Biomedical subjects
M Yoonessi
Publications and source records attributed to M Yoonessi.
Cytologic screening for cancer of the uterine cervix. "The debate of 1980s".
A review of 2971 cytology specimens taken during 4725 college student clinic visits yielded only 14 abnormal Pap smears suggestive of mild to moderate dysplasia. Eight of these patients had colposcopic evaluation and seven had biopsy-proven dysplasia. These findings in a low-risk population along with the recent American Cancer Society's guidelines are discussed.
Hysteroscopy--past and present: a review of 72 cases.
An analysis of the results of media-using hysteroscopy in 72 cases, with a review of the relevant literature available, is presented. The diagnostic and therapeutic usefulness of the technique in selected patients with infertility problems, abnormal uterine bleeding, and those with misplaced IUD's is reaffirmed. Technological advances seem to have increased the scope of application of the technique in research and clinical practice.
Endometrial carcinoma: causes of death and sites of treatment failure.
A retrospective analysis of causes of death in 398 patients with endometrial carcinoma and sites of treatment failure in 105 cases, all seen at the University of Michigan Medical Center between 1930 and 1971, is the subject of this report. Of 398 patients (337 with Stage I, 61 with Stage II disease), 183 (46%) died with endometrial carcinoma, and 122 (31%) died free of cancer. The cause of death in 35 cases (9%) was a known or unknown maligancy, and remained undetermined in 58 patients (14%). The exact site of treatment failure was identified in 105 cases. Forty-one (40%) failures were considered local, 32 (30%) geographic, and 32 (30%) both local and distant. The uterus and lungs were the most common sites of local failure and distant metastasis, respectively. Of patients who died free of cancer, 88% survived 5 or more years, and 32% survived 20 years or longer. It is concluded that 1) Hematogenous dissemination of endometrial carcinoma may occur early and with appreciable frequency. Thorough pretreatment investigative workup, preferably including chest laminograms and liver scans and consideration of adjuvant systemic therapy in advanced cases (i.e. those with positive nodes) is recommended. 2) The uterus, a common site of local failure, must be removed whenever feasible. 3) A realistically aggressive approach to the treatment of patients with endometrial cancer is justifiable despite their older age and coexistent medical problems.
Brenner tumors of the ovary.
The clinicopathologic findings in 24 cases of Brenner tumors of the ovary, seen at the University of Michigan Medical Center between 1941 and 1975, are reported. Abnormal uterine bleeding was the most common presenting symptom. Associated endometrial changes ranging from glandular hyperplasia to invasive adenocarcinoma were found in 5 cases. No consistent relationship was found between the thecomatous appearance of the stoma of the tumor and endometrial changes suggestive of estrogen stimulation. Seven patients had other types of ovarian neoplasms. Four patients had bilateral brenner tumors. Three Brenner tumors were histologically and clinically malignant. This study suggests that the presumed potential steroidogenesis of the Brenner tumors of the ovary may not always be a product of the thecalike cells of the stroma. The need for further biosynthetic studies is reemphasized. Furthermore, when conservative therapy of a benign tumor is attempted, the contralateral ovary should be carefully examined and a wedge resection considered. The optimal therapy of malignant Brenner tumors has not been established; adequate surgery and careful staging followed by individualized adjuvant therapy is recommended.
Carcinoma of the fallopian tube.
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Surgical staging of gynecologic cancer.
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Endometrial stromal sarcomas.
This study is a clinicopathologic evaluation of seven patients with endometrial stromal sarcoma of pure homologous type. Histologic distinction from endometrial stromatosis was based on the presence of high mitotic activity and nuclear anaplasia. One sarcoma appeared to have originated from invasive stromatosis. All patients died within 27 months although the tumor was judged to have been confined to the uterus at the time of hysterectomy in five patients. The aggressive clinical behavior and high mortality rate documented in this and other studies indicate that stromal sarcoma should be distinguished from the better differentiated and more indolent endometrial stromal tumor known as stromatosis or endolymphatic stromal myosis. It is suggested that surgery be supplemented by irradiation and/or chemotherapy as primary treatment for stromal sarcoma in view of its dismal prognosis.
Endometrial stromatosis of the uterus.
This study details the clinicopathologic features of 9 patients with endometrial stromatosis of the uterus, including 1 with the circumscribed variant. The potential of stromatosis for local invasion, intravascular penetration, and pulmonary metastasis is documented. Recurrent lesions often develop late, are amenable to surgical therapy, and do not necessarily portend a fatal outcome. Our findings and those of others indicate that the histopathologic appearance and relatively indolent behavior of stromatosis are sufficiently characteristic to justify its separation from the more aggressive homologous endometrial stromal sarcomas.
Acquired hypertrichosis lanuginosa associated with endometrial malignancy.
A 46-year-old nulligravida complained of the recent development of an erythematous skin eruption and fine blond hair over her face. These complaints appeared to be symptoms of acquired hypertrichosis lanuginosa, which may be associated with malignancy. The patient was found to have an endometrial adenocarcinoma with nodal metastases and was treated with hysterectomy and irradiation. Eighteen months later there was no evidence of the cancer, and the lanugo hairs had vanished. This is the first known instance of hypertrichosis lanuginosa associated with a gynecologic cancer and the first ever observed in which the lanugo hairs disappeared after cancer therapy.
Malignant melanoma of the cervix uteri.
Primary malignant melanoma of the uterine cervix in a 70-year-old Negro female is reported. Only 9 other cases have been reported in the literature. The diagnosis, prognosis, and modern trends in therapy for this lesion are discussed.
Pelvic angiography and the diagnosis of carcinoma of the uterine cervix.
The hospital records and pelvic arteriograms of 31 patients with suspected, persistent or recurrent carcinoma of the uterine cervix were reviewed. The method used was found to be highly accurate in diagnosing and localizing tumors and was considered most helpful in suspected pelvic wall recurrences. Tumor encasement of the vessels can be mimicked by perivascular, postoperative and post radiation fibrosis. Tumor vessels and tumor stain are the better angiographic indicators of the presence of recurrent or persistent disease.