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Acta Bio-medica : Atenei Parmensis Apr 2021We describe the first case to our knowledge of Hypervascularised placental polyp (HPP) presenting with acute pelvic pain and hemoperitoneum.
OBJECTIVE
We describe the first case to our knowledge of Hypervascularised placental polyp (HPP) presenting with acute pelvic pain and hemoperitoneum.
CASE REPORT
A 33 years-old woman with a history of medical abortion three months earlier came to our attention complaining acute pelvic pain and vaginal bleeding. Transvaginal (TV) and transabdominal (TA) ultrasound (US) demonstrated a highly vascular intrauterine lesion and intra-abdominal free fluid consistent with a diagnosis of haemoperitoneum. Emergency laparoscopy yielded no intra-abdominal bleeding and was followed by bilateral selective embolization of the uterine arteries due to persistent vaginal bleeding. Hysteroscopy and pathology findings were consistent with a final diagnosis of HPP.
CONCLUSION
HPP may occur months or years after pregnancy or abortion and the clinical picture of abnormal vaginal bleeding associated with acute abdominal pain and haemoperitoneum should warrant to consider HPP among the differential diagnosis. Clinical and imaging findings need to be considered when planning the conservative management of HPP. Our experience suggests that uterine artery embolization is a safe and effective for the conservative treatment of highly vascularized HPP.
Topics: Adult; Conservative Treatment; Female; Hemoperitoneum; Humans; Hysteroscopy; Placenta; Polyps; Pregnancy
PubMed: 33944840
DOI: 10.23750/abm.v92iS1.9559 -
Annals of Diagnostic Pathology Jun 2005Tamoxifen is a widely used adjuvant treatment of breast carcinoma with partial estrogenic agonist effect. This activity may result in a spectrum of proliferative... (Review)
Review
Tamoxifen is a widely used adjuvant treatment of breast carcinoma with partial estrogenic agonist effect. This activity may result in a spectrum of proliferative endometrial abnormalities including uterine polyps. We report a 53-year-old woman receiving tamoxifen for previously excised breast lobular carcinoma who presented with vaginal bleeding. Histologic examination of the endometrium revealed typical morphology of tamoxifen-associated polyp with foci of metastatic lobular carcinoma. Metastatic breast carcinoma to tamoxifen-associated polyp has rarely been described in the literature. Pathologists and gynecologists should be aware of this possibility in women who have a history of breast carcinoma and who are receiving tamoxifen. Careful histologic evaluation of the endometrium is crucial.
Topics: Antineoplastic Agents, Hormonal; Biomarkers, Tumor; Breast Neoplasms; Carcinoma, Lobular; Combined Modality Therapy; Endometrial Neoplasms; Female; Humans; Immunoenzyme Techniques; Middle Aged; Neoplasm Metastasis; Polyps; Tamoxifen
PubMed: 15944961
DOI: 10.1016/j.anndiagpath.2005.03.003 -
Pediatric Dermatology Nov 2018Pathological conditions of the hymen are rare in everyday medical practice. Hymenal polyps are polypoid formations originating from the hymenal rim and are benign and...
Pathological conditions of the hymen are rare in everyday medical practice. Hymenal polyps are polypoid formations originating from the hymenal rim and are benign and disappear spontaneously within a few weeks of onset. We report two cases of hymenal polyps in two infants.
Topics: Child, Preschool; Female; Humans; Hymen; Infant; Polyps; Vaginal Diseases
PubMed: 30152554
DOI: 10.1111/pde.13650 -
Journal of Clinical Ultrasound : JCU Sep 2004Abnormal vaginal bleeding is one of the most common presenting complaints in women of any age seeking gynecologic health care. Two of the most frequently used diagnostic... (Review)
Review
Abnormal vaginal bleeding is one of the most common presenting complaints in women of any age seeking gynecologic health care. Two of the most frequently used diagnostic tests to investigate the cause of the bleeding are endometrial biopsy and transvaginal sonography. The most worrisome cause of abnormal bleeding is endometrial carcinoma, yet benign etiologies are far more prevalent, including fibroids, polyps, and endometrial atrophy. Endometrial biopsy and transvaginal sonography have equal sensitivities for carcinoma, but sonography is far more effective in diagnosing benign disease. This article reviews the state-of-the-art in the diagnostic evaluation of abnormal vaginal bleeding and analyzes the data, with emphasis on the prevalence of benign and malignant disease as the basis for determining whether sonography or biopsy is more cost-effective in evaluating women with abnormal vaginal bleeding.
Topics: Biopsy; Cost-Benefit Analysis; Diagnosis, Differential; Endometrial Hyperplasia; Endometrium; Female; Humans; Leiomyoma; Polyps; Ultrasonography; Uterine Hemorrhage; Uterine Neoplasms
PubMed: 15293302
DOI: 10.1002/jcu.20049 -
Minerva Ginecologica Nov 1975
Topics: Female; Humans; Middle Aged; Polyps; Vaginal Neoplasms
PubMed: 1187063
DOI: No ID Found -
Human Pathology Aug 1987A 72-year-old woman had a villous adenoma of endodermal derivation involving the rectovaginal septum and contiguous mucosal surfaces that presented clinically as a...
A 72-year-old woman had a villous adenoma of endodermal derivation involving the rectovaginal septum and contiguous mucosal surfaces that presented clinically as a vaginal polypoid tumor. To explain the vaginal involvement, we postulate that the adenoma traversed a tract of developmental origin within the rectovaginal septum. This is the first report of such a unique constellation of findings.
Topics: Adenoma; Aged; Endoderm; Female; Humans; Polyps; Rectal Neoplasms; Vaginal Neoplasms
PubMed: 3610138
DOI: 10.1016/s0046-8177(87)80063-1 -
Menopause (New York, N.Y.) Aug 2023Ospemifene is a novel selective estrogen receptor modulator developed for the treatment of moderate to severe postmenopausal vulvovaginal atrophy (VVA). (Meta-Analysis)
Meta-Analysis
Efficacy, tolerability, and endometrial safety of ospemifene compared with current therapies for the treatment of vulvovaginal atrophy: a systematic literature review and network meta-analysis.
IMPORTANCE
Ospemifene is a novel selective estrogen receptor modulator developed for the treatment of moderate to severe postmenopausal vulvovaginal atrophy (VVA).
OBJECTIVE
The aim of the study is to perform a systematic literature review (SLR) and network meta-analysis (NMA) to assess the efficacy and safety of ospemifene compared with other therapies used in the treatment of VVA in North America and Europe.
EVIDENCE REVIEW
Electronic database searches were conducted in November 2021 in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized or nonrandomized controlled trials targeting postmenopausal women with moderate to severe dyspareunia and/or vaginal dryness and involving ospemifene or at least one VVA local treatment were considered. Efficacy data included changes from baseline in superficial and parabasal cells, vaginal pH, and the most bothersome symptom of vaginal dryness or dyspareunia, as required for regulatory approval. Endometrial outcomes were endometrial thickness and histologic classifications, including endometrial polyp, hyperplasia, and cancer. For efficacy and safety outcomes, a Bayesian NMA was performed. Endometrial outcomes were compared in descriptive analyses.
FINDINGS
A total of 44 controlled trials met the eligibility criteria ( N = 12,637 participants). Network meta-analysis results showed that ospemifene was not statistically different from other active therapies in most efficacy and safety results. For all treatments, including ospemifene, the posttreatment endometrial thickness values (up to 52 wk of treatment) were under the recognized clinical threshold value of 4 mm for significant risk of endometrial pathology. Specifically, for women treated with ospemifene, endometrial thickness ranged between 2.1 and 2.3 mm at baseline and 2.5 and 3.2 mm after treatment. No cases of endometrial carcinoma or hyperplasia were observed in ospemifene trials, nor polyps with atypical hyperplasia or cancer after up to 52 weeks of treatment.
CONCLUSIONS AND RELEVANCE
Ospemifene is an efficacious, well-tolerated, and safe therapeutic option for postmenopausal women with moderate to severe symptoms of VVA. Efficacy and safety outcomes with ospemifene are similar to other VVA therapies in North America and Europe.
Topics: Female; Humans; Dyspareunia; Vagina; Hyperplasia; Bayes Theorem; Network Meta-Analysis; Vulva; Atrophy; Tamoxifen; Selective Estrogen Receptor Modulators; Vaginal Diseases; Endometrial Neoplasms
PubMed: 37369079
DOI: 10.1097/GME.0000000000002211 -
Journal of Lower Genital Tract Disease Jul 2012The study aimed to describe a case of vaginal polypoid endometriosis and its management.
OBJECTIVE
The study aimed to describe a case of vaginal polypoid endometriosis and its management.
MATERIALS AND METHODS
This study is a case report. The patient was a nulliparous woman aged 27 years who presented with pain in her lower abdomen and continuous bleeding per vaginum for 2 months. On speculum examination, multiple, smooth, polypoid masses were seen arising all around the vaginal fornices; cervix was healthy. Ultrasound revealed a bulky uterus with a 5 × 6-cm fibroid in the posterior wall with echogenic area adjacent to cervix and gross left hydroureteronephrosis. The right kidney was removed 6 years consequent to pyonephrosis. Biopsy of the vaginal polypoidal mass was reported as vaginal polypoid endometriosis. The patient was planned for myomectomy and vaginal mass excision. On examination under anesthesia, the base of polypoid mass was thick and fixed and could not be excised completely. Myomectomy was done. Postoperatively, the patient received 3 injections of gonadotropin-releasing hormone agonist, but the size of the mass did not decrease. She was then planned for ureteric reimplantation and panhysterectomy. Hysterectomy was not possible because of extensive parametrial involvement, but Boari flap ureteric implantation with bilateral salpingo-oophorectomy was done.
RESULTS
Vaginal polypoid endometriosis did not respond to medical treatment. However, the widespread vaginal polypoidal masses regressed significantly after oophorectomy.
CONCLUSION
Bilateral oophorectomy was resorted to as an option in this case of vaginal polypoid and extensive pelvic endometriosis not amenable to medical treatment and surgical excision.
Topics: Adult; Biopsy, Needle; Diagnosis, Differential; Endometriosis; Female; Follow-Up Studies; Humans; Immunohistochemistry; Ovariectomy; Polyps; Rare Diseases; Risk Assessment; Treatment Outcome; Vaginal Diseases; Vaginal Neoplasms
PubMed: 22460274
DOI: 10.1097/LGT.0b013e318241052b -
Thorax Dec 1992A patient with multiple cystic hamartomas presented with a pneumothorax and later developed a cystic myxomatous vaginal polyp. This and three of the cysts were resected....
A patient with multiple cystic hamartomas presented with a pneumothorax and later developed a cystic myxomatous vaginal polyp. This and three of the cysts were resected. She remains well 13 years later. Multiple cystic hamartomas are uncommon and may be misdiagnosed as pulmonary metastases.
Topics: Cysts; Diagnosis, Differential; Female; Hamartoma Syndrome, Multiple; Humans; Lung; Lung Neoplasms; Middle Aged; Neoplasm Recurrence, Local; Polyps; Vaginal Neoplasms
PubMed: 1494774
DOI: 10.1136/thx.47.12.1076 -
The Malaysian Journal of Pathology Jun 2013We report an18-year-old girl with a four-year history of a slow-growing labial mass with a sudden increase in size in the last year. Examination revealed a large fleshy...
We report an18-year-old girl with a four-year history of a slow-growing labial mass with a sudden increase in size in the last year. Examination revealed a large fleshy 20 cm perineal mass centering on the left labia majora and attached to it by a 1cm pedicle. It was associated with pain, ulceration and discharge. The lesion was excised via diathermy at the base of the stalk. The excised specimen weighed 1.112kg and measured 20.5 x 17 x 5cm. The lesion showed a solid, soft whitish, cut surface. Histology revealed a hypocellular tumour with focally oedematous fibrous stroma in which were scattered large and small blood vessels, mast cells and other chronic inflammatory cells. True myxoid matrix was not observed. The stromal cells had a spindle to stellate morphology. There was no significant cytological atypia, mitotic activity or necrosis. The tumour cells were negative for SMA, desmin, CD34, S100 protein, EMA and PR. The diagnosis was clinically and histologically challenging because various vulvovaginal soft tissue tumours often have overlapping clinicopathological features. However, based on strict histological criteria and the absence of worrisome cytological features, a diagnosis of fi broepithelial stromal polyp was rendered despite the unusual size. A review of the literature shows that whilst vulvovaginal fibroepithelial stromal polyps are well described, giant variants are rare. Awareness of the extraordinary size that can be attained by such polyps can facilitate swift clinical and histological diagnosis.
Topics: Adolescent; Female; Humans; Neoplasms, Fibroepithelial; Polyps; Vaginal Neoplasms
PubMed: 23817400
DOI: No ID Found