Synchronous benign Brenner's tumor of ovary with leiomyoma and endometrial adenocarcinoma in a postmenopausal female.

Brenner tumors of ovary are usually an incidental finding. It is an uncommon tumor which is seen affecting women of fifth to sixth decade. It is classified under transitional cell tumors of ovary, which includes benign, borderline, and malignant Brenner tumors and transitional cell carcinoma. These tumors have been associated with synchronous and metachronous neoplasia, most commonly other ovarian epithelial tumors such as mucinous cystadenoma. Occasionally, these tumors may be associated with endometrial hyperplasia or carcinomas which are due to hormones elaborated by the stromal component of Brenner tumor. The hormone produced is estrogen and less commonly androgens, which alters the estrogen and progesterone levels, causing hyperstimulation of endometrium. We present a case of 50-year-old postmenopausal women who presented with coexisting incidental Brenner tumor with leiomyoma and Endometrial adenocarcinoma. Only few authors have reported similar tumor occurrence in the past.

Primary amenorrhoea and clitoromegaly in a nulliparous woman: successful medical and surgical management.

Clitoromegaly is an important sign of virilisation and poses difficulty in sex determination, when present since birth. The diagnosis and treatment in an adult is a major challenge to the treating gynaecologist. The primary reason for its development is androgen excess due to congenital adrenal hyperplasia, polycystic ovarian syndrome, ovarian virilising tumours, neurofibromas, adrenal neoplasm and prolonged intake of anabolic steroids. A case of young nulliparous married woman who presented with primary amenorrhoea and clitoromegaly and was managed successfully has been reported.

Ruptured choledochal cyst during early pregnancy with successful fetomaternal outcome.

Choledochal cyst is a rare congenital malformation which is usually found in young children and adolescents but can rarely present in the adult age group. It can present with several complications like cholangitis, pancreatitis, biliary cirrhosis, portal hypertension, liver abscess, malignancy and rarely spontaneous rupture (in 2% of cases) causing biliary peritonitis. A case of spontaneous rupture of choledochal cyst during second trimester of pregnancy is reported where the patient was managed by minimal surgery, peritoneal washout, placement of T-tube and planned for definitive treatment in the postpartum period. The pregnancy continued till 35 weeks with favourable fetomaternal outcome.

Cornual ectopic pregnancy: laparoscopic management step by step.

Cornual (interstitial) ectopic pregnancy is an uncommon type of ectopic pregnancy which is located in the interstitial part of the fallopian tube. It accounts for 2%-4% of all ectopic pregnancies. Cornual pregnancies often pose a diagnostic and therapeutic challenge with a significant high morbidity and mortality as a result of massive intraperitoneal bleeding. A case of unruptured cornual ectopic pregnancy in a patient with abnormal uterine bleeding is reported which was successfully managed laparoscopically.

Xanthogranulomatous oophoritis mimicking malignancy: a diagnostic dilemma.

Xanthogranulomatous inflammation is a chronic condition in which the affected organ is replaced by lipid-filled macrophages with plasma cells, lymphocytes and neutrophils. It is very rare in the ovaries. A case of xanthogranulomatous oophoritis in a premenopausal multiparous woman presenting with abnormal uterine bleeding and adnexal mass whose clinical and imaging findings suggested malignancy is reported.

Low grade endometrial stromal sarcoma: a case report.

Endometrial stromal sarcoma (ESS) is a rare malignant tumor of the endometrium, occurring in the age group of 40-50 years. We report a case of low-grade ESS in a 39-year-old woman, presenting as rapid enlargement of a uterine fibroid polyp associated with irregular and excessive vaginal bleeding. Polypectomy followed by pan hysterectomy was performed. Histopathological examination and immunohistochemistry confirmed LGESS. As the tumor is rarely encountered, management protocols are still questionable. In our case, we tried a different post-surgical protocol and the patient is being closely followed up. Although rare, ESS should be considered in the differential diagnosis of all women who present with a rapid enlargement of a uterine leiomyoma.