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ENDOMETRIOSISGynecol Oncol. 2007 Feb;104(2):406-10. Epub 2006 Oct 2.Thromboembolic complications in patients with clear cell carcinoma of the ovary.Matsuura Y, Robertson G, Marsden DE, Kim SN, Gebski V, Hacker NF.Gynaecological Cancer Centre, Royal Hospital for Women and University of New South Wales, Sydney, Australia. yusuke-m@med.uoeh-u.ac.jpOBJECTIVE: The purpose of this study was to define the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients with clear cell carcinoma (CCC) of the ovary and to investigate the prognostic factors in such patients. METHODS: Between January 1987 and December 2003, 641 women with primary invasive epithelial ovarian cancer underwent treatment at the Royal Hospital for Women in Sydney, Australia. Sixty-six patients (10.3%) with CCC were identified from the data bank, and their data were compared with a matched-control group of 132 patients with non-clear cell epithelial ovarian carcinoma. RESULTS: A thromboembolic event (DVT or PE) was noted in 27.3% of patients with CCC, compared to 6.8% of patients with other epithelial ovarian cancers. PE was detected in 13.6% and 3.8% of patients, respectively. In patients with CCC, DVT was frequently observed before operation or at the time of recurrence. In a multivariate analysis of patients matched for age and stage, the occurrence of a DVT or the presence of endometriosis was significant predictors of clear cell histology. Within the clear cell group, no particular risk factor for DVT could be identified. Metastases of 50 mm or greater in diameter, ascites of 1000 ml or more, advanced FIGO stage, and the occurrence of DVT were poor prognostic factors for CCC in univariate analysis, but in a multivariate Cox regression analysis, only FIGO stage and occurrence of DVT remained significant. CONCLUSION: The incidence of venous thromboembolic events was found to be significantly higher in patients with CCC when compared to patients with other epithelial ovarian cancers.PMID: 17014897 [PubMed – indexed for MEDLINE]J Thromb Haemost. 2007 Mar;5(3):503-6. Epub 2006 Nov 9.The incidence of venous thromboembolism following gynecologic laparoscopy: a multicenter, prospective cohort study.Ageno W, Manfredi E, Dentali F, Silingardi M, Ghezzi F, Camporese G, Bolis P, Venco A.Department of Clinical Medicine, University of Insubria, Varese, Italy. agewal@yahoo.comBACKGROUND: Information on the incidence of venous thromboembolism (VTE) following laparoscopic procedures is inadequate and there is currently no solid evidence to guide the use of thromboprophylaxis in this setting. Gynecologic laparoscopy is a common procedure, and is frequently performed in low-risk patients. To our knowledge, there are no clinical studies specifically designed to assess the incidence of VTE in this setting. METHODS: In a prospective cohort study, consecutive patients undergoing gynecologic laparoscopy underwent compression ultrasonography (CUS) and clinical assessment to evaluate the incidence of clinically relevant VTE. CUS was performed 7 +/- 1 and 14 +/- 1 days postoperatively. A subsequent telephone contact was scheduled at 30 and 90 days. No patient received pharmacologic or mechanical prophylaxis. Patients with malignancy or previous VTE were excluded from the study. RESULTS: We enrolled 266 consecutive patients; mean age was 36.3 years, range: 18-72. The most common indications for laparoscopy were ovarian cysts in 25.6% of patients, endometriosis in 21.0% of patients, unexplained adnexal masses in 12.4% of patients, and infertility in 7.5% of patients. The mean duration of the procedure was 60.5 min (range: 10-300 min). In particular, in 55.6% of patients the duration exceeded 45 min. There were neither episodes of CUS detected DVT (0/247; 0%, 95% CI 0-1.51%) or clinically relevant VTE after follow-up (0/256; 0%, 95% CI 0-1.48%). No patient died of fatal pulmonary embolism (0/266; 0%, 95% CI 0-1.42%). CONCLUSIONS: Gynecologic laparoscopy in non-cancer patients is a low-risk procedure for postoperative VTE.PMID: 17092300 [PubMed – indexed for MEDLINE]Arch Gynecol Obstet. 2007 Jul;276(1):87-9. Epub 2007 Jan 12.Successful outcome following pre-viability amniorrhexis.Engemise S, Kalu E, Haque K.Department of Obstetrics and Gynaecology, St Helier Hospital, Wrythe Lane, Carshalton, Surrey, SM5 1AA, UK. engemisesam@doctors.org.ukA 34-years-old primigravida conceived following a fourth attempt at in vitro fertilization and embryo transfer for severe bilateral tubal disease and grade IV endometriosis. Pregnancy progressed well until 17 weeks gestation when she spontaneously ruptured her membranes. She elected to continue with the pregnancy despite the significant risks associated with prolonged rupture of membranes (PROM) and anhydramnion at extremes of viability. Pregnancy was carried to 28 weeks gestation, when delivery was necessitated by a major antepartum haemorrhage following abruption placentae. A male infant weighing 1,100 g was delivered by emergency caesarean section in good condition, and with no features oligohydramnion tetrad (Potter’s features, skeletal deformities, intrauterine growth restriction, and pulmonary hypoplasia). This case adds to the small number of cases in the literature of successful outcome following prolonged pre-viability PROM. Counselling and psychological support to the parents in this situation is extremely important since the anxiety and uncertainty associated with expectant management of PROM does not end with the "successful" delivery of the baby but persists all through the neonatal period and for several years later.PMID: 17219157 [PubMed – in process]Surg Today. 2007;37(2):141-4. Epub 2007 Jan 25.Successful video-assisted thoracic surgery for pulmonary endometriosis: Report of a case.Haruki T, Fujioka S, Adachi Y, Miwa K, Taniguchi Y, Nakamura H.Division of General Thoracic Surgery, Tottori University Hospital, 36-1 Nishi-machi, Yonago, Tottori, 683-8504, Japan.Pulmonary endometriosis is a disease in which uterine endometrial cells with stromal components grow in the pulmonary parenchymal tissues or pleura. Surgical resection is considered an effective and radical treatment for pulmonary endometriosis to avoid the adverse effects of long-term hormone therapy in young women of childbearing years with a localized abnormal lesion. We report a case of pulmonary endometriosis with catamenial hemoptysis, an uncommon result of this disease, which was diagnosed histologically and treated successfully by video-assisted thoracic surgery.PMID: 17243034 [PubMed – indexed for MEDLINE]Surg Laparosc Endosc Percutan Tech. 2006 Dec;16(6):437-8.Video-assisted thoracoscopic surgery for catamenial hemoptysis: the rationale of preoperative computed tomography-guided hook-wire localization.Chao YK, Ko PJ, Yeow KM, Liu YH.Division of Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, Chang Gung University, Kweishan, Taoyuan, Taiwan.Catamenial hemoptysis is a rare disease. Hormone ablation therapy is the treatment of choice with multiple side effects. We report a case of pulmonary endometriosis with deep and changeable focus. Successful treatment was obtained with the combine use of computed tomography-guided hook-wire localization and video-assisted thoracoscopic surgery. Owing to benign and curable in nature, we suggest a more aggressive attitude toward this disease before proceeding to hormone ablation therapy. The role of preoperative localization in the management of such disease was also discussed.PMID: 17277664 [PubMed – indexed for MEDLINE]Pediatr Pulmonol. 2007 Apr;42(4):386-8.Catamenial hemoptysis from endobronchial endometriosis in a child with type 1 von Willebrand disease.Martire B, Loizzi M, Cimmino A, Peruzzi S, De Mattia D, Giordano P.Dipartimento di Biomedicina dell’Età Evolutiva, University of Bari, Bari, Italy.Catamenial hemoptysis is a rare condition characterized by cyclic pulmonary hemorrhage, synchronous with menses and associated with the presence of intrapulmonary or endobronchial endometrial tissue. Because of the paucity of cases reported in the literature, information regarding the natural history is limited and also the optimal diagnostic workup and management of these patients are not well defined. In this report, we present a case of endobronchial endometriosis in a 12-year-old female diagnosed by bronchoscopy and immunocytochemical assay, associated with type 1 von Willebrand disease. (c) 2007 Wiley-Liss, Inc.PMID: 17335013 [PubMed – indexed for MEDLINE]Rev Mal Respir. 2007 Mar;24(3 Pt 1):339-42.[Catamenial hemoptysis during hormone replacement treatment][Article in French]Chahine B, Malbranque G, Lelong J, Ramon P, Tillie-Leblond I.Service de Pneumologie et d’Immuno-Allergologie, Centre Hospitalier Universitaire de Lille, France.INTRODUCTION: Catamenial haemoptysis is a rare clinical entity resulting from the presence of ectopic intra pulmonary endometrial tissue, either parenchymatous or endobronchial. The main diagnostic criterion is the periodic character of the haemoptysis which is synchronous with menstruation. CASE REPORT: The authors report a case of catamenial haemoptysis due to endobronchial endometriosis in a 46 year old menopausal woman receiving hormone replacement treatment (HRT). She presented with 3 episodes of haemoptysis synchronous with the first days of her menstrual cycle. A thoracic CT scan showed ground glass lesions with micronodulation. Bronchoscopy showed violacious lesions bleeding on contact. The endobronchial and CT abnormalities had disappeared by day 5. After withdrawal of the HRT the haemoptysis did not recur during a follow-up of 2 years. CONCLUSION: Endobronchial endometrioisis remains a rare occurrence. This is the first case reported in a menopausal woman with artificial cycles receiving hormone replacement therapy.PMID: 17417172 [PubMed – indexed for MEDLINE]J Thorac Imaging. 2007 May;22(2):172-5.Endometrioma presenting as a cavitary lung mass with intense 18F-FDG uptake on PET-CT.Derman AY, Sperling D, Merav A, Jain VR, Levin M, Jana S, Haramati LB.Department of Radiology, Albert Einstein College of Medicine, Montefiore Medical Center, 111 East 210th Street, Bronx, NY 10467, USA.[18F]-fluoro-2-deoxy-D-glucose positron emission tomography computed tomography is a useful tool to suggest the diagnosis of malignant processes. However, false positive results are known to occur in benign lesions that have a high metabolic activity. Here we describe the unusual diagnosis of a pulmonary endometrioma in a 47-year-old woman, presenting as a cavitary lung mass with intense (18)F-FDG uptake on PET-CT.PMID: 17527123 [PubMed – indexed for MEDLINE]Respiration. 2007 Jun 28; [Epub ahead of print]Thoracic Endometriosis Syndrome.Augoulea A, Lambrinoudaki I, Christodoulakos G.2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieion Hospital, Athens, Greece.Endometriosis is defined as the presence of endometrial glands and stroma outside the uterine cavity and is usually confined to the pelvis. Thoracic endometriosis syndrome (TES) is a rare disorder characterized by the presence of functioning endometrial tissue in the pleura, the lung parenchyma and the airways. TES may present with hemoptysis, due to the shedding of endometrial tissue in the bronchial tree, or spontaneous pneumothorax or hemothorax if the endometrial tissue is localized peripherally. Patients are of reproductive age, often nulliparous, with long-standing symptoms. The crucial issue for establishing the diagnosis is the cyclicity of the symptoms which occur along with the menstrual cycle. TES is virtually a diagnosis of exclusion, established on clinical grounds, since neither CT nor endoscopy are specific for TES. Treatment consists of gonadotropin-releasing hormone analogues, aiming to suppress the hypophyseal-gonadal axis, so as to ensure a regression of the endometrial implants. If medical treatment fails, surgical resection of the endometriomas is suggested, although relapse rate may be high. Copyright (c) 2007 S. Karger AG, Basel.PMID: 17622704 [PubMed – as supplied by publisher]Am J Respir Crit Care Med. 2007 Nov 15;176(10):1048-53. Epub 2007 Jul 12.Catamenial and noncatamenial, endometriosis-related or nonendometriosis-related pneumothorax referred for surgery.Alifano M, Jablonski C, Kadiri H, Falcoz P, Gompel A, Camilleri-Broet S, Regnard JF.Department of Thoracic Surgery, Hôtel-Dieu Hospital, Paris V University, Paris, France. marcoalifano@yahoo.comRATIONALE: Catamenial and endometriosis-related pneumothorax are considered relatively rare entities. Their clinical characteristics and outcome are incompletely known. OBJECTIVES: To evaluate the frequencies, clinical characteristics, and outcomes of catamenial and endometriosis-related pneumothoraces occurring in women with no underlying lung disease referred for surgical treatment. METHODS: Clinical files of all the women of reproductive age referred to our center during a 6-year period for surgical treatment of spontaneous pneumothorax were retrospectively reviewed. Catamenial pneumothorax (CP) was defined as recurrent pneumothorax occurring between the day before and within 72 hours after the onset of menses. All histologic slides were reviewed to confirm initial diagnoses. MEASUREMENTS AND MAIN RESULTS: A total of 114 women underwent video-assisted thoracic surgery; 28 women (24.6%) had CP (right-sided in all but one), and diaphragmatic abnormalities (perforations and/or nodules) were observed in 22 of them. Diaphragmatic abnormalities were seen in 21 of 86 patients with non-CP. Histologic examination found endometriosis, mainly diaphragmatic, in 18 of 28 CPs and 11 of 86 non-CPs. A 6-month antigonadotropic treatment was prescribed postoperatively to women with either CP or endometriosis-related pneumothorax. Mean follow-up was 32.7 (+/-18.5) months. Recurrence rates in CP, non-CP but endometriosis-related, and non-CP non-endometriosis-related pneumothoraces were 32, 27, and 5.3%, respectively. CONCLUSIONS: Our experience shows that (1) CP and/or endometriosis-related pneumothoraces account for an important percentage of spontaneous pneumothoraces referred for surgery, (2) diaphragmatic abnormalities seem to play a fundamental role in their pathogenesis, and (3) management is difficult because of the high recurrence rate.PMID: 17626909 [PubMed – in process] Interact Cardiovasc Thorac Surg. 2003 Mar;2(1):35-7.Fatal right spontaneous haemothorax in Von Recklinghausen’s disease.Baldó X, Ortiz MR, Sebastián F, Bernadó L.Department of Thoracic Surgery, Hospital Universitari de Girona "Dr. Josep Trueta", Ctra de França s/n, 17007 Girona, Spain.Spontaneous massive haemothorax is uncommon and usually occurs as a result of pulmonary infarction, arteriovenous fistula, neoplasm, ruptured aortic aneurysm, rupture of pleural adhesions or pleural endometriosis. Massive haemothorax in Von Recklinghausen’s disease occurs rarely but with potentially fatal results in spite of surgery. We present a case of a spontaneous massive exsanguinating haemothorax in a patient with neurofibromatosis type 1 caused by rupture of a branch of the right subclavian artery. Bleeding was probably due to neurofibromatous invasion of the arterial wall.PMID: 17669982 [PubMed – in process] FASEB J. 2007 Sep 14; [Epub ahead of print]Dendritic cells support angiogenesis and promote lesion growth in a murine model of endometriosis.Fainaru O, Adini A, Benny O, Adini I, Short S, Bazinet L, Nakai K, Pravda E, Hornstein MD, D’Amato RJ, Folkman J.*Department of Surgery, Vascular Biology Program, Children?s Hospital, andDepartment of Obstetrics and Gynecology, Brigham and Women?s Hospital, Harvard Medical School, Boston, Massachusetts, USA.Endometriosis affects 10-15% of women and is associated with pelvic pain and infertility. Angiogenesis plays an essential role in its pathogenesis. Dendritic cells (DCs) were recently implicated in supporting tumor angiogenesis. As both tumors and endometriosis lesions depend on angiogenesis, we investigated the possibility that DCs may also play a role in endometriosis. We induced endometriosis in 8-wk-old female C57BL/6 mice by implantation of autologous endometrium into the peritoneal cavity. We observed an abundance of CD11c(+) DCs infiltrating sites of angiogenesis in endometriosis lesions. We noticed a similar pattern of infiltrating DCs at sites of angiogenesis in the peritoneal Lewis lung carcinoma tumor model. These DCs were immature (major histocompatability complex class II(low)) and expressed vascular endothelial growth factor receptor 2. Peritoneal implanted bone marrow-derived DCs (BMDCs) incorporated into both endometriosis lesions and into B16 melanoma tumors and enhanced their growth at 8 days compared with controls (5.1+/-2.5 vs. 1.5+/-0.5 mm(2), n=4 and 4, P<0.0001 for endometriosis; 67.6+/-15.1 vs. 22.7+/-14.6 mm(2), n=5 and 7, P=0.0004 for mouse melanoma). Finally, immature BMDCs but not mature BMDCs enhanced microvascular endothelial cell migration in vitro (219+/-51 vs. 93+/-32 cells, P=0.02). Based on these findings, we suggest a novel role for DCs in supporting angiogenesis and promoting lesion growth both in endometriosis and in tumors.-Fainaru, O., Adini, A., Benny, O., Adini, I., Short, S., Bazinet, L., Nakai, K., Pravda, E., Hornstein, M. D., D’Amato, R. J., Folkman, J. Dendritic cells support angiogenesis and promote lesion growth in a murine model of endometriosis.PMID: 17873101 [PubMed – as supplied by publisher]

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