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Introduction and case presentation: Primary vaginal leiomyosarcomas (LMS) are rare, recurrent tumours with an unknown etiology; the prognosis is poor and there is no consensus guideline on their management. A nodular, 25 x 23 x 28 mm-mass, infiltrating the urethra but not the rectovaginal septum, was found in a 58-year-old previously hysterectomized woman (Fig. 1). A biopsy showed a LMS of the vagina and an anterior pelvic exenteration was performed.Methodology: The sample was fixed and prepared for light microscopy, transmission and scanning electron microscopy. An immunohistochemical analysis was performed.Results: The results confirmed a LMS of the vagina that was positive for vimentin, alpha-smooth muscle actin, caldesmon, desmin, p16 and p53. Light microscopy revealed that the mass contained a storiform pattern of spindle-shaped cells with blunt-ended nuclei. Cells were arranged in interwoven fascicles within a dense and richly vascularised stroma, suggesting an active neoangiogenesis. The histopathological analysis revealed a coagulative focal necrosis and low to moderate mitotic indexes, about 1-4/10 high power fields (HPF). Scanning Electron Microscopy (SEM) evidenced a dense collagenous stroma with numerous small blood vessels. Transmission Electron Microscopy (TEM) showed invasive neoplastic and pleomorphic cells with complex labyrinthic cytoplasm projections. Tumoral cells contained paranuclear crowds of dilated mitochondria, free ribosomes and a well-developed rough endoplasmic reticulum. There were atypical mitotic figures. Blood vessels were usually lined by a high and reactive endothelium.Conclusions: The histopathological and ultrastructural analyses confirmed the malignancy of this tumor. Best outcomes occur when the tumour is small, localized, and can be removed surgically with wide, clear margins, as in this case. As there are different kinds of malignant mesenchymal tumours, biopsy followed by immunohistochemistry and electron microscopy still represents a good diagnostic choice.

Introduction: The aim of this study is to compare robotic single-site hysterectomy (RSSH) and robotic multiport hysterectomy (RMPH) for EC in obese patients in term of surgical outcomes.Material and methods: This study compares RSSH with RMPH in obese patients with EC and FIGO stage I or II. According to their Body Mass Index (BMI), patients were divided in 3 groups: from 30 to 34.9 kg/m2 (group A), from 35 to 39.9 kg/m2 (group B) and 40 kg/m2 or higher (group C). Results: We included 225 patients: 76 in the RSSH group divided, respectively, in 53, 18 and 5 in the A, B and C groups; 149 in the RMPH group divided, respectively, in 76, 37 and 36 in the A, B and C groups. When the A classes in the two groups were compared, the median Operative Time (OT) and Blood Loss (EBL) were lower in the RSSH group (respectively p=0.02 and p40 kg/m2).

Introduction / Background: AFRON Oncology for Africa is an Italian non-profit organization that works for female cancer prevention in the Sub-Saharan area, mainly in Uganda. Although the visual inspection with acetic acid (VIA) is one of the most widespread screening method in African countries, it did not show a high accuracy. The aim of this study is to evaluate the efficacy and usefulness of VIA test combined with the PAP smear in Uganda in order to find possible solutions that may be used in a low-resource setting.Methodology: Between January 2011 and October 2018, eight screening campaigns were held in Kampala, Kitgum and Karamoja. In the last two campaigns, we decided to try a new approach: we performed the PAP smear before the VIA test and, in case of a positive VIA test, we sent the slide for examination. To compare them, we divided the data collected in two groups: the first five campaigns (2011-2016), in which a standard approach was used, and the last two campaigns (2017-2018), in which the new approach was used.Results: During the study period, 9,780 women were screened (median age 34), of whom 699 were positive at the VIA test. The VIA test showed 584 (83.5%) false positives. In the first group, the VIA test was positive in 516 women, of whom 483 (93%) were referred for further examinations. In the second group, in which the VIA test was positive in 173 women, the PAP smear was positive in 46 of the 173 slides analysed. Thus, only 46 of the 173 (26.5%) women were referred for further examinations.Conclusion: Combining the PAP smear, VIA test and slide analysis in positive VIA tests may allow women who need treatment to be selected more effectively, while waiting for other more expensive solutions to become more affordable and suitable for these settings.