1,720,966 research outputs found
Spontaneous regression of transplacental metastases from maternal melanoma in a newborn: case report and review of the literature.
No full textWe describe a rare case of transplacental-transmitted maternal melanoma to the placenta and foetus during the second pregnancy of a 28-year-old woman. She was aware of a greyish-brown nodular lesion on the right gluteus during her first pregnancy. On histological examination, this lesion resulted to be an amelanocitic melanoma. Breast metastases occurred during her second pregnancy, 18 months after the surgical excision; an emergency Caesarean section performed for the recrudement of her clinical conditions confirmed widespread metastases to the liver, spleen and peritoneum. The patient died 2 weeks after delivery. The newborn, at 3 months of age, presented metastases secondary to maternal melanoma, which were resistant to chemotherapy. The disease regressed spontaneously and the child is now 24 months, alive in complete remission
Breast cancer with synchronous massive metastasis in the uterine cervix: a case report and review of the literature.
No full textIntroduction Metastatic breast cancer is rare in the female genital tract, and when present it more commonly tends to involve ovary or endometrium; uterine cervix is only occasionally involved. This condition poses differential diagnostic problems in the settings of clinical and pathological investigations. Case presentation An asymptomatic 78-year-old woman came to our attention in the context of routine gynecological surveillance; clinical examination disclosed enlarged uterine body and cervix. Our patient then underwent computed tomography and magnetic resonance imaging that outlined the possibility of cervical cancer with parametrial involvement. Moreover, a suspect mass was found on the mammogram in the left breast. Breast surgical excision was performed, which revealed invasive breast carcinoma, while synchronous cervical biopsy discovered distant metastasis in the uterine cervix. On histological examination, both lesions showed non-cohesive architectural pattern consistent with lobular morphology; anyway, to rule out primary poorly differentiated cervical cancer, appropriate immunohistochemical panel was performed, which con- Wrmed the mammary derivation of the tumor. Due to disseminate disease, the patient underwent multisystemic medical treatment including radiotherapy, chemotherapy and hormone therapy, and she is still alive at 30-month follow-up. Discussion Genital tract metastases in patients with known breast carcinoma can present with abnormal vaginal bleeding, but they often are asymptomatic. Therefore, only strict gynecological surveillance of these patients can permitearly detection of these secondary lesions. Aggressive treatment of isolated cervical metastasis should be performed when feasible; otherwise, systemic chemotherapy with taxane could be suYcient in increasing survival. It should be emphasized that, in most cases, only accurate immunohistochemical investigation, particularly if performed on the primary lesion as well, can solve differential diagnostic problems and allow the clinician to establish appropriate treatment
Immunohistochemical localization of epidermal growth factor receptor in leiomyomas from women treated with goserelin depot.
No full textTransvaginal ultrasonography with water-contrast in the rectum in the diagnosis of bowel endometriosis
No full textAIM: The rectosigmoid is the most frequent location of intestinal endometriosis. Although several techniques have been proposed for the diagnosis of intestinal endometriosis, no gold standard is currently available. In this review, we describe in details a new technique for the diagnosis of rectosigmoid endometriosis: rectal water-contrast transvaginal ultrasonography.
METHODS: During transvaginal ultrasonography, an assistant inserts a 6-mm flexible catheter through the anal os into the rectal lumen; the insertion of this catheter is evaluated under ultrasonographic control. Water contrast is instilled slowly in the rectum to permit intestinal distension. The colonic wall evaluation is obtained by positioning the transvaginal probe against a length of the sigmoid colon to obtain either axial or longitudinal images. The injection of the saline solution facilitates the identification of recto-sigmoid endometriotic nodules which appear as rounded or triangular hypoechoic masses, located anterior or lateral to the bowel.
RESULTS: This technique has high sensitivity and specificity in the diagnosis of rectal infiltration in women with rectovaginal endometriosis. The distance between the nodules and the mucosal layer permits to estimate the depth of infiltration of these endometriotic lesions within the intestinal wall. Rectal distensibility can be estimated. The procedure is well tolerated by the patients.
CONCLUSION: Water distention of the rectum facilitates the identification of intestinal endometriosis during transvaginal ultrasonography
Increasing hirsutism due to a granulosa-cell tumor in a woman with polycystic ovary syndrome: case report and review of the literature.
No full textAbstract Background: Granulosa-cell tumors (GCT), rare malignancies that arise from sex-cord stromal cells, account for less than 5% of ovarian tumors. These tumors present with an endocrine syndrome and mass signs. Surgery is the primary treatment approach. The risk of recurrence is more frequent in the juvenile-onset form. Case report: We report the case of an obese 18-year-old Caucasian women with hirsutism and oligomenorrhea. Abdominal palpation revealed a voluminous firm mass. Hormonal evaluation documented severe hyperandrogenism. The ovary-specific tumor marker CA125 was elevated, whereas human-chorionic-gonadotropin was in the normal range. Abdominal imaging examination revealed a 19 cm mass in the left ovary. Twenty-four hours after removal of the mass, menstrual flow reappeared and androgens progressively normalized. Microscopically, the predominant pattern was one of uniform, bland, epithelioid to spindle-shaped cells. After three months, a significant weight loss was recorded, hirsutism had decreased slightly and oligomenorrhea reappeared. Δ4-Androstenedione levels remained elevated (4200 ng/L), whereas CA125 had normalized. In light of the pre-existing polycystic-ovary-syndrome (PCOS), the patient started estrogen-progestin treatment. Conclusion: We report an interesting case of a woman with severe hirsutism due to GCT, and a history of oligomenorrhea caused by PCOS. After surgery, a dramatic clinical improvement was observed, whereas PCOS signs persisted
A Case of Large Uterine Myoma in a 14-Year-Old Girl
No full textUterine myomas are the most common tumors of the female genital tract; they are mesenchymal tumors that arise from smooth-muscle cells and extracellular matrix of the uterus. They are less common in adolescents than in adults, and their clinical presentation is usually represented by abdominal/back pain, menstrual disorders, and vaginal bleeding. Case: The case report is described of a 14-year-old girl who presented to our Institution with the chief complaint of menstrual disorders (menorrhagia), and abdominal and back pain. The abdominal examination revealed a large mass extending 3 cm above the umbilical-transverse line. Abdominal ultrasound and magnetic resonance imaging (MRI) confirmed the presence of a mass that originated from the myometrium of the posterior uterine wall. The patient received an intramuscular injection of leuprolide acetate (3.75 mg, Decapeptyl, Ipsen, Rome, Italy) in order to reduce the volume of the mass before surgery and to decrease the intraoperative blood loss. Twenty-two (22) days after the first injection of leuprolide, the patient was admitted again to our Department because of fever and intense abdominal pain of increasing severity. Microscopic ex- amination, immunohistochemical and the cytological examination of the fluid found in the pouch of Douglas during surgery confirmed the benign nature of the uterine mass, hypothesized through clinical and imaging examinations. Results: At 2-year follow-up, no recurrence of myoma was observed. Conclusions: Large uterine myomas may be diagnosed in adolescents. Before surgery, combining ultrasonography with MRI permits precise information to be obtained on the nature of the mass. Fertility sparing and low surgical injury are mandatory in this population
Primitive Uterine Rhabdomyosarcoma Of The Uterus In Adult Patients: A Systematic Review Of A Rare Entity
No full textOvarian Recovery after total body irradiation (TRI) and allogeneic bone marrow transplantation (BMT); long term follow up of 79 females
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