Endodermal sinus tumor of the ovary in pregnancy.

The ultrasonographic evidence of an irregular mixed mass, cystic and solid, in retrouterine area and the high levels of alpha(1)-FP values in a young pregnant woman, indicated the possibility of an ovarian germ cell neoplasia. Respecting the patient's will, pregnancy was protracted until the 36th week. A cesarian section allowed the releasing of a vital fetus and the removal of a neoplastic mass which proved to be an endodermal sinus tumor (EST) at stage Ia. Then the patient, the 12th case of EST in pregnancy reported in the literature, underwent 5 PVB chemotherapy cycles and, 3 years after the intervention, appears disease-free.

[Emergency cerclage and twin pregnancy]. / Cerchiaggio urgente e gravidanza gemellare.

This report describes emergency cerclage on dilated and effaced cervices prior to 24 weeks' gestation with membranes bulging into the vagina in a primigravida with twin pregnancy. This operation enabled us to obtain an extension of the pregnancy of 11.2 weeks and the survival of the two foeti.

[Ovarian granulosa cell tumor of juvenile type associated with pregnancy. Clinical case and review of the literature]. / Tumore ovarico a cellule della granulosa di tipo giovanile associato alla gravidanza. Caso clinico e review della letteratura.

The granulosa cell tumor is the most common sex ovary stromal tumors. Ten percent of cases present during pregnancy. Two histopathologically well defined patterns of granulosa cell tumors are known: the common adult granulosa cell tumors (AGCT) and the less frequent juvenile granulosa cell tumor (JGCT). This report describes a case of juvenile tumor of the granulosa occurring in a 22 year-old pregnant woman.

[Therapeutic posterior colpo-celiotomy. Authors' experience]. / Colpoceliotomia posteriore terapeutica. Nostra esperienza.

BACKGROUND: To evaluate the advantages of posterior colpoceliotomy. METHODS: A retrospective analysis of the results of posterior colpoceliotomy performed between 1995 and 1998 for tubal sterilization, ectopic pregnancy or benign ovarian cyst. RESULTS: Surgery was possible in all 32 cases. The mean surgical time was 15 minutes. No intra- or postoperative complications were observed. The mean postoperative hospitalization lasted 32 hours. In 14 of 16 cases of ectopic pregnancy salpingectomy has been performed. In 2 cases tubal curettage has been performed with enucleation of contralateral dermoid cyst in 1 case. CONCLUSIONS: Colpoceliotomy is, in selected cases, a valid alternative to laparoscopy.

[Combined pregnancy]. / Gravidanza combinata.

Simultaneous intrauterine and ectopic pregnancy is a rare entity, with a difficult preoperative diagnosis, potentially dangerous for the mother and for the intrauterine pregnancy. A case of combined intra- and extrauterine pregnancy diagnosed at 5 weeks' menstrual dates in a 31-year-old woman non treated for infertility is described. Incidence, etiology, diagnosis and treatment of this uncommon complication are discussed.

[Meigs' syndrome with high blood levels of CA 125. Clinical case and review of the literatureø]. / Sindrome di Meigs con elevati livelli sierici di CA 125. Caso clinico e review della letteratura.

A case of Meigs' syndrome is reported. The patient presented with: hydrothorax, ascites, benign ovarian tumor (thecoma) and increased serum levels of CA 125. Ovarian thecoma is a rare tumor, accounting for less than 1% of all ovarian tumors. When associated with Meigs' syndrome, it can produce a clinical picture similar to that of ovarian carcinoma, but the prognosis is much more favourable. The condition was managed by bilateral salpingo-oophorectomy and hysterectomy. The ascites and hydrothorax disappeared spontaneously after removal of the ovarian tumor and CA 125 level decreased.

[Buschke and Loewenstein tumors (giant condyloma acuminata). Immunologic features]. / Tumore di Buschke e Loewenstein (condiloma acuminato gigante). Aspetti immunologici.

The Buschke-Loewenstein tumor, also called giant condyloma acuminatum, is generally observed in male subjects, usually on the penis and rarely occurs in women. A case of Buschke-Loewenstein tumor located on the vulva is reported. It is a cauliflower-like tumor which behaves clinically in a malignant fashion, although it shows no histomorphological criteria of malignancy. Histologically it is a benign papillomatous growth characterized predominantly by epithelial hyperplasia, hyperacanthosis and hyperkeratosis. The assessment of humoral and cellular immunity demonstrated an unusual circulating increase of CD4+ lymphocytes suggesting their major role in the very slow progression of the disease. Surgery remains the treatment of choice for this tumor.

First-trimester sonographic diagnosis of Cantrell's pentalogy with exencephaly.

We report a case of Cantrell's pentalogy with exencephaly detected by sonography at 11 weeks 4 days' menstrual age and confirmed at autopsy. Cantrell's pentalogy consists of defects of the lower sternum, anterior diaphragm, midline supraumbilical abdominal wall, and diaphragmatic pericardium with ectopia cordis. Exencephaly involves acrania with a disorganized mass of brain tissue. Both conditions are rare; the combination of the 2 has been reported only twice before. To our knowledge, this is the earliest reported diagnosis of the 2 conditions by prenatal sonography.