Endometrial stromal sarcoma with intracaval extension at initial presentation.

Endometrial stromal sarcoma (ESS) is a rare uterine neoplasm. Tumor involvement of the large vessels is extremely rare. This is a case report of ESS with tumor invasion of the inferior vena cava at initial presentation.

Evaluation of osteopontin and CA125 in detection of epithelial ovarian carcinoma.

The objective of this study was to determine the potential of osteopontin (OPN) and OPN + CA125 (cancer antigen 125) combination in differential diagnosis of the ovarian cancers and non-malignant ovarian disease. Serum and plasma samples were obtained preoperatively from 79 women undergoing surgery for pelvic mass; 48 of them had ovarian carcinoma, and 31 had benign cyst. The samples were analyzed for the levels of OPN and CA 125 (using ELISA and CMIA methods) and then compared with the final pathologic results. The median plasma level of OPN in patients with benign and malignant cysts was 356.33 ng/ml and 865.15 ng/ml, respectively (p < 0.001). Receiver operating characteristic (ROC) analysis for plasma OPN revealed the area under the curve (AUC) of 0.838. At the predefined specificity of 90%, OPN showed sensitivity of 62.5%, whereas the combination of OPN + CA125 reached 74.9% at the same specificity.

Evaluation of utero-ovarian hemodynamics in relation to fertility and stage of endometriosis.

OBJECTIVE: The aim of this study was to compare hemodynamic changes in the uterine and ovarian arteries between infertile women with moderate and/or severe endometriosis and healthy women. In this prospective study, 99 women in their generative age were subjected to color Doppler ultrasonography to measure hemodynamic parameters from July 2010 to January 2011. The examination was performed during the proliferative or ovulatory phase of the natural menstrual cycle in a random sample of 54 women treated for endometriosis-induced infertility and 45 healthy women were included in control examination procedure. Irrespective of considered stage, endometriosis was most often found in the ovaries, in the sacro-uterine ligaments, peritoneum, and rectovaginally. Resistance to blood flow expressed as the resistance index (RI) in the measured arteries, was significantly higher in severe endometriosis compared to moderate form. Average values of pulsation index (PI) and RI are significantly higher, in both endometriosis stages, compared to measured values in healthy women.

Two cases of immature teratoma with positive reproductive outcomes.

The peak incidence of immature teratoma is in the early reproductive period of a woman's life and fertility preservation is an inevitable topic when discussing treatment options. We present two cases of immature teratoma with positive reproductive outcome. Our experience supports the standpoint that surgery alone is curative in most cases, irrespective of tumor grade. Bearing this in mind, the long-term effect of chemotherapy on ovarian function can be avoided and fertility, an important factor in the overall quality of life, can be preserved.

Cold-knife conization versus the loop electrosurgical excision procedure for treatment of cervical dysplasia.

INTRODUCTION: Classical conization is a standard procedure for treatment of cervical lesions. Conization with loop diathermy is well established and lesions can be excised in more than 90% of cases. OBJECTIVE: To compare two methods of conization for the treatment of cervical dysplasia. METHOD: The study included 172 patients who had conization for diagnosed cervical dysplasia. A retrospective analysis was conducted on incidence of complications and presence of dysplasia on the specimen edges after classical conization compared to conization with loop diathermy. The possibilities for analyzing specimen edges were reviewed. RESULTS: A significantly higher incidence of complications was found among patients who underwent classical conization compared to those who had the loop diathermy procedure. The loop procedure is sufficient for treatment of cervical dysplasias. CONCLUSION: The authors suggest loop diathermy conization as the method of choice for treatment of cervical dysplasia.

Solitary ovarian mass: a case of metastatic malignant melanoma.

Malignant melanoma involving the ovaries is rare and in most cases metastatic in origin. We present a case of ovarian malignant melanoma presenting as a large adnexal mass in a patient with no previous history of malignant melanoma.

Leiomyoma of the uterus and retroperitoneal angioleiomyoma: case report.

Retroperitoneal angioleiomyoma is a benign mesenchymal neoplasm that is composed of smooth muscle cells and thick-walled vessels. In a 36-year-old patient a retrouterine and retroperitoneal tumor, 70 x 65 x 50 mm in size, was discovered during a surgical procedure due to uterine myoma. The tumor had a soft consistency and was completely removed. Histopathology showed features of angioleiomyoma. Angioleiomyoma is a rare benign entity; hence a benign course and good prognosis are expected.

Survival rate and prognostic factors for patients who underwent surgical procedures for invasive carcinoma of the vulva in Serbia.

OBJECTIVES: To determine five-year survival rate and prognostic factors for patients who underwent radical surgery for carcinoma of the vulva. MATERIAL AND METHOD: 94 women were operated on from 1989 to 1996 at the Clinical Centre of Serbia. RESULTS: Five-year survival was 78.56% for Stage I, 73.5% for Stage II, for Stage III--14.28%, and for Stage IV--7.14%. Five-year survival rate for tumor size between 2 cm and 5 cm was 57.14%, and for tumors larger than 5 cm, 28.57%. Five-year survival rate was 64.28% if no lymph nodes were involved, 21.43% if there were unilateral metastatic lymph nodes and 14.28% if bilateral lymph nodes had metastatic disease. Histologic grades of the tumor showed that for grade 1, five-year survival was 64.28%, for grade 2, 35.71% and there were no survivors five years after surgery among patients with grade 3 tumor. CONCLUSION: FIGO stage, size of tumor, lymph node involvement and grade of tumor are significant prognostic factors for survival of patients after surgery.

The incidence of vulvar pathology and vulvectomy within risk and non-risk groups.

At the Institute of Gynecology and Obstetrics over a period of five years, more than 180,000 women were examined; 580 simple and 178 radical vulvectomies were performed.

Vaginal malignant melanoma in a healthy pregnancy--a case report.

Vaginal melanomas account for fewer than 2% of vaginal malignancies. The mean age at diagnosis is 55 years and the prognosis is poor, with an overall 5-year survival rate of 5% to 10%.

Hysterectomy in a malignant molar pregnancy and a healthy baby.

Hydatidiform mole is a degenerative chorion disturbance of unknown etiology. It is characterized by a permanent whitish enlargement of the chorionic villi with a grape-like appearance and poor vascularization. The symptoms of a molar pregnancy are nausea and vomiting which are present in more than one-third of the patients. Other symptoms include an enlarged uterus and vaginal bleeding. Our patient was a 19-year-old primipara with a twin pregnancy where one embryo was molar. Diagnosis was confirmed by beta-hCG levels.

Cervical carcinoma and pregnancy in a young primipara.

Cervical carcinoma is the fourth most common malignant disease in women, after breast, lung and colon cancer. It is present in two-thirds of all malignant diseases of the genital tract. Although in most of Europe patients are subjected to regular health screening, diagnoses of severe life-threatening alterations are often made when they are already in late stages.

Breast cancer and borderline ovarian carcinoma in young patients--case report.

Cystosarcoma phyloides is a breast cancer with deterrent features because of its size and fast growth. Borderline ovarian tumors comprise 10% to 15% of all epithelial tumors of the ovary. Regardless of the tumor type (serous, mucinous, clear cell, Brenner, mixed) they can be benign, borderline or malignant. There is a close physiological relation between the breasts and genital tract. By routine examination of girls in secondary schools, suspected ultrasonography findings were found in two out of 180 examinees.

Ultrasound and surgery for gall bladder carcinoma during pregnancy.

Gall bladder carcinoma is the most common carcinoma of the biliary tract and the fifth most common malignant tumor of the gastrointestinal tract. The patients usually have no symptoms at all or non-specific symptoms are present. The therapy for gall bladder carcinoma is complete removal. Unfortunately, in 80% of the cases the survival period is less than one year.

The significance of detailed examination of hemorrhoids during pregnancy.

In the population of pregnant women in Serbia and Montenegro, hemorrhoids are present in 85% of the cases during the second and third pregnancy. Urged by the complications of non-treated hemorrhoids, we carried out a routine diagnostic procedure to examine hemorrhoids during pregnancy, i.e. a differential diagnosis with other possible complications was performed. Fifty patients, aged between 36 and 38, were examined by anoscope and rectoscope during the second trimester. Rectal carcinoma was found in three cases, which is a disturbing number. The patient with the most serious clinical picture was subjected to urgent artificial fetal lung maturation and surgical delivery. One of the patients had clinical cachexia, and in view of the fact that the magnetic resonance imaging during pregnancy showed infiltration and that the patient was 38 years old, with the patient's consent, surgery was performed together with hysterectomy and salpingo-oophorectomy and immediate removal of the rectum and anus. In the other two cases, the delivery ended vaginally between the 35th and 38th week of gestation, after which the patients were moved to the surgery ward. Besides a positive family history for digestive tract carcinoma (95%), smoking and increased body mass index, there were no significant parameters distinguishing these three patients from others with hemorrhoids. Interesting data were obtained from the fact that there was no increase in body mass during pregnancy which patients correlated with their already present obesity. Moreover, pain was correlated with the fact that the patients did not follow a healthy dietary regime. In all 50 patients, the following procedures were performed: anoscope, rectoscope and digestive tract tumor markers. Observing the results of the biopsies, we found rectal carcinoma Stage C according to Dukes staging (tumor included serosa) in one case. In the other two cases, Stage B1 carcinomas were found (which included all layers except serosa). Magnetic resonance imaging was performed and confirmed progression of the disease. The delivery ended per vias naturalis in two cases in view of the fact that it was the third pregnancy for both patients. Surgery was performed 40 days after delivery. Postoperative recovery was unremarkable in all described cases.

Hyperemesis or stomach carcinoma in pregnancy--a true diagnosis with two lives saved: a case report.

The cause of stomach carcinoma is still unclear but a variety of possible factors are presently under investigation. The clinical signs of stomach carcinoma are deceitful, and the disease is mainly asymptomatic. The first symptoms are dyspeptic disturbances, the feeling of satiety after meals, belching, and loss of appetite. This interesting and educative case starts with an almost classical story of a patient admitted with hyperemesis during pregnancy. She was a primipara, 18 years old, with a significantly low body mass index and electrolyte imbalance and at the 23rd week of gestation.

Fetal and maternal plasma leptin levels during the second half of normal pregnancies and those with Down syndrome.

OBJECTIVE: To assess the correlation of fetal and maternal plasma leptin concentrations during the second half of uncomplicated, euploid pregnancies and to compare these values with those obtained from pregnancies with Down syndrome. METHODS: Paired maternal venous and fetal umbilical blood samples were obtained during cordocentesis in 36 uncomplicated, euploid pregnancies and nine pregnancies with Down syndrome fetuses. Concentrations of leptin were measured by sensitive radioimmunoassay. RESULTS: Among pregnancies with euploid fetuses, there was significant correlation between both fetal and maternal leptin levels and gestational age (r = 0.464, p = 0.005 and r = 0.629, p < 0.001, respectively). Fetal plasma leptin concentrations also correlated with maternal levels (r = 0.485, p = 0.003), but fetal levels were significantly lower than maternal values (mean 2.12 +/- 0.44 ng/ml vs. 17.79 +/- 5.48 ng/ml, respectively; p < 0.001). Down syndrome fetuses had significantly lower fetal plasma leptin levels than gestational age-matched control euploid fetuses (0.72 + 0.54 ng/ml vs. 2.12 + 0.44 ng/ml; p < 0.002). However, there was no difference in maternal leptin concentrations between euploid and Down syndrome pregnancies. CONCLUSION: In euploid pregnancies, fetal leptin levels were significantly lower than the corresponding maternal values but increased across gestation. Down syndrome was associated with significantly lower fetal leptin levels.

[Histochemical reaction to NPK fertilizer in the fascicular and reticular zones of the adrenal cortex]. / Histohemijski odgovor snopovne i mrezaste zone kore nadbubrega nakon delovanja NPK-gnojiva.

Male, white rats were kept for 30 days in an NPK fertilizer factory. The animals were then sacrificed and the samples of the fascicular and reticular zone of the adrenal gland were analyzed for fat substances. In the fascicular zone, as affected by NPK, the quantity of neutral lipids and triglycerides was decreased, whereas phospholipids were augmented. At the level of reticular zone the lowest rise in the quantity of neutral lipids was found, whereas the amount of the other two sorts of fat substances was conspicuously elevated. Nucleic acids change their presence in that pironynophilia disappeared; in the cells of both zones, the full discharge of RNA took place. Judging by the results obtained, the cells of both fascicular and reticular zone are in the phase of an intensified secretion.

[Histochemical features of the adrenal glomerulor zone 30 days after exposure to NPK fertilizer]. / Histohemijska svojstva klupcaste zone nadbubrega trideset dana nakon delovanja NPK-dubriva.

Sexually mature, male, Wistar rats lived for 30 days in a workshop of an NPK artificial fertilizer factory and were subjected to the effects of different chemical matters used in the synthesis of the fertilizer. After that time period, the experimental animals were sacrificed on the same day with the control ones, in the morning hours. The histochemical characteristics of the adrenal glomerular zone were studied. The results obtained show an increased content of the following lipid substances in the cells of the glomerular zone of the experimental animals: neutral lipids, triglycerides and phospholipids. The content of nucleic acids was also changed. The quality of fat substances was altered in the experimental rats. The total appearance of the glomerular zone gives the impression of an intensified activity.