RESUMO
BACKGROUND: DICER1 mutation has been linked to development of Sertoli-Leydig cell tumor and cystic nephroma, among other neoplasms. CASE: We present a unique case of recurrent ovarian Sertoli-Leydig cell tumor in a pediatric patient with a known DICER1 mutation and history of cystic nephroma. She underwent surgical staging and adjuvant chemotherapy, and her recurrences have been treated with chemotherapy, whole-abdomen radiation therapy, and further surgical debulking. CONCLUSION: This report adds to the small body of evidence about this rare but unexpectedly highly aggressive tumor, especially in the recurrent setting, and reminds the reader of the importance of cancer diagnosis in this population.
Assuntos
Neoplasias Ovarianas , Tumor de Células de Sertoli-Leydig , Tumores do Estroma Gonadal e dos Cordões Sexuais , Criança , Feminino , Humanos , RNA Helicases DEAD-box/genética , Mutação , Neoplasias Ovarianas/patologia , Ribonuclease III/genética , Tumor de Células de Sertoli-Leydig/genética , Tumor de Células de Sertoli-Leydig/patologia , Tumores do Estroma Gonadal e dos Cordões Sexuais/patologiaRESUMO
BACKGROUND: Ovarian carcinoma diagnosed in pregnancy is rare. Treatment should take both mother and fetus into consideration. CASE: We present the case of a patient diagnosed with a stage IC1 yolk sac tumour of the ovary at 15 weeks gestation, who underwent surgical staging and adjuvant chemotherapy during pregnancy. Intrauterine growth restriction was diagnosed and the patient delivered by cesarean at 36 weeks gestation for obstructed labour. CONCLUSION: Yolk sac tumour of the ovary in pregnancy with concomitant chemotherapy is uncommon. Adverse outcomes, including restricted fetal growth, are possible and their identification may help guide timing of delivery.
Assuntos
Tumor do Seio Endodérmico , Neoplasias Ovarianas , Quimioterapia Adjuvante , Tumor do Seio Endodérmico/diagnóstico por imagem , Tumor do Seio Endodérmico/tratamento farmacológico , Tumor do Seio Endodérmico/cirurgia , Feminino , Humanos , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/cirurgia , Gravidez , Saco VitelinoRESUMO
OBJECTIVE: We sought to describe the pattern of age at menopause and factors associated with type of menopause. STUDY DESIGN: This was a prospective cohort study of 5113 postmenopausal health survey respondents in the Royal College of General Practitioners' Oral Contraception Study. Logistic regression was used to evaluate associations between sociodemographics, lifestyle, and medical history and menopause type. RESULTS: Median age at natural menopause (n = 3650) was 49.0 years (interquartile range, 45.0-51.0), and at surgical menopause (n = 1463) was 42.4 years (38.0-46.4). Early natural menopause was associated with smoking, ever-use of oral contraception, sterilization, and history of endometriosis (all increased odds ratios) and ever-use of hormone replacement therapy (decreased). Surgical menopause was associated with manual social class, sterilization, and having a history of endometriosis, menorrhagia, or painful menstruation (all increased), and ever-use of hormone replacement therapy (decreased). CONCLUSION: Age at natural menopause was younger in this cohort than in other studies. More associations were found for surgical menopause than early natural menopause.