Mesothelial cyst of the round ligament mimicking a metastasis: a case report.

A mesothelial cyst of the round ligament is a rare cause of an inguinal mass. Clinically, it is frequently misdiagnosed as one of commoner diseases such as an inguinal hernia, femoral hernia, lipoma, and lymphadenopathy upon physical examination. Some previous reports elaborated the sonographic features of a mesothelial cyst of the round ligament. However, to our knowledge, few reports have described the CT features of a mesothelial cyst. We illustrated here the sonographic and multidetector CT features of a case of a mesothelial cyst of the round ligament that presented as an inguinal palpable mass and mimicked a metastasis in a patient with a Sertoli-Leydig cell tumor of the ovary.

Gonadotropin-releasing hormone agonist reduces aromatase cytochrome P450 and cyclooxygenase-2 in ovarian endometrioma and eutopic endometrium of patients with endometriosis.

AIMS: To investigate whether the GnRH agonist may reduce aromatase P450 and COX-2 in the eutopic endometrium of patients with endometriosis and ovarian endometrioma. MATERIALS AND METHODS: Endometrial specimens and ovarian endometrioma were obtained from 15 women with endometriosis undergoing laparoscopic surgery. The stromal cells of the eutopic endometrium and ovarian endometroma were cultured in the presence of the GnRH agonist (leuprolide acetate 0, 1, 5 and 10 microM) for 24 h. To investigate the effects of the GnRH agonist on the eutopic endometrium in vivo, biopsy samples of the endometrium (n = 5) among the patients who underwent laparoscopy were obtained after GnRH agonist therapy. The protein production of aromatase cytochrome P450 and COX-2 was examined by Western blot. RESULTS: Proteins of aromatase P450 and COX-2 were reduced in the eutopic endometrium of patients with endometriosis treated with the GnRH agonist for 3 months. The stromal cells in the culture of endometrial explants and ovarian endometrioma which were treated with the GnRH agonist reduced the aromatase P450 and COX-2. CONCLUSION: The GnRH agonist reduced aromatase P450 and COX-2 by direct action on the eutopic endometrium of patients with endometriosis and ovarian endometrioma.

Uterine artery pseudoaneurysm manifesting delayed postabortal bleeding.

OBJECTIVE: To study a case of a huge pseudoaneurysm of the uterine artery presenting with vaginal bleeding 2 years after termination of pregnancy in a 23-year-old woman. DESIGN: Retrospective clinical case. SETTING: Academic-based gynecology center of university hospital. PATIENT(S): A 23-year-old women, 2 years after termination of pregnancy, presenting with vaginal bleeding. INTERVENTION(S): The diagnosis of uterine artery pseudoaneurysm was made by color and duplex Doppler ultrasonography and confirmed by arteriography. The angiographic study showed a pseudoaneurysm arising from the right uterine artery. MAIN OUTCOME MEASURE(S): Clinical response to treatment. RESULT(S): The uterine artery pseudoaneurysm was successfully treated by embolization. The vaginal bleeding subsided immediately after embolization. The patient was monitored monthly for 12 months, during which she had normal menstruation period and no further vaginal bleeding. CONCLUSION(S): Although likely not a common complication of abortion, the diagnosis should be considered in those patients with postabortive bleeding and cystic lesion in the pelvis on ultrasonography.

Perivascular epithelioid cell tumor of the uterus: immunohistochemical, ultrastructural and molecular study.

A case of perivascular epithelioid cell tumor of the uterus is reported, occurring in a 32-year-old woman. The tumor (8.0 cm in dimension) showed exophytic growth from the outer half of the myometrium. Histopathologically, the tumor was composed of thick blood vessels and perivascular epithelioid cells. The neoplastic cells were strongly immunoreactive for HMB45 antigen, CD117 (c-kit), vimentin and the progesterone receptor, but completely negative for S-100 protein, smooth muscle actin, desmin, CD34, the estrogen receptor and p16. The Ki-67 labeling index was low (1.25%). Ultrastructurally, the neoplastic cells had numerous premelanosomes with some glycogen deposits. Single-stranded DNA conformational polymorphism of p53 and methylation-specific polymerase chain reaction of p16 revealed negative results. Definite melanosomes on electron microscopic analysis and coexpression of HMB45 antigen and stem cell factor receptor (CD117) may provide the clue to understanding perivascular epithelioid cell tumor because angiomyolipoma also coexpresses HMB45 antigen and CD117.