1.Prevalence of premalignant and malignant changes in hysteroscopically removed endometrial polyps in reproductive aged women: A 5-year review of cases in a Tertiary Government Hospital in the Philippines
Maria Angela B. de de Castro-Abesamis ; Chiaoling Sua Lao
Philippine Journal of Reproductive Endocrinology and Infertility 2022;19(2):31-
Objective:
To determine the prevalence of premalignant and malignant changes in
hysteroscopically removed endometrial polyps in reproductive aged women, and to determine
clinical, ultrasonographic and hysteroscopic characteristics of such women.
Methods:
This is a cross-sectional study of patients diagnosed with endometrial polyp, and
underwent hysteroscopy from 2015-2019. A review of the medical records (ultrasound results,
intraoperative findings and histopathology results) was done.
Results:
A total of 117 patient records were included in the analysis. The median age of
all patients who underwent hysteroscopy was 38 years old (age range: 19-44 years). The
prevalence of endometrial hyperplasia or carcinoma in the 18-44 year old age group was 8.5%
(n=10/117). Among patients with endometrial hyperplasia or carcinoma, 70% were nulligravid,
40% had anovulation disorder, and 40% had infertility. Most of the patients were overweight or
obese (70%). Co-morbidities were present in only 3 cases, and diabetes mellitus (30%) was
the predominant illness seen in these patients.
Conclusion
Our findings showed a higher prevalence (8.5%) of endometrial hyperplasia or
carcinoma in endometrial polyps among Filipino reproductive-aged women, compared to reports
in published literature. Among the different clinical characteristics, ultrasound and hysteroscopic
findings, no particular factor had a significant association with endometrial hyperplasia or
malignancy.
Hysteroscopy
;
Endometrial Neoplasms
;
Endometrial Hyperplasia
2.An approach to the management and care of an individual with 46, XX ovotesticular disorder of sexual differentiation
Maria Angela B. De Castro-Abesamis ; Mikaela Erlinda G. Martinez-Bucu
Philippine Journal of Obstetrics and Gynecology 2023;47(1):30-36
Ovotesticular disorder of sexual differentiation (OT-DSD) is a rare condition defined by the presence of both testicular and ovarian elements in the same individual. Definitive diagnosis is made based on histological assessment of the gonad/s confirming both ovarian and testicular components. In this paper, we describe how a diagnosis of 46XX, OT-DSD was made in a 20-year-old individual with enlarged breasts and ambiguous genitalia. The initial impression was congenital adrenal hyperplasia (CAH) based on 46, XX karyotype and absence of testes on physical examination and imaging. However, biochemical tests were inconsistent with CAH, hence a more probable diagnosis of 46, XX OT-DSD was considered. The patient suffered from gender dysphoria and after extensive counseling, he decided to undergo gender-affirming surgery: laparoscopic excision of the left gonad, subtotal hysterectomy, bilateral mastectomy, and a masculinizing genitoplasty. Histopathology of the left gonad revealed an ovotestes which confirmed the diagnosis of 46, XX OT-DSD.
Ambiguous genitalia
;
disorders of sex development
;
intersex
;
ovotesticular