Background: Port site metastasis (PSM) has been reported as a rare metastasis in women with endometrial carcinoma (EC). However, even more rarely, it has also been described in patients with low- or intermediate-risk EC. Unfortunately, knowledge appears limited on the topic. Objectives: Our objective was to systematically review the literature on PSM in low- or intermediate-risk EC. Search Strategy: A systematic review of the literature was performed by searching six electronic databases from their inception to January 2023. Selection Criteria: We included in our research all peer-reviewed studies which reported PSM in low- or intermediate-risk EC women. Data Collection and Analysis: Data on PSM were collected from the included studies and compared. Results: Seven studies with 13 patients (including our case) were included in the systematic review. PSM was reported in patients with low- or intermediate-risk EC independently from tumor histologic characteristics, endoscopic approach, lymph node staging type, number and site of the port, route of specimen removal, prevention strategies for PSM, and concomitant metastases. Among several proposed treatments, local resection and radiotherapy with or without chemotherapy might be the most appropriate ones. Nevertheless, the prognosis appears poor. Conclusions: In patients with low- or intermediate-risk EC, PSM can occur as a rare metastasis, regardless of tumor characteristics or surgical strategy. Unfortunately, no consensus has been reached regarding treatment, and the prognosis appears poor. Additional cases are needed in order to confirm and further explore this rare EC metastasis.

Background: Intestinal-type vulvar adenocarcinoma (VAIt) is an exceptionally rare form of primary vulvar cancer, characterized by histological features resembling mucinous colonic carcinomas, including villo-glandular structures composed of goblet and Paneth cells with intracytoplasmic mucin. Objective: To provide a comprehensive synthesis of the existing literature on VAIt and to also report a case from our institution in order to define its clinical, pathological, and immunohistochemical characteristics and its management and prognosis. Materials and Methods: A systematic review of the literature according to PRISMA guidelines was performed through searching five electronic databases (MEDLINE, EMBASE, Web of Science, SCOPUS and Cochrane Library), considering studies from 1998 to May 2025. In our research, we included all peer-reviewed studies which reported cases of VAIt. Data about VAIt were extracted by included studies and compared. Results: All in all, 32 studies with a total of 40 cases (including our case) of VAIt were assessed. The median age at diagnosis was 58 years. Most tumors arose in the labia or perineal structures, often mimicking benign lesions. Immunohistochemistry consistently showed CK20 and CDX2 positivity, with variable CK7 and p16 expression. FIGO stage IA was the most frequent stage at diagnosis. Surgical excision was the mainstay of treatment, while adjuvant therapy was less commonly reported. Lymph node metastases were present in about 31.5% of cases. Despite aggressive histology, most patients were disease-free at follow-up. Mortality due to disease occurred in 10% of cases. Conclusions: VAIt is a very rare histotype of vulvar cancer. Compared to vulvar squamous cell carcinomas, approximately 40% of early-stage clinical diseases reported in the literature presented positive inguinal lymph nodes with recurrence even after many years. The optimal treatment is not well defined and should be based on the individual clinical history of the patient, as there are no established guidelines. Further studies and longer follow-up periods are needed to clarify the best therapeutic management and its long-term prognosis.

Introduction: Medical treatment with misoprostol represents one of the main treatments for Early Pregnancy Loss (EPL). In our study, we aimed to identify clinical features associated with a successful response to this approach. Methods: A prospective single-center observational study was conducted at the EPL Clinic of the Department of Obstetrics and Gynecology, Fondazione A. Gemelli IRCCS Rome, Italy. Patients were categorized according to the type of treatment received: spontaneous delivery, elective dilatation and curettage, or medical treatment. A separate analysis was performed within the medical treatment group to distinguish women with a successful response from those with an unsuccessful one. The success of medical treatment was calculated as the response rate (number of patients who successfully responded to treatment/total number of treated patients) with a 95% Confidence Interval (CI). For patients undergoing misoprostol treatment, a multivariable analysis was planned to identify predictors of a successful response, including variables with a p value less than 0.05 in the univariable analysis. Receiver Operating Characteristic (ROC) analysis was performed to evaluate the predictive ability of continuous obstetrics parameters for medical treatment success. The optimal cut-off value to differentiate responsive from unresponsive patients was also determined. The significance level was set at p < 0.05. Results: Sixty-four patients who underwent medical treatment were analyzed. Amenorrhea age was the only parameter inversely associated with treatment success, indicating that an earlier amenorrhea age correlated with a better response to misoprostol. ROC analysis identified a cut-off of 62.5 days, with an AUC (95% CI) of 0.72 (0.55–0.89). An amenorrhea age of ≤ 62.5 days predicted a successful response to medical treatment with a specificity (95% CI) of 90.0% (89.8–90.2) and sensitivity (95% CI) of 54.9% (41.2–68.6). Conclusions: Amenorrhea age emerged as a potential predictor of treatment response in women with EPL undergoing misoprostol therapy. However, further studies of larger sample sizes are needed to validate and improve our model.