7 research outputs found
Cesarean scar pregnancy: A clinical case report
No full textBackground: Among the different forms of ectopic pregnancy, cesarean scar pregnancy is one of the most uncommon with an estimated incidence of 1/1800 pregnancies. A major risk of massive hemorrhage, it requires active management as soon as it is diagnosed because it can affect the functional prognosis of the patient (hysterectomy) but can also be life-threatening. Different surgical techniques are generally proposed in first intention to patients who no longer wish to have children, who are hemodynamically unstable and/or in case of failure of medical treatment.Case presentation: We hereby report the case of a young 19-year-old patient with no particular medical history, gravida 2 para 1 with a live child born after a cesarean section for fetal heart rhythm abnormalities during labor 5 months earlier and who presented to the emergency room of our structure for the management of a cesarean pregnancy scar diagnosed at 6 weeks of amenorrhea. She was successfully managed with an intramuscular injection of methotrexate. The follow-up was uneventful.Conclusion: The implantation of a pregnancy on a cesarean section scar is becoming more and more frequent. With consequences that can be dramatic, ranging from hysterectomy to life-threatening hemorrhage, clinicians must be familiar with this pathological entity and be prepared for its management. The latter must be rapid and allow, if necessary, the preservation of the patient's fertility. In this sense, conservative medical treatment with methotrexate injections should be proposed as a first-line treatment in the absence of contraindication
Malignant Degeneration of a Mature Ovarian Teratoma
No full textMature cystic teratoma is the most common type of ovarian germ cell neoplasm, but occasionally, it can undergo malignant transformations, especially in postmenopausal women. These secondary malignant neoplasms are most commonly squamous cell carcinomas. The absence of clinical and radiological specificity of this transformation means that the diagnosis remains purely histological. Data is insufficient regarding the appropriate management given their rarity. However, the treatment is multidisciplinary and is based on surgery and a platinum-based chemotherapy regimen. We report the case of a 53-year-old postmenopausal female patient with malignant transformation of the ovarian teratoma who was treated surgically and whose outcome was favorable. The diagnosis of the teratoma was evoked on imaging, while the diagnosis of squamous cell carcinoma was revealed on histology. Malignant transformation is an uncommon complication of mature ovarian teratomas. No clinical, radiological, or biological sign is specific; therefore, resection of any ovarian mass, even asymptomatic, is required
Meigs syndrome: About an uncommon case report
No full textBackground: Ovarian fibroma is a very unusual epithelial tumor representing less than 1% of all ovarian tumors. It can be asymptomatic and discovered during surgery or be associated with a pleural effusion preferentially located on the right side and a more or less abundant free ascites in the framework of the so-called Meigs syndrome. The challenge of management then lies in distinguishing benign from malignant since clinically, radiologically, and biologically everything points towards malignant which requires radical surgical treatment. We report here the case of a 69-year-old postmenopausal patient with a clinical form of Meigs' syndrome that strongly suggested ovarian cancer.Case presentation: We hereby report here the case of a 69-year-old patient, menopausal, gravida 4 para 3 with 3 live children delivered vaginally and one miscarriage. She presented with ascites, hydrothorax, and a solid tumor of the ovary. Serum CA 125 and HE 4 levels were very high. ROMA score was highly suggestive of malignancy. A hysterectomy with adnexectomy was performed. It was only the histological evidence of ovarian fibroma and the rapid resolution of its effusions that confirmed Meigs syndrome.Conclusion: Meigs syndrome is an anatomical-clinical entity that associates a benign tumor of the ovary, ascites, and hydrothorax. Highly elevated CA 125 and HE-4 tumor markers often point clinicians toward a malignant tumor and compel radical surgical treatment. This case report reminds us once again that only histology confirms the diagnosis of cancer
MAYER ROKITANSKY SYNDROM: A CASE REPORT AND REVIEW OF LITTERATURE
No full textThe Mayer-Rokitansky-Küster-Hauser syndrome is a rare disorder affecting women with normal karyotype and ovarian function. It is characterized by partial or total aplasia of the uterus and two thirds of the vagina. The main symptom is a primary amenorrhea and absence of the uterus which are diagnosed during examination and imagery. This paper reports the case of a 20 year-old woman diagnosed with the MRKH syndrome and discusses its psychological, fertility and sexual intercourse impact on patients. A large number of studies have been conducted to improve the management of patients. This article presents these studies and treatment options like a neovagina or a human uterine allotransplantation
