Luboš Minář

A rare childhood uterine malignancy combined with complete uterine inversion

Objective: An overview of the types of uterine sarcoma, supplemented by an illustrative case report of a rare uterine childhood tumor. Case report: Our case report describes the case of a 9-year-old girl with a 15-cm tumor in the abdominal cavity, which prolapsed vaginally before introitus during a clinical examination of the abdominal wall causing life-threatening bleeding. This bleeding was stopped by ligation of the tumor pedicle and its resection. Histological examination of the resected specimen described Müllerian adenosarcoma of the uterus. Based on the staging, laparoscopic hysterectomy with bilateral salpingectomy was indicated by the oncogynecological committee. The operation was performed without complications, and intraoperatively, a complete inversion of the uterus was diagnosed.  Key words: uterine sarcoma – leiomyosarcoma – endometrial stromal sarcoma – Müllerian adenosarcoma – uterine inversion

Low-volume regional lymph node metastasis in endometrial cancer – 2024 update

Due to the implementation of sentinel lymph node ultrastaging, the prevalence of isolated tumor cells and micrometastases have increased. This literature review comprises of articles published between January 2019 and September 2024 aiming at low-volume metastases in regional lymph nodes, their prognosis, and links to molecular classification. Micrometastases are currently considered as having metastatic lymph node involvement; however, they have a better prognosis than macrometastases. Accordingly, therapy is tailored. In contrast, isolated tumor cell presence is not considered metastatic involvement according to International Federation of Gynecology and Obstetrics (FIGO) 2023 staging and does not affect the therapeutic procedure because their significant prognostic importance has not been proven so far. Key words: low-volume metastasis – endometrial cancer – ultrastaging – isolated tumor cells – micrometastases – sentinel lymph node

Risk of atrial fibrillation in endometrial cancer patients

Objective: The study aimed to define atrial fibrillation frequency in endometrial cancer patients, identify risk factors, and propose preventive steps for early detection and treatment leading to decreasing cardiovascular risk. Secondly, we aimed to highlight this topic by presenting a systematic literature review. Methodology: Retrospective analysis of endometrial cancer patients treated at the Department of Gynecology and Obstetrics at University Hospital Brno between 2006 and 2023 complemented by a systematic literature review. Results: The incidence of atrial fibrillation in endometrial cancer patients in our study group (1,101 patients) was 10.4%. Overall, 27% of patients suffered from obesity, hypertension, and diabetes, 26% from both hypertension and obesity, and 10% from diabetes and obesity. The incidence of other risk factors and their combination was less than 10%. Conclusion: Endometrial cancer patients are at a higher risk of developing atrial fibrillation compared with the general population. The risk is enhanced by the presence of other common risk factors such as hypertension, diabetes, and obesity. Key words: endometrial cancer – atrial fibrillation – cardiovascular dis ease – obesity – hypertension – diabetes mellitus

Ultrasound finding of endometrial polyp and factors increasing risk of malignancy

This article presents a comprehensive review of factors that increase the risk of malignancy in ultrasound findings of an endometrial polyp. We collected original studies, reviews, and meta-analyses that dealt with the topic of endometrial polyps and the risk of developing endometrial cancer. Each presumed risk factor was analysed individually. According to searched studies, abnormal uterine bleeding, old age, and body mass index are valid risk factors for developing endometrial cancer in endometrial polyps. Lynch syndrome patients are also in a high-risk group for endometrial cancer. On the other hand, the number of polyps, their size, diabetes mellitus, hypertension, and positive family history are factors with inconclusive results. There are either not enough data or different results among several studies. Key words: endometrial polyp – risk factors – endometrial carcinoma – polyp size – tamoxifen – abnormal uterine bleeding