A 35-year-old woman underwent laparoscopic radical hysterectomy, pelvic lymphadenectomy and ovarian transposition for stage IB2 cervical adenocarcinoma. She received adjuvant concurrent chemoradiation for poor pathologic risk factors but had tumor recurrence 20 months after the surgery. Transposed ovaries were uninvolved in the recurrence and progression. Salvage chemotherapy and radiotherapy were given. Despite systemic chemotherapy and repeat pelvic radiotherapy, the patient was able to maintain ovarian function. Ovarian transposition in cervical cancer is an easily performed procedure that does not alter the prognosis of the disease in some cases. Present recommendations for its use should be reevaluated so that more premenopausal cancer patients may benefit from this underutilized procedure.
Adenocarcinoma ; Female ; Humans ; Hysterectomy ; Laparoscopy ; Lymph Node Excision ; Ovary ; Prognosis ; Quality of Life ; Recurrence ; Risk Factors ; Uterine Cervical Neoplasms

We report a case of a 33-years old, nulligravid, diagnosed with mullerian adenosarcoma with sarcomatous overgrowth (MASO), who presented with vaginal bleeding and recurrent endometrial polyp. MASO is a rare type of uterine sarcomas, it is a variant of adenosarcomas with poor prognosis. The index patient underwent primary surgical management with lymphadenectomy with a final stage of IC. Histologic diagnosis was Mulllerian adenosarcoma with sarcomatous overgrowth. A panel of immunostaining for estrogen receptors, progesterone receptors and CD 10 showed diffused positivity for the hormones with loss of CD 10 which is consistent with MASO. The rarity of MASO has a distinctive histologic features which merits meticulous sectioning as the clinical course and management vary. It has a poor prognosis due to its short and fast course of the disease.
Adenosarcoma ; Sarcoma ; Uterine Neoplasms ; Soft Tissue Neoplasms

OBJECTIVE: This study aimed to determine the accuracy of internal examination and ultrasound in early stage cervical cancer. Specific objectives were to determine the accuracy of internal examination and sonography in measuring tumor size and the accuracy of sonography in detecting vaginal involvement, stromal invasion, parametrial and lymph node involvement by comparing them with the surgicopathologic findings.
MATERIALS AND METHODS: 35 patients diagnosed with early stage cervical cancer for radical hysterectomy with bilateral salpingooophorectomy were recruited. Presence of poor prognostic factors was determined by internal examination and sonography and compared with the surgicopathologic result.
RESULTS: Ultrasound and internal examination have an accuracy of 74% and 68%, respectively. Ultrasound accuracy in detecting more than one third stromal invasion is 68%, vaginal involvement is 85%, parametrial involvement is 92% and lymph node involvement is 100%.
CONCLUSION: Ultrasound can be recommended as an adjunct to internal examination in the preoperative assessment of early stage cervical cancer.

Human ; Female ; Middle Aged ; Adult ; Uterine Cervical Neoplasms ; Prognosis ; Hysterectomy ; Ultrasonography ; Vagina ; Lymph Nodes

INTRODUCTION

The conventional teaching of laparoscopic surgery in academic centers in the apprentice/mentor model is highly subjective. The Gynecological Endoscopic Surgical Education and Assessment is a well-structured education program proposed by the European Society for Gynaecological Endoscopy (ESGE). This program uses the Laparoscopic Skills Training and Testing (LASTT) kit, an objective, validated, and measurable test to evaluate an individual’s competence level in basic laparoscopic psychomotor skills. The LASTT kit may be used to assess the basic laparoscopic psychomotor skills of Filipino doctors, guide surgical training recruitment, and improve the local minimally invasive surgery curriculum.

GENERAL OBJECTIVE

The study will describe the implementation of the LASTT kit in evaluating the psychomotor skills of Filipino physicians in training and assess the feasibility and user acceptance of the kit.

METHODOLOGY

A descriptive cross-sectional research design was used. A total of 34 trainees (19 medical interns and 15 surgical residents) were included. All trainees underwent the LASTT test to have the baseline data for comparison of each cohort. A posttest questionnaire for the feasibility and user acceptance of the kit was accomplished.

RESULTS

A majority of participants were right-handed, and female, with 0–30 laparoscopic assists. The mean age of surgical residents was higher than medical interns. Surgical residents showed a significantly shorter time to accomplish the exercises than medical interns. Finally, it showed that the kit was clear and understandable, easy to use, and represented a realistic model of the actual laparoscopic surgery.

CONCLUSIONS

The surgical residents were superior to medical interns in laparoscopic psychomotor skills, which supports that hands-on training and exposure to procedures improve skill proficiency. Furthermore, the LASTT kit was well accepted and would greatly aid in recruitment and skills training in the Philippines.

Human ; Laparoscopy