1,138 women with adnexal mass: pathologic findings according to age.

Purpose ofinvestigation: Influence of the patients' age are not well established to predict the malignancy potential of adnexal masses. This study was conducted to evaluate the impact of women's age on both histopathology and malignancy potential of adnexal masses. MATERIALS AND METHODS: This is a retrospective chart review study. Patients who were operated for suspected adnexal masses were included in the study. Malignancy potentials of tumors were divided in benign and at least borderline in univariate and multivariate analyses. Univariate analyses and RR calculations were performed according to malignancy potential for age, serum cancer antigen-125 (CA-125) levels and menopause status. RESULTS: A total of 1,138 women were included for this study; median age was 39 (16-92) years. Patients > 50 years had 5.920 times higher risk (95% CI 4.091-8.566; p = 0.0001) of having at least borderline tumor compared the younger group. The risk of at least borderline pathology was calculated as 3.723 (95% CI 2.595-5.342;p = 0.0001) in patients with CA 125 ≥ 35 IU/ml compared to the others. In multivariate analyses, only ≥ 35 IU/ml CA 125 level and > 50 years age groups were defined as independent variables for having at least borderline tumor. (OR: 4.456, 95% CI 2.982-6.659, p = 0.0001 and OR: 3.134, 95% CI 1.435-6.843, p = 0.004, respectively). CONCLUSION: In this study; the age of > 50 years was detected as an independent factor for having at least borderline pathology for adnexal masses. The data from these results might be used as a differential diagnostic tool in a new combination for benign and malignant adnexal masses in future studies.

The role of N-Acetylcysteine in preventing cyclophosphamide-induced gonadotoxicity: An experimental study in rats.

This study assessed whether NAC could prevent cyclophosphamide (CY)-induced damage, by measuring the anti-Müllerian hormone (AMH) levels. Forty-eight Sprague-Dawley female rats were divided into four groups: CY + NAC, CY, NAC and control, each including 12 rats. There was no significant difference among the 24-h AMH values of the groups (p = 0.452), whereas a significant difference was found in terms of 72-h values (p = 0.003). Paired comparisons revealed no significant difference between CY and CY + NAC (p>0.699) and NAC (p = 0.065) groups regarding 72-h AMH values. However, AMH concentrations of the CY group at 72 hours were significantly lower than those of the control group (p = 0.015). AMH concentrations of the CY + NAC group at 72 hours were also significantly lower than those of the NAC group (p = 0.002) and the control group (p = 0.002). The AMH levels of CY and CY + NAC groups at 72 hours were significantly lower than those at 24 hours. The 24-h and 72-h AMH levels in the NAC and control groups were similar. In the present study, a single dose of NAC failed to prevent the cytotoxic effects of CY.

Gliosarcoma associated with neurofibromatosis type I: a case report.

Neurofibromatosis type I (NF I) is the most common hereditary syndrome predisposing to neoplasia. We report the third case in the literature, documenting the combination of gliosarcoma with NF I. The patient's son was known at our center because of a history of pleomorphic xanthoastrocytoma (PXA) with NF I. A 48-year-old man who had a number of café-au-lait spots with neurofibroma since birth presented with severe headache. Neuroradiological studies revealed a cystic tumor of the right temporal lobe of high grade nature. Surgical excision was performed and the tumor was found to be located on the surface of the temporoparietal area with cystic formation and vascular and infiltrative features. Postoperative MRI Key words: gliosarcoma, neurofibromatosis I, temporal lobe. showed no detectable contrast enhancing tissue. Immunohistochemical examination evidenced the characteristics of typical gliosarcoma. The patient received radiation therapy but five months following surgery recurrence of the tumor was diagnosed. Reoperation was performed and histopathological studies confirmed the diagnosis of gliosarcoma. We believe that the neurofibromatosis was inherited by the son with PXA from the father with gliosarcoma. The rarity of the combined occurrence of gliosarcoma and NF I, in addition to this uncommon family history, makes this case remarkable. Our findings suggest that NF I is a multifaceted disease associated with benign as well as malignant astrocytic tumors.

Treatment of the subarachnoid-pleural fistula. Case report.

Subarachnoid-pleural fistula is a rare type of cerebrospinal fluid (CSF) fistula, and there are only several cases reported in the literature. The authors describe a 65-year-old male patient in whom a diagnosis of T7-8 disc herniation had been made. He underwent surgery via a right lateral extracavitary approach. Postoperatively he developed progressive respiratory distress and headache. A chest x-ray film revealed a pleural effusion, and computerized tomography (CT) myelography demonstrated a subarachnoidal-pleural fistula at the level at which the herniated disc had been removed. The patient had been managed via a CSF drainage system and a chest tube. He was discharged after relief of symptoms was attained. Subarachnoid-pleural fistulas can be secondary to traumatic injury and surgery, or they can be spontaneous. Patients present with rapidly filling pleural effusion and headache. A diagnosis can be established using CT myelography or myeloscintigraphy. Treatment is conservative, with the placement of a chest tube and insertion of a CSF drainage catheter, and surgical repair should be considered only if the conservative therapy fails.