Background and Objectives: The relationship between the vaginal microbiota, human papillomavirus infection (HPV), and cervical precancerous lesions is a critical area of research, as it influences both the progression of HPV-related diseases and potential treatment strategies. New evidence suggests that Lactobacillus crispatus dominance in the microbiota may protect against HPV persistence and speed the elimination of HPV. This study aims to explore the relationship between the vaginal microbiota composition and HPV infection, focusing on the impact of these factors on the development of cervical precancerous lesions. Materials and Methods: A comprehensive literature review was conducted using the PubMed database, focusing on studies that analyzed the association between the vaginal microbiota and HPV infection in the context of cervical dysplasia. This study was primarily based on clinical data on HPV integration in women with low-grade squamous intraepithelial lesions (LSILs), high-grade squamous intraepithelial lesions (HSILs), and cervical cancer. Results: Different types of vaginal microbiota communities (CSTs) have different pathogenic or protective potential. Healthy women predominantly exhibited CST I, with Lactobacillus crispatus as the dominant microorganism. CST IV, associated with increased anaerobic bacteria, was most common in HSIL and cervical cancer patients. Statistical analysis revealed that bacterial vaginosis (BV) was significantly associated with HPV persistence, with studies reporting a 1.8–3.4-fold increased risk (p < 0.05) of persistent HR-HPV infection in BV-positive women. Conclusions: Our literature review suggests that the composition of the vaginal microbiota can modulate the local immune response, the expression of viral oncogenes, and the integrity of the epithelial barrier. Furthermore, certain bacterial genes or metabolic pathways can be associated with a favorable or unfavorable outcome of the disease. Analysis of the vaginal microbiota could serve as an additional risk assessment tool, helping to distinguish between regressing and progressive precancerous conditions.

Background: Phyllodes tumors are highly uncommon fibroepithelial neoplasms of the breast, accounting for less than 1% of all breast tumors. Differential diagnosis between phyllodes tumors and fibroadenomas by using imaging techniques such as ultrasound or mammography, as well as histological methods, can be challenging due to overlapping features. Phyllodes tumors are categorized into benign, borderline, and malignant types, each posing a different risk of recurrence and metastasis. Despite many advances in the imaging and biopsy techniques, diagnosing phyllodes tumors remains challenging. The purpose of this study is to review the existing literature on this topic and describe two cases of misdiagnosed phyllodes tumors.Materials and methods. A literature review was conducted by using the Medline (PubMed) database over 10 years. Information concerning the patients was sourced from the Uster Hospital database. After analyzing the cases of women with breast lumps from 2020 to 2023 in the Uster Hospital database, two cases of misdiagnosed phyllodes tumors were identified. These two cases were analyzed retrospectively.Results. A retrospective study of two cases confirms that phyllodes tumors are a rare phenomenon. A 51-year-old premenopausal woman presented with an 8 × 4 × 5 cm mass, initially diagnosed as a fibroadenoma. The final histopathology after surgical excision revealed a borderline phyllodes tumor with features overlapping those of a fibroadenoma. The second case involved a 59-year-old postmenopausal woman with a rapidly growing mass, which reached 11.9 × 11.3 cm and was initially diagnosed as a fibroadenoma but later confirmed as a borderline malignant phyllodes tumor with focal malignant components. Both cases highlight the limitations of imaging and core biopsy in accurately diagnosing phyllodes tumors and emphasize the need for comprehensive histopathological evaluation. The described clinical cases corresponded to the characteristics of phyllodes tumors indicated in the literature: they appeared in women older than 35 years, were hard to distinguish from fibroadenomas, and required surgical treatment.Conclusions. Phyllodes tumors are challenging to distinguish from fibroadenomas based on imaging and the initial biopsy results alone. Accurate diagnosis requires thorough histopathological examination following surgical excision. A multidisciplinary approach is essential for optimal management. Our cases show the complexity of phyllodes tumor diagnosis and the importance of considering phyllodes tumors in the differential diagnosis of breast masses, especially when clinical and imaging findings suggest a more aggressive pathology.

Background: Cysts are called giant when they are >10 cm in diameter. Today the frequency of giant ovarian cysts is decreasing due to good diagnostic methods and regular gynecological examination. These cysts occur more frequently in women of reproductive and postmenopausal age. The most common giant cysts are benign serous cystadenomas. Diagnosing giant cysts can be hindered by nonspecific symptoms, the patient‘s reluctance to see a doctor and fear of surgery. The purpose of this study is to review the existing literature on this topic and describe three cases of giant cysts found at autopsy.Materials and methods: A literature review was conducted in the Medline (PubMed) database over a period of 10 years. The information concerning the examination of deceased individuals after their death was sourced from the database of the Lithuanian State Forensic Medicine Service. After the analysis of the deceased persons in the years 2015–2022 in the State Forensic Medicine Service, out of 1638 deceased persons, three cases of giant cysts were identified. These three cases were analyzed retrospectively. During these investigations, the circumstances of finding the scene, the results of the autopsy, and the data of additional toxicological and microscopic tests were evaluated.Results: A retrospective study of 3 cases confirms the fact that giant ovarian cysts are a rare phenomenon. In case 1, the corpse of a 75-year-old woman was examined, a 30x30x25 cm left ovarian cyst was found, the woman had chronic ischemic heart disease; case 2 was a 65-year-old woman with a 19x25x12 cm right ovarian cyst and deep vein thrombosis with pulmonary embolism; case 3 was a 62-year-old woman with a 40x30x30 cm right ovarian cyst and chronic ischemic heart disease. In all cases, giant ovarian cysts were incidental findings and not the primary cause of death. The described clinical cases corresponded to the characteristics of giant cysts indicated in the literature: appeared in the postmenopausal period, benign course, diagnosed in patients who did not seek medical attention.Conclusions: Thanks to good early diagnosis, ovarian cysts are diagnosed early, before they reach gigantic size, so giant cysts are extremely rare. Delayed diagnosis is related to reluctance of patients to consult doctors and confusion with ascites and obesity. They are usually benign, and the symptoms they cause are related to mass effect – pressure on nearby organs.

Aim: To select and analyse the scientific literature on the impact of contraception on women with depression, bipolar disorder, schizophrenia, and premenstrual dysphoric disorder. Material and Methods: A detailed literature analysis was performed using PubMed, WebMD, ScienceDirect, and Google Scholar databases. The articles and books included were written in English and published between 2011 and 2024. Results: Hormonal contraceptive use is linked to mental health concerns, particularly depression, with adolescents being the most vulnerable. Studies show that hormonal contraception, such as oral contraceptives and levonorgestrel-releasing intrauterine systems, may be associated with an increased risk of depressive symptoms. However, the evidence remains mixed, with some studies reporting no significant link. Women with bipolar disorder and schizophrenia face higher rates of unplanned pregnancies due to cognitive and behavioural challenges. Therefore long-acting reversible contraceptives are recommended as the most suitable option. Additionally, hormonal contraceptives can interact with medications used for psychiatric disorders, potentially reducing contraceptive efficacy, or affecting the metabolism of psychotropic drugs. For women with premenstrual dysphoric disorder, combined oral contraceptives are effective in alleviating symptoms. Personalized contraceptive counselling is important to meet the specific needs of women with mental health conditions and ensure effective contraception use. Conclusions: The impact of hormonal contraception on mental health varies across conditions, making personalized contraceptive counselling essential. Further research is needed to fully understand these complex interactions and develop evidence-based guidelines.