Minilaparotomy-assisted LAVH for a very large fibroid.

We present the case report of a minilaparotomy-assisted LAVH carried out for the largest uterine myoma ever reported, with size equivalent to a full-term gestation.

Laparoscopic management of a large viable cornual pregnancy.

We present herein a case report of a viable cornual pregnancy rupture, inducing massive hemoperitoneum, treated laparoscopically.

A new quantitative method to evaluate adnexal tumors.

OBJECTIVE: The purpose of this study was to assess endometriomas and follicular cysts using a new quantitative method provided by the picture archiving and communication system. MATERIALS AND METHODS: We reviewed our computer ultrasound database of endometriomas and follicular cysts between November 2003 and July 2007. A total of 123 consecutive women diagnosed with an endometrioma or follicular cyst on two-dimensional sonography were re-evaluated using new parameters with the picture archiving and communication system. We chose quantitative tumor density and standard deviation on sonographic images as the new diagnostic parameters. Analysis of variance and Scheffé post hoc test were analyzed to compare the mean tumor density of the endometriomas and follicular cysts. The receiver operating characteristic curve was plotted to choose the cutoff value of the endometrioma tumor density with the best sensitivity and specificity. RESULTS: There was a significant difference when the tumor density of the follicular cyst and endometrioma groups was compared using the vaginal, abdominal or endovaginal approach (p < 0.001). Based on the results of the receiver operating characteristic curve, endovaginal ultrasonography is an excellent diagnostic tool with which to evaluate endometriomas. With endovaginal ultrasonography examination, the best cutoff value of tumor density is 28 and the sensitivity and specificity are 64% and 100%, respectively. CONCLUSION: The use of quantitative tumor density and standard deviation on sonographic images is a potential new diagnostic tool in the assessment of endometriomas and follicular cysts.

Age and prevalence of cervical carcinoma in subsequent hysterectomy following a conization procedure.

OBJECTIVE: To determine the prevalence and age of patients with cervical carcinoma missed by a loop electrosurgical excision procedure. MATERIALS AND METHODS: A total of 253 women with cervical dysplasia who underwent conization and 248 women who later underwent hysterectomy were retrospectively reviewed. The age and prevalence of those with cervical carcinoma diagnosed and missed by conization were determined. RESULTS: Of the 248 patients, 11 cases (4.4%) of cervical carcinoma were missed by cervical conization. The age of those with cervical carcinoma missed by conization was significantly greater than those whose diagnosis was not missed (p < 0.05). CONCLUSION: Women with severe cervical dysplasia who no longer wish to preserve fertility should be advised to undergo hysterectomy if the conization margins are not free of disease. Older women with incomplete resection margins tend to have undiagnosed hidden cervical carcinoma after cervical conization.

Ovarian capillary hemangioma presenting as pseudo-Meigs' syndrome: a case report.

We report a case of pseudo-Meigs' syndrome, consisting of bilateral ovarian hemangiomas, hydrothorax, ascites, and an elevated CA 125 level, which was resolved after laparoscopic bilateral salpingo-oophorectomy.