No abstract

Objectives To assess the diagnostic performance of Pap smear screening with or without human papillomavirus (HPV) testing and colposcopy in detecting preinvasive lesions of the cervix among women with reference to histopathological findings. Materials and methods We performed a retrospective study in a tertiary care center of the clinical and pathological records of women with evocative symptomatology. The diagnostic performance of Pap smear screening and colposcopy was analyzed. The sensitivity and specificity of Pap smear screening and colposcopy in detecting preinvasive lesions of the cervix were calculated in 388 patients. Results The mean age was 45.12 years, and the most frequent gynecological symptoms included abnormal bleeding (17.2%) and postcoital bleeding (10.9%). Histopathology showed abnormal results in 26.5% of the 388 patients, including cervical intraepithelial neoplasia 1 (CIN 1; 20.4%), CIN 2 (2.8%), CIN 3 (1.3%), and SCC (1.3%). Both Pap smear screening and colposcopy were highly sensitive in detecting CIN 1+ (94.2%vs.93.2%, respectively) and CIN 2+ (100.0% vs.95.8%, respectively) intraepithelial lesions; however, Pap smears had very low specificity in detecting both CIN 1+ (8.1% vs.73.7%, respectively) and CIN 2+ (8.0% vs. 59.3%, respectively) compared with colposcopy. When combined with HPV status, the specificity of Pap smear increased considerably. Conclusion It has become a high priority to improve the efficiency of cervical cancer (CC) screening programs by optimizing the practice of Pap smear screening, increasing the test specificity, and implementing systematic cytology-HPV co-testing.

Growing teratoma syndrome is a rare entity of tumors, it arises seldomly from ovarian and testicular carcinoma. It presents with disseminating masses of mature teratoma during or following chemotherapy of malignant germ cell tumors. We are reporting a 19-year old presented with recurrent left ovarian mass and supra renal large mass close to the porta hepatis was seen on magnetic resonance imaging. This patient was treated 3 years ago for stage I immature teratoma with left ovarian cystectomy and chemotherapy. Surgical excision of the left ovary and the abdominal mass required meticulous dissection, and the mass was shaved off the porta hepatis with no intraoperative or postoperative complications. Pathology showed mature teratoma. She has no recurrent 5 years after treatment. To the best of our knowledge, this is the first case report describing close relation of growing teratoma syndrome to the porta hepatis, no such case report like this has been reported in our region.

Objectives: To assess survival and prognostic factors among women with epithelial ovarian cancer in Western Saudi Arabia.Methods: A retrospective cohort study was carried out between October 2000 and May 2018, reviewing clinical and pathology data of all women who underwent staging or debulking surgery for epithelial ovarian cancer. Analysis of disease-free survival (DFS), overall survivals (OS) and the associated factors used Kaplan-Meier method in addition to cox multivariate regression.Results: A total of 144 patients were included (median age=49.5 years), with a median follow-up time was Original Article3.4 years. Majority (59.7%) of the patients were diagnosed at an advanced stage (III or IV). The mean (95% CI) DFS was 82.3 (67.8-96.8) months, OS was 96.2 (81.3-111.2) months, and the 5-year survival rate was estimated as 38.9%. Univariate analysis showed that older age, clear cell or papillary carcinoma subtypes, serous type, advanced International Federation of Gynecology and Obstetrics (FIGO) stage and the presence of residual disease were associated with poorer DFS and OS (log rank <0.05). Cox regression showed FIGO stage and residual disease >1cm as the strongest prognostic factors independently associated with DFS and OS. Conclusion:Improving early diagnosis and achieving optimal cytoreduction are the most critical challenges to achieve significant positive impact on survival of women with epithelial ovarian cancer.