Type of publication:
Book chapter
Author(s):
*Joanne Kathleen Ritchie, *Martyn Underwood, and *William Parry-Smith
Citation:
In: Coomarasamy, A. (ed.) (2016). Gynecologic and Obstetric Surgery Challenges and Management Options.Chichester, West Sussex: John Wiley & Sons. Chapter 42, pages 127-130.
Type of publication:
Book chapter
Author(s):
*Joanne Kathleen Ritchie, *Anuradha Radotra, and *Martyn Underwood
Citation:
In: Coomarasamy, A. (ed.) (2016). Gynecologic and Obstetric Surgery Challenges and Management Options.Chichester, West Sussex: John Wiley & Sons. Chapter 41, pages 125-126.
Type of publication:
Book chapter
Author(s):
*Karen Louise Moores, *William Parry-Smith, and *Martyn Underwood
Citation:
In: Coomarasamy, A. (ed.) (2016). Gynecologic and Obstetric Surgery Challenges and Management Options.Chichester, West Sussex: John Wiley & Sons. Chapter 40, pages 121-124.
Type of publication:
Book chapter
Author(s):
*Andrew Sizer
Citation:
In: Fiander, A. and Thilaganathan, B. (2016) MRCOG part one: your essential revision guide: the official companion to the Royal College of Obstetricians and Gynaecologists revision course. 2nd edn. London: Royal College of Obstetricians and Gynaecologists.
Type of publication:
Book chapter
Author(s):
*Andrew Sizer, Mary Ann Lumsden
Citation:
In: Fiander, A. and Thilaganathan, B. (2016) MRCOG part one: your essential revision guide: the official companion to the Royal College of Obstetricians and Gynaecologists revision course. 2nd edn. London: Royal College of Obstetricians and Gynaecologists.
Type of publication:
Book
Author(s):
*Andrew Sizer, Chandrika Balachandar, *Nibedan Biswas, *Richard Foon, Anthony Griffiths, *Sheena Hodgett, *Banchhita Sahu, *Martyn Underwood
Citation:
Sizer, A. (2016) Part 2 MRCOG : single best answer questions. Chichester, West Sussex: John Wiley & Sons
Type of publication:
Journal article
Author(s):
*Papoutsis D., *Underwood M 
., *Parry-Smith W., *Panikkar J.
Citation:
Archives of Gynecology and Obstetrics, May 2015, vol./is. 292/6(1329-1337)
Abstract:
Purpose: To determine any risk factors for cytology recurrence in women after cold coagulation ablative treatment for cervical intraepithelial neoplasia (CIN). Methods: This was a retrospective observational study of a cohort of women having had cold coagulation between 2001 and 2011 in the colposcopy unit of an NHS hospital. We retrospectively collected data from our colposcopy unit database. Women with previous cervical treatment were excluded. Results: 559 eligible women we re identified with a mean age of 28.7 +/- 6.2 years. Nulliparous women were 66.3 % with smokers involving 35.3 %. Referral cytology, pretreatment cervical punch biopsies and colposcopy were high grade in 51.9, 71.9 and 45.8 % of women. Endocervical crypt involvement (ECI) on pretreatment cervical punch biopsy involved 9.7 % of women. Mean follow-up was 3.1 +/- 2.4 years. Overall cytology recurrence (mild/moderate/severe dyskaryosis) at 6 and 12 months follow-up was 7.4 and 5 %. High-grade cytology recurrence (moderate/severe dyskaryosis) involved 2.7 % of women over the entire follow-up period . Multiple regression analysis showed that ECI on pretreatment cervical pun ch biopsy was a risk factor for high-grade cytology recurrence (HR 3.72; 95 %CI 1.18-11.71; p = 0.024). There were no risk factors identified for overall cytology recurrence. However, when cytology tests with borderline nuclear changes at follow-up were pooled with mild/moderate/severe dyskaryosis cytology tests, then parity >2 was a risk factor for abnormal cytology (HR 1.71; 95 %CI 1.08-2.69; p = 0.022). Conclusions: Endocervical crypt involvement on pretreatment cervical punch biopsy and multiparity >2 are risk factors that increase the likelihood of abnormal cytology following cold coagulation. These two risk factors should be taken in consideration when performing cold coagulation cervical treatment for CIN pathology.
Type of publication:
Journal article
Author(s):
*Papoutsis D., Haefner H.K.
Citation:
American Journal of Obstetrics and Gynecology, November 2015, vol./is. 213/5(738e1)
Type of publication:
Conference abstract
Author(s):
*Abdelsalam H., *Malcolm A.
Citation:
Journal of Pathology, September 2015, vol./is. 237/(S46)
Abstract:
Introduction: Primary Extraskeletal Myxoid Chondrosaroma (EMC) of the vulva is a rare mesenchymal neoplasm. The myxoid tumour differential diagnosis on a core biopsy can be quite challenging. To date, few cases have been reported in the literature. Case Report: A 42-year old woman noticed a swelling on the right side of the labia, thought to be a Bartholin's cyst i n 2011. She was managed conservatively. She had drainage and marsupialization under general anaesthesia. This resulted in extreme bruising of the vulva. This was managed with antibiotics and non-steroidal anti-inflammatory medication, and it resolved after 3 weeks. Six months later, the patient presented again with a persistent vulval mass. A biopsy was obtained under general anaesthesia, and it showed a myxoid tumour with differential diagnosis of low grade chondroid tumour. An MRI was performed to assess the extent of the disease. The tumour was excised. At surgery, a 7 x 5 cm lobulated, extremely vascular vulval tumour was found. The tumour was inseparable from the inferior pubic ramus of the pelvic bone. A complete macroscopic resection was obtained. Histology confirmed low grade myxoid chondrosarcoma. Conculsion: Vulval lesions with unusual characteristics or insidious evolution in the labia majora or Bartholin's glands area should be carefully and pr omptly investigated. Differential diagnosis of myxoid tumours in the vulva should include myxoid chondrosarcoma amongst other diagnoses.
Type of publication:
Journal article
Author(s):
*Papoutsis, Dimitrios, *Panikkar, Jane, *Underwood, Martyn, Blundell, Sue, *Sahu, Banchita, *Blackmore, Jill, *Reed, Nicholas
Citation:
Journal of Lower Genital Tract Disease, Oct 2015, vol. 19, no. 4, p. 311-318
Abstract:
The primary objective was to determine whether endocervical crypt involvement (ECI) by cervical intraepithelial neoplasia (CIN) on the excised cervical tissue after large loop excision of the transformation zone (LLETZ) represents a predictor of cytology recurrence. Secondary objective was to identify the ability of a pretreatment cervical punch biopsy to predict cytology recurrence. This was a case series study conducted in an NHS hospital. Women with LLETZ treatment performed over a 2-year period (2010-2011) were identified through our colposcopy database. Women with previous cervical treatment, cervical cancer on cone histopathology, or missing follow-up data were excluded. A group of 526 eligible women was identified over the study period. Crypt involvement was not a predictor of recurrence in the total sample. However, in the subgroup of women with CIN2-3 on pretreatment punch biopsy and with ECI on cone specimen in comparison to those without ECI, we identified an increased risk for overall cytology recurrence (HR, 3.1; 95% CI, 1.04-9.28; P = 0.043) and a trend for increased risk of high-grade cytology recurrence (HR, 4.62; 95% CI, 0.84-25.28; P = 0.07). A pretreatment punch biopsy showing crypt involvement by CIN2-3 was indicative of women at risk for abnormal cytology after excision. In women with CIN2-3 on pretreatment punch biopsy and ECI on excised tissue, the high-grade cytology recurrence was significantly reduced if more than 1.9 cm of cervix was removed. It seems that the presence of crypt involvement on the excised cervix in the subgroup of women with CIN2-3 on pretreatment punch biopsy is predictive of cytology recurrence.