Objective: Accurate preoperative differentiation between benign endometrial conditions and malignancies is essential for guiding therapeutic interventions. However, high-quality evidence regarding the diagnostic accuracy of endometrial sampling techniques remains insufficient. This study aimed to evaluate the diagnostic efficiency of hysteroscopically directed biopsy, Pipelle suction curettage, and dilatation and curettage (D&C) for detecting endometrial hyperplasia or carcinoma in premenopausal women and to identify associated risk factors. Methods: A retrospective single-center cohort analysis was conducted on 2054 premenopausal women. Demographic, clinical, and obstetric data, along with biopsy techniques and histopathological findings, were recorded. Diagnostic accuracy of biopsy methods was compared against definitive surgical pathology. Results: The prevalence of endometrial hyperplasia and carcinoma was 5.6% and 1.0%, respectively. Hysteroscopically directed biopsy demonstrated superior diagnostic accuracy (AUC 0.957) compared to D&C (AUC 0.909) and Pipelle suction curettage (AUC 0.858). Sensitivity was highest for hysteroscopically directed biopsy (91.3%), followed by D&C (82.0%) and Pipelle suction curettage (71.7%), while specificity remained excellent across all methods (p < 0.001). Elevated BMI increased the risk of hyperplasia or carcinoma by 1.05 times per unit increase (OR = 1.054, p = 0.005), while hypertension nearly doubled the risk (OR = 1.99, p = 0.009). Multiparity showed protective effects, reducing risk with each additional delivery (OR = 0.877, p = 0.029). Conclusions: Hysteroscopically directed biopsy provides superior diagnostic accuracy for detecting endometrial hyperplasia and carcinoma in premenopausal women. Hypertension and elevated BMI increase risk, while multiparity offers protective benefits.

Endometrial carcinoma is the most common genital malignancy in women. Endometrioid type is the most common variant of endometrial carcinoma described in literature. Giant cell carcinoma is a rare, and infrequently reported variant of endometrial carcinoma. We present a 75-year-old patient admitted with vaginal bleeding. Transvaginal ultrasound revealed a 26x28 mm hypodense lesion without any adnexal pathology. The patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, and bilateral pelvic, and paraaortic lymph node dissection. The final histopathology report indicated a 3.8x2x9 cm giant cell carcinoma variant of endometrial carcinoma and one positive external iliac lymph node metastasis. Administration of adjuvant carboplatin and paclitaxel chemotherapy was given. As far as we know, this is the fifteenth case reported in the English literature.

Objective: The aim of the present study is to evaluate the long-term outcomes in patients with early stage ovarian cancer undergoing fertility-sparing surgery. Methods: The present study performed a retrospective analysis of recurrence, pregnancy and survival of a total of 66 patients who were diagnosed with early stage ovarian cancer (stage I) in XXX Faculty of Medicine Hospital between 2004 and 2019. Of these patients, 16 had undergone fertility-sparing surgery, and the remaining 50 patients had undergone radical surgery. Results: Of 66 eligible patients, 16 had undergone fertility-sparing surgery, and the remaining 50 patients had undergone radical complete surgery. When demographic and descriptive data are taken into consideration, the mean age was 32.6 ± 6.76 years in patients undergoing fertility-sparing surgery and 54.05 ± 10.8 years in patients undergoing complete surgery, and the difference between the groups was statistically significant (p = 0.001). Of patients undergoing fertility-sparing surgery, 11 (16.7%) had stage Ia disease (most common), 5 (7.5%) had stage Ic disease, whereas no patient with stage Ib disease was detected. Of patients undergoing complete radical surgery, 32 (48.5%) had stage Ia disease (most common), 1 (1.5%) had stage Ib disease with bilateral ovarian involvement, and stage Ic was the second most common disease stage. Also, stage Ic3 was the most common disease stage (8 patients, 12.1%) among those with stage Ic disease. The rate of recurrence was 4.5% (3 patients) in patients undergoing fertility-sparing surgery, and recurrences occurred at 37 months, 69 months, and 76 months, respectively. A patient with stage Ic3 disease and endometrioid type tumor who developed recurrence at 37 months died at 130 months. Of patients undergoing complete surgery, ten patients (15.2%) developed recurrence, and there was no significant difference between the two groups in terms of recurrence (p = 1.00). At the end of 15-year follow-up period, there was no significant difference between patients undergoing fertility-preserving surgery and those undergoing complete surgery in terms of mortality (p = 0.668). Conclusion: The observation of significant findings in terms of the rate of recurrence and disease-free survival following fertility-sparing surgery in patients with low-risk early stage ovarian cancer suggests that survival is positively affected in early stage ovarian cancer.

Objectives: Considerable debate exists among guidelines regarding when cervical cancer screening can be safely stopped. The authors aimed to compare the efficiency of human papillomavirus (HPV) test, cytology, and previous screening history for the diagnosis of cervical intraepithelial neoplasia (CIN) 2+ lesions in women aged older than 65 years. Materials and Methods: This is a retrospective cohort study. Multiple logistic regressions were used to compare the efficiency of the HPV test, cytology, and previous screening history for the diagnosis of histologically proven CIN 2+ lesions. Results: A total of 5,427 women were included in the study. A total of 2,143 women were tested with HPV and 52 (2.4%) of them were HPV-positive. Abnormal cytology was detected in 359 (6.6%) women. Most of the women (70.4%) had inadequate screening in the previous 10 years. According to regression analysis, an HPV-positive test increases the risk of probability of CIN 2+ 136.111 times [95% CI for odds ratio (OR) = 41.212–449.538] compared with an HPV-negative test (p < .001). Abnormal cytology increases the probability of CIN 2+ 13.072 times (95% CI for OR = 3.878–44.062) compared with normal cytology (p < .001). Inadequate or positive previous screening increases the likelihood of CIN 2+ 9.705 times (95% CI for OR = 1.603–58.756) compared with adequate and negative previous screening (p = .013). Conclusions: Adequate previous screening is a valuable strategy, and abnormal cytology is an important screening test in women aged older than 65 years. However, the HPV test is the most determinant parameter for CIN 2+ risk in elderly women.

BACKGROUND Endometrial polyps are a common gynecological condition that often cause significant clinical symptoms. Hysteroscopic resection is considered the gold standard treatment; however, recurrence remains a notable risk even after surgery. The recurrence of endometrial polyps after surgery raises concerns for women, due to persistent symptoms and potential malignancy risk. Therefore, this study aims to identify factors influencing recurrence in reproductive-aged women undergoing hysteroscopic polyp resection. MATERIAL AND METHODS We conducted a retrospective analysis of 1021 reproductive-aged women who underwent hysteroscopic polypectomy for abnormal uterine bleeding between 2010 and 2024. Diagnoses were confirmed by histopathological examination. Multivariable logistic regression modeling was used to determine predictors of recurrence. RESULTS Endometrial polyp recurrence occurred in 8% of patients, with a median recurrence time of 42.5 months. Levonorgestrel-releasing intrauterine system (LNG-IUS) treatment significantly reduced recurrence (odds ratio [OR]=0.043, 95% CI=0.019-0.097, P<0.001). Risk factors for recurrence included adenomyosis (OR=10.297, 95% CI=5.251-20.188, P<0.001), polycystic ovarian syndrome (OR=8.990, 95% CI=2.855-28.312, P<0.001), body mass index ≥30 kg/m² (OR=8.698, 95% CI=4.521-16.736, P<0.001), tamoxifen use (OR=6.088, 95% CI: 1.936-19.140, P=0.002), and leiomyoma uteri (OR=4.012, 95% CI: 2.143-7.509, P<0.001). CONCLUSIONS Clinicians should inform patients at high risk, including those with adenomyosis, myoma uteri, polycystic ovarian syndrome, or tamoxifen use, about the increased risk of recurrence and should conduct regular follow-ups. LNG-IUS treatment can be considered for the prevention of recurrence and enhancement of management strategies.