Pure large cell neuroendocrine carcinoma of ovary: A rare clinical entity.

OBJECTIVE: Large cell neuroendocrine carcinoma (LCNEC) of the ovary is a rare tumour. Its pure form without any associated surface epithelial stromal or germ cell component is more rarely seen. Its prognosis is generally very poor even when the diagnosis is made at an early stage. We report a case of pure large cell neuroendocrine tumour of ovary. The patient was a 73-year-old woman with symptom of pelvic pain. Ultrasonography detected an abdominal tumour larger than 10 cm. She underwent an exploratory laparotomy with resection of the pelvic mass. After the surgery six cycles of chemotherapy (Etoposide and Cisplatin) were administered to the woman. She is still healthy after the last chemotherapy. Due to the rarity of the disease, few number of reported cases and the lack of systematic population based studies or registry data, we reported this case.

Contraceptive choices of adolescents before and after the voluntary termination of pregnancy.

In this retrospective study, we aimed to investigate the contraceptive choices before and after voluntary termination of pregnancy among adolescents. Seventy pregnant adolescents aged 17-19 and undergone voluntary pregnancy termination were included. Counseling about contraceptives was given before the procedure. Contraceptive choices before and after termination of pregnancy were evaluated. Before pregnancy termination, all of the adolescents reported the use of a contraceptive method. The most commonly used method was coitus interruptus (37.1%), followed by male condom (34.3%) and the rhythm method (18.6%). The use of oral contraceptive pills (7.1%) and intrauterine devices (IUDs; 2.9%) were very low. Implants and injections were not used. None of the methods used were dual methods (used with the male condom). After the termination procedure, IUD was main choice (54.3%) followed by oral contraceptive pills (31.4%). Four adolescents (5.7%) selected to insert subdermal implants and three adolescents (4.3%) preferred injections. All of these preferred methods were dual methods. The preference of male condom as a single method decreased by about 3%. The rhythm method and coitus interruptus were not preferred. As a conclusion, contraceptive choices of adolescents significantly change to more effective methods by sufficient counselling during the termination of an unintended pregnancy. Impact statement What is already known on this subject? Adolescent pregnancies are an important public health problem. The prevention of these pregnancies is important in this respect. However, especially in developing countries, adolescents do not have sufficient knowledge of effective contraceptive methods. What do the results of this study add? The contraceptive choices of adolescents significantly change to more effective methods by appropriate counselling during the termination of unintended pregnancies. What are the implications of these findings for clinical practice and/or further research? An unintended pregnancy termination may be an opportunity to provide appropriate counselling to prevent subsequent pregnancies in adolescents, especially in countries where the sexual and reproductive health or family planning services are inadequately used.

Unilateral angiokeratoma of vulva: a rare clinic entity.

The aim of this study is to present a very rare dermatologic condition of the vulva. Angiokeratoma is a benign dilation of ectatic thin-walled blood vessels and congested capillaries in the superficial dermal layer of skin. It occurs predominantly in men and extremely rare in women. Angiokeratoma presents as single or multiple papular lesions on the vulva with smooth or verrucous surface. These lesions are easily confused with infectious disease, inflammatory lesions, and epithelial tumors. In this report, we presented a 42 year old unmarried woman who was admitted to our clinic with complaints of two papuler lesions of the right labium majus with vaginal discharge, vulvar pruritis, and vulvar edema. She had been previously treated with different local or systemic antiinfectious agents and her screening tests for sexually transmitted disease were negative. The genital examination showed a very thinned, hyperemic and edematous vulvar skin with two lesions measured 0,5-1 cm in diameter on the right labium majus. The surface of the lesions was partly uneven and partly veined. A local excision was performed. Histological examination showed hyperkeratosis, papillomatosis and acanthosis with dilated vascular areas in the dermis and the specimen revealed angiokeratoma. In conclusion, we should be aware of this clinical entity to make the differential diagnosis of a lesion on the vulva.