Gastrointestinal stromal tumors of the colon and rectum.

Gastrointestinal stromal tumors (GISTs) are rare neoplasms, colorectal location being met in less than 5% of cases. Knowledge about this site related particularities are limited. The aim of this study is to present our experience with colorectal GISTs between 2005 and 2018 from the clinical, morphological, and immunohistochemical perspectives, with emphasis on prognostic factors. From a total of 203 gastrointestinal stromal tumors registered, 12 were colorectal (6%). The number of colonic tumors surpassed that of the rectum (9 : 3) and on the right side were registered more cases than on the left side (6/3). 9 were primary tumors and 3 were recurrences. Men and women were represented equally and the age range was between 22 and 76. Tumor dimensions varied between 0.5 and 14 cm. Microscopically, spindle cell type was dominant. Mitotic rate was variable between 1 and 115/50HPFs. Accordingly, for primary tumors progression risks were assigned (low risk: 2 cases, intermediate risk: 3 cases and high risk: 4 cases). All GISTs were CD117 and DOG1 positive. Four of the patients died of the disease.

Use of Thermal Black as Eco-Filler in Thermoplastic Composites and Hybrids for Injection Molding and 3D Printing Applications.

Thermal black (TB) is one of the purest and cleanest forms of carbon black (CB) commercially available. TB is manufactured by the decomposition of natural gas in the absence of oxygen while the common furnace CB is derived from the burning of organic oil. TB has a larger particle size, a lower surface area, and lower level of particle aggregation, while being the most eco-friendly grade among the CB family. This study is the first-time evaluation of TB as filler in composites and hybrids based on thermoplastics such as polypropylene (PP), polyamide 6 (PA6), polyphenylene sulfide (PPS), and acrylonitrile butadiene styrene (ABS). TB loadings in composites were varied from 1 up to 40 wt. % and, in hybrids, the TB was used in combination with carbon fibers (CFs) at total contents up to 20 wt. %. TB-containing composites and hybrids based on PA6 and ABS were also extruded in filaments, used in 3D printing, and the obtained 3D printed parts were characterized. TB provided a very high loadability in thermoplastics while preserving their viscosity and performance. TB can replace a fraction of expensive CFs in composites without important changes in the composites' performance. The composites and hybrids exhibited electrical resistivity and good mechanical and thermal properties when compared to commercial compounds, while enabling significant cost savings. TB also showed to be an excellent coloring agent. TB proved to be an outstanding eco-filler for compounds to be used in injection molding and 3D printing technologies.

Tumor-to-Tumor Metastasis of Lung Cancer to Kidney Cancer: A Review of the Literature and Our Experience.

Tumor-to-tumor metastasis (TTM) is a rare phenomenon documented in patients with multiple primary cancers. This condition is defined as a metastasis between two true primary tumors. The most frequently reported recipient tumor is renal cell carcinoma (RCC), and the lung carcinomas are the most common metastatic tumor donors. Therefore, this paper attempts to address the current gap in knowledge about this rare phenomenon. The first part of this review outlines the recently proposed models and mechanisms involved in the TTM process. The second part then summarizes and analyzes previous case reports in the literature. We also present our experience with the case of lung cancer that metastasized into RCC. Given the sporadic incidence of TTM, no specific management guidelines exist. Therefore, considering TTM in patients with multiple primary tumors is important as it could potentially modify the oncological management offered.

Active Case-Finding: An Effective Solution for Tuberculosis Detection in Vulnerable Groups - The Romanian Experience.

Introduction: Tuberculosis (TB) remains a global health challenge, requiring enhanced active case finding (ACF) through screening strategies. This study assesses the effectiveness of such an approach in locating TB cases among vulnerable groups, such as homeless persons, injecting drug users, those detained in prison, and people living in rural areas. Methods: The study focuses on socio-economic characteristics and TB detection rates across Romanian counties using modern techniques including computer-aided detection of lesions on chest X-ray and GeneXpert tests. Results: The results highlight the disproportionate burden of TB in vulnerable groups, by revealing significant differences in TB detection rates between regions. Notably, the TB detection rates among these vulnerable groups (250.85 per 100,000 population) are five times higher than the national incidence rate (46.1). Discussion: These findings underscore the imperative integration of ACF into National TB Program to provide customized and efficient solutions for diverse vulnerable groups, thereby informing crucial public health initiatives and interventions.

Combined Oxygen-Ozone Therapy for Mesh Skin Graft in a Cat with a Hindlimb Extensive Wound.

This case report describes a new therapeutic approach for a domestic shorthaired female cat, who has an extensive posttraumatic wound in the right hind limb. After patient stabilization, general anesthesia was started and the wound was cleaned and debrided of devitalized tissues, followed by the application of ozone therapy and bandage. Eight sessions of ozone therapy were performed for 17 days until the application of the skin graft. Three more sessions of ozone therapy were performed every 3 days postoperatively. The bagging method and the perilesional infiltration method were used. The ozone therapy ensured an accelerated recovery of the patient without any complications. According to our knowledge, this is the first case report with the use of ozone therapy to support a free skin graft in a cat. The new therapeutic approach could be used to accelerate healing of the wounds with a significant lack of substance, by supporting pre- and post-operative skin grafts.

Biochemical Changes Induced by the Administration of Cannabis sativa Seeds in Diabetic Wistar Rats.

The present pilot study investigates the blood biochemical changes induced by hemp seeds in rats with diabetes. The composition of industrial hemp seeds, antioxidant activity, identification and quantification of phenols and fatty acids from hemp oil were determined. The Wistar adult rats used in the experiment were divided into three groups (n = 6) and kept under standard conditions. Group one, the control group (individuals without diabetes), and group two (diabetic individuals) received water and normal food ad libitum, while the third group, also including diabetic individuals, received specific food (hemp seeds) and water ad libitum. Subsequent blood biochemical parameters were determined. Hemp seeds had higher phenol (14 compounds), flavonoids and PUFA contents compared to other plants seeds. In addition, the antioxidant activity in Cannabis sativa was also increased. Moreover, the ratio between n-6 and n-3 was 4.41, ideal for different diseases. Additionally, all biochemical parameters showed significant changes following the treatment. It was shown that high doses of hemp seeds decreased diabetes-induced biochemical damage in rats most probably due to the high content of active compounds. In order to use these seeds in humans, it is essential to find out which hemp compounds are particularly responsible for these effects. Moreover, for the objective investigation of their effects, longer-term studies are needed.

E, K, B5, B6, and B9 vitamins and their specific immunological effects evaluated by flow cytometry.

It has been proven that vitamins play an essential role in preventing certain diseases since ancient times. It is thus fruitless to approach the roles of vitamins without making reference to the techniques used in evaluating the effects of these micronutrients. Therefore, the aim of this paper was to summarize the immunological effects of E, K, B5, B6, and B9 vitamins evaluated by flow cytometry. Some of these significant effects were presented and discussed: (a) The role of vitamins E in the prevention and treatment of different types of cancer. (b) The properties of K vitamins in the development and maintenance of pheochromocytoma Cell Line 12 (PC12) cells in Parkinson's disease; (c) The improvement effect of vitamin B5 on the loss of bone mass in low estrogen conditions; (d) The anticancer role of vitamins B6. (e) The role of Vitamin B9 in the regulation of Treg cells. As such, the flow cytometry technique used to assess these properties is essential to evaluate the immunomodulatory effects of certain vitamins. The technique undergoes constant improvement which makes it possible to determine several parameters with a role in the modulation of the immune function and at the same time increase the accuracy of the methods that highlight them.

Anthocyanins from Agro-Industrial Food Waste: Geographical Approach and Methods of Recovery-A Review.

Drastic growth in the amount of global food waste produced is observed every year, not only due to incessant population growth but also economic growth, lifestyle, and diet changes. As a result of their increasing health awareness, people are focusing more on healthy diets rich in fruits and vegetables. Thus, following worldwide fruit and vegetable consumption and their processing in various industries (juice, jams, wines, preserves), significant quantities of agro-industrial waste are produced (pomace, peels, seeds) that still contain high concentrations of bioactive compounds. Among bioactive compounds, anthocyanins have an important place, with their multiple beneficial effects on health; therefore, their extraction and recovery from food waste have become a topic of interest in recent years. Accordingly, this review aims to summarize the primary sources of anthocyanins from food waste and the novel eco-friendly extraction methods, such as pulsed electric field extraction, enzyme-assisted extraction, supercritical fluid extraction, pressurized liquid extraction, microwave-assisted extraction, and ultrasonic-assisted extraction. The advantages and disadvantages of these techniques will also be covered to encourage future studies and opportunities focusing on improving these extraction techniques.

Microencapsulation and Bioaccessibility of Phenolic Compounds of Vaccinium Leaf Extracts.

In recent years, Vaccinium spp. (bilberry-VMT, lingonberry-VVIT, and blueberry-VCS) have sparked particular interest for their prospective health benefits. The latest investigations have place them as important alternative sources of nutraceuticals as their leaves are the main by-products of berry harvesting. The present study is aimed at investigating the bioaccessibility of phenolic compounds from leaves of the Vaccinium species, both as microencapsulated powder and aqueous extracts, following exposure to in vitro simulated digestion. Moreover, the impact of maltodextrin and glucose microencapsulation carriers on the extracts' phenolic content was assessed. Prior to encapsulation, the viscosity of the emulsions was shown at a shear stress of 50 s-1 dilatant and a Newtonian behaviour above this value with a final viscosity between 1.024 and 1.049 mPa·s. The final microencapsulation yield for the samples ranged between 79 and 81%. Although the microencapsulated forms presented a targeted release at the intestinal level, the phenolic content decreased after gastrointestinal digestion. The bioaccessibility of the microencapsulated extracts showed higher values than their non-encapsulated counterparts, with the highest value of 45.43% in the VVIT sample, followed by VCS with 41.07%. However, the non-encapsulated VCS sample presented high bioaccessibility after in vitro digestion (38.65%). As concluded, further in vivo research should be conducted on the leaves of the Vaccinium species.

The Use of Chitosan, Alginate, and Pectin in the Biomedical and Food Sector-Biocompatibility, Bioadhesiveness, and Biodegradability.

Nowadays, biopolymers as intelligent and active biopolymer systems in the food and pharmaceutical industry are of considerable interest in their use. With this association in view, biopolymers such as chitosan, alginate, pectin, cellulose, agarose, guar gum, agar, carrageenan, gelatin, dextran, xanthan, and other polymers have received significant attention in recent years due to their abundance and natural availability. Furthermore, their versatile properties such as non-toxicity, biocompatibility, biodegradability, and flexibility offer significant functionalities with multifunctional applications. The purpose of this review is to summarize the most compatible biopolymers such as chitosan, alginate, and pectin, which are used for application in food, biotechnological processes, and biomedical applications. Therefore, chitosan, alginate, and pectin are biopolymers (used in the food industry as a stabilizing, thickening, capsular agent, and packaging) with great potential for future developments. Moreover, this review highlights their characteristics, with a particular focus on their potential for biocompatibility, biodegradability, bioadhesiveness, and their limitations on certain factors in the human gastrointestinal tract.

Transitional cell tumors of the ovary: a compact group with a heterogeneous histological and immunophenotypical pattern.

A small percentage of ovarian neoplasms are transitional cell tumors, which proves to be a distinct group with various histological and immunohistochemical patterns. In this study, 13 archived formalin-fixed paraffin-embedded samples of transitional cell tumors of the ovary have been assessed using standard HE stain and the indirect tristadial ABC peroxidase IHC method for 11 antibodies (CA125, CK7, CEA, EMA, MNF116, CK20, Vim, ER, PgR, PCNA, Ki-67). More than 50% were malignant Brenner tumors. CA125 was positive in all malignant tumors (of Brenner type and transitional cell carcinomas), but not in benign and borderline tumors, while CK7 was positive in approximately 70% of all cases. These two antibodies have shown a high sensitivity and low specificity, but do not correlate to each other. PCNA was positive in the study batch with a mean value of 40% and Ki-67 with a mean value under 25%. A direct correlation statistically significant has been noted between the aforementioned proliferation factors and the tumor grade (r = 0.4, p = 0.05). The other markers were unspecific, with low sensitivity and independently of the histopathological type.

Extrusion foaming of semi-crystalline PLA and PLA/thermoplastic starch blends.

Low density open-cell foams were obtained from polylactic acid (PLA) and from blends of PLA with thermoplastic starch (TPS) using CO(2) as a blowing agent. Two unexpected features were found. First, a 2D cavitation process in the fractured cell walls was unveiled. Elliptical cavities with dimensions in the 100-300 nm range were aligned perpendicular to large cell cracks clearly exhibiting 2D crazing prior to macroscopic cell rupture. Secondly, a significant crystallization rate increase associated with the CO(2) foaming of PLA was discovered. While the PLA used in this study crystallized very slowly in isothermal crystallization, the PLA foams exhibited up to 15% crystallinity, providing evidence that CO(2) plasticization and the biaxial stretching upon foam expansion provided conditions that could increase the crystallization rate by several orders of magnitude.

Ultrastructural analysis of the endometrial mucosa of female patients at menopause with hormonal substitutive therapy (TSH).

The objective of the paper was to observe the ultrastructural aspects of the endometrial biopsies taken from female patients at post-menopause with substitutive hormonal therapy (TSH). Material and methods. A number of three endometrial biopsies were taken from female patients at post-menopause with TSH. The ultrastructural analysis was carried out with the help of the electronic microscope Philips ME 301 using classical electronic microscopy methods. Results and discussions. The ultrastructural analysis has highlighted the presence of cuboidal and columnar epithelial cells, with basally situated nuclei, well represented cellular organelles, some cells having at the apical pole microvilli. At the electronic microscope, three types of epithelial cells are described, at the level of the endometrial mucosa of the woman who is in a fertile period: secretory cells (cells with an average electronic density with microvilli on the luminal surface), ciliated cells and clear cells (cells with a low electronic density). These cells have certain ultrastructural characteristics and of receptivity towards the steroid hormones. The stroma is axial with elongated cells with oval nuclei, with nucleoli and with smooth or undulated membrane. Conclusions. The ultrastructural aspects suggest the presence at endometrial level of epithelial active glandular cells, secretory cells and stromal active cells at female patients at post-menopause with TSH.

Quantification of apoptotic phenomenon on endometrial biopsies in postmenopausal patients under hormonal replacement therapy (HRT).

AIM: To quantify the apoptotic phenomenon on endometrial biopsies in postmenopausal patients under hormonal replacement therapy (HRT). MATERIAL AND METHODS: The study lot consisted of 30 endometrial biopsies on which we studied the apoptotic phenomenon through morphological and molecular biology techniques (TUNEL reaction). Examination of endometrial biopsies before and post-therapeutically has been made. RESULTS AND DISCUSSIONS: From morphological point of view, pre-therapeutically, endometrial biopsies presented apoptotic changes in about 1-3% of cells and under TSH there have been observed apoptotic changes in about 1-2% of cells. In female reproductive system, we found out a raised rate of cellular proliferation and concurrently a raised rate of apoptosis. Apoptotic phenomenon can be observed in endometrium at every menstrual cycle. In proliferative endometrium apoptosis rate is low, but in endometrial carcinoma apoptosis rate grow up. Bcl2 and Bax are expressing in normal and hyperplastic endometrium, but in endometrial carcinoma Bcl2/Bax ratio decline. CONCLUSIONS: Quantification of apoptosis, using morphological and TUNEL reaction methods, on endometrial biopsies in postmenopausal patients before and after therapy indicate a low rate of apoptotic phenomenon.

Patterns of Road Traffic Accident in North-East Romania.

Romania is ranked first among mortality road traffic accidents in Europe. The aim of our study was to evaluate some statistical patterns of population group who unfortunately was admitted at an emergency hospital of Iasi, a large city in the North East of the country. Material and Methods: The study was performed on 1623 patients admitted in the Emergency Room ("Sf. Spiridon" Emergency Hospital of Iasi, Romania) suffering from road traffic accidents, during 2009 and 2013. Results: The prevalence of 19-45 age group cases represented more than 50% of all patients, with a high significance (p<0.05), and men were involved more frequently (69.69%) than women (30.31%); most of the patients were injured while driving an automobile; 6 PM was the "rush" hour (6.4%), Monday was the "black" week day (16.02% of total cases), September the "harvest" time (12.7%), and Summer the "hottest" season (48.49%). Conclusions: The "B plan" is imperative to be implemented in Romania, including better roads, better vehicles, better legislation, and better teens' education, in order to avoid road traffic accidents.

Primary retroperitoneal seminoma - embryology, histopathology and treatment particularities.

INTRODUCTION: Retroperitoneal seminoma is a very rare form of cancer, with embryological origin represented by primordial germ cells from the urogenital ridges left behind during the fetal development. Extragenital germ cell tumors can also occur in the mediastinum or the pineal gland. The aim of this paper is to outline the particularities and draw embryological, histopatological and treatment conclusions regarding extragonadal germ cell tumors. PATIENT AND METHODS: A 43-year-old patient without any additional pathology was admitted for anemia of unknown etiology. The clinical examination revealed through deep abdominal palpation a mass in the left flank, and normal testes. Thoraco-abdomino-pelvic computed tomography (CT) scan showed a large retroperitoneal tumor adjacent to the great vessels in the left lumbo-iliac region. The blood work revealed just a low hemoglobin and hematocrit. With the established diagnosis of retroperitoneal tumor, radical surgical removal was decided. During the surgery, we were required to dissect a large solid encapsulated tumor mass from the aorta and the common iliac artery, starting at the renal pedicle all the way to the left iliac bifurcation. The surgical access was obtained through a transperitoneal left subcostal incision prolonged pararectally. Histopathological and immunohistochemical studies revealed a seminoma of the usual type. After the histological findings, the patient's tumor markers were investigated (LDH - lactate dehydrogenase, ßHCG - beta-human chorionic gonadotropin, αFP - alpha-fetoprotein), all values being within normal ranges. In addition, the left testicle was thoroughly reexamined, clinically, through ultrasound and magnetic resonance imaging (MRI) scans, and no abnormalities were observed. After the surgery, the patient followed three courses of chemotherapy (BEP - Bleomycin, Etoposide and Cisplatin). RESULTS: The CT scan done 24 months after surgery found no signs of local or distant tumor recurrence. The patient entered a follow-up schedule consisting of periodical clinical, serological and imagistic evaluations. CONCLUSIONS: Primary retroperitoneal seminoma is a rare entity that must be taken into account when treating a retroperitoneal tumor. It develops out of the urogenital ridge, while the testes are normal. Thorough testicular evaluation (clinical, ultrasound and serum markers) is mandatory in all retroperitoneal tumors. The histopathological analysis is crucial for an accurate diagnosis and a proper management strategy. Through radical surgery and chemotherapy, the patients that are diagnosed prior to massive visceral metastatic dissemination can be cured.

Surveillance Seasonal Program. Antibiotic Resistance of Pathogenic Agents Isolated From Children With Acute Gastroenteritis, in a Region of North-East Romania.

The acute gastroenteritis is a population health problem, frequently met everywhere in the world. In Romania, for certain etiologies the reporting is compulsory. Also, these infections are reported in the TESSy system, too (The European Surveillance System). In this context, antibiotics therapy and antibiotics resistance have a particular importance. The study aim was to assess the prevalence of bacterial pathogens involved in the etiology of acute gastroenteritis (AGE) on the Iasi County, Romania and the surrounding areas and the determination of the profile of resistance to the antibiotics for the identified agents. Material and methods: 72 strains of isolated and identified bacterial agents involved in the acute gastroenteritis (AGE) in the case of children (0-14 years), with the exception of the Campylobacter spp., in the municipality of Iasi and its surrounding areas were studied in 2012, during the surveillance period of AGE (May to October). Results: The most frequent has been the Salmonella spp. (63.9%) from which the S. enterica Thyphimurium in 21 cases (29.2%) and S. enteritidis in 7 cases (9.7%), followed by E. coli (20.8%) from which E. coli O:127 in 3 cases (4.2%), Shigella sonnei S (13.9%) and Yersinia enterocolitica (1.4%). In the case of the children from the group of 0-1 year, the Salmonella enterica Thyphimurium has been the pathogenic agent most frequently encountered (6 cases ­ 29.2%), followed by Salmonella Colindale, S. enteritidis, Shigella sonnei S, E. coli O:127 registered with a frequency of 5.6%. The antibiotic resistance rates are high in the case of ampicillin (43.1%), tetracycline (31.9%), amoxicillin ­ clavulanic acid (26.4%), trimethoprim/ sulfametoxazole (22.2%), sulfonamides (11.1%). Conclusions: The antibiotic resistance rates are high in the case of ampicillin, tetracycline, amoxicillin ­ clavulanic acid, trimethoprim/ sulfametoxazole, sulfonamides.

Epidemiological assessments on incidence of acute gastroenteritis in 0-14 aged children, in the Iasi County, Romania, between 2009-2012.

UNLABELLED: The study aim was to assess the epidemiological potential of acute gastroenteritis (AGE) in children between 2009 and 2012. MATERIAL AND METHODS: We studied two groups; first, a lot of 7237 cases (group A) recorded in the Iasi County through passive surveillance system, reported monthly by the network of primary health care, the assisted outpatients, respectively, those reported by hospitals. The second group (group B) was composed of 4191 hospitalized cases reported also in the passive surveillance system m by telephone, weekly, during only June/end of May to October/beginning of November. Structural peculiarities of the two groups are due to different reporting methodology, so that they were analyzed separately. RESULTS: AGE cases come from urban or rural areas in relatively stable proportions and slightly increased in rural areas compared to urban. The distribution by sex of cases from the group B is maintained at the same shape from one year to another, with a slight predominance in males. The best represented age group in every studied was 0-3 (54.3% of all cases), followed by children between 5 and 10 years with 17.5%). Laboratory investigations have enabled the etiologic diagnosis for hospitalized cases, which ranged from 15.3 to 17.5%, with the exception of 2009 when the diagnosis was noted for almost half of the discharged patients (47.5%). CONCLUSIONS: AGE remains a public health problem in the Iasi County and Romania also, by affecting all age groups, but especially children under 3, an insufficient knowledge of the etiology, and economic losses insufficiently evaluated.

Descriptive study on acute gastroenteritis in 3,883 patients admitted in "sf. Maria" children hospital from Iasi, Romania, between 2008 and 2013.

UNLABELLED: The aim of study was to assess some population characteristics in children of acute gastroenteritis (AGE) admitted in a regional pediatric hospital. MATERIAL AND METHODS: For the present transversal descriptive study we considered a group of subjects hospitalized for AGE in 2008-2013 (2013--only 6 months) in "Sf. Maria" Emergency Hospital for Children Iasi, Romania. Consultations in the Emergency Unit of this hospital did not take into consideration. RESULTS: Number of AGE cases admitted to "St. Maria" Emergency Hospital for Children Iasi between 2008 and 2013 has seen a steady decline. Male subjects are better represented (54.1%); largest age group 1-4 years, with 1,827 cases, immediately followed by group 0-1 year (1789 cases); together, the two-age groups account for 93.1% of admissions for AGE. Distribution of cases by seasons showed balanced values, with higher percentages in summer (29.7%) and spring (25.5%). The number of cases is relatively constant and lower in winter, affecting predominantly younger groups (0-5 years) compared to the summer when cases aged 5 to 14 years were admitted more frequent. Most cases presented at admission vomiting (41.2%) and fever (40.7%); the presence of bacterial flora was identified in 82.2% of stool specimens, and blood in 13.4% of cases. CONCLUSIONS: A higher number of education measures should be implemented in urban and rural areas in order todecrease the contamination with pathogenic agents involved in infectious acute gas- troenteritis in children.

Testicular feminization: complete androgen insensitivity syndrome. Discussions based on a case report.

INTRODUCTION AND OBJECTIVES: Testicular feminization is the syndrome when a male, genetically XY, because of various abnormalities of the X chromosome, is resistant to the actions of the androgen hormones, which in turn stops the forming of the male genitalia and gives a female phenotype. The androgen insensitivity syndrome occurs in one out of 20,000 births and can be incomplete (various sexual ambiguities) or complete (the person appears to be a woman). The aim of this paper is to present the diagnosis and treatment of a case of testicular feminization. PATIENT AND METHODS: A 22-year-old patient is admitted at Gynecology for primary amenorrhea. The clinical examination shows a female phenotype: the breasts are normally developed, but there is no hair in the groins and axillary areas, the labia are small and hypoplastic, the urinary meatus is normally inserted, and the vulva is unpigmented. The gynecological exam reveals that the hymen is present, the vagina has 1.5 cm in length, while the uterus is absent. At Endocrinology, the levels of gonadotropins were measured and found normal (FSH 3.18 mU/mL, LH 15 mU/mL), the progesterone was 5.79 nmol/L, estradiol was 82.39 pmol/L and the testosterone was 4.27 nmol/L. The karyotype was mapped in order to differentiate the androgen insensitivity syndrome from other genetic abnormalities, like the Klinefelter syndrome (46XXY), Turner syndrome (45XO), mixed gonadal dyssynergia (45XO/46XY) or tetragametic chimerism (46XX/46XY). These tests confirmed the suspected diagnosis - testicular feminization (46XY). The pelvic CT scan revealed the lack of uterus and ovaries, hypoplastic vagina, and intra-abdominal prepsoic testes. The testes were removed in order to avoid the malignant risk. We performed laparoscopic bilateral orchiectomy. RESULTS: Surgically, the patient had a simple evolution, being discharged in the second day postoperatory, and estrogen therapy was started from that moment on. Mentally, the patient kept thinking she was a woman, so the decision of telling her the truth was left to the parents. CONCLUSIONS: Testicular feminization is a rare disease that must be diagnosed and treated through close work between gynecologists, endocrinologists, geneticians, urologists, and psychiatrists. Bilateral laparoscopic orchiectomy is the best procedure to remove the intra-abdominal testes, in order to avoid their malignant transformation.