Screening is clearly a complex multifactorial process, not a test. Nowadays, with the human papillomavirus vaccine on the horizon, screening is the best strategy for cervical cancer control. Good screening programs, with high coverage, quality control and follow-up included, are the basis of obtaining better results. The Papanicolaou test and its variants are the best methods of cervical cancer screening in high-resource settings. Alternative visual inspection using cervical dyes could be the most useful method in low-resource settings. The challenge for the future may be less of a technical nature and more dependent on local finances and screening policies.

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The endometrial stromal sarcoma is a rare neoplasm of the uterine origin. Intracardiac metastasis form the low-grade endometrial stromal sarcoma is an extremely rare event. A case of a patient who underwent surgical resection of metastatic tumors of the low-grade endometrial stromal sarcoma in the right atrium is described in the present report. Cardiac malignancies account for less than 1% of cardiac surgery and around 0.1% of cardiac echo graphic studies. The presence of metastatic tumor to the heart usually indicates widespread metastases. Lung carcinomas are the most commonly encountered tumor followed by breast and pancreas cancer and melanoma.We show the case report of a woman with endometrial stromal sarcoma who developed a right heart failure, lower extremity edema, dyspnea and orthopnea after the initial step of comprehensive surgery and radiotherapy. Heart metastases was diagnosed by computed tomography and echocardiophy after a palliative metastasectomy; the patient received chemotherapy and hormotherapy without showing response, re-developing a heart metastasic tumor. Tumoral activity was the cause of her death.It is very difficult to standardize care procedures for these patients due to the rarity of this condition. However, it is possible that aggressive therapy (surgery plus radiotherapy and chemotherapy) may lengthen patients survival and improve life quality.

We reported 2 cases of micrometastasis in dysgerminoma, specify incidence of micrometastasis is unknown. Many times when micrometastasis is reported, the variability is constant, those are reported in nodal sentinel dissection, or systematic lymphadenectomy, or with immunohistochemistry. We use the definition of micrometastasis agree with AJCC. (American Joint Committee on Cancer).

Endometrial cancer can be dividen into two types I and II. Type I is the endometroide cancer (G1 and G2) with a hormonal drive etiology and the more aggressive Type II is the G3 endometroide, clear cell, serous cancer and carcinosarcoma type. Type II endometrial cancer are often older, normal weight; type II are estrogen idependent and associated with endometrial atrophy. With extended life expectancy and growing part of population with obesity the incidence of endometrial cancer is growing.Endometrial cancer is an important cause of death but not the primary cause of mortality. We do not have question about preventive strategies on cervical cancer have successful in decreasing cervical cancer. Cervical cancer remains a hallmark of low access to health care.Implementation of screening could help to significantly decrease the incidence of and mortality from cervical cancer. Endometrial cancer has not a screening strategy has proven efficacy for women with risk to develop hereditary non-polyposis colon cancer or Lynch syndrome or any type of endometrial cancer. Endometrial biopsy could improve screening performance but the acceptability to women of this screening strategy and potential compliance with such a strategy are unknown. Furthermore, the relevance of outpatient hysteroscopy in detection of endometrial cancer is still under investigation.A significant increase of endometrial cancer type II, including G3, serous cancer, cell clear, and carcinosarcomas, were observed in 12 years, in our hospital. This tumor subtype require a more treatments than G1/G2 tumors. This represent an overload in medical oncology services because often needs chemotherapy or radiotherapy or both. Whereas Type I, G1/G2 tumor are treated with hysterectomy with bilateral adenexectomy with or without lymphadenectomy.We have a large number of patients examined over 12 years, and we observe a change in endometrial cancer; this observation has been reported in different countries; with forms more aggresive, in the current clinical practice.