[Comparison of two groups of patients with serous and mucinous types of borderline ovarian tumors]. / Analiza porównawcza chorych z surowiczymi i sluzowymi nowotworami jajnika o granicznej zlosliwosci.

OBJECTIVE: The retrospective comparison of two groups of patients with the most common types of borderline ovarian tumors (BTO): serous and mucinous. METHODS: All patients were treated between 1978 and 2000 at the 2nd Department of Obstetrics and Gynecology Medical University of Gdansk. The first group consisted of 58 patients with serous BTO. The second group consisted of 48 patients with mucinous BTO. These groups were compared according to such parameters: age at diagnosis, parity, clinical symptoms, localization of tumor, tumor size, type of operation, stage of disease, utilization of adjuvant therapy, presence of recurrence and 5-year survival. Statistical comparisons were made by the chi 2 test. The clinical life table analysis was performed to determine 5-year survival and comparisons were made by means of the Long Rank tests. RESULTS: The mean age of serous BTO was 53.1 +/- 12.8 and of mucinous BTO 43.3 +/- 17.9 (p = 0.0000). In the first group 15.5% and in the second 43.8% women were nullipara (p = 0.0602). The main symptom of serous BTO was pain--53.5% patients and that of mucinous BTO increasing girth--47.9% patients (p = 0.0456). The mean size of serous BTO was 13.7 +/- 6.9 cm and that of mucinous BTO was 20.3 +/- 9.5 cm (p = 0.004). 43 patients (89.6%) with mucinous and 28 patients (48.3%) with serous BTO were at I A stage and 9 patients (15.5%) with serous and only one (2.1%) with mucinous were at III stage (p = 0.0008). The mucinous BTO--affected were more frequently treated conservatively than serous BTO--ones which were rather treated radically with using adjuvant therapy (p = 0.003). Residual disease was observed mainly in patients with serous BTO. 5-years survival was better in patients with mucinous BTO, 87.7% and 85.2% respectively (p = 0.0001). CONCLUSIONS: 1. The mucinous BTO occurred more frequently than serous BTO in women of the childbearing age. 2. The extraovarian disease was observed more often with serous BTO than the mucinous BTO. 3. The mucinous BTO was usually bigger than serous BTO and mainly affected only one ovary. 4. The mucinous BTO was more frequently treated conservatively than serous BTO which were rather treated radically with use of adjuvant therapy. 5. The recurrence rate was higher and the 5-year survival was worse in patients with serous BTO.

[Pregnancy and delivery after conservative surgical treatment and radiotherapy of vulvar carcinoma]. / Ciaza i poród po wieloetapowym, oszczedzajacym leczeniu chirurgicznym i radioterapii z powodu raka sromu.

The study presents a rare case of a very young women with carcinoma of the vulva who was pregnant and delivered after therapy of vulvar cancer. First surgical management was performed on a 16-year-old patient. Further therapy included wide resection of ipsilateral groin lymph nodes affected by carcinoma. Ipsilateral pelvic lymphadenectomy was also performed. After resection of a local recurrence from the right inguinal region, the patient was administered external beam irradiation of 45 Gy to the hemi-pelvis. At 6.5 year after the completion of the therapy (surgical management and radiotherapy) the patient is free of disease. Such therapy allowed to preserve fertility and the patient conceived and delivered. Partial post-irradiation damage of the uterus might have caused immature labor.

[Co-existence of myoma uteri and pregnancy]. / Ciaza powiklana obecnoscia miesniaków macicy.

OBJECTIVE: Myomas of uterus are the most common mild tumours of uterus. There is often observed the rapid increase of them during the pregnancy and then they could caused complications from 0.3% to 2.6% of pregnancies. DESIGN: The aim of study was the general valuation of the course and delivery means of the pregnancies coexisted with myoma uteri. MATERIALS AND METHODS: We have analysed 11 pregnancies, which we observed during hospitalisation of pregnant women at 2nd Department of Obstetrics and Gynaecology at Medical University of Gdansk. RESULTS: We observed pain in abdomen during pregnancy in 63.6% of analysed group. The 6 (54.5%) pregnant women were pharmacologically treated against symptoms of miscarriages and preterm labors. We investigated in the connection of the complicated pregnancy at women with myomatous uterus. The results confirm the high risk of the pregnancy. Almost 82% of analysed group delivered at time. The frequency of caesarean sections in our study was about 36%, but 2 of them were performed because of myomas. CONCLUSION: We made conclusion that pregnancy complicated by myomas had not significant increase in failure at the end. Myomatous uterus in pregnancy required to be quickly diagnosed and take care to prevent complications.

[Coexistence of ovarian carcinoma with pregnancy--case report]. / Zlosliwy nowotwór jajnika wspólistniejacy z ciaza.

OBJECTIVE: Ovarian tumors during pregnancy are a rare event. More ovarian tumors are detected accidently during ultrasonography examination or caesarean section at term. STUDY DESIGN: Ovarian tumor was recognized at the 36 years old patient during 21 weeks of pregnancy and was observed and treated during caesarean section. RESULTS: During caesarean section the mesonephroid ovarian carcinoma at IA stage has been diagnosed and unilateral cystectomy after meticulous surgical exploration was done.

[Pregnancy and delivery after conservative treatment of borderline ovarian tumor with FIGO stage III C--a case report]. / Ciaza i poród po oszczedzajacym leczeniu operacyjnym z powodu nowotworu jajnika o granicznej zlosliwosci w stopniu zaawansowania III C.

This study presents a case of pregnancy after conservative surgical treatment of borderline ovarian tumor with III C stage according to FIGO classification. The caesarean section in 37 week of pregnancy was performed and connected with very precise staging. In normal-appearing both ovaries the foci of borderline ovarian tumor were found. There were no foci of borderline ovarian tumor or foci of invasive carcinoma in tissues routinely sampled during the second look operation. All benefits and costs of conservative surgical approaches to very young, childless women with advanced borderline ovarian tumor were exactly estimated.

[The late recurrence of ovarian cancer seventeen years after radical surgery]. / Wznowa raka jajnika po 17 latach po radykalnym leczeniu operacyjnym.

The study presents a very interesting case of ovarian cancer with long-term survival. The patient was primary treated by conservative surgery without chemotherapy. Cystadenocarcinoma mucinous G-1 was recognized. Ovarian cancer relapsed after eight years and the second operation was performed. During next, radical operation other histological typ of ovarian cancer (mixed, sero-mucinous cystadenocarcinoma) was recognized. Eight years after second surgery and seventeen years after primary surgery ovarian cancer again recurred. There were a very diffuse neoplastic process at the abdominal cavity. Although patient was treated by surgery and chemotherapy, she died. The study presents new opinions of pathogenesis of ovarian cancer and origin of recurrences, including theory of multifocal neoplasia of mesothelium.