Ioannis Boutas

National and Kapodistrian University of Athens | uoa · Division of Obstetrics - Gynecology III

Making decisions on fertility preservation while receiving cancer treatment is a difficult and multifaceted task. With an emphasis on breast cancer patients, this chapter examines several choices and factors for fertility preservation. The patient’s age, the cancer’s severity and stage, the need for prompt treatment, her marital status, and her des...

Simple Summary Malignant Brenner tumors are rare ovarian neoplasms. Our aim is to provide insights concerning this rare entity. We reviewed 115 cases reported in the English literature until 15 September 2023, and analyzed the available demographic, clinical, and pathologic data. We also described the treatment modalities. A comparison of the avail...

Breast cancer and cardiovascular diseases (CVD) represent significant global health challenges, with CVD being the leading cause of mortality and breast cancer, showing a complex pattern of incidence and mortality. We explore the intricate interplay between these two seemingly distinct medical conditions, shedding light on their shared risk factors...

Introduction: Breast cancer affects almost 1.5 million women worldwide below the age of 45 years each year. Many of these women will be advised to undergo adjuvant chemotherapy to minimize the risk of death or recurrence of the tumor. For these patients, chemotherapy is a known cause of infertility, as it can damage primordial follicles, which can...

Background: Axillary lymph node metastasis is a rare stage IV ovarian carcinoma manifestation. This manuscript aims to systematically review the literature regarding axillary lymph node metastasis from ovarian carcinoma. Methods: We searched three medical internet databases (PubMed, Scopus, and Web of Science) for relevant articles published until...

Breast cancer and cardiovascular diseases (CVD) represent significant global health challenges, with CVD being the leading cause of mortality and breast cancer showing a complex pattern of incidence and mortality. We explore the intricate interplay between these two seemingly distinct medical conditions, shedding light on their shared risk factors...

Higher mammographic breast density in premenopausal and postmenopausal women is related to a higher breast cancer risk. In this review, we analyze the correlation between estrogen, progesterone, and mammographic density in postmenopausal women and clarify whether these findings are consistent across different types of mammographic breast density. W...

Introduction: Breast cancer affects worldwide almost 1.5 million women below the age of 45 years each year. Many of these women will be advised to undergo adjuvant chemotherapy to minimize the risk of death or recurrence of the tumor. For these patients, chemotherapy is a known cause of infertility, as it can damage primordial follicles which can l...

Prostatic adenocarcinoma (PA) is the second most common malignancy in men globally. Signet-ring cell-like adenocarcinoma (SRCC) is a very rare PA subtype, with around 200 cases reported in the English literature. Histologically, the tumor cells show a vacuole compressing the nucleus to the periphery. Pagetoid spread in acini and ducts is usually re...

This study aimed to assess an eligible cut-off value of anti-Müllerian hormone (AMH) to detect ovarian senescence in a group of premenopausal Greek women to evaluate the possible link between AMH-values and the severity of climacteric symptoms during a follow-up of 24 months. This study included 180 women (group A, 96 women of late reproductive sta...

Ectopic or accessory breast tissue may occur in primitive embryonic milk lines or locations other than the milk line. The same pathology arising in breast tissue may occur less frequently in ectopic breast tissue. Fibroadenomas rarely occur in ectopic breast tissue, with less than 50 reported cases in the English literature, despite being the most...

Mammary myofibroblastoma is a benign mesenchymal tumor composed of fibroblasts, myofibroblasts, and a variable number of adipocytes. Mammary myofibroblastoma usually occurs in men of older age and is less common in postmenopausal women. It may also happen in extramammary sites along the milk line. In this instance, it is referred to as mammary-type...

Background/aim: Utilizing an experimental animal model, we investigated the correlation between aromatase inhibitors (AIs) (anastrozole and letrozole) and Calprotectin levels. AIs have demonstrated superior efficacy when used as adjuvant endocrine therapy or monotherapy for postmenopausal patients with hormone receptor (HR)-positive early-stage br...

Leiomyomas are the most common benign smooth muscle tumors of the female genital tract. Among the recognized histologic variants, one of the least common is plexiform leiomyoma. When they are small, even microscopic findings, they are referred to as plexiform tumorlets. In this report the authors describe a case of plexiform tumorlet found incident...

The objective of the present systematic review was the determination of methodologies preferable for treating phyllodes tumors (PTs) of the breast and whether the malignancy of the tumor is of significance to the selected treatment. In addition, to investigate if local recurrence (LR) within patients is different based on the therapeutic approach f...

Microglandular adenosis is a non-lobulocentric haphazard proliferation of small round glands composed of a single layer of flat to cuboidal epithelial cells. The glandular structures lack a myoepithelial layer; however, they are surrounded by a basement membrane. Its clinical course is benign, when it is not associated with invasive carcinoma. In a...

Background/aim: Soy contains genistein and daidzein isoflavones. Isoflavones are phytoestrogens, with a similarity in structure to human 17-β estradiol hormone. They imitate the action of estrogen on organs by binding and activating estrogen receptors. Numerous studies have examined the relationship between soy consumption and breast cancer but no...

Background Galectin-3 is part of a protein group called lectins and acts as a multifunctional glycoprotein due to its expression location. Galectin-3 is expressed by different human tissues. It plays a significant role in carcinogenesis and the selection of tumor-related physiological and pathological activities. Galectin-3 has been utilized throug...

Dermatofibrosarcoma protuberans (DFSP) is a superficial mesenchymal neoplasm that originates from the dermal fibroblasts and tends to be locally aggressive. Although infrequent, it is one of the most common cutaneous sarcomas. It mainly affects young and middle-aged patients 20 to 50 years old. Any area of skin may be involved, but the most common...

Breast cancer is the most common form of cancer and the second highest cause of cancer mortality in female patients. The significance of the expression of Galectin-3 has been correlated with various malignancy types and in data from several research papers, the expression of Galectin-3 has been associated with the progression and metastasis of brea...

Purpose Galectin-3 is a Mr 31,000 protein that belongs to a family of carbohydrate-binding proteins. Galectin-3 has already been associated with protection against apoptosis through cell to cell or cell to matrix adhesion processes. It seems that galectin-3 plays an important role in tumor progression, cell growth, invasion and metastasis. Galectin...

The aim of the present study was to investigate the impact of anastrozole and letrozole supplementation following surgically induced menopause on bone metabolism and biomechanical properties. A total of 45 Wistar rats underwent ovariectomy and were then randomly allocated to receive no treatment, anastrozole or letrozole. At 2 and 4 months followin...

Objective: To describe two clinical cases concerning patients at risk of developing severe ovarian hyperstimulation syndrome (OHSS) during in vitro fertilization (IVF) stimulation. Design: Description of clinical management and outcomes of patients using an IVF antagonist rescue protocol to prevent OHSS. Setting: Reproductive medicine unit, Un...

Purpose of investigation: To report a rare case of maternal hyperthyroidism after intrauterine insemination due to hypertrophic action of hCG. Materials and methods: A 36-year-old woman after successful intrauterine insemination and triplet pregnancy, developed hyperthyroidism with resistance to medical treatment. Results: All signs of hyperth...

( Can J Anesth . (2015) 62:901–906) Vertebral hemangiomas are benign vascular tumors that tend to develop within the vertebra and occur in roughly 10% of the population. These tumors do not typically grow quickly and do not cause any symptoms as long as they remain within the vertebra. However, if these tumors grow beyond the spine’s bony structure...

Introduction: Aromatase inhibitors are widely used in the treatment of hormone sensitive breast cancer in postmenopausal women. The purpose of this study was to evaluate the strength of the bone by conducting a biomechanical study on the femoral bones and to access the levels of bone turnover markers in ovariectomized rats treated with anastrazole...

Introduction: Compared to laparotomy, laparoscopy has many benefits for patients, such as shorter recovery and lower morbidity rates. Port site metastases after laparoscopic approach in the treatment of gynecologic malignancies are uncommon. The purpose of this review is to identify and summarize possible risk factors for port-site metastases in p...

Anastrazole and Letrozole are used as endocrine therapy for breast cancer patients. Previous studies suggested a possible association with metabolic and liver adverse effects. Their results are conflicting. Fifty-five 4-week-old female Wistar rats were allocated in 4 groups 1) ovariectomy control (OC), 2) ovariectomy-Anastrazole (OA) 3) ovariectomy...

Ulipristal acetate (UA), a selective progesterone modulator, has been approved for short-term therapy for symptomatic fibroids. We decided to undertake a systematic review of the best available evidence and draw a more definitive conclusion regarding the efficacy of UA for the management of uterine fibroids. The outcomes included symptomatic relief...

An ectopic pregnancy is defined as cesarean scar pregnancy (CSP) when the products of conception are implanted within the myometrium in the area of a cesarean section scar. CSP can be a life-threatening condition and to date there is no clear consensus for CSP management. A medical approach joining high treatment rates with fertility preservation c...

Introduction: Anastrazole and Letrozole are used as endocrine therapy for breast cancer patients. Previous studies suggested a possible associationwith metabolic and liver adverse effects. Their results are conflicting. Materials and methods: Fifty-five 4-week-old female Wistar rats were were maintained in weather controlled chambers (temperature 2...

To assess whether the levels of anti-Mullerian hormone (AMH) are related to outcome of intrauterine insemination (IUI) in patients treated with gonadotropins. A total of 195 patients underwent controlled ovarian stimulation (COS) with recombinant follicle stimulating hormone (rFSH) (50-150 IU/d). All patients were submitted upto three cycles of IUI...

Endometriosis is a common, estrogen-dependent, gynecological disease, which is defined as the presence of endometrial tissue outside the uterine cavity. Current data have associated endometriosis with specific malignancies, including ovarian and breast cancer. The purpose of our study is to summarize and present published literature providing evide...

To determine whether in vitro fertilization (IVF), frozen replacement cycles offer better outcomes than fresh cycles in order to support, or not, a possible shift towards total replacement of fresh IVF/intracytoplasmic sperm injection (ICSI) cycles from frozen elective transfers (FETs). Systematic review; opinion paper. Initial results seem to supp...

Aberrant activation of the Akt/mTOR/pS6 signaling pathway has been identified in various types of cancer and is under investigation in cervical cancer. The purpose of this study was to assess the expression of the phosphorylated/activated forms of Akt (upstream molecule), 4E-BP1 and pS6 (downstream molecules) in biopsy samples of cervical low grade...

Vertebral hemangiomas are benign vascular tumours of the bony spine which are usually asymptomatic. Pregnancy-related anatomical and hormonal changes may lead to expansion of hemangiomas and development of neurological symptoms. We present an unusual case of vertebral fracture due to an undiagnosed hemangioma presenting as postpartum back pain foll...

Primary fallopian tube carcinoma (PFTC) is an uncommon gynecologic tumor, responsible for 0.14% to 1.8% of genital malignancies, with a mean incidence of 3.6 per million women per annum. The factors that contribute to its appearance are not well-known. Overall survival percentages for patients with PFTC are generally low. Although the preoperative...

The most frequent ovarian germ cell tumors are mature cystic teratomas (MCTs), composing 10-25% of all ovarian neoplasms. MCTs have the potential of undergoing malignant transformation, typically in postmenopausal women, with a frequency of 0.17-3%, with squamous cell carcinoma being the most common malignant tumor arising from MCT. We present the...

Within the last decades, the percentage of diagnosed cervical cancer in women of reproductive age has increased. The possibility of diagnosing small cervical tumors (< or = twocm) in childbearing age, can be explained due to the fact that many women, are aware of the benefits of Pap smear or colposcopy examination. Many demand a more conservative p...

Tuberous sclerosis (TS) or tuberous sclerosis complex (TSC), also known as Bourneville disease or Bourneville-Pringle disease, is an autosomal dominant disorder classically characterized by the presence of hamartomatous growths in multiple organs. A combination of symptoms may include seizures, developmental delay, behavioral problems, skin abnorma...

The objective of this study was to evaluate the effect oftamoxifen on the endometrium of45 postmenopausal women with breast cancer, as evidenced by hysteroscopic, ultrasound, histological methods, and by immunohistochemical investigation of the expression of Bcl-2 and Ki67. Forty-five postmenopausal women with breast cancer (ER and/or PgR positive)...

Introduction The issue of violence against women within the family, or as it is widely known domestic violence, is appearing now firmly as much in European policies as in Greek legislation in order to tackle and prevent this phenomenon. Unfortunately, European and Greek laws do not fully cover this important subject and as the respective studies sh...

Introduction The percentage of couples around the world facing infertility problems is especially high, resulting in the acquisition of a child to become an unfulfilled desire. The medical definition of infertility is the failure of a couple to conceive following 12 months of free and frequent intercourse without any type of contraception. This rev...

Verrucous carcinoma of the female genital tract is a rare lesion, primarily affecting postmenopausal women. We present a 78-year-old patient with verrucous carcinoma of the vulva, who was admitted to the "Aretaieion" Athens University Hospital. She had complained of vulvar itching during the last two years without visiting a specialist doctor.

Uterine tamponade with the Bakri catheter is effectively used as a treatment in postpartum hemorrhage and as a means to prevent fertility. We present a case of a 40-year-old pregnant woman who had a massive hemorrhage during cesarean section who was successfully treated with a tamponade balloon. Furthermore, we comment on a similar technique--Logot...

Atypical squamous cells of undetermined significance (ASCUS) are a cervical cytologic finding category suggestive but not definitive of squamous intraepithelial lesions. ASCUS remains an incompletely described entity and accounts for even 5%-10% of reported Papanicolaou (Pap) smears. The management of women with such cytologic findings remains cont...

Introduction: Ovarian function is controlled not only by endocrine system, but also by autocrine/paracrine regulation in the ovarian cells, which may be mediated by a network of cytokines. The aim of this study was to elucidate the involvement of a multifunctional cytokine, interleukin-6 (IL-6), in human ovarian function especially in human luteol...