Pyometrium as an Early Indicator of Cervical Squamous Cell Carcinoma: A Systematic Review
Bibliographic record
Abstract
We present the case of an 81-year-old G5P5 Caucasian female who presented to the emergency room for lower abdominal pain, bloating, and green-colored vaginal discharge for the past 3 weeks. A computed tomography of the abdomen and pelvis showed markedly distended endometrial cavity containing fluid and small air bubble concerning for cervical stenosis verses endometrial neoplasm/endometritis suggestive of pyometra. Dilation and curettage was performed with endometrial curette, of which pathology revealed endometritis and detached fragments of squamous cell carcinoma, which showed positive staining with p16, p63, and high Ki67, which is consistent with cervical HPV-related squamous cell carcinoma. The endometrial tissue seen was negative for malignancy. The patient underwent total hysterectomy with bilateral salpingo-oophorectomy and pelvic/para-aortic lymph node dissection, and postoperative recovery was complicated by postoperative ileus which led to a small bowel obstruction. Pyometrium is uncommon, however often presents in postpartum or postmenopausal women and has an 80% association with malignancy. After thorough review of 80 case reports of women with pyometrium, we highlight the importance of considering gynecological malignancy as an underlying cause of pyometra in postmenopausal women, and the importance of early diagnosis in attempt to decrease rates of spontaneous perforated pyometra. J Clin Gynecol Obstet. 2022;11(4):89-100 doi: https://doi.org/10.14740/jcgo830
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.009 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".