Obesity is a significant health issue associated with increased cancer risks, including gynecological malignancies. The worldwide rise in obesity rates is significantly impacting both cancer development and treatment outcomes. Adipose tissue plays a crucial role in metabolism, secreting various substances that can influence cancer formation. In obese individuals, dysfunctional adipose tissue can contribute to cancer development through inflammation, insulin resistance, hormonal changes, and abnormal cholesterol metabolism. Studies have shown a strong correlation between obesity and gynecological cancers, particularly endometrial and breast cancers. Obesity not only increases the risk of developing these cancers but is also associated with poorer outcomes. Additionally, obesity affects the perioperative management of gynecological cancers, requiring specialized care due to increased complications and resistance to therapy. Treatment strategies for managing metabolic dysregulation in patients with gynecological cancers include weight management, statin therapy, and insulin-sensitizing medications. Emerging studies suggest that interventions like intermittent fasting and caloric restriction may enhance the effectiveness of cancer treatments. Furthermore, targeting cholesterol metabolism, such as with statins or proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, shows potential in cancer therapy. In conclusion, addressing metabolic issues, particularly obesity, is crucial in preventing and treating gynecological malignancies. Personalized approaches focusing on weight management and metabolic reprogramming may improve outcomes in these patients.

This review examines hormone replacement therapy (HRT) in cases of surgical menopause following gynecological malignancies. It aims to capture current knowledge, summarize recent findings, and provide recommendations for clinical settings. Unlike natural menopause, surgical menopause occurs abruptly, without an adjustment period, and is associated with a notably higher risk of fractures, arthritis, cognitive decline, dementia, Parkinson’s disease, and various metabolic disorders affecting glucose and lipid levels—all of which contribute to an increased risk of major cardiovascular events. In 2017, The North American Menopause Society recommended that, barring contraindications, HRT should be initiated in women who enter surgical menopause before age 45. If these women do not experience vasomotor symptoms or other issues, HRT should be maintained consistently at least until age 52. This guideline reflects contemporary knowledge and is the result of a multidisciplinary consensus, based on a review of existing literature and several randomized clinical trials focusing on women who have survived gynecological cancers and whose quality of life is significantly impacted by surgical or early menopause. Estrogen supplementation is particularly beneficial, as it is linked to marked improvements in quality of life, including delayed onset of chronic cardiovascular issues, reduced fracture risk, enhanced cognitive function, reduced inflammation, and improved self-esteem, as well as better social and work performance. Clinical implementation of HRT, however, requires a highly individualized approach. This approach must consider the type and stage of malignancy, histopathological characteristics, risk factors for recurrence (such as diet, concurrent medications, medical history, and genetic predispositions), and a thorough assessment of the potential benefits and risks of HRT, as well as the patient’s personal wishes and expectations.

Background/Objectives: Detection of adrenal tumors is increasing, mainly due to the widespread use and improved availability of radiological imaging. Their occurrence increases with age, and recent studies have reported a substantial increase in detection rates over the past few decades. This study aimed to describe the clinical spectrum and management of adrenal tumors in a real-world tertiary referral setting. Methods: This retrospective observational study was conducted to characterize the clinical presentation, diagnostic evaluation, management, and pathological spectrum of adrenal tumors treated at the University Clinical Center of Vojvodina between January 2020 and December 2025. This study included 862 patients with adrenal tumors from the outpatient clinic, day hospital, and hospital ward of the Clinic for Endocrinology, Diabetes, and Metabolic Disorders, University Clinical Center of Vojvodina, from January 2020 to December 2025. Results: Mean age was 60.73 ± 11.51 (range 19–90) years. Peak prevalence was observed in the seventh decade of life. Accordingly, 86.5% of tumors were smaller than 4 cm, 50.3% of tumors were detected in the left adrenal gland, and 14.4% were bilateral. Non-functioning tumors accounted for 85.3% of cases, while tumors showing biochemical cortisol autonomy, aldosterone-secreting tumors, and catecholamine-secreting tumors accounted for 5.7%, 4.4%, and 4.6%, respectively. CT-based assessment of tumors showed that 88.6% were adenomas, while 3.2% were cases of pheochromocytoma, 2.6% metastasis, 2.1% carcinoma, and, in smaller percentages, cysts, myelolipoma, macro- and micronodular hyperplasia, and other types. Tumor histopathology (n = 121) showed adenoma, pheochromocytoma, and metastasis as the most common (45.5%, 24%, and 10.7%, respectively). Patients with malignant lesions were significantly older than those with benign lesions (p < 0.01) and pheochromocytoma (p < 0.01). In the subgroup with histopathological diagnosis (n = 121), histopathology was significantly associated with tumor size (χ²(4) = 19.80, p < 0.001), which may reflect selection for surgery or biopsy. The mean age of patients with benign tumors, pheochromocytoma, and malignant tumors was 52.34 ± 13.86, 51.07 ± 12.35, and 63.73 ± 12.38, respectively. In the tissue-diagnosed subgroup, right-sided localization was more frequent among malignant tumors (p = 0.035), although the small number of cases warrants cautious interpretation. Conclusions: In our cohort, most adrenal tumors were benign and non-functioning, while hormonally active and malignant lesions represented a smaller but clinically important proportion requiring specialized evaluation and management. These findings provide real-world insights into adrenal tumor care in a tertiary referral setting and support the need for standardized data collection and prospective multicenter studies.

Introduction: Surgical treatment is the method of choice for treating primary hyperparathyroidism. Determining parathyroid hormone (PTH) levels intraoperatively allows for real-time monitoring of the functional activity of parathyroid gland tissue and facilitates minimally invasive parathyroidectomy. Aim: Our study aimed to investigate the significance of intraoperative parathyroid hormone level determination in achieving physiological parathyroid hormone levels and cure. Material and Methods: A retrospective academic study analyzed 70 patients from the Clinic for Endocrinology, Diabetes, and Metabolic Disorders at the University Clinical Center of Vojvodina who underwent parathyroidectomy. Participants were divided into control and study groups based on whether intraoperative parathyroid hormone levels were determined. Demographic and laboratory-clinical data from medical records were statistically analyzed. Results: In the study group, the median of parathyroid hormone level was 104.30 pg/mL, while in the control group, it was 128.09 pg/mL; no statistically significant difference was observed (p=0.380). There was no statistically significant difference between groups regarding the number of reoperations indicated and the diagnosis of persistent hyperparathyroidism (p=0.355). A statistically significant difference in treatment outcomes was found among participants who met the Miami and Dual protocol criteria. Conclusion: Determining parathyroid hormone levels during surgical treatment while meeting the criteria of current protocols can contribute to a higher cure rate. A more extensive prospective study is required for a more in-depth analysis of our healthcare center's experience.