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As a result of the Human Papillomavirus (HPV) vaccination program, the prevalence of precancerous dysplasia and invasive cervical cancer has substantially decreased. In this brief report, we present a case of a young patient who was diagnosed with in situ adenocarcinoma of the cervix. This 30-year-old female had completed the HPV vaccination after she became sexually active and has been undergoing annual gynecological assessments, including clinical examination and Pap test, all of which had been negative. This year, her Pap test revealed a low grade squamous intraepithelial lesion (LGSIL) and additionally a colposcopy was performed. Given the extent of the lesion and since the colposcopy was inadequate, the patient underwent a type 3 large loop excision of the transformation zone and a curettage of the endocervix under local anesthesia. The pathological diagnosis from cervical biopsy revealed an in situ adenocarcinoma of the endocervix with negative limits. The HPV subtypes 16 and 83 were detected with PCR. After proper consultation she decided to preserve her fertility and to undergo a regular follow-up, postponing hysterectomy after the completion of her family planning. In conclusion, this case report highlights the need for diagnostic surveillance regarding HPV-related cervical cancer even after vaccination.

Yolk Sac Tumours (YSTs) of the ovary, also called Endodermal Sinus Tumours (ESTs), are the second most common Malignant Ovarian Germ Cell Tumours (MOGCTs), after dysgerminomas. YSTs occur primarily in children and young women. We present a case report of a 20-year-old woman who had been diagnosed with YST (tumour diameter of 29 cm). The patient underwent fertility sparing surgery and was subsequently treated with adjuvant chemotherapy (four cycles of bleomycin, etoposide and cisplatin). Two years after the diagnosis of YST, she successfully gave birth to a healthy girl (birth weight 3,500 g, Apgar score of 9-10 and a spontaneous vaginal delivery). During pregnancy, she had microscopic hematuria and bilateral nephrolithiasis, was ultrasonographically diagnosed. The conception after fertility sparing treatment of YST is possible and the birth of a healthy child is feasible. There are no current guidelines for surveillance of such patients during pregnancy; however, structured pregnancy surveillance in such survivors seems necessary.

Introduction and Purpose: Artificial neural networks (ANNs) and Classification and Regression Trees (CARTs) have been previously used for the prediction of cancer in several fields. In our study, we aim to investigate the diagnostic accuracy of three different methodologies logistic regression, ANNs and CARTs for the prediction of endometrial cancer in post-menopausal women with post-menopausal vaginal bleeding or endometrial thickness u2265 5 mm, as determined by ultrasound examination. A classification tree is constructed from many repeated splits related to the target variable, these splits are producing rules of the form: If X is less than value A or Y is within a range [C,D] then the sample is classified as normal with probability p. These splits end when no further split can be done, either because all of their observations belong to the same group, or because the number of observations at the same node is small (according to a predefined value). These represent the terminal nodes of the tree. Artificial Neural Networks are complex computational models inspired by the human nervous system which are capable of machine learning and pattern recognition. They are constructed by interconnected neurons. Each neuron sums the weighted inputs (sum of the product of each input is multiplied with the corresponding weight w) and the summation result is passed from a non-linear non-convex and non-concave module (transfer function or activation function). The output of this function is the artificial neuron output as well.Methods: We conducted a retrospective case control study in the section of Gynecologic Oncology of the 3rd department of Obstetrics and Gynecology of our hospital. A consecutive series of post-menopausal women with vaginal bleeding or endometrial thickness u22655 mm were included in the present study. Among them several patients were diagnosed with endometrial carcinoma, whereas the remaining sample of women had no malignancy on the final pathology report. Women with endometrial hyperplasia with, or without atypia were excluded from the present study, as well as women that received hormone therapy, were treated for any type of cancer or for autoimmune diseases.Results: Overall, 178 women were enrolled. Among them, 106 women were diagnosed with carcinoma; whereas the remaining 72 women had normal histology in the final specimen. The test for proportions showed no statistically significant difference between the sensitivity of the CART (78.30%) and the LR (76.42%) model (p=0.7663); on the other hand sensitivity of the ANN model (86.79%) was higher than both the CART and the LR models (p

Background: Human Papilloma Virus has been considered as the main cause for cervical cancer. In this study we investigated epigenetic changes and especially methylation of specific sites of HPV genome. The main goal was to correlate methylation status with histological grade as well as to determine its accuracy in predicting the disease severity by establishing optimum methylation cutoffs.Methods: 145 cases genotyped as HPV16 were obtained from formalin-fixed, paraffin-embedded tissue of cervical biopsies, conization or hysterectomy specimens of females that visited the gynecology clinic of Attikon University General Hospital, Athens, Greece. DNA was extracted from formalin-fixed, paraffin-embedded tissue sections, using QIAamp DNA FFPE Tissue Kit (Qiagen, Heidelberg Germany). All steps in the purification procedure were done using the automated QIAcube technology (Qiagen, Heidelberg Germany). DNA typing was performed with the HPV Genotypes 14 Real-TM Quant (Sacace Biotechnologies, Como Italy). DNAs were then bisulfite converted using the EpiTect Bisulfite Kit (Qiagen, Heidelberg Germany), according to the manufactureru2019s instructions and stored at u201380u00b0C. Biotin-labeled primer sets, sequencing primers and polymerase chain reaction conditions to amplify HPV16 UTR region, while biotin-labeled primer sets and sequencing primers for E6 and E7 genomic regions were designed in the present study with the aid of PyroMark Assay Design 2.0. The statistical analysis was performed by programming in SAS 9.4 for Windows (SAS Institute Inc. NC, USA).Results: Highly accurate pyrosequencing technology which was performed after bisulfite treatment of DNA was used to calculate methylation percentage of specific sites harbored at 5u2019UTR, enhancer and promoter of the viral genome (nt 7270, 7461, 7455, 7428, 31, 37, 43, 52, 58, 7862) as well as the E6 (494, 502, 506) and E7 (765, 780, 790) gene.Conclusion: Knowledge of viral genomeu2019s alterations during the viral life cycle is adding valuable information on understanding the biology of cervical cancer and to the exploring of new biomarkers. Viral HPV16 genome was found methylated in NF-1 binding sites of UTR in cases with high grade disease. Methylation percentages of E6 and E7 CpG sites were elevated at the cancer group.

Endometrial cancer is the most common malignancy of the female genital tract while aberrant DNA methylation seems to play a critical role in endometrial carcinogenesis. Galanin’s expression has been involved in many cancers. We developed a new pyrosequencing assay that quantifies DNA methylation of galanin’s receptor-1 (GALR1). In this study, the preliminary results indicate that pyrosequencing methylation analysis of GALR1 promoter can be a useful ancillary marker to cytology as the histological status can successfully predict. This marker has the potential to lead towards better management of women with endometrial lesions and eventually reduce unnecessary interventions. In addition it can provide early warning for women with negative cytological result.

Background. Abdominal masses in female adolescents are uncommon. A rare cause of this condition is hematocolpos due to imperforate hymen. Case. We present a case of an unusually massive asymptomatic abdominal bulk in a 14-year-old female patient, who sought for medical advice after unusual abdominal pain lasting for few weeks. The patient was otherwise asymptomatic, apart from an unusual dramatic expansion of her abdominal wall during the last month. We describe the surgical management and the follow-up of the patient. Summary and Conclusion. Clinicians should keep in mind that an imperforate hymen can cause abdominal growth due to hematocolpos and include it in the differential diagnosis of such a clinical entity in female adolescents. 2D ultrasound is usually efficient for the confirmation of the diagnosis of hematocolpos, but 3D ultrasound is more accurate. Wide excision should be undertaken, as an initial approach, to avoid recurrence.