[A second trimester ovarian ectopic pregnancy: A case report]. / Embarazo ovárico del segundo trimestre: presentación de un caso.

BACKGROUND: Ovarian pregnancy (OP) is a low-frequency pathology but with devastating effects on women reproductive health. It is often difficult to distinguish from tubal or abdominal pregnancy. Diagnostic procedures and actual medical approaches to the treatment of OP are still a challenge. CLINICAL CASE: In this paper we present a 21 years old woman, seen at the Hospital as emergency abdominal pain and hypovolemic shock, with a pregnancy of 14 weeks of gestational age. Emergency laparotomy was performed and right salpingo-oophorectomy was made. The findings were massive hemoperitoneum with a live fetus implanted on the surface of the right ovary. H istopathology report fulfilled Spiegelberg's criteria of primary ovarian pregnancy. The association of IUDs and ectopic pregnancy are discussed as well as some basic aspects of trophoblast biology. CONCLUSION: Ectopic pregnancy is an obstetric problems including poorly understood pathophysiology, clinical diagnostic dilemma and a very poor arsenal of therapeutic options.

[Identification of surgical margins by intraoperative mammography of quadrantectomys specimens for breast cancer and histopathological comparison]. / Identificación de los márgenes quirúrgicos mediante mastografía transoperatoria de cuadrantectomías por cáncer de mama y comparación histopatológica.

BACKGROUND: Wide surgical margins are prognostic indicators to prevent recurrences after conservative surgery in breast cancer; type of surgery and histopathological analysis are key factors too. OBJECTIVES: To evaluate tumoral size and surgical margins of quadrantectomy specimens utilizing mammography and histopathology, and decide if mammography of quadrantectomy specimens are useful for close margins prediction. MATERIALS AND METHODS: Prospective, observational and descriptive study based on the findings of specimen projections of two mammography quadrantectomies, and histopathological data. Ten patients with breast cancer were evaluated from May to November 2006. Surgical margins of quadrantectomys were marked with radiopaque material. RESULTS: Tumoral size was similar in mammography and histopathological analysis of quadrantectomys, however there was a tendency to report a larger size in mammography. With mammography only one case was reported as close superficial margin, the rest of patients has adequate margins (1 cm or higer). Five cases were close by histopathology (3 in the deep margin, one superior and one more in the superior and inferior margins), and five had adequate margins. Four additional surgical procedures where practiced (3 re-excisions and one mastectomy), in one of them additional surgery was unnecessary. CONCLUSIONS: Mammography evaluation was useful to identify peripheral margins (superior, inferior medial and lateral) as well as tumoral size, but useless to identify close borders (deep and superficial areas). It is necessary to evaluate more cases to improve this technique and to establish a common language between specialists.