Background and objective Duchenne muscular dystrophy (DMD) is a severe, progressive, X-linked genetic disorder caused by pathogenic variants in the dystrophin gene, leading to progressive muscle weakness, loss of ambulation, and premature mortality. Clinical trials are essential for advancing evidence-based management of DMD; however, the overall patterns of study design, intervention strategies, funding, and results reporting remain incompletely characterized. This study aimed to characterize interventional DMD clinical trials registered in ClinicalTrials.gov as of May 25, 2026, and to assess patterns in study design, intervention type, trial phase, funding, results reporting, and trial start era. Methods A retrospective registry-based descriptive study was conducted using ClinicalTrials.gov. DMD-related records were identified using the free-text terms "Duchenne muscular dystrophy," "Duchenne," and "DMD"; the search was not restricted by trial start year. Eligible records were interventional trials with a DMD-specific objective. Trial-level eligibility characteristics, study design, intervention type, trial phase, funding source, results posting, and start year were summarized. Era-wise comparisons were performed using the Fisher-Freeman-Halton exact test. Results A total of 232 interventional DMD trial records were included. Male-only eligibility was recorded for 198/232 trials (85.3%), and treatment was the primary purpose in 179/232 (77.2%). Drug interventions were the most frequent coded intervention category (101/232; 43.5%), Phase 2 was the largest phase category (58/232; 25.0%), and industry was the most common funder class (118/232; 50.9%). Results were posted on ClinicalTrials.gov for 76/232 trials (32.8%). The proportion of drug-intervention trials differed across start-year eras (p = 0.002). Biological interventions showed numerically greater representation in the most recent era, but the era-wise difference was not statistically significant (p = 0.420); industry sponsorship, Phase 3/4 status, randomization, and masking also did not differ significantly across eras. Conclusions ClinicalTrials.gov records show a predominantly treatment-oriented DMD research profile, with substantial industry involvement and frequent small-cohort studies. Therapeutic modalities are diverse, with biological and genetic approaches representing an important share of recent registered activity; however, most temporal comparisons of trial-design characteristics were not statistically significant. Limited registry results posting remains an important gap.
Introduction Orbital compartment syndrome is a rare but sight-threatening ophthalmic emergency requiring immediate recognition and intervention to prevent irreversible vision loss. Emergency lateral canthotomy and cantholysis remain the definitive treatment; however, the infrequent nature of the procedure means many ophthalmologists have limited practical experience and reduced procedural confidence. In addition to technical familiarity, delays in treatment may arise from difficulties locating emergency equipment within clinical environments. This quality improvement project evaluated clinician preparedness for the management of orbital compartment syndrome within a UK National Health Service (NHS) ophthalmology department and assessed the impact of introducing standardised emergency lateral canthotomy grab kits alongside focused educational teaching. Methods A single-centre closed-loop quality improvement project was undertaken within a UK NHS ophthalmology department. Clinicians of varying grades completed a baseline questionnaire assessing confidence in recognising orbital compartment syndrome, performing emergency lateral canthotomy, and locating the equipment required to undertake the procedure under time-critical conditions. Following baseline assessment, two interventions were implemented: a focused departmental teaching session reviewing recognition and management of orbital compartment syndrome and a dedicated emergency lateral canthotomy grab kit containing all equipment required for orbital decompression. A repeat survey was undertaken following implementation to evaluate changes in clinician preparedness, procedural confidence, and perceived accessibility of emergency equipment. Results Baseline findings demonstrated variable confidence in performing emergency lateral canthotomy and highlighted uncertainty regarding the location of essential equipment. Following implementation of the educational intervention and emergency grab kit, clinicians reported improved preparedness and procedural confidence. Around 92% of participants agreed that the introduction of dedicated grab kits improved procedural efficiency and accessibility, while all respondents reported being able to identify the equipment required to perform emergency lateral canthotomy following implementation. Conclusion This quality improvement project demonstrated that simple, low-cost interventions can improve clinician preparedness for the management of orbital compartment syndrome. Combining focused education with standardised emergency equipment may reduce avoidable delays during time-critical ophthalmic emergencies and represent an easily reproducible intervention that could be adopted across ophthalmology departments nationwide to improve the management of orbital compartment syndrome.
Infant-type hemispheric glioma is a distinct form of high-grade glioma occurring in infancy and early childhood. It arises in the cerebral hemispheres and is characterized by recurrent molecular alterations involving genes such as NTRK, ROS1, MET, and ALK. We present the case of a four-month-old infant with a large solid-cystic parietal-occipital hemispheric mass. Histologic examination revealed a cellular, poorly differentiated tumor with areas of necrosis and prominent desmoplasia. DNA methylation profiling supported classification as infant-type hemispheric glioma, and next-generation sequencing identified a TPM3::NTRK1 fusion. An integrated diagnosis of infant-type hemispheric glioma was made. Following surgical resection, targeted therapy with an NTRK inhibitor was initiated, resulting in a sustained clinical and radiologic response. This case underscores the importance of integrated histologic and molecular evaluation in establishing the diagnosis and guiding management of these tumors, as well as the clinical relevance of identifying targetable alterations.
BACKGROUND:Iron deficiency is the leading cause of anemia during pregnancy, and serum ferritin is the most widely used biochemical marker of body iron stores. However, population-specific evidence describing the relationship between serum ferritin concentrations and hemoglobin levels remains limited. PURPOSE:This study aimed to assess the relationship between serum ferritin and hemoglobin levels among pregnant women attending antenatal care. METHODS:A cross-sectional, laboratory-based study was conducted among 522 pregnant women in their second and third trimesters. Serum ferritin concentrations were measured using the hospital's standardized laboratory procedures. Iron deficiency was defined as a serum ferritin concentration <30 µg/L, and anemia was defined as a hemoglobin concentration <11 g/dL. Statistical analyses included descriptive statistics, independent-samples Student's t-tests, chi-square tests, binary logistic regression, and receiver operating characteristic (ROC) curve analysis. FINDINGS:Iron deficiency was identified in 209 participants (40.0%), and anemia was present in 235 participants (45.0%). Serum ferritin concentrations and mean corpuscular volume (MCV) were significantly lower in women with anemia than in those without anemia (p < 0.001). Serum ferritin was independently associated with anemia (OR = 0.95, p < 0.001). Notably, 35 women without anemia (12.2%) had low serum ferritin concentrations, indicating subclinical iron deficiency. ROC curve analysis demonstrated good discriminative performance, with serum ferritin showing greater diagnostic accuracy than MCV. The optimal serum ferritin cutoff was 17.0 µg/L, with a sensitivity of 81% and a specificity of 83%. CONCLUSION:Pregnant women with anemia had significantly lower serum ferritin concentrations than those without anemia, and a substantial proportion of women with normal hemoglobin levels had depleted iron stores. These findings support the potential value of serum ferritin as an adjunctive marker for assessing iron status during pregnancy. However, prospective studies are needed to further evaluate its clinical utility.
Central retinal vein occlusion (CRVO) typically presents with optic disc edema, venous dilation, and widespread retinal hemorrhages; however, atypical optic nerve head findings can mimic neuro-inflammatory or infiltrative disease, posing a diagnostic challenge. We report a 67-year-old woman with diabetes mellitus, rheumatoid arthritis, hypertension, and hyperlipidemia who presented for routine evaluation without visual symptoms and was found to have non-proliferative diabetic retinopathy bilaterally and clinical signs of non-ischemic CRVO in the left eye, including optic disc edema, hyperemia, and intraretinal hemorrhages. Optical coherence tomography (OCT) demonstrated mild macular thickening, and fluorescein angiography (FA) showed scattered hyperfluorescent foci with minimal leakage. Two months after intravitreal faricimab injection, macular edema resolved and visual acuity improved; however, as disc edema subsided, new large whitish nodular lesions emerged on the optic nerve head inferiorly, nasally, and superiorly, corresponding to hyperreflective deposits on OCT. Given the atypical appearance, brain and orbits MRI with contrast, lumbar puncture, and infectious and inflammatory laboratory testing were performed, all of which were unremarkable, with no evidence of infiltrative, demyelinating, or vasculitic disease. Repeat FA revealed no vessel wall staining or leakage to suggest retinal vasculitis. The nodular optic nerve lesions were ultimately determined to be prominent cotton wool spots (CWS) associated with CRVO, presenting in an unusual peripapillary distribution that spared the maculopapillary bundle, consistent with localized inner retinal ischemia and disruption of axoplasmic transport. The lesions resolved over several months without development of optic atrophy or collateral vessels, and final visual acuity returned to 20/20 with normal visual fields. This case highlights that large CWS on the optic nerve head in non-ischemic CRVO can closely mimic neuro-inflammatory or infiltrative processes and that multimodal imaging combined with multidisciplinary evaluation is essential to avoid misdiagnosis and unnecessary treatment.
Heterotopic pregnancy, the simultaneous presence of an intrauterine and an ectopic gestation, is rare after spontaneous conception but may be life-threatening, as an intrauterine pregnancy can provide false reassurance during early assessment. Interstitial ectopic implantation is particularly hazardous because rupture can lead to severe hemorrhage. A 35-year-old gravida 3, para 2, presented at 9+4 weeks of gestation with mild lower abdominal discomfort and no vaginal bleeding. Ultrasound confirmed a viable intrauterine pregnancy but also free pelvic fluid, prompting short-interval reassessment. At 9+5 weeks, pain persisted with one episode of vomiting. Hemoglobin (Hb) fell from 127 g/L to 115 g/L, and intraperitoneal fluid increased. Transvaginal ultrasound showed a left interstitial mass adjacent to the uterine cavity, measuring 23.6 × 23.5 mm, raising suspicion for an interstitial ectopic pregnancy. Diagnostic laparoscopy revealed a ruptured left interstitial pregnancy with active bleeding and approximately 500 mL hemoperitoneum. Laparoscopic wedge resection with left salpingectomy was performed. The uterine defect was sutured with V-Loc, and total blood loss was estimated at 800 mL. Postoperative ultrasound confirmed continued viability of the intrauterine pregnancy, and histopathology confirmed ectopic pregnancy tissue. The patient was discharged on postoperative day seven with progesterone supplementation. Pregnancy continued uneventfully, and an elective primary cesarean section at 36+5 weeks delivered a healthy neonate with a well-healed uterine scar. Abdominal pain with free fluid warrants systematic adnexal evaluation even when an intrauterine pregnancy is confirmed. Pregnancy-preserving laparoscopy is feasible but requires close monitoring thereafter and planned delivery to avoid labor.
INTRODUCTION:Peyronie's disease (PD) is a penile connective tissue disorder characterized by fibrous plaque formation within the tunica albuginea, resulting in penile curvature, pain, deformity, and impaired sexual function. Due to embarrassment and limited awareness, many patients seek health information online, with YouTube becoming a widely used source of medical education. However, the quality and reliability of PD-related YouTube content remain unclear. This study aimed to evaluate the quality, reliability, and educational value of YouTube videos related to PD and assess their suitability as a patient information resource. METHODS:A YouTube search was conducted on May 20, 2026, using five predefined search terms related to PD. The first 20 videos from each search were screened. Videos were included if they were English-language, patient-oriented educational videos lasting between 1 and 20 minutes. Video characteristics were recorded, and content quality was assessed using the DISCERN instrument, Global Quality Scale (GQS), and Journal of the American Medical Association (JAMA) Benchmark Criteria. Statistical analysis included one-sample t-tests and Spearman's rank correlation analysis. RESULTS:Of 100 screened videos, 12 met the inclusion criteria. The mean video duration was 4:03 ± 3:08 minutes, with a mean of 212,275 ± 440,000 views. The mean total DISCERN score was 51.42 ± 9.59, indicating lower-range good-quality information, with no significant difference from the score of 51, which is the good-quality threshold (p = 0.883). Individual DISCERN domains, compared to the midpoint score of 3, demonstrated statistically significantly higher scores for clarity of aims (3.92 ± 1.08, p = 0.0137), achievement of aims (3.67 ± 0.98, p = 0.0388), and relevance to patients (3.83 ± 0.94, p = 0.0105). The mean GQS score of 2.92 ± 1.38 was consistent with moderate educational quality and did not differ significantly from the reference score of 3 for moderate-quality educational content (p = 0.838). The mean JAMA Benchmark Criteria score was 1.50 ± 1.23, indicating low reliability. No significant correlations were identified between DISCERN, GQS, and JAMA scores. CONCLUSION:YouTube videos regarding PD provide generally acceptable but inconsistent educational value and reliability. While many videos effectively address patient concerns, important deficiencies remain in treatment-related information, transparency, and evidence-based content. Patients should be encouraged to critically evaluate online information, and clinicians should guide individuals toward reliable educational resources. Further development of transparent, comprehensive, and patient-centered digital resources is required to improve online education for men with PD.
Severe nonhepatic hyperammonemia is a rare but potentially life-threatening condition in immunocompromised patients. Ureaplasma and Mycoplasma species are fastidious urogenital organisms that generate ammonia and may cause disseminated, culture-negative infection. We report the case of a 63-year-old woman receiving dual biologic therapy, ocrelizumab for multiple sclerosis and secukinumab for psoriasis, who presented with a history of sterile pyuria and lower urinary tract symptoms. Within two months, her condition progressed to polyserositis, paralytic ileus, multiorgan dysfunction, and metabolic encephalopathy requiring admission to intensive care. Imaging suggested a left ovarian neoplasm with peritoneal carcinomatosis, prompting exploratory laparotomy, which ultimately revealed diffuse seropurulent pachyperitonitis and a small localized purulent collection, without evidence of malignancy. Plasma ammonia rose despite the absence of hepatic failure, causing severe encephalopathy requiring continuous renal replacement therapy (CRRT). Conventional cultures of urine, blood, ascitic fluid, vaginal exudate, and peritoneal specimens were repeatedly negative, prompting investigation for unusual organisms. Urine polymerase chain reaction ultimately detected Ureaplasma parvum and Mycoplasma hominis. Plasma ammonia remained dependent on CRRT, with recurrent rebound following interruptions before targeted antimicrobial therapy was established. Following treatment with levofloxacin and doxycycline, sustained metabolic control allowed discontinuation of CRRT without further rebound hyperammonemia. The temporal pattern, while occurring alongside surgical drainage and peritoneal lavage, supports targeted treatment of the presumed underlying invasive infection as an important component of recovery. This case highlights the importance of considering fastidious urogenital organisms in immunosuppressed patients with unexplained nonhepatic hyperammonemia and persistently negative conventional cultures, particularly when ammonia levels remain dependent on extracorporeal clearance.
During aortic valve replacement, after weaning from the cardiopulmonary bypass (CPB), systemic vascular resistance, which constitutes the left ventricular afterload, fluctuates significantly due to systemic inflammatory responses, changes in body temperature, and the use of vasoconstrictors. Particularly in hypertrophic hearts that have adapted to increased afterload for a long time, a sudden increase in afterload following weaning from CPB carries a risk of inducing left heart failure or prosthetic valve failure. With mechanical prosthetic valves, a slight physiological regurgitation is observed during valve closure. In this case, by using pulse Doppler echocardiography and transesophageal echocardiography to monitor this physiological regurgitation in real time, we were able to rapidly assess changes in left ventricular afterload and accurately manage the administration of vasoactive agents; we therefore report on the clinical course of this case.
Venous tumor thrombus is a well-recognized feature of clear cell renal cell carcinoma (ccRCC), most commonly involving the renal vein and, in advanced cases, the inferior vena cava. However, simultaneous extension into multiple collateral venous pathways, particularly the gonadal and hemiazygos veins, is exceedingly uncommon. We report the case of a patient with a giant left-sided ccRCC measuring 20 cm, presenting with extensive venous tumor thrombus involving the left renal vein, the left gonadal vein, the left ascending lumbar vein, and the hemiazygos vein without direct inferior vena cava invasion. Contrast-enhanced computed tomography demonstrated complete distortion of the renal architecture, marked local mass effect on adjacent abdominal structures, encasement of the left renal artery, and extensive perirenal fat infiltration. The tumor thrombus reached the ostium of the left renal vein at the inferior vena cava while remaining confined to the renal venous system and collateral veins. Additional findings included delayed bilateral renal excretion, mild-to-moderate ascites, and indeterminate small hepatic lesions without significant retroperitoneal lymphadenopathy. Histopathological examination confirmed ccRCC. This case illustrates an exceptionally rare pattern of multivenous tumor thrombus involving the renal, gonadal, ascending lumbar, and hemiazygos veins. Comprehensive preoperative CT evaluation is essential for accurately delineating the extent of venous involvement, guiding therapeutic planning, and raising awareness of atypical collateral venous extension in advanced RCC.
Colovaginal fistulas are abnormal communications between the colon and vagina that typically present with the passage of flatus or fecal material through the vagina and usually require surgical repair. Most cases occur in association with diverticular disease or a prior hysterectomy; occurrence in the absence of these risk factors is uncommon and may delay diagnosis. We present the case of a 69-year-old woman with a colovaginal fistula despite the absence of diverticular disease and a history of prior hysterectomy. She underwent successful multidisciplinary surgical management involving Urology, Gynecology, and General Surgery, followed by a favorable postoperative recovery. This report highlights the importance of considering colovaginal fistula in elderly patients presenting with feculent vaginal discharge, even in the absence of traditional risk factors, and demonstrates the value of coordinated multidisciplinary management in atypical presentations.
Background Arthrodesis is a standard intervention for musculoskeletal pain, yet non-union remains a significant challenge. Systemic comorbidities such as smoking, diabetes, and obesity can lead to biological deficiencies in the signaling proteins required for bone healing at the surgical site. This study evaluates the clinical safety and efficacy of a next-generation cellular bone matrix (CBM) designed to preserve high concentrations of endogenous growth factors and viable cells that may help address potential biological deficits in at-risk populations. Methods Data were pooled from two single-center retrospective studies. The analysis included 35 high-risk participants (mean age 61.4 years with an average of 2.6 risk factors per participant) undergoing either spinal (n=18) or foot and ankle arthrodesis (n=17). Risk factors included advanced age, tobacco use, diabetes, obesity, hypertension, and revision surgery, among others. Primary efficacy was defined as radiographic fusion at standard follow-up time points. Rates of major complications and unplanned revisions were examined for safety. Results Despite these high-risk profiles, radiographic union rates were high in both cohorts. In the spine group, 100% fusion was achieved for all interbody (n=33/33) and posterolateral (n=95/95) levels by 12 months, with a median time to fusion of 6.0 months. Notably, the time to fusion was not significantly impacted by construct length in this small, exploratory subgroup comparison. In the foot and ankle cohort, 100% radiographic fusion was achieved by 24 weeks, with a median time to fusion of 6.0 weeks. There were no statistically significant differences in healing times between forefoot/midfoot and hindfoot/ankle subgroups, though these subgroups were also small and likely underpowered. Across both cohorts, the rate of non-union and graft-related adverse events was 0% (n=0). Conclusions In this small retrospective study, use of the next-generation CBM was associated with favorable fusion rates and no reported graft-related complications in a high-risk patient population. These findings are consistent with the hypothesis that a concentrated source of native growth factors and viable cells may support fusion even in biologically compromised environments. However, future powered studies, including a control group and larger patient population, are needed to confirm our preliminary findings and determine causation.
Oral leukoplakia is the most common oral potentially malignant disorder and represents a well-recognized precursor of oral squamous cell carcinoma (OSCC). Although incisional biopsy remains the diagnostic gold standard, false-negative results may occur because of sampling error and lesion heterogeneity, creating a potential discordance between histopathological findings and clinical evolution. We report the case of a 67-year-old former heavy smoker who presented with a two-year history of persistent leukoplakia involving the right lateral border of the tongue, accompanied by an unintentional 20-kg weight loss over the same period. An initial incisional biopsy demonstrated no epithelial dysplasia, and the lesion was attributed to chronic mechanical irritation related to a dental implant. Despite adjustment of the dental prosthesis, the lesion remained unchanged, prompting further diagnostic evaluation. Following exclusion of metabolic causes, continued clinical suspicion prompted referral to a tertiary head and neck oncology center, where partial glossectomy revealed a moderately differentiated invasive squamous cell carcinoma (pT1N0M0). The patient underwent curative surgical treatment and remained free of recurrence after one year of follow-up. This case highlights the importance of integrating histopathological findings with the patient's evolving clinical picture and demonstrates that persistent clinicopathological discordance should prompt diagnostic reassessment. Ultimately, a negative biopsy should not represent the endpoint of investigation when clinical suspicion remains high.
Background Urine drug screening (UDS) using immunoassay-based panels is widely implemented in acute and intensive care settings for patients presenting with altered sensorium, unexplained agitation, or suspected intoxication. The diagnostic yield of UDS, however, varies considerably across regions and time periods, and data from North India remain limited. Immunoassays are subject to limitations such as cross-reactivity and false-positive results. Consequently, longitudinal, center-specific data are essential for contextualizing test utility and optimizing clinical decision-making. Aims and objectives This retrospective study evaluated annual and seasonal variation in UDS positivity and characterized the spectrum of substances detected over a consecutive four-year period at a North Indian tertiary care center. Methods A retrospective observational study was conducted at Max Super Speciality Hospital, Vaishali, a tertiary care center in the National Capital Region (NCR), India. All unique urine drug assay panels performed between January 2022 and December 2025 were analyzed (N = 323), irrespective of patient age, sex, or clinical indication. A panel was considered positive if at least one drug analyte was detected. Data were analyzed by year and season (winter: December-February; summer: March-May; monsoon: June-September; post-monsoon: October-November). Categorical variables were compared using the Chi-squared test, with p < 0.05 considered statistically significant. Results Overall, 42 of 323 panels (13.0%) were positive. Annual UDS positivity was 8.33% in 2022 and 7.63% in 2023, with higher rates of 23.64% in 2024 and 26.83% in 2025. The annual distribution differed significantly across the study years (p = 0.0005). Significant seasonal variation was observed (p = 7.7 × 10⁻⁶), with the highest positivity during the monsoon (27.14%) and summer (20.83%) and the lowest during winter (3.87%). Among 52 analyte-level detections, benzodiazepines accounted for 28 of 52 detections (53.8%), followed by tricyclic antidepressants (6/52, 11.5%) and cannabinoids (5/52, 9.6%). Conclusion UDS positivity varied significantly across study years and showed pronounced seasonal variation, with the highest yield during the monsoon. Benzodiazepines were the most frequently detected drug class. Given the limitations of immunoassays, UDS results should be interpreted within the clinical context, and confirmatory testing should be considered when results would materially affect diagnosis or management. Future multicenter prospective studies incorporating clinical indications and definitive toxicological testing are needed to validate these findings.
INTRODUCTION:Heart rate variability (HRV) is a measure of the function of the brainstem nuclei that modulate heart rhythm through the parasympathetic and sympathetic nervous systems. HRV is reduced in many health conditions. It is a predictor of increased mortality in patients who have had myocardial infarction, and of sudden death in persons with epilepsy. Methods: We measured HRV in the single-channel electrocardiogram (ECG) of 103 patients undergoing a short electroencephalogram (EEG) of 20 to 90 minutes' duration, whose EEG results were normal. RESULTS:We found that despite the normal EEG results of the patients, their measures of HRV were reduced compared to normal values. The single most widely used measure of HRV is the square root of mean squared differences of successive heartbeats (RMSSD), which was 28.1 ± 21.8 in our subjects. The high frequency (HF) band was specifically affected. In these patients, HRV was only slightly affected by state of wakefulness, and was stable during wakefulness, N1 sleep, and N2 sleep. A significant reduction in HRV with age was also observed in our subjects. There was a non-significant trend toward lower HRV in our female subjects. CONCLUSION:In patients selected by their clinicians to undergo EEG, HRV is reduced. Our results indicate that HRV during the first five minutes of EEG, regardless of sleep state, is a reliable measure of HRV in patients undergoing short-term EEG. We conclude that a normal EEG result does not predict normal HRV and that routine measurement of HRV during EEG could provide useful prognostic information for patients undergoing EEG.
Gynecologic cancers are a diverse group of malignancies with distinct microbiological, histopathological, and molecular characteristics. This systematic review examined the available evidence on these features in gynecologic cancers and premalignant lesions. A total of 46 studies involving 18,742 patients or samples were included. Because the studies differed considerably in design, sampling methods, laboratory techniques, histopathological classification, and reported outcomes, the findings were synthesized narratively. The strongest and most consistent evidence was found for persistent high-risk human papillomavirus (HPV) infection, particularly HPV-16 and HPV-18, in cervical cancer and other lower genital tract neoplasms. Cervicovaginal dysbiosis, marked by reduced Lactobacillus dominance, increased microbial diversity, and anaerobic bacterial overgrowth, was frequently associated with HPV persistence and higher-grade cervical lesions. However, current evidence suggests that dysbiosis acts as a contributing factor rather than an independent cause of malignancy. Histopathology remained central to tumour diagnosis, classification, and risk assessment. Squamous cell carcinoma was the predominant histological type in cervical, vulvar, and vaginal cancers. Endometrioid adenocarcinoma was commonly reported in endometrial cancer, while high-grade serous carcinoma was the main ovarian cancer subtype. Evidence regarding uterine, endometrial, and ovarian tumour-associated microbiota was limited and exploratory because of low microbial biomass, methodological variation, and the risk of contamination. Combining microbiological findings with histopathological and molecular classification may improve understanding of gynecologic carcinogenesis and support future risk-stratification approaches. Standardized sampling, strict contamination control, and well-designed longitudinal studies are needed before microbiome-based markers can be introduced into routine clinical practice.
