PubMed Health⌕ Search

Biomedical subjects

L Giambanco

Publications and source records attributed to L Giambanco.

4 recordsLinked to original sources

Uterine leiomyoma metastasis as a first sign of breast cancer.

Uterine metastases from extragenital cancer are rarely reported in the literature. More frequently, the female genital tract is involved by direct extension from an adjacent pelvic organ. A 37-year-old woman had a myoma of the uterine wall and hypermenorrhea. The mass was laparoscopically enucleated, and frozen section examination was performed because it was macroscopically suspicious for sarcomatoid degeneration. The final diagnosis was metastatic carcinoma in the uterus of probable breast origin.

Adult↗

[Diagnosis of extrauterine pregnancy].

In pregnancies, the incidence of ectopic pregnancy varies from 1.2% to 1.4%. Diagnostic management of ectopic pregnancy is made by biochemical and ultrasonographic analysis. The evaluation of symptoms and anamnesis improves both comprehension and evaluation of technical data. This review analyzed the risk factors most commonly reported in women with ectopic pregnancy. According to the literature, the improvement of biochemical knowledge has determined the study of many substances: beta hCG, specific glycoproteins beta 1, creatine kinase, renine, progesterone. Transvaginal ultrasound examination presents different specificity and sensitivity. When ultrasonic imagining is not clear, it is useful to study uterine and adnexal vascularization by color Doppler and pulsed Doppler. The majority of authors consider laparoscopy as a gold standard for diagnosing an ectopic pregnancy. The endoscopic approach has multiple advantages: it could be in the same time diagnostic and therapeutic. The curettage of uterine cavity has been proposed as a diagnostic tool for analyzing by frozen section the presence or not of chorial villi. In personal opinion, an easy and simple diagnostic management should involve the clinical, biochemical and ultrasonographic procedures. Laparoscopy should be the last step in order to confirm a diagnosis and to establish the best therapeutical approach.

Adult↗

[Cervical pregnancy: an obstetric emergency. A clinical case].

Cervical implantation could develop in three different ways. The gestational sac can grow up to external os and interruption may simulate an abnormal menstruation. Theoretically the gestational sac could reach the uterine cavity, with a normal evolution of the pregnancy, even if the implantation of the placenta would be on internal uterine os. Lastly, the ectopic gestational sac developes all in cervical channel with an "obstetrical catastrophe". The incidence of cervical pregnancy presents great differences between authors, from 1:1,000 to 1:95,000 pregnancies; this is due to the variability of diagnostic criteria. A 36 year-old woman, para 1001, came to the emergency unit with painless vaginal bleeding. She was pregnant at 8 weeks of amenorrhoea, and previously undergone a cesarean section. The portio was swollen and bluewish, the external os was opened. The uterus was slightly increased, expecially in the peri-isthmic area; no adnexal mass. The urinary hCG was < 15,000 I.U. An ultrasound examination showed the endometrium in decidual transformation, without identification of embrional or extraembrional structures. The diagnosis was retained miscarriage. During the cervical dilatation, an impressive and uncontrollable haemorrhage occurred. It was decided to perform a total hysterectomy via laparotomy. The macroscopic examination of the uterus showed the cavity empty and the sopravaginal cervical area enlarged, invaded by an ectopic trophoblastic proliferation. The majority of obstetricians will never see a cervical pregnancy; the minority who has to treat this pathology wishes to have never seen one.

Abortion, Spontaneous↗