1/24. Long-lasting remission and successful treatment of acquired factor viii inhibitors using cyclophosphamide in a patient with systemic lupus erythematosus. Acquired deficiency of clotting factor viii (FVIII) is a rare bleeding diathesis seldom encountered in systemic lupus erythematosus (SLE). Reduction of FVIII activity by autoantibodies can cause potentially life-threatening situations. Herein, an SLE patient with a positive lupus anticoagulant (LAC) test who abruptly developed metrorrhagia 4 yr after diagnosis is reported. Coagulation tests revealed FVIII activity reduced to 3% and a prolonged aPTT. FVIII inhibitor(s) were found to be as high as 3.0 Bethesda Units. plasmapheresis, immunoglobulins, prednisolone and FVIII plasma concentrates induced the cessation of metrorrhagia, but the clotting tests were barely improved. One month later, extensive ecchymosis appeared and worsened, despite re-administration of the previous therapy. pulse cyclophosphamide followed by oral administration was then started with normalization of coagulation parameters and long-lasting disease remission. ( info) |
2/24. Uterine adenocarcinoma after GnRH agonist treatment. We report endometrial adenocarcinoma in two patients shortly after suspending GnRH-agonist treatment for menometrorrhagia and uterine fibromata. ( info) |
3/24. Imaging of membranous dysmenorrhea. Membranous dysmenorrhea is an unusual clinical entity. It is characterized by the expulsion of huge fragments of endometrium during the menses, favored by hormonal abnormality or drug intake. This report describes a case with clinical, US, and MRI findings before the expulsion. Differential diagnoses are discussed. ( info) |
| sarcoidosis rarely affects the female genitalia. We report a 36-year-old woman who had a hysterectomy for metrorrhagia. Histologic examination showed sarcoid granulomas in the endometrium and myometrium. Subsequent examinations revealed pulmonary sarcoidosis as well. ( info) |
| INTRODUCTION: Intravenous leiomyomatosis (IVL) is rare and it is characterized by intravascular nodular masses of histologically benign smooth muscle that may extend variable distances. Although histologically benign, IVL might be malignant in its mode of behavior. CASE REPORT AND DISCUSSION: A case of IVL is reported with emphasis on immunohistochemical analysis and recent literature. ( info) |
| We report a child with Down's syndrome in whom metrorrhagia and precocious puberty revealed primary autoimmune hypothyroidism. The patient had a decreased growth velocity, exaggerated weight gain, bone age delay, and bilaterally enlarged multicystic ovaries. Delays in the diagnosis and treatment of hypothyroidism can lead to this peculiar presentation. ( info) |
7/24. Endometrioid adenocarcinoma arising in uteri with incomplete fusion of Mullerian ducts. Report of three cases. The clinicopathological findings of three cases of endometrial adenocarcinoma arising in uteri with developmental anomalies are described. ( info) |
| BACKGROUND: Uterine adenomatoid tumors may be present in up to 1% of hysterectomy specimens, and their infiltrative pattern may simulate that of adenocarcinomas. CASE: This is a report on the coexistence of a uterine adenomatoid tumor and an endometrial adenocarcinoma, both chance findings in a 41-year-old woman undergoing hysterectomy because of a preoperative diagnosis of metrorrhagia due to leiomyomas. CONCLUSION: Although uterine adenomatoid tumors are believed to be rare, they may pose a differential diagnostic problem in the pathologic staging of endometrial carcinomas, because they form gland-like lumina and infiltrate the myometrium. To our knowledge, no previous coexistence of these two tumors has been reported. ( info) |
9/24. Diagnostic and therapeutic imaging in a case of cervical pregnancy. Clinical aspects and ethical implications. A case of a 37-year-old, 8 week pregnant woman come to the emergency service with the diagnosis of cervical pregnancy an metrorrhagia, is reported. Uterine artery embolization was performed to arrest the bleeding. BCF monitoring documented its disappearance after approximately 15 days with progressive decrease in serum beta-hCG levels. Once the death of the fetus was ascertained, placental detachment was facilitated with the administration of methotrexate therapy. In view of the curettage of the uterine cavity a second uterine artery embolization was performed. Twenty days after the diagnosis of abortion, curettage was performed and the patient could be discharged. The combined action of embolization, methotrexate therapy and curettage allowed to preserve the potential fertility of the woman. ( info) |
10/24. Ovarian sex cord tumor with annular tubules. Clinicopathologic report of two benign and one malignant cases with long follow-ups. The clinicopathologic features of three new cases of ovarian sex cord tumors with annular tubules are presented, thereby increasing to 23 the number of the published cases in the world literature. These three observations, along with another one which was previously published, were found in the files of the Institute of pathology of the University of Lausanne from 1939 to 1978. Forty-seven granulosa cell tumors and eight Sertoli and/or Leydig cell tumors of the ovary were found during the same 40-year period. The patients were 48, 64 and 71 years of age. No sign of the peutz-jeghers syndrome was noticed in the three patients. All three tumors caused metrorrhagias as a cardinal sign. They were bulky, unilateral and were formed by solid tissue with cystic spaces. Histologically, the most characteristic pattern consisted of simple and complex tubular structures as described by Scully in 1970. Two patients, in which the mitotic indexes of the tumors were lower than 5 mitoses per 10 HPF, died without evidence of a recurrence 36 and 37 years after surgical ablation of the tumor. The third patient, whose neoplasm featured fewer well differentiated tubular structures than the two previous ones and had a mitotic index of over 70 mitoses per 10 HPF, died from massive abdominal recurrence after 5 years and 5 months. ( info) |