Background/Objectives: Abdominal wall and extrapelvic endometriosis are uncommon entities that may mimic other surgical conditions and delay diagnosis. This study evaluated their clinicopathological, diagnostic, and surgical features in a single-center case series. Methods: This retrospective study included 29 patients with histopathologically confirmed abdominal wall or extrapelvic endometriosis treated at a tertiary referral center between 2009 and 2025. Demographic and clinical characteristics, surgical history, CA-125 levels, imaging findings, lesion size, and surgical features were analyzed. Abdominal wall cases were further evaluated based on the presence of muscle or fascial invasion. Results: Abdominal wall lesions comprised 93.1% of cases, while extrapelvic lesions (6.9%) were all vaginal. Most cases had a history of cesarean section; however, one patient had no prior abdominal surgery, consistent with spontaneous disease, with concomitant endometrioma and deep infiltrating endometriosis. Muscle or fascial invasion was observed in 63.0% of cases. Both CA-125 levels (p = 0.005) and CA-125 positivity (≥35 U/mL) (p = 0.029) were significantly higher in patients with invasion. Cyclic symptoms were present in 89.7% of patients, and mesh repair was required in two cases with large lesions. Conclusions: Abdominal wall endometriosis should be suspected in patients with cyclic pain or swelling at surgical sites, particularly after cesarean delivery, although it may occur without prior surgery. Deep muscle and fascial invasion may be associated with elevated CA-125 levels and increased CA-125 positivity, sometimes requiring wider excision and mesh repair. These findings may support earlier diagnosis and surgical planning.
Background/Objectives: Angiogenesis plays a central role in the progression of cervical intraepithelial neoplasia (CIN) to cervical cancer (CC). Transvaginal Doppler ultrasonography (TVDUSG) offers a non-invasive means of assessing hemodynamic changes associated with neoplastic transformation. This study aimed to evaluate the diagnostic performance of uterine artery (UA) Doppler parameters across the full cervical disease spectrum and their associations with adverse prognostic features and clinicopathological features in CC. Methods: This prospective observational cohort study enrolled 170 patients who were divided into four groups: controls, CIN 1, CIN 2–3, and CC. All underwent TVDUSG prior to treatment. Pulsatility index (PI), resistance index (RI), peak systolic velocity (PS), end-diastolic velocity (ED), PS/ED ratio, ED/PS ratio, and time-averaged maximum velocity were recorded. ROC curve analysis was performed to assess diagnostic performance. Results: PI and RI increased progressively from controls to CC, while ED declined across groups (all p < 0.001). In patients with CC, PI correlated with tumor volume and was elevated in those with advanced-stage, parametrial and lymph node involvement (all p < 0.001). ROC analysis revealed strong diagnostic performance for PI in distinguishing CC from controls (AUC = 0.861, sensitivity 80.0%, specificity 80.4%); however, PI showed limited ability to distinguish cervical cancer specifically from high-grade CIN (AUC = 0.593). Conclusions: UA Doppler parameters, particularly PI, are associated with cervical neoplastic severity and adverse prognostic features in CC. TVDUSG may serve as a practical, non-invasive adjunct in the preoperative evaluation of cervical neoplasia, especially where advanced imaging is unavailable.
8 June 2026 in Anti-Cancer Agents in Medicinal Chemistry
Introduction: The study aims to evaluate programmed cell death ligand-1 (PD-L1) expression in complex atypical hyperplasia and early-stage endometrial cancer and to assess its association with tumor grade. Materials and Methods: This retrospective study was conducted at a single tertiary university hospital and included hysterectomy specimens obtained between 2010 and 2020. A total of 80 cases were analyzed: 20 with complex atypical hyperplasia and 60 with Stage IA endometrioid endometrial cancer, comprising 20 Grade 1, 20 Grade 2, and 20 Grade 3 tumors. All specimens underwent immunohistochemical staining with the PD-L1 (22C3) antibody, and PD-L1 expression was assessed using the combined positive score. Results: PD-L1 expression was absent in complex atypical hyperplasia but present in 4 of 20 Grade 1 cases (20%), 6 of 20 Grade 2 cases (30%), and 16 of 20 Grade 3 cases (80%). PD-L1 positivity increased significantly with higher tumor grade (p < 0.001). No significant associations were identified between PD-L1 expression and patient age, tumor diameter, depth of myometrial invasion, endometrial confinement, or lymphovascular invasion. Discussion: PD-L1 expression appears to be detectable in early-stage endometrioid endometrial cancer and may increase with tumor grade, suggesting early immune checkpoint activity. Conclusion: PD-L1 expression may be associated with tumor grade in early-stage endometrioid endometrial cancer. However, its clinical significance remains unclear. These findings may be relevant in the context of fertility- preserving management and require further investigation.
11 August 2025 in Journal of Ultrasound in Medicine