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Re: hysteroscopy:diagnostic vs therapeuticFrom: Bernard Cristalli (bclaure@club-internet.fr)Mon Jan 27 01:21:07 1997
Dr Paul-André Latulippe wrote: > > I want to submit two cases: > > 1)A woman who is 43 years old,5feet 1 inch and 300 lbs. > G2P2,two c-sections and a cholecystectomy.Her plaint is > menometrorragia 3 weeks each month since one year. > I did not have diagnosis hysteroscope. I made an hysteroscopy in the > operating room with a general anesthesia. I took directed biopsies > and at the end of the procedure, I made an endometrial ablation with > the roller ball (about ten minutes) > Patho:adenocarcinomatous transformation of the endometria > She had total abdominal hysterectomy and SOB. > Definitive patho:Adenocarcinoma of the endometria stade 1a G1. > > 2)A woman who is 57 years old.She had HTR with premarine and provera > cyclic and blood loss during 7 days at the end of the month. A pap > test had show abnormal cells probably from the uterine cavity. > I made an hysteroscopy in the operating room with a general > anesthesia. I took directed biopsies and at the end of the procedure, > an endometrial ablation with a roller ball. > Patho:Simple hyperplasia,complex hyperplasia and rare sites suspect > of carcinomatous transformation. > She had total abdominal hysterectomy and SOB. > Definitive patho: Absence of residual carcinoma tissue > Nothing more to say. You are right in what you did, & justified it. In older woman I would have done an hysterectomy afetr a simple D&c (or diagnostic hysteroscopy) but for these "young" women you did well. Cancer is a severe disease.
-- Bernard Cristalli MD CNGOF Paris - France
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