title: Laparoscopically assisted vaginal hysterectomy with bilateral salpingo-oophorectomy due to endometrial cancer in a heart transplant recipient. A case report.
abstract: BACKGROUND
  Transplant recipients have a higher incidence of cancer compared with the general population. This increased risk is related to the intensity and chronicity of immunosuppression that these patients receive. In this report, we present a case of a heart transplant woman with endometrial cancer who was diagnosed six months after transplantation.
  
  
  METHODS
  A 49-year-old woman who had undergone a heart transplant was referred to our department in May 2002 for final treatment. The diagnosis of endometrial cancer was established on the basis of the histopathology findings of the fractional curettage. Her heart transplant had occurred six months before, as a result of idiopathic restrictive cardiomyopathy. The patient received triple immunosuppression with cyclosporin, azathioprine and prednisone and she displayed no signs of acute graft rejection features. Laparoscopically assisted vaginal hysterectomy with adnexa was performed without any complications. Duration of surgery was 85 minutes. The patient was operated on under general anesthesia and intraabdominal pressure was automatically maintained at 10 mmHg with a carbon dioxide insufflator (AESCULAP, Germany). Immunosuppressive therapy was continued without modification. The postoperative course was uncomplicated in our patient. No significant changes in heart rate or blood pressure were observed. The patient was discharged from the hospital on the 11th postoperative day. Microscopic appearance revealed Stage I endometrial cancer. The patient is in good physical condition with normal heart performance and without disease recurrence.
  
  
  CONCLUSIONS
  In our opinion LAVH was a justifiable form of surgical management in the treatment of a heart transplant recipient with an early-stage endometrial cancer.
authors.affiliation: Gynaecological Surgery Department, Polish Mother's Health Center Institute, Lódź, Poland.
authors.forename: K
authors.initials: K
authors.lastname: Szyłło
authors.forename: U
authors.initials: U
authors.lastname: Bartodziej
authors.forename: B
authors.initials: B
authors.lastname: Włodarczyk
authors.forename: Z
authors.initials: Z
authors.lastname: Dobrowolski
authors.forename: H
authors.initials: H
authors.lastname: Romanowicz-Makowska
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005187:Fallopian Tubes / Q000601:surgery; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D010535:Laparoscopy / Q000379:methods; D008875:Middle Aged; D010052:Ovariectomy / Q000379:methods; D014621:Vagina / Q000601:surgery