Grape sarcoma of cervix arises typically in
adult women somewhat similar tumor are
known to develop in cervix and vagina in
children in very early age. In these cases
prognosis is very poor and rapid recurrence
follows their removal.