Signs Of Malignancy Research Articles

De novo Light Chain Deposition Disease in a kidney allograft. A case report and literature review

Light chain deposition disease (LCDD) is a rare entity that can occur with and without an associated hematological malignancy, involves the deposition of clonal light chains in the kidney, and can often progress to end-stage kidney disease. Managing LCDD involves treatment to eliminate the underlying clone, which can recur in the transplanted kidney. Very few cases of de novo LCDD have been described in a kidney allograft; and most of them have occurred with an associated malignancy. They have also had variable outcomes as their management can be extremely challenging to mitigate infection risk and avoid rejection. We report a de novo case of LCDD occurring in a renal allograft without an associated hematological malignancy that presented with rapidly progressive acute kidney injury and crescentic glomerulonephritis on the kidney biopsy. Early initiation of chemotherapy using bortezomib, cyclophosphamide and dexatmethasone with minimal adjustment of the immunosuppressive therapy mostly preserved kidney function. De novo LCDD disease after renal transplantation can be challenging to suspect, especially in the absence of signs of hematologic malignancy. An early kidney biopsy is beneficial for diagnosis with light chain restriction using fluorescent immunostaining, even if there is no M-protein present and the mode of presentation is crescentic glomerulonephritis, which is atypical LCDD.

Undescended Testis and Right Inguinal Hernia in Adult: A Case Report

Cryptorchidism also known as undescended testis of at least one side is one of the causes of an inguinal hernia. This case report discusses an adult patient presented with a swelling in the right groin. On examination, the patient was found to have a right inguinal hernia and right undescended testis. Testis was intraabdominal lying near deep ring. Testicular tumor markers were normal. Right orchidectomy and right inguinal hernia repair with polypropylene mesh was done. Following surgery, postoperative course was uneventful. Histopathological examination revealed marked hypo spermatogenesis with no signs of testicular malignancy (No granuloma/parasite/intratubular germ cell neoplasia/malignancy). Keywords: undescended testis, cryptorchidism, inguinal hernia, testicular malignancy.

Esophageal melanosis: Two case reports and review of literature

BACKGROUND Esophageal melanosis (EM) is a rare condition characterized by melanin pigmentation in the esophageal mucosa. It is not well understood and has been documented in less than 100 cases worldwide. CASE SUMMARY We report two cases of African American patients who complained of significant weight loss (over 20 pounds in approximately six months) and abdominal pain during their first visit. The first case involves a 54-year female with a history of hepatic steatosis and polysubstance abuse, who also experiences nausea and vomiting. The second case is a 59-year-old male with hypertension and gastroesophageal reflux disease (GERD), who was diagnosed with esophageal squamous cell carcinoma. Both cases show benign melanocytes in the basal layer on the esophagus biopsy and are diagnosed as EM. CONCLUSION It is important to note that EM has been associated with malignancies such as carcinoma and melanoma. Therefore, accurate diagnosis and appropriate management are crucial. Patients with EM, especially those with concurrent risk factors (e.g. , GERD, smoking), should be carefully monitored for any signs of malignancy.

Ovarian Steroid Cell Tumor About a Case

Tumors of the sex cords and stroma of the ovary are relatively rare, accounting for around 8% of all primary ovarian tumors. Steroid cell tumors of the ovary are rare, accounting for less than 0.1% of all ovarian tumors. The majority of these tumors produce steroid hormones, and only 10-15% of patients are asymptomatic. Although steroid cell tumors are generally benign, there is a risk of malignant transformation. Surgery is the main treatment. We report a case of a steroid cell tumour of the left ovary discovered on anatomopathological examination of the left adnexectomy operative specimen in a 47-year-old hypertensive diabetic patient who clinically presented with virilism with severe hirsutism, muscular and clitoral hypertrophy and frontotemporal baldness, and biologically increased androgens without associated hypercorticism, and in whom an abdomino-pelvic scanner showed a left latero-uterine mass measuring 74x66x64 mm, pelvic MRI showed a polylobed left ovarian mass classified ORADS 5, measuring 53x65x87 mm. After histological confirmation of the diagnosis, the patient was taken back for total surgery with total hysterectomy, right adnexectomy, omentectomy, appendectomy, multiple peritoneal biopsies, with no signs of malignancy on histological examination, simple postoperative follow-up and our patient placed under surveillance.

The histologic diagnosis and the management of cystic neutrophilic granulomatous mastitis: a case report

BackgroundCystic neutrophilic granulomatous mastitis is a rare subtype of inflammatory mastitis characterized by a distinct histopathologic pattern, often associated with Corynebacterium species. This entity has been recently distinguished and should be differentiated from other types of chronic idiopathic mastitis due to its specific treatment.Case presentationA 44-year-old North African female patient, gravida 2, para 2, with no significant past medical history, presented with a 4-month history of a painful palpable mass in her left breast, with no history of trauma. Ultrasound imaging showed three lesions in the lower quadrant of the left breast, communicating with a superficial areolar abscess collection, creating a fistulous path to the skin. This ultrasound appearance was suspicious for suppurative mastitis; although, a necrotic tumor could not be ruled out. An ultrasound-guided needle biopsy revealed inflammatory and abscess features of the breast parenchyma without histological signs of malignancy. Steroid therapy and empirical antimicrobial treatment were started, and surgical excision was performed. Histologic features confirmed the diagnosis of cystic neutrophilic granulomatous mastitis. The patient recovered and was discharged due to clinical improvement.ConclusionCystic neutrophilic granulomatous mastitis is a recently defined entity, and its association with infection by Corynebacterium species can be detected by Gram stain and/or microbiological culture. Various treatment modalities are suggested, but the optimal treatment still requires further investigation.

Mature Ovarian Teratoma about a Case

We report a case of mature ovarian teratoma in a 36-year-old nulliparous patient who presented for one year with menstrual cycle disorders. The diagnosis was suspected by pelvic ultrasound and MRI and confirmed by anatomopathological study with absence of histological signs of malignancy.

Treatment of a patient with Ollier’s disease

The objective was to demonstrate a clinical case of an adult patient with Olier’s disease (enchondromatosis), severe hand deformity, and its treatment in orthopedic department. Patient K., 71 years old, was treated with severe deformation of the left hand due to Ollier’s disease in Ya. L. Tsiv’yan Novosibirsk Research Institute of Traumatology and Orthopedics in 2017. The patient underwent a one-stage multi-stage surgical intervention with removal of the endochondromas of the 1st, 2nd, 4th and 5th fingers, bone and tendon grafting of the defects.In 5 years after surgery, patient notes a high degree of satisfaction with the treatment. At the control visit, the preservation of the intraoperatively achieved result was established without signs of recurrence of the process or signs of malignancy. The achieved result led to the improvement of motor skills, restored a number of social self-service functions.Due to the high risks of recurrence and malignancy of the process, patients with Olier’s disease require close monitoring by clinicians. Surgical treatment of benign forms of the disease involves the implementation of an organ-preserving intervention with the reconstruction of bone and tendon ligament defects. The main goals of the intervention in this case were a removing of the pathological substrate and the improvement of hand function.

The method for evaluating the symmetry of the globule pattern in artificial intelligence systems for the diagnosis of skin neoplasms

Methods for early non-invasive diagnosis of melanoma using computer vision systems are considered. Existing computer vision systems using neural networks for classifying dermoscopic images do not allow tracking which diagnostic features are used to assign images to a particular class, reducing physicians' trust in the results. As an alternative, an image analysis algorithm is proposed with the ability to present justifications for decisions made at each processing stage. The implementation of this algorithm is based on the medical algorithm of modified globular pattern analysis. A significant sign of malignancy in a neoplasm is its asymmetry. This criterion is widely used by doctors in visual assessment of skin neoplasms. However, currently, the issues of evaluating the symmetry of globular patterns in artificial intelligence systems are not fully studied and described. A method for evaluating the symmetry of globular patterns in artificial intelligence systems for diagnosing skin neoplasms has been developed. A dataset of dermoscopic images was formed, containing 50 images each of neoplasms with symmetrically and asymmetrically arranged globular patterns. Methods for isolating the neoplasm area and globules are described. A classification system based on a set of 12 quantitative symmetry characteristics has been developed. The Random Forest algorithm was used to classify images based on symmetry features. In the conducted experiment, a classification accuracy of 85% was achieved. The presented results contribute to the development of computer vision methods in dermatology and demonstrate the possibility of using the proposed method in clinical decision support systems for modified analysis of dermoscopic patterns for diagnosing skin neoplasms.

Giant Cervical Teratoma In Adults: Case Report

Teratomas are tumours of embryonic origin, most commonly found in the sacrum and coccyx. Localisation in the neck is rare, occurring in only 3% of cases, with a high mortality rate of up to 80% in the neonatal period as a result of airway obstruction. Immaturity is not a sign of malignancy when the tumour is managed during the neonatal period. We will report a case of a patient diagnosed and treated in the otorhinolaryngology surgery department of the Hassan II military hospital in LAAYOUNE, highlighting the fact that there is still a lack of antenatal screening, despite improvements in the management of newborns

010. Ileus Obstruktif Letak Tinggi E.C Susp Hirschprung pada Pasien Umur 22 Tahun di RSUP Prof. Dr IGNG Ngoerah pada Tahun 2023

Background: Hirschsprung is a disease that occurs in the intestine, and cases most often appear in the colon (colon). Symptoms that usually arise are chronic constipation, failure to grow, and malnutrition. The surgical procedure approach that can be performed in this case is by carrying out an exploration laparatomy and placed a colostomy on the patient. Case: A 22-year-old male patient presents to the emergency department with abdominal pain, His pain began suddenly then dissappear gradually, accompanied by flatulence and nausea since a week ago. Other complaints such as fever and vomiting are denied. Patients with a history of defecation patterns every 2-3 days. Patients complain of difficulty defecating since last week before admitted, the stool form was a small amount of liquid, frequency is 2-3x/day. Stool with blood (-), black or tarry stool (-). Patients with a history of circumcision surgery. The results of the examination showed an increase in WBC 15.11. Based on the BOF results, the results described as a leading to paralytic ileus, Fecal material prominent as high as the pelvic cavum. In addition, based on the results of abdominal ultrasound, it is said that most of the scanning areas are covered by prominent intestinal gas, mild fatty liver. After the exploratory laparatomy, no signs of malignancy were found in the patient, but there was suspicion towards Hirschsprung where the patient did not have the flexura hepatica ligament and the lienalis flexura ligament. Conclusion: Hirschsprung requires surgical procedures that must be explained throughly to patient and families. The surgical procedure approach that can be performed in this case is by carrying out an exploratory laparatomy and the placed a colostomy on the patient. And colon in loop will be used to determine and evaluate the intestine height with aganglionic.

Relevance of Thyroid Microcarcinoma and Its Diagnosis

Microcarcinoma is a thyroid gland cancer with a size of less than 1 cm. The aim: To determine the frequency of microcarcinoma among malignant pathologies of the thyroid gland based on fine-needle aspiration biopsies (FNAB) data. Materials and Methods: A retrospective analysis of 2490 FNAB data was conducted under ultrasound control from 2007 to 01.07. 2024 at the Ternopil Regional Clinical Hospital. FNAB results were categorized into four groups: the first group – non-diagnostic results, the second – suspicion of thyroid cancer, the third – thyroid cancer, and the fourth – benign lesions. After the Bethesda system was introduced, FNAB classifications were based on this system. Results: Thyroid cancer was diagnosed in 186 cases (7.5%). Among these, macrocarcinoma was identified in 152 cases (81.7%) and microcarcinoma in 34 cases (18.3%). The peak incidence of microcarcinoma is observed in the 40-50 age, with approximately 90% of patients being women. Microcarcinomas in solitary nodules were found in 16 cases (47%); among multinodular goiters in 18 cases (53%). In 8 cases (23.5%), microcarcinoma was associated with larger thyroid cancers (multifocal process) and in 4 cases (11.8%) with benign nodules. In 6 cases (17.7%), microcarcinomas were associated with nodules suspicious for cancer. Conclusions: Indications for FNAB should be guided by the identified sonographic characteristics (solid echostructure of the nodule; hypoechogenicity; vertical orientation of nodules; indistinct margins of the nodule; presence of microcalcifications; regional cervical lymphadenopathy with signs of malignancy).

Tuberculous Pleurisy in a Patient with a History of Breast Cancer: Diagnostic Challenges and Management Options

Background: Tuberculosis (TB) and cancer are increasingly prevalent diseases that can be challenging to diagnose due to similarities in clinical and radiological findings. This case report describes a 46-year-old woman with a history of breast cancer who developed tuberculous pleurisy (TP). Case presentation: A 46-year-old woman who underwent mastectomy and chemotherapy for BC in 2023 had hypertension, but no history of TB. The patient presented with dry cough, fever, and stomach discomfort, with an oxygen saturation level of 60%, but no respiratory distress before their appointment. Microscopy and culture tests were negative for Mycobacterium TB, A positive result was observed with an IFN-γ level of 0.35 IU/ml and 26% of the negative control after TB antigen stimulation. Histological analysis using hematoxylin and eosin staining showed Langhans giant cells, epithelioid cell granulomas, caseous necrosis, and necrotic foci. These findings indicate granulomatous inflammation with no signs of malignancy. Following the diagnosis, the patient received a daily dose of 300 mg isoniazid, 600 mg rifampin, 1500 mg pyrazinamide, and 10 mg pyridoxine for six months without any adverse effects. Conclusion: Physicians must employ a combination of diagnostic techniques, including morphological and microbiological confirmation, to accurately diagnose pleural effusion in this patient population.

Een ongebruikelijke oorzaak van een hoge digestieve bloeding: amyloïdose van de maag

An unusual cause of major upper digestive bleeding: gastric amyloidosis Amyloidosis is a systemic disease that may target the gastrointestinal tract. The disease is caused by the extracellular tissue deposition of fibrils composed of low-molecular weight subunits of a variety of proteins. Amyloidosis may encompass multiple presentations and symptoms, being a challenge for both the diagnosis and the treatment. Gastrointestinal amyloidosis can cause bleeding, malabsorption, protein-losing enteropathy and dysmotility. The authors describe the case of a 71-year-old patient with persisting epigastric discomfort. The initial gastroscopy revealed ulcerative gastritis. Biopsies turned out to be Helicobacter pylori negative. There were no signs of malignancy either. An additional gastroscopy because of discomfort confirmed ulcerative gastritis. Anatomopathological examination of new biopsies revealed amyloidosis of the stomach. Additional examinations (including an echocardiography, a PET CT scan and a colonoscopy with rectal biopsies and Congored staining) did not confirm other organs to be involved in the amyloidosis. The patient was readmitted later because of a major upper digestive bleeding due to persisting gastric ulcerations. A partial distal gastrectomy turned out to be inevitable. Anatomopathological examination of the stomach confirmed non-AA amyloidosis of the stomach. Additionally, a short overview of amyloidosis with special attention to the impact of the disease in the gastrointestinal tractus is presented.

Diagnostic Value of Osteopontin, Lymphocyte-to-Monocyte Ratio, and CA-125 in Ovarian Carcinoma Suspect

Osteopontin (OPN) is an important protein in cancer development and progressivity. Lymphocyte-to-Monocyte Ratio (LMR) as a systemic immunity and inflammatory indicator could be an ideal predictor biomarker because of its method’s simplicity and availability. Elevated CA-125 and OPN as well as decreased LMR were reported as signs of ovarian malignancy. Limited studies about OPN and LMR as diagnostic biomarkers, as well as various specificity and sensitivity of CA-125 intrigued the researcher to prove OPN, LMR, and CA-125 as diagnostic biomarkers for ovarian carcinoma. This study aimed to measure the diagnostic value of OPN, LMR, and CA-125 levels against histopathology results for ovarian carcinoma diagnosis. Eighty patients involved with suspected ovarian carcinoma who were referred to Dr. Kariadi Hospital, Semarang. Osteopontin and CA-125 levels were measured using ELISA, and LMR was calculated from absolute lymphocyte and monocyte counts using an automated hematology analyzer. The receiver operating characteristics curve was used to determine the cut-off and 2x2 table. The cut-off values for OPN, LMR, and CA-125 were 124 ng/mL, 3.7 and 45.4 U/mL, respectively. The sensitivity for OPN, LMR, and CA-125 was 67.24%, 62.07% and 60.34%. Specificity for OPN, LMR, and CA-125 were 68.18%, 54.55% and 59.09%. Osteopontin is the best parameter for determining the diagnosis of ovarian carcinoma but it is still not sufficient because OPN cut-off was still within the normal reference value.

The umblicus says it all

Abstract Introduction/Objective Umbilical nodules can be divided into benign and malignant. Malignant lesions of the umbilicus are very rare. They can arise from primary tumors or secondary to abdominal and pelvic malignancies. Literature review suggests that these umbilical lesions can present as primary tumor in 38% of the cases, endometriosis in 32%, and metastatic lesions in 30%. Umbilical metastasis is one of the main characteristic signs of extensive neoplastic disease and is known as Sister Mary Joseph’s nodule (SMJN). It is a very rare finding and the incidence of SMJN is 1- 3% in people diagnosed with intra-abdominal or pelvic malignancies. Methods/Case Report A 31-year-old male with no past medical history presented to the emergency room with 3 months history of umbilical nodule and 60 pounds weight loss. He experienced early satiety, abdominal pain, nausea and generalized fatigue. CT abdomen showed hepatomegaly with numerous hypoattenuating lesions throughout the liver with peripheral enhancement, and hypoattenuating mass within the pancreatic tail and body measuring approximately 2.1 x 5.8 cm that appears contiguous with hilar splenic lesion. CT chest showed multiple pulmonary metastases with prominent precarinal and subcarinal lymph nodes. Serologic tests revealed elevated Alpha fetoprotein, ALP, ALT, and CA19-9. Patient underwent umbilical nodule core biopsy and right liver core biopsy. Microscopic evaluation of the specimens revealed pancreatic acinic cell carcinoma with two different morphological variants. Umbilical nodule with glandular pattern and liver lesion with trabecular pattern. Immunohistochemical stains were performed with tumor cells positive for CK 7, Trypsin and BCL-10 and negative for Glypican 3, CK 20, AFP and CD56. The prognosis is poor, with an average survival time of about 19 months. After the diagnosis patient underwent chemotherapy. Results (if a Case Study enter NA) NA Conclusion Umbilical nodules can be diagnosed with careful clinical and histopathological evaluation. The prognosis of patients presenting with SMJN is generally poor as it is a sign of advanced malignancy. Sometimes it may be the first and only sign of an internal neoplasm. Therefore, this is an important differential diagnosis to consider.

Profiling cytokines in peritoneal effluent through a targeted multiplex cytokine panel provides novel insight into the localized proinflammatory processes in patients undergoing peritoneal dialysis.

The number of relevant markers indicating local intraperitoneal inflammation in patients undergoing peritoneal dialysis (PD) is limited. Therefore, this study aimed to evaluate the compatibility of peritoneal effluent (PE) for proteomic analysis and assess its potential utility in immunoprofiling studies. This pilot study included six PD patients from the Peritoneal Dialysis Center, Department of Nephrology, Transplantology, and Internal Medicine in Szczecin, Poland. All patients were clinically stable, with no signs of infections or malignancy at the time of study. PE samples were collected during routine surveillance visits at the Peritoneal Dialysis Center. Proteomic analysis of the samples was conducted using the Olink® (Olink Proteomics AB, Uppsala, Sweden) Target 48 Cytokine panel. PE samples were successfully analyzed, with 28 out of 45 proteins found within the limit of quantitation (LOQ) and 32 out of 45 proteins detected above the limit of detection (LOD). No significant interference from the matrix was observed in the assay. Biomarkers associated with low-grade inflammation showed varied levels, and the observed patterns were comparable across all patients. This study suggests that utilizing a cytokine panel with relative quantification is a promising method for PE immunoprofiling.

Skin Cancer Detection in Diverse Skin Tones by Machine Learning Combining Audio and Visual Convolutional Neural Networks

Introduction: Skin cancer (SC) is common in fair skin (FS) at a 1:5 lifetime incidence for nonmelanoma skin cancer. In order to assist clinicians’ decisions, a risk intervention technology was developed, which combines a dual-mode machine learning of visual and sonified (pixel to sound) data. The addition of an audio technology enhances malignant features of lesions, increases sensitivity and was previously validated under a prospective clinical setting in FS. In dark skin (DS), although rare by a 10–30 factor, skin cancer is diagnosed at more advanced stages resulting in a delayed diagnosis and affecting life quality and expectancy. It is known as well that SC diagnostic accuracy by machine learning in DS is decreased as compared to FS. The present study tests the use of sonification aided by artificial intelligence algorithms to compare diagnostics of different skin tones. Methodology: Biopsy-validated smartphone images were diagnosed in a retrospective study by a dual audio-visual convoluted neural network. A total of 60 Fitzpatrick I-III were compared to 72 Fitzpatrick IV-VI. A dichotomous diagnostic output, either malignant or benign, was assessed for sensitivity, specificity and area under the curves (AUCs) for the receiver operating characteristic (ROC) curve. Results: ROC curve analytics indicated an AUC of 0.858 (95% CI: 0.795–0.921) and 0.856 (95% CI: 0.759–0.953) for fair and DS (p = NS). Sensitivity of Fitzpatrick I-III skin and Fitzpatrick IV-VI were 84.4% (71.8–96.9) and 79.6% (63.4–93.8), respectively (p = NS). Specificity of Fitzpatrick I-III skin and Fitzpatrick IV-VI were 84.2% (72.6–95.8) and 85.3% (73.4–97.2), respectively (p = NS). The positive predictive and negative predictive values as well as accuracy (0.817 vs. 0.847) were all within the same range (p = NS). Conclusions: The results demonstrate that the dual-modality classifier identifies skin cancer of FS and DS similarly well. Sonification of malignant signs of a skin lesion demonstrates promising results, even with smartphone images, which should be considered as a tool to achieve more effective and accessible healthcare.

Standardized IETA criteria enhance accuracy of junior and intermediate ultrasound radiologists in diagnosing malignant endometrial and intrauterine lesions.

To transform the standardized descriptions of the ultrasound characteristics of endometrial and intrauterine lesions devised by the International Endometrial Tumor Analysis (IETA) group into a practical scoring method and to investigate whether application of this method enhances the diagnostic accuracy of ultrasound radiologists with different levels of experience in detecting malignancy compared with subjective assessment. This was a retrospective study of 855 patients with endometrial and/or intrauterine lesions, who were divided into a training (n = 600) and a validation (n = 255) set. Ultrasound radiologists with varying levels of experience (expert, intermediate and junior) evaluated all lesions by subjective assessment and according to IETA rules. Using IETA rules, the experts identified signs of malignancy in the training set, assigned scores for each indicator and validated the scoring method in the validation set. The intermediate-level and junior ultrasound radiologists reassessed the malignancy of the lesions using the IETA scoring method and compared their classifications with those made previously by subjective assessment. Postsurgical pathological evaluation was used as the reference standard. Using subjective assessment, the experts demonstrated the highest level of diagnostic accuracy, with a sensitivity of 85.0%, specificity of 94.3% and an area under the receiver-operating-characteristics curve (AUC) of 0.897. Applying the IETA scoring method (comprising eight ultrasound characteristics that contributed to the total score) with a threshold of > 25 points for the diagnosis of malignancy achieved a sensitivity of 84.7%, specificity of 94.7% and AUC of 0.9533 in the training set, with similar performance in the validation set, when performed by experts. Using the IETA scoring method, both junior and intermediate ultrasound radiologists showed improvement in sensitivity (from 55.5% to 74.8% and from 70.2% to 77.1%, respectively), specificity (from 88.4% to 91.5% and from 87.4% to 92.2%, respectively) and AUC (from 0.704 to 0.827 and from 0.793 to 0.841, respectively) for diagnosing malignant lesions. The IETA scoring method exhibits high diagnostic efficacy for malignant endometrial and intrauterine lesions. This method compensates for the lack of experience among junior and intermediate-level ultrasound radiologists, enhancing their diagnostic skill to a level nearing that of experienced senior ultrasound radiologists. Further research is essential to validate the practicality of implementing this method and to confirm its clinical value. © 2024 International Society of Ultrasound in Obstetrics and Gynecology.

Endometrial carcinoma with cervical stromal invasion: Three case reports

BACKGROUND Endometrial cancer is a kind of well-known tumors of female genitourinary system. Cervical stromal invasion is an adverse factor for poor prognosis of endometrial cancer. There is still controversy regarding the use of magnetic resonance imaging (MRI) in the diagnosis of cervical stromal invasion of endometrial cancer. The diagnosis of cervical stromal invasion varies significantly between different observers and institutions. We present a limited case series of the particular pattern of endometrial cancer, which infiltrates the cervical stroma and is often overlooked. CASE SUMMARY We present three cases of endometrial carcinoma with cervical stromal invasion with cancer-free uterine cavity. One patient, a reproductive-aged woman, exhibited irregular menstruation and was diagnosed with endometrial polyps by hysteroscopy and segmental curettage. A MRI scan revealed polypoid nodules within the internal cervical orifice. The other two cases were postmenopausal women who presented with abnormal vaginal bleeding. Hysteroscopy and segmental curettage suggested atypical hyperplasia of the endometrium. MRI scans did not detect any malignant signs in the endometrium. In one case, a non-thickened endometrium was observed, while in another, hyperplasia of the endometrium was seen. Notably, none of these patients had malignant tumors identified in the uterine cavity via MRI scans. However, postoperative pathological results following hysterectomy consistently indicated cervical stromal invasion. CONCLUSION Cervical stromal invasion is easily missed if no cancer is found in the uterine body on MRI. Immunohistochemistry of endoscopic curettage specimens should be conducted to avoid underestimation of the disease.

Cutaneous Signs of Internal Malignancy

Cutaneous Signs of Internal Malignancy