ABSTRACT
In vitro maturation (IVM) of immature oocytes retrieved from surgically resected ovaries has been proposed as a method of fertility preservation in ovarian cancer patients undergoing definitive surgery. While there had been several reports of successful derivation of mature oocytes and or embryos, there have been no reports as yet of successful pregnancies. In this case report, we present a pregnancy and live birth from a young patient, with stage IIIC ovarian cancer, who had undergone fertility sparing surgery. The immature oocytes recovered after oophorectomy were fertilized after IVM. The embryos obtained were cryopreserved and later transferred to achieve a singleton healthy pregnancy leading to a live birth.
Subject(s)
Cryopreservation , Embryo Transfer , In Vitro Oocyte Maturation Techniques , Oocytes/cytology , Ovarian Neoplasms/complications , Ovarian Neoplasms/therapy , Ovariectomy , Female , Fertility Preservation , Humans , Infertility, Female/etiology , Infertility, Female/therapy , Ovary/surgery , Pregnancy , Pregnancy Complications , Pregnancy Outcome , Young AdultABSTRACT
INTRODUCTION: Pregnancy following successful embolisation of a uterine arteriovenous malformation (AVM) is rare. Hypovascularity of treated areas affecting placentation and fetal growth has been postulated to be the cause for adverse pregnancy outcomes. CLINICAL PICTURE: A 37-year-old multiparous lady presented with anaemia from repeated heavy vaginal bleeding from an iatrogenic uterine AVM. This was diagnosed with power Doppler ultrasonography and embolised after pelvis angiography with hystoacryl and lipiodol. Following this she had a spontaneous pregnancy with a normal outcome. CONCLUSION: There are no distinguishing clinical features of a uterine AVM. An index of suspicion and power Doppler sonography help in reaching a diagnosis. Dilatation and curettage should be avoided as this can precipitate torrential vaginal bleeding.
Subject(s)
Arteriovenous Malformations/therapy , Embolization, Therapeutic/methods , Pregnancy Complications, Cardiovascular/therapy , Pregnancy Outcome , Adult , Angiography , Arteriovenous Malformations/complications , Arteriovenous Malformations/diagnosis , Cesarean Section , Female , Follow-Up Studies , Humans , Infant, Newborn , Pregnancy , Pregnancy Complications, Cardiovascular/diagnosis , Pregnancy, High-Risk , Prenatal Care , Ultrasonography, Doppler , Uterine Hemorrhage/etiology , Uterine Hemorrhage/therapyABSTRACT
OBJECTIVES: The aims of this study were to review our local experience with bowel surgery for epithelial ovarian cancer at the Gynaecological Cancer Centre, KK Women's and Children's Hospital, and to document the outcome of such surgery as well as their complication rates. MATERIALS AND METHODS: The retrospective medical records of 38 patients with epithelial ovarian cancer who underwent surgery including bowel surgery from January 1997 to May 2002 at the Gynaecological Cancer Centre, KK Women's and Children's Hospital, Singapore, were reviewed. RESULTS: Indications for surgery were predominantly debulking of disease. Fifty-eight per cent of patients had primary debulking surgery, 34% had debulking of recurrence and 3% had interval debulking. Only 5% of patients had bowel obstruction as the only indication for surgery. Rectosigmoid resection was the most common bowel operation overall, being performed in 76.3% of patients. The stoma rate for rectosigmoid resection was 61%. The remaining procedures included 7 colectomies, 1 intestinal bypass procedure and 1 intestinal diversion procedure. Optimal debulking (defined as < 1 cm of residual disease) was achieved in the majority (71%). The median operating time was 4 hours. The median blood loss was 1300 mL. The major complication rate was 10.5%. Major complications encountered were as follows: 1 patient (2.6%) had an anastomotic leak, 2 patients (5.3%) had intra-abdominal abscess and 1 patient (2.6%) developed intestinal fistula. Three patients (7.8%) required a re-operation within 30 days. There were 3 deaths (7.8%) within 30 days of surgery. CONCLUSION: Bowel surgery is commonly indicated for epithelial ovarian cancer to facilitate optimal debulking. Such surgery is feasible with acceptable complication rates in our local centre.
Subject(s)
Colorectal Neoplasms/secondary , Colorectal Neoplasms/surgery , Neoplasms, Glandular and Epithelial/secondary , Ovarian Neoplasms/pathology , Adult , Aged , Aged, 80 and over , Anastomosis, Surgical , Biopsy, Needle , Colectomy/methods , Colorectal Neoplasms/pathology , Female , Follow-Up Studies , Humans , Intestinal Obstruction/etiology , Intestinal Obstruction/surgery , Middle Aged , Neoplasm Staging , Neoplasms, Glandular and Epithelial/mortality , Neoplasms, Glandular and Epithelial/surgery , Ovarian Neoplasms/surgery , Retrospective Studies , Risk Assessment , Sampling Studies , Singapore , Survival Analysis , Treatment OutcomeABSTRACT
⺠We present four cases of benign granular cell tumours of the vulva managed between 1998 and 2001. ⺠We discuss the clinical and histopathological features of this condition. ⺠Treatment of this condition is primarily surgical.