Primary peritoneal cancer after bilateral salpingo-oophorectomy in two patients with Lynch syndrome.
ABSTRACT Women with Lynch syndrome or hereditary nonpolyposis colorectal carcinoma (HNPCC) have a 40-60% lifetime risk of endometrial cancer and a 7-12% lifetime risk of ovarian cancer. Risk-reducing surgery, including hysterectomy and bilateral salpingo-oophorectomy (BSO), is currently recommended once child bearing is complete. We describe two cases of primary peritoneal cancer after BSO in women with Lynch syndrome or HNPCC.
The first patient was a 44-year-old woman who underwent hysterectomy with BSO for benign disease. She presented 12 years later with a pelvic mass and was diagnosed with a high-grade serous primary peritoneal cancer. Genetic testing showed a mutation in the MSH2 DNA mismatch repair gene. The second case was a 58-year-old woman who had a hysterectomy and BSO for endometrial cancer. She developed a high-grade serous primary peritoneal cancer 8 years later and was found to have a mutation in the PMS2 DNA mismatch repair gene.
Women with Lynch syndrome or HNPCC should be counseled that they may be at risk for developing primary peritoneal cancer despite undergoing gynecologic cancer risk-reducing surgery. The magnitude of this risk remains to be determined.
Conference Paper: Switching losses of IGBTs under zero-voltage and zero-current switching[Show abstract] [Hide abstract]
ABSTRACT: Turn-off switching losses of punch-through (PT) and nonpunch-through (NPT) IGBTs under hard switching (HS) and zero-voltage switching (ZVS) are presented and evaluated at 25°C, 75°C and 125°C. A comparison between PT and NPT devices based on their internal device characteristics is given for HS and ZVS. The low emitter efficiency NPT IGBTs used in this paper have smaller switching losses under HS and ZVS at 125°C than PT devices. Zero-current switching (ZCS) techniques are also evaluated for both IGBT structures. PT IGBTs are found to have lower turn-off losses than NPT IGBTsPower Electronics Specialists Conference, 1996. PESC '96 Record., 27th Annual IEEE; 07/1996
Article: Genetic Risk and Gynecologic Cancers[Show abstract] [Hide abstract]
ABSTRACT: Although most gynecologic malignancies are sporadic, hereditary cancer syndromes cause a substantial portion of these cancers. Given that the diagnosis of these syndromes has prognostic and therapeutic implications for the patient, as well as preventive implications for her family members, genetic testing is now an accepted part of the management of the patient who has gynecologic cancer.Hematology/oncology clinics of North America 02/2012; 26(1):13-29. DOI:10.1016/j.hoc.2011.11.003 · 2.07 Impact Factor
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ABSTRACT: Lynch syndrome (LS) is an autosomal dominant familial cancer risk syndrome that occurs due to a germline mutation in one of several mismatch repair genes and is associated with an increased risk of colorectal, endometrial, and ovarian cancer. The risk of endometrial cancer equals or exceeds that of colorectal cancer in women with LS. The diagnosis of gynecologic cancer precedes that of colorectal cancer in over half of women with metachronous gynecologic and colon cancers, making gynecologic cancer a "sentinel cancer" for LS. There are no studies addressing the effectiveness or safety of chemoprevention for women with LS. Surveillance with gynecologic examination including assessment of symptoms, transvaginal pelvic ultrasonography, endometrial biopsy, and CA125 tumor marker assessment can be offered, but has not been shown to improve outcomes for these patients. Prophylactic hysterectomy with bilateral salpingo-oophorectomy performed after the completion of childbearing may be offered for gynecologic cancer prevention.Clinics in Colon and Rectal Surgery 06/2012; 25(2):97-102. DOI:10.1055/s-0032-1313780