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Saturday, August 10, 2013

Endometrial Cancer in a Hypothetical Patient

Hypothetical Patient is XY
54 yo G4P3 (3013)
Pre-op Diagnosis: Endometrial adenocarcinoma secretory type with cervical extension IIA
Operative Findings:
Uterus measures 11x6.5x 3cm
cervix 3.5x3.5x2.5
Right ovary 2x1.5x0.5
Left ovary 2x1x0.5
Right Fallopian tube 8x0.5
Left Fallopian tube 8x0.5
Endocervical canal 2.5cm
UC 8.5
myometrium 2cm
endometrium 0.5cm
obturator nerve (L) 3.5x4x1.0
omentum 10x 8x3cm

Post Operative Diagnosis: Endometrial adenocarcinoma secretory type intraoperative stage  IIIC1
Management; Chemotherapy+ Pelvic EBRT+ Brachytherapy

Surgery done: Exploratory laparotomy,Peritoneal fluid cytology, Extrafascial hesterectomy with bilateral salpingooophorectomy, Random peritoneal biopsy,bilateral lymph node dissection, infracolic omentectomy,paraaortic lymph node sampling/CLEA

Infracolic omentectomy was done:
1.) poor histologic type *
2.) ovarian metastasis
3.) serosal extension*( yellowish at the back)
Plan:
Chemotherapy: Carboplatin-Paclitaxel

Notes:
Women who are at high risk for endometrial cancer are those known to carry HNPCC associated
mutations(pedigree showed 3 generations).

"Kadar and associates and Lurain and colleagues noted that positive peritoneal cytology was associated primarily with adverse features such as extrauterine disease and that therapy  for positive peritoneal cytology as an isolated finding did not appear to improve survival"-Compre Gyne

Wednesday, August 7, 2013

International Publication on Springer

I cant believe that in the next few months my international  publication about Rice iron transporter genes will be out. Im so  happy  and proud about it.