Background: Accurate and timely diagnosis of endometrial cancer is crucial for guiding effective treatment and improving patient survival. Endometrial cancer diagnosis, staging, metastasis detection, and treatment planning utilize endometrial biopsy, magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET/CT) scanning as crucial diagnostic modalities. Aggressive subtypes such as serous, mixed cell, clear cell, and grade 3 endometrioid carcinomas present considerable diagnostic and therapeutic obstacles given their unfavorable prognosis, underscoring the importance of accurate preoperative evaluation. Methods: A retrospective analysis was conducted using data from seventy patients diagnosed with serous, mixed cell, clear cell, or grade 3 endometrioid endometrial cancer, who received surgical treatment from 2020 to 2023. To assess the diagnostic capabilities of each modality in determining final pathology and disease staging, a comparison was performed using results from preoperative endometrial biopsy, MRI, PET/CT, and postoperative histopathology. Cohen’s kappa coefficient was employed to determine the level of agreement observed between pre- and postoperative results. Results: Endometrial biopsy demonstrated moderate yet statistically significant concordance with definitive histopathological diagnoses (κ = 0.537, p < 0.001); however, diagnostic errors were observed, especially in instances of mixed and clear cell carcinomas. MRI demonstrated efficacy in identifying local tumor invasion, yet its capacity to detect distant metastases was demonstrably limited. PET/CT was most effective in identifying distant metastases and omental involvement in advanced-stage disease. Conclusions: Definitive pathological diagnosis and staging of endometrial carcinoma are effectively established using endometrial biopsy and MRI. The utility of PET/CT is particularly pronounced in identifying distant metastases in patients with serous carcinoma and advanced-stage disease. Integrating biopsy, MRI, and PET/CT into a multimodal diagnostic strategy enhances diagnostic accuracy and enables personalized treatment planning, particularly for aggressive tumor subtypes.

Background: Adnexal masses are common in women across different age and hormonal states: pregnancy, premenopause, and postmenopause. Ovarian carcinoma, a malignancy arising in the adnexa, poses significant health risks. While malignancy risk increases with age and postmenopausal status, current methods for stratifying borderline cases remain inadequate, potentially leading to over- or undertreatment that may affect fertility or survival. Methods: This retrospective study was conducted with 318 adult women who were diagnosed with adnexal masses and underwent surgery at a university hospital between 2020 and November 2023. Patient data were retrieved from the hospital’s electronic medical record system. Routinely measured preoperative serologic parameters—carbohydrate antigen (CA)125, CA19-9, CA15-3, carcinoembryonic antigen (CEA), Alpha-fetoprotein (AFP), Lactate dehydrogenase (LDH), and fibrinogen-to-albumin ratio (FAR) levels—were analyzed alongside final histopathological results. No procedures outside routine clinical practice were performed. Diagnostic performance of each marker was evaluated using receiver operating curve (ROC) analysis. Results: A total of 318 patients with adnexal masses were analyzed. The FAR levels were significantly elevated in malignant compared to borderline and benign groups (p < 0.001), and FAR alone showed 47% sensitivity and 91% specificity for borderline tumors, whereas CA125 showed 70% sensitivity and 85% specificity. Multivariate models combining FAR, CA125, and CA15-3 achieved the highest diagnostic accuracy, with superior AUCs compared to single biomarkers. Conclusions: FAR is a simple, accessible inflammatory marker that complements CA125 by enhancing specificity. Combination of multiple markers with the highest sensitivity and specificity, together with FAR, may reduce the risk of both false negatives, offering a more balanced and accurate diagnostic tool for preoperative stratification of borderline tumor cases.

Background and Objectives: Culture-based cervicovaginal assessment in late pregnancy may reveal bacterial and fungal findings beyond routine Group B Streptococcus (GBS) detection; however, third-trimester non-GBS findings remain insufficiently characterized. This study aimed to describe the distribution of culture-based cervicovaginal findings and to explore the associations between culture-confirmed Candida colonization and maternal, obstetric, and microscopic parameters. Materials and Methods: This prospective observational study included 300 third-trimester pregnant women at ≥28 gestational weeks who were receiving routine antenatal care at a tertiary center. Cervicovaginal samples were obtained using sterile swabs and analyzed with conventional culture-based methods. Findings were categorized according to the identified microorganisms, and GBS positivity was recorded. For Candida-focused analyses, only samples reported as fecal contamination were excluded; women with GBS-positive cervicovaginal cultures were retained in the evaluable cohort. Associations were evaluated using the Mann–Whitney U test and Fisher’s exact test. Results: The mean maternal age was 26.48 ± 5.67 years. Normal vaginal flora was observed in 252 women (84.0%). Candida colonization was the most frequent non-GBS finding, identified in 35 women (11.7%), whereas GBS was detected in seven women (2.3%). Other non-GBS bacterial isolates and fecal contamination were reported in four women (1.3%) and two samples (0.7%), respectively. Clue cells, direct microscopic yeast positivity, and Trichomonas vaginalis were identified in 20 women (6.7%), 12 women (4.0%), and 6 women (2.0%), respectively. After excluding samples reported as fecal contamination, 298 evaluable cervicovaginal cultures were included in the Candida-focused analysis. Direct microscopic yeast detection was more frequent among women with culture-confirmed Candida colonization than among those without colonization (14.3% vs. 2.3%, p = 0.005), whereas Candida colonization was not associated with maternal age, gravidity, parity, gestational age, clue cell positivity, Trichomonas vaginalis positivity, or GBS-positive cervicovaginal culture. Conclusions: In third-trimester pregnancy, culture-based cervicovaginal assessment showed that Candida colonization was the most prominent non-GBS finding. The higher detection rate of culture-confirmed Candida colonization compared with direct microscopic yeast positivity suggests that microscopy alone may underestimate fungal colonization. These findings suggest that reporting non-GBS culture-based cervicovaginal findings may provide additional descriptive microbiological information beyond routine GBS detection in late pregnancy; however, they should not be interpreted as evidence of clinical outcome associations.

Aims: This study evaluated the clinical, laboratory, ultrasonographic, histopathological, treatment, and follow-up characteristics of patients with molar pregnancy and assessed the clinical relevance of baseline factors associated with the development of postmolar gestational trophoblastic neoplasia (GTN) in a contemporary single-center cohort.Methods: This retrospective cohort included 259 patients with hydatidiform mole. Demographic, clinical, laboratory, ultrasonographic, histopathological, treatment, and follow-up data were reviewed. Patients with unknown GTN status were excluded from comparative analyses. Group comparisons used the Mann-Whitney U, Chi-square, or Fisher’s exact test. Multivariable logistic regression was used to evaluate factors independently associated with postmolar GTN development. Firth-penalized logistic regression and a sensitivity analysis restricted to patients with adequate follow-up were additionally performed to assess the robustness of the findings.Results: Among 259 patients, partial hydatidiform mole was diagnosed in 163 patients (62.9%), complete hydatidiform mole in 80 (30.9%), and hydatidiform mole of unspecified subtype in 16 (6.2%). Postmolar GTN developed in 39 patients (15.1%), while GTN status was unknown in 12 (4.6%). Chemotherapy was administered to 33 patients (12.7%); all received a methotrexate folinic acid regimen. Overall, normalization of beta-human chorionic gonadotropin (β-hCG) was achieved in 247 patients (95.4%). In multivariable analysis, initial β-hCG level per 100.000 mIU/ml increase (adjusted OR, 1.34; 95% CI, 1.15-1.56; p

Objectives: To evaluate appendectomy specimen findings and their association with tumor type and stage. Concurrent appendectomy is frequently performed during gynecologic oncology surgery to prevent postoperative appendicitis and detect occult pathology, yet its value remains debated. Methods: In this study, we reviewed the medical records of 300 women who underwent gynecologic oncologic surgery accompanied by appendectomy at Başakşehir Çam and Sakura City Hospital (Istanbul, Türkiye) over the period from July 2020 to April 2025. Clinical, surgical, andhistopathologic data were collected. Appendiceal pathologies were categorized as reactive hyperplasia, chronic inflammation, benign neoplasms, metastatic tumors, or primary. Statistical analyses included chi-square, t-test, and ANOVA. Results: Participants had an average age of 55.6 ± 13.4 years, and 61.7% of them were postmenopausal. Among ovarian tumors, malignant epithelial lesions represented 54.7% of cases, while borderline tumors accounted for 17.7% and benign tumors for 17%. Histopathology revealed chronic inflammation in 40.7%, reactive changes in 34.3%, metastatic disease in 23.3%, benign neoplasms in 1.3%, and primary malignancy in 0.3%. Metastases occurred only in malignant ovarian tumors (35.7%), predominantly high-grade serous carcinomas (p < 0.001). Borderline and benign tumors were mainly associated with reactive findings, and no metastatic involvement was detected. Conclusion: Concurrent appendectomy during gynecologic oncology surgery is safe and frequently reveals clinically relevant pathology. Appendectomy should be encouraged during cytoreduction, while its role in benign and early-stage cases warrants further investigation.