Search

Aim of the paper is to investigate the suspicious role of HPV in synchronous endometrial and cervical carcinomas and to discuss the relation between HPV and endometrium epithelium. The first case is 68- year-old and the second case is 56 year-old postmenopausal woman who were diagnosed with invasive cervical carcinoma synchronously with endometrial carcinoma. Following surgical procedures, high risk HPV DNA analysis using PCR were undertaken in both cases to investigate the possible role of HPV in synchronous malignancies. All endometrial samples were considered as negative for high risk HPV types however all cervical samples were considered as positive. Unlike cervical pathologies, HPV does not seem to play active role as etiologic agent in endometrial neoplasms, even detected synchronously with invasive cervical cancers.

Ovarian malignancies, especially in advanced stages, are typically presented by ascites and elevated serum Ca-125 levels. Rarely pleural effusion could be seen in these cases due to metastasis or diaphragmatic transportation. Meig’s syndrome defines coexistence of a benign ovarian tumor (fibroma, tecoma or granulose cell tumor), ascites and hydrothorax. In this report, a case of postmenauposal adnexial mass with acute ascites and elevated serum Ca-125 level, that was suspicious for an adnexial malignancy preoperatively. Intraoperative frozen section analysis revealed ovarian tecoma. Meig’s syndrome is a benign pathology that mimicks ovarian malignancy. Differential diagnosis of these two situations is a diagnostic challenge especially in postmenauposal women. Intraoperative frozen section is an important diagnostic method for accurate diagnosis and proper treatment.

To present a case of chylous ascites after staging surgery for endometrial carcinoma A 57 years old postmenopausal woman was operated for endometrial cancer, chylous ascites developed after this surgery. Chylous ascites was treated conservatively include low fat diet and medium chained triglyceride parenterally. Chylous ascites may be successfully managed with conservative approach without surgical intervention.

We report a case of 72-year-old woman who was hospitalized with vaginal bleeding and abdominal pain. Magnetic resonance imaging showed tumor both in endometrial cavity and ovaries with multiple distant metastasis. Her serum alpha-fetoprotein level was >54000 ng/mL. Total abdominal hysterectomy with bilateral salpingo-oophorectomy, total omentectomy, appendectomy, bilateral pelvic and paraaortic lymph node dissection, a 20 cm ileal resection with ileal anastomosis, metastasectomy were performed and peritoneal washing was obtained. The pathologic diagnosis was endometrial hepatoid adenocarcinoma. Because of her poor medical condition, she received only palliative chemotherapy. After two days of 5-fluorouracil she died within 2 months. Hepatoid adenocarcinomas are extrahepatic neoplasms that exhibit features of hepatocellular carcinoma. It was first reported as gastric neoplasm but is seen in many different organs and its frequency is increasing. To date only 11 cases of hepatoid adenocarcinoma of the endometrium were reported. It has a poor prognosis and there isn’t an effective treatment yet.