Uterine myoma is a benign neoplasm composed of uterine smooth muscle and connective tissue that supports it and is often referred to as fibromyoma, leiomyoma, fibroids. Can be single or multiple and reach large sizes (100 pounds). It has a tough consistency, with a clear cap boundary so that it can be removed from the surroundings. Uterine myoma, also known as leiomyoma or fibroid is a benign tumor that is often found in women of reproductive age (20-25%). At age> 35 years the incidence is higher, that is, closer to 40%. The high incidence of uterine myomas between the ages of 35 and the ages of 50 indicates a relationship between the incidence of uterine myomas and estrogen.
Uterine leiomyomas, or fibroids, are benign tumors composed of smooth muscle and fibrous tissue that develop in the uterus. They are very common, affecting 20-30% of women of reproductive age. Fibroids are hormone dependent and usually shrink after menopause. They can cause heavy periods, pelvic pain or pressure, urinary issues, and pregnancy complications. Diagnosis involves physical exam, ultrasound, MRI or other imaging tests. Treatment options depend on symptoms and may include pain medications, hormone therapies, surgical procedures like myomectomy or hysterectomy, or watchful waiting.
Carcinoma of the uterine and cervix are the two main types of cancer affecting a woman's reproductive system. Uterine cancer begins in the uterus and there are two main types - endometrial carcinoma and uterine sarcoma. Endometrial carcinoma starts in the uterine lining while uterine sarcoma starts in the connective tissues. Cervical cancer is caused by HPV infection and there are two types - squamous cell carcinoma and adenocarcinoma. Risk factors, symptoms, diagnosis, staging, treatment and prevention of uterine and cervical cancers are discussed in detail in the document.
Benign disease of the uterus includes fibroids, adenomyosis, and uterine polyps. Endometrial polyps are common growths in the uterus that can cause abnormal bleeding. They are more frequently seen in women taking medications like tamoxifen. Uterine fibroids are also very common non-cancerous growths that arise from the muscle cells of the uterus and can cause heavy bleeding and pain. While many fibroids cause no issues, some may lead to complications like infertility or problems in pregnancy. Diagnosis is often done with ultrasound or MRI. Treatment depends on symptoms but may include medication, surgery, or watchful waiting.
gynaecology.Benign tumor of the uterus.(dr.sundus)student
Benign disease of the uterus includes fibroids, adenomyosis, and uterine polyps. Fibroids are non-cancerous tumors that form in the uterus and are very common. They can cause heavy bleeding and pain. Uterine polyps are overgrowths of tissue in the uterus that can also cause abnormal bleeding. While many women do not experience symptoms, fibroids and polyps sometimes require treatment such as surgery to remove them.
The document discusses the classification and management of ovarian cysts and tumors. It covers:
1) The classification of ovarian cysts and tumors into non-neoplastic functional cysts, primary ovarian neoplasms including epithelial tumors, sex cord stromal tumors, and germ cell tumors.
2) The clinical presentation, diagnosis, and management of benign ovarian cysts and tumors depending on factors like age and symptoms.
3) Malignant ovarian tumors are most common in older women above 50 years old and often require surgery.
Uterine leiomyomas, or fibroids, are benign smooth muscle tumors that are the most common pelvic tumor in women. Fibroids can be described by their location in the uterus and may cause abnormal uterine bleeding, pelvic pressure and pain, or reproductive dysfunction. Symptoms are often relieved at menopause.
This document provides background information on ovarian cancer, including its pathophysiology, etiology, epidemiology, clinical presentation, diagnosis, and screening. It states that ovarian cancer typically spreads within the peritoneal cavity. Several risk factors are identified, including genetic and reproductive factors. Epithelial ovarian cancer represents the most common histology and has a poor prognosis when diagnosed at advanced stages, due to nonspecific symptoms. No approved screening methods exist for ovarian cancer detection.
Uterine leiomyomas, or fibroids, are benign tumors composed of smooth muscle and fibrous tissue that develop in the uterus. They are very common, affecting 20-30% of women of reproductive age. Fibroids are hormone dependent and usually shrink after menopause. They can cause heavy periods, pelvic pain or pressure, urinary issues, and pregnancy complications. Diagnosis involves physical exam, ultrasound, MRI or other imaging tests. Treatment options depend on symptoms and may include pain medications, hormone therapies, surgical procedures like myomectomy or hysterectomy, or watchful waiting.
Carcinoma of the uterine and cervix are the two main types of cancer affecting a woman's reproductive system. Uterine cancer begins in the uterus and there are two main types - endometrial carcinoma and uterine sarcoma. Endometrial carcinoma starts in the uterine lining while uterine sarcoma starts in the connective tissues. Cervical cancer is caused by HPV infection and there are two types - squamous cell carcinoma and adenocarcinoma. Risk factors, symptoms, diagnosis, staging, treatment and prevention of uterine and cervical cancers are discussed in detail in the document.
Benign disease of the uterus includes fibroids, adenomyosis, and uterine polyps. Endometrial polyps are common growths in the uterus that can cause abnormal bleeding. They are more frequently seen in women taking medications like tamoxifen. Uterine fibroids are also very common non-cancerous growths that arise from the muscle cells of the uterus and can cause heavy bleeding and pain. While many fibroids cause no issues, some may lead to complications like infertility or problems in pregnancy. Diagnosis is often done with ultrasound or MRI. Treatment depends on symptoms but may include medication, surgery, or watchful waiting.
gynaecology.Benign tumor of the uterus.(dr.sundus)student
Benign disease of the uterus includes fibroids, adenomyosis, and uterine polyps. Fibroids are non-cancerous tumors that form in the uterus and are very common. They can cause heavy bleeding and pain. Uterine polyps are overgrowths of tissue in the uterus that can also cause abnormal bleeding. While many women do not experience symptoms, fibroids and polyps sometimes require treatment such as surgery to remove them.
The document discusses the classification and management of ovarian cysts and tumors. It covers:
1) The classification of ovarian cysts and tumors into non-neoplastic functional cysts, primary ovarian neoplasms including epithelial tumors, sex cord stromal tumors, and germ cell tumors.
2) The clinical presentation, diagnosis, and management of benign ovarian cysts and tumors depending on factors like age and symptoms.
3) Malignant ovarian tumors are most common in older women above 50 years old and often require surgery.
Uterine leiomyomas, or fibroids, are benign smooth muscle tumors that are the most common pelvic tumor in women. Fibroids can be described by their location in the uterus and may cause abnormal uterine bleeding, pelvic pressure and pain, or reproductive dysfunction. Symptoms are often relieved at menopause.
This document provides background information on ovarian cancer, including its pathophysiology, etiology, epidemiology, clinical presentation, diagnosis, and screening. It states that ovarian cancer typically spreads within the peritoneal cavity. Several risk factors are identified, including genetic and reproductive factors. Epithelial ovarian cancer represents the most common histology and has a poor prognosis when diagnosed at advanced stages, due to nonspecific symptoms. No approved screening methods exist for ovarian cancer detection.
Uterine fibroids, or leiomyomas, are benign tumors that arise from the smooth muscle cells of the uterus. They are the most common solid pelvic tumors in women. While many fibroids do not cause symptoms, they can cause heavy bleeding, pelvic pain or pressure, and problems during pregnancy. Fibroids are diagnosed using ultrasound or other imaging tests and the treatment depends on the severity of symptoms, but may include medication, surgery, or observation.
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.
This document discusses uterine fibroids and laparoscopic myomectomy. It defines different types of fibroids and their locations in the uterus. Laparoscopic myomectomy is described as a technique for removing fibroids through small incisions instead of open surgery. While it has advantages over traditional laparotomy, laparoscopic myomectomy requires skill and experience to perform carefully without complications. Factors such as fibroid size and location can increase the difficulty of the procedure and risk of conversion to open surgery.
This document provides information on endometrial cancer including its definition, incidence, epidemiology, risk factors, clinical presentation, investigation, pathology, classification, staging, and treatment. It notes that endometrial cancer is the most common gynecologic cancer, occurring most often in post-menopausal women. Common risk factors include obesity, diabetes, infertility, and family history. The main symptom is abnormal vaginal bleeding, especially after menopause. Treatment depends on staging and may involve surgery, radiation therapy, chemotherapy, or hormonal therapy.
Ca ovary staging(AJCC 8th Edition& FIGO 2014) and classificationDr.Bhavin Vadodariya
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Principles of Staging in Ca Ovary.
Staging according to AJCC 8th edition & Figo 2014.
Summary of changes in 8th Edition AJCC
Awareness and current knowledge of breast cancerMehwish Iqbal
Breast cancer remains a worldwide public health dilemma and is currently the most common tumour in the globe.
Awareness of breast cancer, public attentiveness, and advancement in breast imaging has made a positive impact
on recognition and screening of breast cancer. Breast cancer is life-threatening disease in females and the leading
cause of mortality among women population. For the previous two decades, studies related to the breast cancer
has guided to astonishing advancement in our understanding of the breast cancer, resulting in further proficient
treatments. Amongst all the malignant diseases, breast cancer is considered as one of the leading cause of death in
post menopausal women accounting for 23% of all cancer deaths. It is a global issue now, but still it is diagnosed in
their advanced stages due to the negligence of women regarding the self inspection and clinical examination of the
breast. This review addresses anatomy of the breast, risk factors, epidemiology of breast cancer, pathogenesis of breast
cancer, stages of breast cancer, diagnostic investigations and treatment including chemotherapy, surgery, targeted
therapies, hormone replacement therapy, radiation therapy, complementary therapies, gene therapy and stem-cell
therapy etc for breast cancer.
This document provides information on carcinoma endometrium, including its introduction, predisposing factors, pathology, symptoms, investigations, differential diagnosis, screening, staging, treatment, survival rates, and sarcoma of the uterus. Some key points include:
1. Carcinoma endometrium accounts for 7% of cancers in women and peaks between ages 55-69. Over three-fourths are diagnosed when still localized.
2. Predisposing factors include unsupervised hormone therapy, hyperestrogenic states, familial factors, and tamoxifen use.
3. Investigations include ultrasounds, endometrial sampling, hysteroscopy, and biopsy. Staging involves assessing
Benign ovarian masses include functional cysts and tumors; most are asymptomatic.Most functional cysts and benign tumors are asymptomatic. Sometimes they cause menstrual abnormalities. Hemorrhagic corpus luteum cysts may cause pain or signs of peritonitis, particularly when they rupture. Occasionally, severe abdominal pain results from adnexal torsion of a cyst or mass, usually > 4 cm. Treatment varies depending on the patient's reproductive status.
1. Ultrasound, CT, MRI, and other imaging modalities can be used to evaluate cancers of the female genital tract. Transvaginal ultrasound provides high quality images of the pelvic organs.
2. Imaging can detect masses in the uterus, ovaries, or other pelvic structures but often cannot distinguish between benign or malignant tumors. Features suggesting malignancy include solid components, thick septations, or invasion of surrounding tissues.
3. Common gynecologic cancers include those of the cervix, uterus, ovaries, vulva, and vagina. Leiomyomas (fibroids) are benign uterine tumors that can be identified on imaging. Sarcomas are rare malignant uterine tumors.
This document discusses ovarian tumors. It notes that ovarian tumors can be cystic or solid, functional, benign or malignant. In reproductive-aged women, most ovarian enlargements are functional cysts, while 25% prove to be nonfunctional neoplasms of which 90% are benign. Ovarian masses in postmenopausal patients or those unresponsive to birth control present a higher risk of malignancy. Evaluation involves examination and imaging like ultrasound. Common benign ovarian tumors include serous cystadenomas, mucinous cystadenomas, dermoid cysts, and granulosa cell tumors. Complications can include torsion, rupture, hemorrhage, and infection. Ovarian cancer is the fifth most common cancer in
The peritoneum is a membrane that lines the abdominal cavity. In women, the peritoneum is an "open system" interrupted by the fallopian tubes, allowing transmission between the genital tract and peritoneal cavity. Many inflammatory conditions can involve the peritoneum. Endometriosis is a common condition where endometrial tissue grows outside the uterus, often on the ovaries or peritoneum. Symptoms include pelvic pain and infertility. Mesothelial tumors of the peritoneum range from benign to aggressive malignancies. Serous tumors are the most common type of peritoneal tumor and can be borderline or adenocarcinomas.
The document discusses malignant disorders of the uterine corpus, specifically endometrial carcinoma. It covers the embryology and anatomy of the uterus, risk factors and epidemiology of endometrial carcinoma, screening and classification. Diagnosis involves endometrial sampling and imaging. Staging is done according to FIGO criteria. Prognosis depends on stage, with stage I having a 5-year survival rate of 85%. Treatment options include surgery, radiation therapy, chemotherapy, and hormone therapy depending on the stage. Follow up after treatment monitors for recurrence or complications.
This document discusses endometriosis, which is a condition where cells similar to the endometrium grow outside the uterus, most often on the ovaries and surrounding tissues. It affects 6-10% of women and can cause pain, infertility, and other issues. The cause is unknown but theories include retrograde menstruation and genetic factors. Diagnosis involves a medical history, physical exam, ultrasound, and laparoscopy. Treatment options include pain medications, hormonal therapy to suppress menstruation, and surgery to remove lesions and restore anatomy. Left untreated, it can progress in severity over time.
Witch's milk in newborns is caused by maternal and placental hormones crossing the placenta and causing breast tissue proliferation before birth. This results in swelling and occasional milky discharge from nipples in both sexes during the first week, which resolves on its own as hormone levels fall.
Breast examination involves inspecting for symmetry, swelling, nipple retraction, and dimpling of skin during maneuvers that compress or lift the breast tissue. This helps identify tumors, cysts, abscesses, or signs of carcinoma.
Supernumerary or retracted nipples are congenital anomalies, while a retracted nipple in older individuals usually indicates an underlying carcinoma pulling on ducts
1) The document discusses MRI features of common benign conditions of the female pelvis, including physiologic cysts, benign ovarian neoplasms, and benign pelvic disease processes.
2) Key MRI findings of physiologic cysts include the appearance of follicles as high signal intensity cysts under 1cm, corpus luteum cysts with thick irregular walls, and hemorrhagic cysts appearing high signal on T1-weighted images.
3) Common benign ovarian neoplasms discussed are dermoid cysts with signal intensity similar to fat, ovarian fibromas appearing similar to smooth muscle, and serous cystadenomas appearing as thin-walled fluid-filled cysts.
This document provides a classification and overview of ovarian cysts and tumours. It discusses the different types of cysts including physiological cysts such as follicular and luteal cysts. It also covers the different types of primary ovarian neoplasms including epithelial tumours, sex cord stromal tumours, and germ cell tumours. For each type, it describes the histological features, clinical presentation, diagnosis, and management. Overall, the document serves as a comprehensive reference for the various ovarian cysts and tumours that healthcare providers may encounter.
This document discusses breast pathology, including cancer diagnosis and benign breast diseases. It covers breast anatomy, histology of different tumor types, lymph node groups related to breast cancer metastasis, and diagnostic techniques. Diagnosis is based on symptoms, palpation, mammography, and biopsy. Common benign breast anomalies include supernumerary breasts, absence of breast tissue, and gynecomastia in men. Surgical treatment aims to remove tissue in cases of hyperplasia and implant prosthetics for hypoplasia or absence of breast tissue.
This document discusses several pathologies that can occur in breast tissue, both male and female. It begins with normal breast histology and then covers mixed connective tissue and epithelial tumors such as fibroadenoma and phyllodes tumor. It describes the microscopic appearance and characteristics of these tumors. The document also discusses duct papilloma, gynecomastia in males, and carcinoma of the male breast. It provides clinical, radiographic, and microscopic images to illustrate these conditions. Management and prognostic factors are summarized for phyllodes tumors and carcinoma of the male breast.
Pancreatic Adenocarcinoma with Isolated Venous Involvement: Is Neoadjuvant Tr...EditorSara
Neoadjuvant Treatment (NAT) is indicated in locally advanced tumors and improves the results of subsequent surgery. In borderline tumors, the place of this preoperative treatment is more controversial, probably because borderline tumors are a heterogeneous group. We focused on the tumors with venous involvement without any arterial involvement and studied the results of neoadjuvant treatment in this particular group.
Racial Differences in Accepting Pegfilgrastim Onpro Kit (On-Body Injector) Us...EditorSara
Neulasta Onpro kit eliminates need for additional clinic visit after chemotherapy. Given the racially diverse population in our institution, we investigated acceptance of Onpro kit among patients on chemotherapy.Single-institution, retrospective review conducted in patients with GI tumors who received Onpro kit within 1 hour of completion of systemic chemotherapy from Jan 2014 through Jan 2018...
APL:Retinoic Acid and Retinoid Pharmacology, a Breakthrough TodayEditorSara
Acute promyelocytic leukemia(APL),a specific characteristic of t(15;17) chromosomal translocation,molecular gene analyses are conclusive in vivo evidence that oncogenic pml/RARa fusion plays a crucial role in APL leukemogenesis [1-3]. Since the introduction of initial 13-cis retinoic acid(13-cis RA)[4],and currently all-trans RA(ATRA) [5] and tamibarotene [6],RA plus chemotherapy or RA plus As2O3 regimen is currently the standard of care [7]...
Hairy Cell Leukemia (HCL) is a rare subtype of B-cell chronic lymphoid leukemia which was first described by Bertha Bouroncle in 1958 [1]. The annual incidence of HCL is approximately 0.3 cases per 100,000 and the disease comprises 2-3% of all leukaemia?s in the Western world [2,3]...
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Uterine fibroids, or leiomyomas, are benign tumors that arise from the smooth muscle cells of the uterus. They are the most common solid pelvic tumors in women. While many fibroids do not cause symptoms, they can cause heavy bleeding, pelvic pain or pressure, and problems during pregnancy. Fibroids are diagnosed using ultrasound or other imaging tests and the treatment depends on the severity of symptoms, but may include medication, surgery, or observation.
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.
This document discusses uterine fibroids and laparoscopic myomectomy. It defines different types of fibroids and their locations in the uterus. Laparoscopic myomectomy is described as a technique for removing fibroids through small incisions instead of open surgery. While it has advantages over traditional laparotomy, laparoscopic myomectomy requires skill and experience to perform carefully without complications. Factors such as fibroid size and location can increase the difficulty of the procedure and risk of conversion to open surgery.
This document provides information on endometrial cancer including its definition, incidence, epidemiology, risk factors, clinical presentation, investigation, pathology, classification, staging, and treatment. It notes that endometrial cancer is the most common gynecologic cancer, occurring most often in post-menopausal women. Common risk factors include obesity, diabetes, infertility, and family history. The main symptom is abnormal vaginal bleeding, especially after menopause. Treatment depends on staging and may involve surgery, radiation therapy, chemotherapy, or hormonal therapy.
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
Awareness and current knowledge of breast cancerMehwish Iqbal
Breast cancer remains a worldwide public health dilemma and is currently the most common tumour in the globe.
Awareness of breast cancer, public attentiveness, and advancement in breast imaging has made a positive impact
on recognition and screening of breast cancer. Breast cancer is life-threatening disease in females and the leading
cause of mortality among women population. For the previous two decades, studies related to the breast cancer
has guided to astonishing advancement in our understanding of the breast cancer, resulting in further proficient
treatments. Amongst all the malignant diseases, breast cancer is considered as one of the leading cause of death in
post menopausal women accounting for 23% of all cancer deaths. It is a global issue now, but still it is diagnosed in
their advanced stages due to the negligence of women regarding the self inspection and clinical examination of the
breast. This review addresses anatomy of the breast, risk factors, epidemiology of breast cancer, pathogenesis of breast
cancer, stages of breast cancer, diagnostic investigations and treatment including chemotherapy, surgery, targeted
therapies, hormone replacement therapy, radiation therapy, complementary therapies, gene therapy and stem-cell
therapy etc for breast cancer.
This document provides information on carcinoma endometrium, including its introduction, predisposing factors, pathology, symptoms, investigations, differential diagnosis, screening, staging, treatment, survival rates, and sarcoma of the uterus. Some key points include:
1. Carcinoma endometrium accounts for 7% of cancers in women and peaks between ages 55-69. Over three-fourths are diagnosed when still localized.
2. Predisposing factors include unsupervised hormone therapy, hyperestrogenic states, familial factors, and tamoxifen use.
3. Investigations include ultrasounds, endometrial sampling, hysteroscopy, and biopsy. Staging involves assessing
Benign ovarian masses include functional cysts and tumors; most are asymptomatic.Most functional cysts and benign tumors are asymptomatic. Sometimes they cause menstrual abnormalities. Hemorrhagic corpus luteum cysts may cause pain or signs of peritonitis, particularly when they rupture. Occasionally, severe abdominal pain results from adnexal torsion of a cyst or mass, usually > 4 cm. Treatment varies depending on the patient's reproductive status.
1. Ultrasound, CT, MRI, and other imaging modalities can be used to evaluate cancers of the female genital tract. Transvaginal ultrasound provides high quality images of the pelvic organs.
2. Imaging can detect masses in the uterus, ovaries, or other pelvic structures but often cannot distinguish between benign or malignant tumors. Features suggesting malignancy include solid components, thick septations, or invasion of surrounding tissues.
3. Common gynecologic cancers include those of the cervix, uterus, ovaries, vulva, and vagina. Leiomyomas (fibroids) are benign uterine tumors that can be identified on imaging. Sarcomas are rare malignant uterine tumors.
This document discusses ovarian tumors. It notes that ovarian tumors can be cystic or solid, functional, benign or malignant. In reproductive-aged women, most ovarian enlargements are functional cysts, while 25% prove to be nonfunctional neoplasms of which 90% are benign. Ovarian masses in postmenopausal patients or those unresponsive to birth control present a higher risk of malignancy. Evaluation involves examination and imaging like ultrasound. Common benign ovarian tumors include serous cystadenomas, mucinous cystadenomas, dermoid cysts, and granulosa cell tumors. Complications can include torsion, rupture, hemorrhage, and infection. Ovarian cancer is the fifth most common cancer in
The peritoneum is a membrane that lines the abdominal cavity. In women, the peritoneum is an "open system" interrupted by the fallopian tubes, allowing transmission between the genital tract and peritoneal cavity. Many inflammatory conditions can involve the peritoneum. Endometriosis is a common condition where endometrial tissue grows outside the uterus, often on the ovaries or peritoneum. Symptoms include pelvic pain and infertility. Mesothelial tumors of the peritoneum range from benign to aggressive malignancies. Serous tumors are the most common type of peritoneal tumor and can be borderline or adenocarcinomas.
The document discusses malignant disorders of the uterine corpus, specifically endometrial carcinoma. It covers the embryology and anatomy of the uterus, risk factors and epidemiology of endometrial carcinoma, screening and classification. Diagnosis involves endometrial sampling and imaging. Staging is done according to FIGO criteria. Prognosis depends on stage, with stage I having a 5-year survival rate of 85%. Treatment options include surgery, radiation therapy, chemotherapy, and hormone therapy depending on the stage. Follow up after treatment monitors for recurrence or complications.
This document discusses endometriosis, which is a condition where cells similar to the endometrium grow outside the uterus, most often on the ovaries and surrounding tissues. It affects 6-10% of women and can cause pain, infertility, and other issues. The cause is unknown but theories include retrograde menstruation and genetic factors. Diagnosis involves a medical history, physical exam, ultrasound, and laparoscopy. Treatment options include pain medications, hormonal therapy to suppress menstruation, and surgery to remove lesions and restore anatomy. Left untreated, it can progress in severity over time.
Witch's milk in newborns is caused by maternal and placental hormones crossing the placenta and causing breast tissue proliferation before birth. This results in swelling and occasional milky discharge from nipples in both sexes during the first week, which resolves on its own as hormone levels fall.
Breast examination involves inspecting for symmetry, swelling, nipple retraction, and dimpling of skin during maneuvers that compress or lift the breast tissue. This helps identify tumors, cysts, abscesses, or signs of carcinoma.
Supernumerary or retracted nipples are congenital anomalies, while a retracted nipple in older individuals usually indicates an underlying carcinoma pulling on ducts
1) The document discusses MRI features of common benign conditions of the female pelvis, including physiologic cysts, benign ovarian neoplasms, and benign pelvic disease processes.
2) Key MRI findings of physiologic cysts include the appearance of follicles as high signal intensity cysts under 1cm, corpus luteum cysts with thick irregular walls, and hemorrhagic cysts appearing high signal on T1-weighted images.
3) Common benign ovarian neoplasms discussed are dermoid cysts with signal intensity similar to fat, ovarian fibromas appearing similar to smooth muscle, and serous cystadenomas appearing as thin-walled fluid-filled cysts.
This document provides a classification and overview of ovarian cysts and tumours. It discusses the different types of cysts including physiological cysts such as follicular and luteal cysts. It also covers the different types of primary ovarian neoplasms including epithelial tumours, sex cord stromal tumours, and germ cell tumours. For each type, it describes the histological features, clinical presentation, diagnosis, and management. Overall, the document serves as a comprehensive reference for the various ovarian cysts and tumours that healthcare providers may encounter.
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This document discusses several pathologies that can occur in breast tissue, both male and female. It begins with normal breast histology and then covers mixed connective tissue and epithelial tumors such as fibroadenoma and phyllodes tumor. It describes the microscopic appearance and characteristics of these tumors. The document also discusses duct papilloma, gynecomastia in males, and carcinoma of the male breast. It provides clinical, radiographic, and microscopic images to illustrate these conditions. Management and prognostic factors are summarized for phyllodes tumors and carcinoma of the male breast.
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2. from uterine myoma. The differences between America and Af-
rica may be attributed to differences in life patterns. In the USA,
of the 650,000 hysterectomies performed per year, 27% (175,000)
are due to uterine myoma arenas. Based on the residive incidence
of uterine myoma as much as 15% (4-59%), then as much as 10%
(3-21%) must be performed again [2].
Uterine myoma are often found in women of reproductive age (20-
25%), where the prevalence of uterine myomas increased by more
than 70% by pathological examination of uterine anatomy, proving
that many women suffer from asymptomatic uterine myomas. It is
estimated that the incidence of uterine myoma is about 20% -30%
of all women [3]. Aims of the article is to review uterine myoma,
risk factor and pathophysiology.
3. Discussion
Uterine myoma is a benign tumor in the uterine area or more pre-
cisely the uterine muscle and connective tissue around it. Myomas
have never been found before the occurrence of menarche, where-
as after menopause only about 10% of myomas are still growing.
According to localization, myoma uteri is found in cervical (1-
3%), and corporal. The cervix is less common but when it reaches
a large size it can compress the bladder and cause impaired mictu-
rition and is also technically more difficult to operate [4].
Uterine myomas are usually multiple, separate and spherically or
irregularly lobulated. Although myomas have a pseudocapsule,
they can be clearly distinguished from normal myometrium and
can be enucleated easily from the surrounding tissue. Macroscop-
ically in cross section, the myoma is paler, rounded, slippery and
usually dense and if the myoma that has just been removed is
cleaved, the tumor surface separates and is easily distinguished
from the pseudocapsule. Microscopically, myoma uteri consists
of bundles of smooth muscle and connective tissue, which are ar-
ranged like a whorled like appearance [5].
According to the position of the myoma to the uterine lining, it can
be divided into 3 types:
a. Submucosal Myomas
It grows just below the endometrium and protrudes into the uterine
cavity. Often also growing long and protruding stem through the
cervix into the vagina so that it can be seen inspeculo and is called
Myom Geburt. Myoma in the cervix can protrude into the cervical
canal so that the OUE is crescent shaped [6].
Because it grows under the endometrium and in the endometrium,
the uterine bleeding is the most abundant, so that this submuco-
sal myoma most often causes profuse and irregular uterine bleed-
ing (menometrorrhagia). As a result, a hysterectomy is required
in cases of myoma with profuse bleeding despite its small size.
Myoma submucosa with a stem is often infected (ulcerated) and
torsion (twisted) or becomes necrotic and if this happens then this
condition is a major concern before treating the myoma itself (a
syndrome similar to acute abdomen) [3].
The possibility of sarcoma degeration is also greater in this type
of myoma submucosa. The presence of sub mucosa myoma can be
felt as a "curet bump" (lump curettage time) [6].
b. Intramural / Interstitial Myomas
It grows on the uterine wall between the myometrial fibers. The
size and consistency varies, if large or multiple can cause uterine
enlargement and lumps [4].
c. Subserous / Subperitonal Myoma
It grows under the tunica serosa (grows outside the uterine wall)
so that it protrudes outward on the surface of the uterus, covered
by serosa. This type of myoma can also be stemmed. If the myoma
subserosa with this stem gets extrauterine bleeding from the blood
vessels of the omentum, then the stalk can atrophy and be absorbed
so that it is released so that it becomes "parasitic myoma". Some-
times the veins on the surface rupture and cause intra-abdominal
bleeding. This subserous myoma can also grow between the 2 peri-
toneal layers of the broad ligament into an "intraligamenter myo-
ma" which can compress the ureter and A. iliaca, causing urinary
disorders and pain [1, 7].
4. Risk Factors of Uterine Myomas
4. 1. Age of the Patient
Most women are diagnosed with uterine myoma in their 40s; but
it is not certain whether uterine myomas occur due to increased
formation or increased enlargement secondary to hormonal chang-
es at this time of age. Based on the autopsy, Novak found 27%
of women aged 25 years had a myoma nest. Myomas have never
been reported before menarche and after menopause only 10% of
myomas are still growing [8].
4. 2. Endogenous Hormones (Endogenous Hormonal)
Very few uterine myomas were found in specimens taken from the
results of hysterectomy for women who had menopause, it was
explained that the endogenous estrogen hormone in menopausal
women was low or low. Early menarche (age under 10 years) was
found to increase the risk (RR 1.24) and past menarche (age after
16 years) decreased the risk (RR 0.68) for suffering from uterine
myoma [8].
4. 3. Family History
Women with first-degree lineages with uterine myoma sufferers
have a 2.5 times increased risk of suffering from uterine myoma
compared with women without lineage with uterine myoma. Myo-
ma sufferers who have a family history of uterine myoma sufferers
have 2 times the power of expression of VEGF-α (a myoma-relat-
ed growth factor) compared to myoma patients who do not have a
family history of uterine myoma sufferers [9].
4. 4. Ethnicity
From a study conducted involving self-reports by patients regard-
Volume 4 Issue 3 -2021 Review Article
clinicsofoncology.com 2
3. ing uterine myoma, medical records, and sonographic examina-
tions showed that African-American ethnic groups have a 2.9
times likelihood of suffering from uterine myoma compared to
women with caucasian ethnicity, and this risk is not related to risk
factors. another. It was also found that African-American women
suffer from uterine myomas at a younger age and have myomas
that are many and larger and show clinical symptoms. However, it
is not clear whether these differences are due to genetic problems
or differences in circulating estrogen levels, estrogen metabolism,
diet, or the role of environmental factors. However, a recent study
demonstrated that the Val / Val genotype for an essential enzyme
for estrogen metabolism, catechol-O-methyltransferase (COMT)
was present in 47% of African-American women versus only 19%
of white women. Women with this genotype are more prone to
suffer uterine myoma. This explains why the high prevalence of
uterine myoma among African-American women is higher [8].
4.5. Weight Loss
One prospective study was conducted and found that the possible
risk of developing uterine myoma was as high as 21% for every
10kg increase in body weight and with an increase in body mass
index. The same findings were also reported for women with 30%
excess body fat. This occurs because obesity causes increased con-
version of adrenal androgens to estrone and decreased sex-binding
globulin. The result causes an increase in estrogen biologically
which could explain why there is an increase in the prevalence of
uterine myoma and its growth [7].
Several studies have found an association between obesity and an
increased incidence of uterine myoma. A study at Harvard con-
ducted by Dr. Lynn Marshall found that women who have a Body
Mass Index (BMI) above normal are 30.23% more likely to suffer
from uterine myoma. Ros et al, (1986) found that the risk of uter-
ine myoma increases by 21% for every 10 kg of weight gain and
this is in line with the increase in BMI [1, 7, 8].
4.6. Diet
There are studies that link the increase in the occurrence of uter-
ine myoma with consumption of such as beef or red meat or ham
which can increase the incidence of uterine myoma and green veg-
etables can reduce it. This study is very difficult to interpret be-
cause this study does not calculate the caloric value and fat intake
but for information only and it is also not certain whether vitamins,
fiber or phytoestrogens are associated with uterine myoma [7, 8].
4.7. Pregnancy and Parity
Increased parity reduces the incidence of uterine myoma. Uterine
myomas exhibit the same characteristics as normal myometrium
in pregnancy including increased extracellular matrix production
and increased expression of receptors for peptides and steroid hor-
mones. The postpartum myometrium returns to original weight,
blood flow and size by apoptosis and differentiation. This remod-
eling process may be responsible for the reduction in the size of
the uterine myoma. Another theory also says that the blood vessels
in the uterus return to their original state or size in postpartum and
this causes the uterine myoma to lack blood supply and lack of nu-
trients to continue to enlarge. Pregnancy at mid-reproductive age
(25-29 years) was also found to provide protection against myoma
enlargement [7, 8].
4.8. Smoking Habits
Smoking can reduce the incidence of uterine myoma. Many fac-
tors can reduce the bioavailability of the hormone estrogen in tis-
sues, such as: decreased conversion of androgens to estrone by
inhibition of the aromatase enzyme by nicotine [7, 8].
5. Patophysiology of Uterine Myomas
Each uterine myoma is derived from a single myocyte progenitor
cell. Thus, various tumors of the uterus indicate their respective
cytogenic origins. Some of the defects involve chromosomes 6,
7, 12, and 14 and some correlate with the rate and direction of
tumor growth. Some of the specific genetic mutations, including
the MED12 and HMGA2 genes, which are less common are the
COLAA5-A6 or the FH gene, causing most uterine myomas. Of
the genes, the FH (Fumarate Hydratase) gene is a rare gene murasi
but can lead to Hereditary Leimyomatasis and Renal Cell Can-
cer (HLRCC) syndrome. This is characterized by skin and uterine
leiomyoma and renal cell cancer [8, 9].
Based on its origin, myoma uteri is a tumor that is sensitive to es-
trogen and progesterone, so as a result, myoma uteri grows during
the reproductive period. In the postmenopausal period, uterine my-
oma generally shrinks and new tumor growth rarely occurs. The
above sex steroids may have an effect either stimulating or inhib-
iting transcription or cell growth factor production. Myoma uteri
itself creates a hyperestrogenic environment, which is needed for
its growth and maintenance. Compared with normal myometrial
cells, cells from myoma uteri have a higher density of estrogen
receptors, which makes more bonds from estradiol. Then these tu-
mors also convert less estradiol to weaker estrone. The third mech-
anism is the large amount of cytochrome P450 in uterine myoma
compared to normal myocyte cells, this specific enzyme catalyzes
the conversion of androgens to estrogens [10].
Some conditions also provide continuous estrogen exposure which
triggers the formation of uterine myoma. For example, in a high
BMI condition because obese women produce more estrogen due
to the conversion of androgens to estrogen in adipose tissue by
aromatase. Women with Polycystic Ovarian Syndrome (PCOS)
also have a greater risk of developing uterine myoma. Of the many
factors, estrogen and progesterone hormonal therapy in premeno-
pausal women does not have much of an effect that induces the
formation of uterine myoma. Smoking alters estrogen metabolism
and decreases physiologically active serum estrogens. This ex-
Volume 4 Issue 3 -2021 Review Article
clinicsofoncology.com 3
4. plains why women who smoke have a lower risk of developing
uterine myoma [8, 11].
Apart from estrogen, uterine myoma also carries more progester-
one receptors than the surrounding myometrium. Progesterone is
considered to have an important role in mitogen in the growth of
uterine myoma and maintain progesterone receptors. Thus, cell
proliferation, accumulation of extracellular matrices, cellular hy-
pertrophy all lead to the growth of uterine myoma directly con-
trolled by progesterone and in some role by estrogen. This rela-
tionship is evidenced by the provision of anti-progestins, atrophy
occurs in most uterine myomas [9, 11].
6. Conclusion
Some conditions also provide continuous estrogen exposure which
triggers the formation of uterine myoma. This risk factor including
age, family history, ethnic, bad habit, diet, weight loss and preg-
nancy.
References
1. Ling FW, Duff P. Obstetri and Gynaecology Principle of Practice.
McGraw-Hill. 2001; 1151-72.
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3. Anonim. Gynecology by Ten Teachers, 17 th edition, Editor Camp-
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4. DeCherney AH, Nathan L. Current Obstetry and Gynecology Diag-
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8. Parker WH. Etiology, symptomatology, and diagnosis of uterine my-
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