Proceedings in Obstetrics and Gynecology
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Diagnosis of endometrial cancer complicated by morbid obesity—a case report
Get PDFA 47 year old morbidly obesity nulligravid female presented to a local hospital with chest pain and shortness of breath, CT of the chest confirmed pulmonary embolism, and endometrial biopsy performed showed grade 1 endometrioid adenocarcinoma with squamous differentiation. CT scan performed demonstrated pelvic, retroperitoneal, inguinal and right axillary lymphadenopathy, and hepatomegaly with grossly unremarkable uterus and ovaries. Due to the burden of disease, axillary and inguinal lymph node biopsy was attempted, however due to depth of nodes, the tissue was not reached and biopsy efforts were abandoned. It required a great deal of discussion with the radiology department to decide which lesion would be least morbid to biopsy. After failed attempts at several methods, the gastroenterologist consulted felt the retroperitoneal lymphadenopathy adjacent to the duodenum was a possibility. The sample was sparse, but confirmed a metastatic adenocarcinoma and ruled out an inflammatory or granulomatous process. Ultimately, this unfortunate woman’s obesity caused her to have a worse outcome, not only due to medical comorbidities, but also with regards to delayed diagnosis and treatment and progression of disease. As the obesity epidemic worsens, this is likely to occur more commonly. It is important to realize the limitations of our consults as all aspects and fields of medicine are limited by morbid obesity
Long-term Outcomes Among Women With Cervical Cancer Treated from 1960-1987
Get PDFTo determine long term survival among women treated for cervical cancer and to provide long-term information regarding mortality and morbidity following treatment. Among a cohort of young women treated for cervical cancer over a 27 year period, with survival available up to 48 years from initial diagnosis, there were no variables identified which impacted the duration of survival beyond the initial stage of cervical cancer at presentation
Michael J. Goodheart, MD
Get PDFDr. Michael Goodheart is an Assistant Professor of Obstetrics and Gynecology in the Division of Gynecologic Oncology at the University of Iowa. In addition to clinical duties, Dr. Goodheart does research the focus of which is unraveling the role of the Wnt pathway in endometrial cancer
The relationship between vascularity, p53 gene mutations and distant metastatic disease in epithelial ovarian carcinoma
Get PDFMutations of the p53 tumor suppressor gene are associated with large differences (>7 vessels/HPF) in Microvessel density (MVD) counts between primary and metastatic tumor sites in patients with epithelial ovarian cancer. These data are consistent with models demonstrating p53 mutation functions directly to influence angiogenesis. This information supports continued therapy and research involving angiogenesis inhibitors in patients with ovarian cancer, especially in the setting of increased differences in MVD between primary and metastatic sites
Wnt/ß-catenin/Lef-1 signaling in the uterus and its implications in uterine gland formation and cancer development
No full textWnt/b-catenin signaling appears to be important in a multitude of cancers. This review article details current knowledge of the Wnt/b-catenin/Lef1 pathway in generalized gland regulation and formation in addition to endometrial cancer. Wnt signaling is critical for the development of the female urogenital system, in particular mullerian duct formation. Dysregulation of this signaling pathway at multiple nodes has been observed in numerous tumor types, including endometrial cancer. In particular, nuclear accumulation of b-catenin correlates with tumor severity. As such, therapeutic modulation of Wnt signaling represents an emerging avenue for the treatment of cancers that rely on this pathway
Division of Gynecologic Oncology
Get PDFThe Gynecologic Oncology Division at the University of Iowa consists of four attending physicians, three fellows-in-training, two physician assistants, three nurses and supporting research and clerical staff. The concentration of our division remains the care of women with gynecologic malignancies. Our service area includes all counties of Iowa as well as western Illinois. Our patients are seen and treated in the National Cancer Institute designated Holden Comprehensive Cancer Center on the University of Iowa Hospitals campus
Stephen K. Hunter, MD, PhD
Get PDFStephen Hunter is a Professor and Division Director of Maternal-Fetal Medicine in the Department of Obstetrics and Gynecology at the University of Iowa. He’s an outstanding clinician, is the Associate Director of the Iowa Statewide Perinatal Care Program, and maintains a high-quality research program