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Benitez Delgado T, Laseca-Modrego M, Gonzalez Garcia-Cano D, Rave Ramirez A, Arencibia-Sánchez O. Uterine Primitive Neuroectodermal Tumor. Cureus 2021; 13:e16437. [PMID: 34422469 PMCID: PMC8366186 DOI: 10.7759/cureus.16437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2021] [Indexed: 11/28/2022] Open
Abstract
Uterine primitive neuroectodermal tumors (PNETs) are rare entities, with only around 70 cases published in the literature. Most of them are diagnosed in advanced stages with rapid progression and poor prognosis. Herein, we present a case of a 71-year-old patient with postmenopausal metrorrhagia and an ultrasound finding of endometrial thickening. The pathological diagnosis after an endometrial biopsy showed PNET. In the study of extension, possible distant dissemination with infiltration of the sigmoid and liver was observed. Chemotherapy treatment was proposed, but not begun due to the rapid progression of the disease. Four months after the initial diagnosis, the patient died of multiple organ failure. While there is no optimal chemotherapy treatment regimen for PNET, some studies have reported encouraging results. It is necessary to publish more studies emphasizing the follow-up and survival of the disease to establish which may be the best treatment option and thus improve the current poor prognosis.
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Affiliation(s)
- Taysa Benitez Delgado
- Gynecologic Oncology, Complejo Hospitalario Universitario (C.H.U.) Insular-Materno Infantil, Las Palmas de Gran Canaria, ESP
| | - Maria Laseca-Modrego
- Gynecologic Oncology, Complejo Hospitalario Universitario (C.H.U.) Insular-Materno Infantil, Las Palmas de Gran Canaria, ESP
| | - Daniel Gonzalez Garcia-Cano
- Gynecologic Oncology, Complejo Hospitalario Universitario (C.H.U.) Insular-Materno Infantil, Las Palmas de Gran Canaria, ESP
| | - Andres Rave Ramirez
- Gynecologic Oncology, Complejo Hospitalario Universitario (C.H.U.) Insular-Materno Infantil, Las Palmas de Gran Canaria, ESP
| | - Octavio Arencibia-Sánchez
- Gynecologic Oncology, Complejo Hospitalario Universitario (C.H.U.) Insular-Materno Infantil, Las Palmas de Gran Canaria, ESP
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2
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Primitive neuroectodermal tumor of the uterus: Excellent clinical response following a multimodal treatment approach. Gynecol Oncol Rep 2020; 32:100550. [PMID: 32149182 PMCID: PMC7033317 DOI: 10.1016/j.gore.2020.100550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
PNET of the genital tract is rare and often presents at an advanced stage highlighting their aggressive nature. Universally accepted treatment guidelines for PNETs are not available. A multimodal treatment approach may be effective in treating this rare disease.
We present a case report of a patient with uterine primitive neuroectodermal tumor (PNET). The patient underwent surgical management followed by pelvic radiation and intravaginal brachytherapy. Following a stable interval, the patient was found to have new onset spinal, pulmonary, and adrenal metastatic disease. She was subsequently started on high dose carboplatin and etoposide. An interval reduction of her metastatic disease was observed after three cycles. We conclude that a multimodal approach, including platinum-based adjuvant chemotherapy with etoposide, can be effective in patients who present with residual or recurrent disease after surgical and radiation therapy. However, more robust studies with longer follow-up periods will be needed to establish a consensus regarding effective treatment options.
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3
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Primitive Neuroectodermal Tumor (PNET) of the Endometrium. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2019. [DOI: 10.1007/s40944-019-0325-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Chang L, Enriquez M, Lerman N, Wilson-Smith R. High grade sarcoma, with predominant neuroectodermal and minor embryonal rhabdomyosarcomatous tumor of the uterus: A case report. Gynecol Oncol Rep 2019; 28:128-132. [PMID: 31032392 PMCID: PMC6479011 DOI: 10.1016/j.gore.2019.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 04/02/2019] [Accepted: 04/03/2019] [Indexed: 11/18/2022] Open
Abstract
Background There have been few documented cases of combined primitive neuroectodermal and embryonal rhabdomyosarcomas (ERMS) in the uterus. Due to their rarity, there is no consensus on the optimal treatment for patients with primitive neuroectodermal tumor (PNET) and ERMS of the uterus. Studies on treatment and outcome are limited. Case presentation A 32 year-old female presented with heavy vaginal bleeding. Ultrasound revealed an 18 cm uterus with thickened endometrium. Histopathology revealed embryonal rhabdomyosarcoma. She underwent a total abdominal hysterectomy, bilateral salpingectomy, lymph node dissection, and omentectomy. Pathologic review confirmed a tumor with mainly central-type PNET and focally ERMS within the uterus and cervix. She was treated with adjuvant chemoradiation. Conclusion Treatment of the predominant tumor, PNET, should be the primary goal of therapy. Vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide with tumor directed radiation may be efficacious for the treatment of this specific high grade uterine sarcoma.
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Affiliation(s)
- Leona Chang
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, MD Anderson Cancer Center at Cooper, Cooper University Health System, Camden, NJ, USA
- Corresponding author at: Division of Gynecologic Oncology, Cooper University Hospital, 3 Cooper Plaza, Suite 221, Camden, NJ 08103, USA.
| | - Miriam Enriquez
- Department of Pathology, Cooper University Health System, Camden, NJ, USA
| | - Nati Lerman
- Department of Hematology/Medical Oncology, MD Anderson Cancer Center at Cooper, Cooper University Health System, Camden, NJ, USA
| | - Robin Wilson-Smith
- Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, MD Anderson Cancer Center at Cooper, Cooper University Health System, Camden, NJ, USA
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Yakıştıran B, Taşkın S, Cansız Ersöz C, Ortaç F. Primitive neuroectodermal tumor of genital tract in hysterectomized patient: A case report. Turk J Obstet Gynecol 2018; 15:204-209. [PMID: 30202633 PMCID: PMC6127471 DOI: 10.4274/tjod.88714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Accepted: 05/26/2018] [Indexed: 02/07/2023] Open
Abstract
Primitive neuroectodermal tumors are high-grade malignant neoplasms. These are uncommon entities for the female genital tract. The treatment, management and follow-up period of Ewing’s tumors are not well-defined because of their rarity in the genital tract. Surgical debulking is the mainstay treatment in all cases. After debulking surgery, patients receive chemotherapy and/or radiotherapy and there is a relation between disease stage and survival. Herein, we present a case of ovarian primitive neuroectodermal tumor with a review of previously reported cases.
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Affiliation(s)
- Betül Yakıştıran
- Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Salih Taşkın
- Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| | | | - Fırat Ortaç
- Ankara University Faculty of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
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6
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Akazawa M, Saito T, Ariyoshi K, Okadome M, Yokoyama R, Taguchi K. Adjuvant chemotherapy for a primitive neuroectodermal tumor of the uterine corpus: A case report and literature review. J Obstet Gynaecol Res 2018; 44:2008-2015. [PMID: 30051552 DOI: 10.1111/jog.13753] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 06/17/2018] [Indexed: 12/16/2022]
Abstract
A primitive neuroectodermal tumor (PENT) belongs to the category of a Ewing sarcoma. A PENT of the uterus is rare and has been known to be very aggressive by nature. Owing to the rarity of the tumor, there is no optimal treatment at present. In many cases, after hysterectomy, chemotherapy or radiation therapy has been performed. However, an effective chemotherapy regimen was unclear. In the soft tissue sarcoma area, the chemotherapy approach has recently greatly improved. Vincristine, doxorubicin, cyclophosphamide, ifosfamide and etoposide (VDC-IE) therapy has improved the survival rate of patients with Ewing sarcoma/PENT. Thus, VDC-IE therapy may be used for a uterine PENT. Here, we report a case of a uterine PENT in a premenopausal woman successfully treated with multimodality treatment including VDC-IE therapy and discuss the optimal chemotherapy for a uterine PENT through a literature review.
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Affiliation(s)
| | - Toshiaki Saito
- Gynecology Service, National Kyushu Cancer Center, Fukuoka, Japan
| | - Kazuya Ariyoshi
- Gynecology Service, National Kyushu Cancer Center, Fukuoka, Japan
| | - Masao Okadome
- Gynecology Service, National Kyushu Cancer Center, Fukuoka, Japan
| | - Ryohei Yokoyama
- Orthopedic Service, National Kyushu Cancer Center, Fukuoka, Japan
| | - Kenichi Taguchi
- Department of Pathology, National Kyushu Cancer Center, Fukuoka, Japan
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Homma T, Nakao T, Maebayashi T, Ishige T, Hao H. Uterine corpus tumor with neuroectodermal differentiation and frequent ganglion-like cells in a postmenopausal woman. Gynecol Oncol Rep 2018; 24:65-77. [PMID: 29915801 PMCID: PMC6003429 DOI: 10.1016/j.gore.2018.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Revised: 04/10/2018] [Accepted: 04/15/2018] [Indexed: 11/25/2022] Open
Abstract
Uterine neuroectodermal tumors (NETs) are uncommon malignant neoplasm with poor prognosis. Ganglion-like cells with fibrillary background as major component of uterine NETs are extremely rare. We present a patient affected by uterine NET with frequent ganglion-like cells, resembling ganglioneuroblastoma. This case report is important to define the pathogenesis and establish better treatments for neuroectodermal tumors.
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Affiliation(s)
- Taku Homma
- Division of Human Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine, 1-30 Ohyaguchikamimachi, Itabashi, Tokyo 173-0032, Japan
| | - Takehiro Nakao
- Department of Gynecology, Nihon University School of Medicine, 1-30 Ohyaguchikamimachi, Itabashi, Tokyo 173-0032, Japan
| | - Toshiya Maebayashi
- Department of Radiology, Nihon University School of Medicine, 1-30 Ohyaguchikamimachi, Itabashi, Tokyo 173-0032, Japan
| | - Toshiyuki Ishige
- Division of Human Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine, 1-30 Ohyaguchikamimachi, Itabashi, Tokyo 173-0032, Japan
| | - Hiroyuki Hao
- Division of Human Pathology, Department of Pathology and Microbiology, Nihon University School of Medicine, 1-30 Ohyaguchikamimachi, Itabashi, Tokyo 173-0032, Japan
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De Nola R, Di Naro E, Schonauer LM, Lucarelli G, Battaglia M, Fiore MG, Mastrolia SA, Loverro G. Clinical management of a unique case of PNET of the uterus during pregnancy, and review of the literature. Medicine (Baltimore) 2018; 97:e9505. [PMID: 29480840 PMCID: PMC5943895 DOI: 10.1097/md.0000000000009505] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
RATIONALE PNETs (primitive neuroectodermal tumors) are a family of highly malignant neoplasms characterized by small round cells of neuroepithelial origin. They usually involve bone and soft tissues, and have a higher incidence in childhood. PATIENT CONCERNS In this case report, we describe the obstetric and oncological outcome of a huge mass diagnosed as a leiomyoma in a 39-year-old pregnant woman who complained of low back pain, dysuria, and urinary frequency at 22 weeks of gestation. DIAGNOSES During the 25th week of pregnancy, the patient was referred to our hospital at night with severe anemia and suspected hemoperitoneum. She underwent an emergency caesarean section, delivering a female fetus weighing 400 g, with an Apgar score of 7 at 1 minute and 9 at 5 minutes. INTERVENTION During surgery, we found a huge uterine sarcoma-like metastatic tumor, invading the pelvic peritoneum and parametria bilaterally; the adnexae seemed disease-free. We performed a type B radical hysterectomy, bilateral salpingo-oophorectomy, pelvic peritonectomy, omentectomy, appendectomy, and excision of a bulky lymph node. Seven days after delivery, staging computed tomography (CT) scan demonstrated a large lombo-aortic lymph node compressing the left renal vein and we completed debulking with a second surgery, including diaphragmatic peritonectomy and excision of a huge lymph node by lombo-aortic lymphadenectomy, requiring partial reconstruction of an infiltrated renal vein. OUTCOME Ten days after the second surgery, echo-color Doppler showed a regular microcirculation in the left kidney. The patient was discharged after 10 days, and the baby after 1 month, both in good health.Histological examination revealed a uterine body cPNET (central primitive neuroectodermal tumor) orienting the clinical management toward chemotherapy with cisplatin and etoposide. LESSONS PNETs are aggressive neoplasms, usually diagnosed at an advanced stage. Due to their low incidence, universally accepted guidelines are still unavailable. Radical surgery leaving no macroscopic residual disease is mandatory in advanced stages. A good fertility-sparing procedure can be performed only in young women at early stages of disease, when the wish for childbearing is not yet fulfilled.
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Affiliation(s)
- Rosalba De Nola
- Department of Biomedical Sciences and Human Oncology, Gynaecologic and Obstetrics Clinic
| | - Edoardo Di Naro
- Department of Biomedical Sciences and Human Oncology, Gynaecologic and Obstetrics Clinic
| | - Luca Maria Schonauer
- Department of Biomedical Sciences and Human Oncology, Gynaecologic and Obstetrics Clinic
| | - Giuseppe Lucarelli
- Department of Emergency and Organ Transplantation, Urology and Kidney Transplantation Unit
| | - Michele Battaglia
- Department of Emergency and Organ Transplantation, Urology and Kidney Transplantation Unit
| | | | | | - Giuseppe Loverro
- Department of Biomedical Sciences and Human Oncology, Gynaecologic and Obstetrics Clinic
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Galmiche E, Hudry N, Sagot P, Ginod P, Douvier S. [Original management of small cell carcinoma of the endometrium]. ACTA ACUST UNITED AC 2017; 45:381-383. [PMID: 28552752 DOI: 10.1016/j.gofs.2017.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 04/19/2017] [Indexed: 10/19/2022]
Affiliation(s)
- E Galmiche
- Service de gynécologie-obstétrique, CHU François Mitterrand, 14, rue Paul-Gaffarel, 21000 Dijon, France.
| | - N Hudry
- Service de gynécologie-obstétrique, CHU François Mitterrand, 14, rue Paul-Gaffarel, 21000 Dijon, France
| | - P Sagot
- Service de gynécologie-obstétrique, CHU François Mitterrand, 14, rue Paul-Gaffarel, 21000 Dijon, France
| | - P Ginod
- Service de gynécologie-obstétrique, CHU François Mitterrand, 14, rue Paul-Gaffarel, 21000 Dijon, France
| | - S Douvier
- Service de gynécologie-obstétrique, CHU François Mitterrand, 14, rue Paul-Gaffarel, 21000 Dijon, France
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Elizalde C, Yagüe A, Fernandez J, Dieste P, Puente M, Hernandez J. Primitive neuroectodermal tumor of the uterus. Gynecol Oncol Rep 2016; 18:25-28. [PMID: 27822490 PMCID: PMC5090192 DOI: 10.1016/j.gore.2016.07.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 07/04/2016] [Accepted: 07/05/2016] [Indexed: 12/12/2022] Open
Abstract
•PNET of the uterus is rare and requires early diagnoses and treatment.•Molecular analysis is important to distinguish it from other tumors.•Different combinations of adjuvant chemotherapy have been report.
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Affiliation(s)
- C.R. Elizalde
- Department of Gynecology, Hospital San Pedro, 98 Piqueras st, 26006 Logroño, Spain
| | - A. Yagüe
- Department of Pathology, Hospital San Pedro, 98 Piqueras st, 26006 Logroño, Spain
| | - J. Fernandez
- Gynecology Department, Aberdeen Maternity Hospital, Cornhill rd, AB25 2ZL Aberdeen, UK
| | - P. Dieste
- Department of Obstetrics and Gynecology, Hospital San Pedro, 98 Piqueras st, 26006 Logroño, Spain
| | - M.J. Puente
- Senior Consultant in Gynecology Oncology, Hospital San Pedro, 98 Piqueras st, 26006 Logroño, Spain
| | - J. Hernandez
- Department of Obstetrics and Gynecology, Hospital San Pedro, 98 Piqueras st, 26006 Logroño, Spain
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Endometrial carcinosarcoma with prominent neuroectodermal component. Pathology 2015; 47:475-7. [PMID: 26126038 DOI: 10.1097/pat.0000000000000289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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12
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Xie J, Wen J, Bi YL, Li HZ. Primitive neuroectodermal tumour of the kidney: An unusual case mimicking renal angiomyolipoma with minimal fat. Can Urol Assoc J 2015; 9:E337-9. [PMID: 26029311 DOI: 10.5489/cuaj.2581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Primitive neuroectodermal tumour (PNET) is a highly aggressive neoplasm that develops classically in the central nervous system. PNET of the kidney (rPNET) is extremely rare. Recently, a 23-year-old woman complained of left flank pain and intermittent hematuria for 3 months and was admitted to our hospital. A computed tomography (CT) scan and magnetic resonance imaging demonstrated a 5.1 × 4.4-cm heterogenous mass with unconspicuous reinforcement in the upper pole of the left kidney. F18-FDG positron emission tomography CT (PET-CT) revealed the mass as a benign lesion with internal extensive bleeding. Renal angiomyolipoma with minimal fat was diagnosed. Three months later, a CT scan showed that the mass shrank to 3.1 × 2.6 cm and nephron-sparing surgery of the left kidney was performed at the patient's request. However, histologic features and immunohistochemical analysis confirmed the diagnosis of rPNET. Five cycles of combined chemotherapy were executed. At the 11-month follow-up, the patient showed no evidence of metastasis or recurrence.
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Affiliation(s)
- Jing Xie
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jin Wen
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ya-Lan Bi
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Han-Zhong Li
- Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Yi T, Wang P, Lin L, Jiang W. Ewing's sarcoma/peripheral primitive neuroectodermal tumors of the uterus confirmed with fluorescencein situhybridization in a 29-year-old Chinese female: A case report and published work review. J Obstet Gynaecol Res 2014; 41:478-82. [PMID: 25303625 DOI: 10.1111/jog.12552] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 07/29/2014] [Indexed: 12/15/2022]
Affiliation(s)
- Tianjin Yi
- Department of Gynecology; West China Second University Hospital of Sichuan University; Chengdu China
| | - Ping Wang
- Department of Gynecology; West China Second University Hospital of Sichuan University; Chengdu China
| | - Lin Lin
- Department of Gynecology; West China Second University Hospital of Sichuan University; Chengdu China
| | - Wei Jiang
- Department of Pathology; West China Second University Hospital of Sichuan University; Chengdu China
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