1/20. Bilateral granulosa cell tumor in a patient with blepharophimosis syndrome.blepharophimosis syndrome is a rare, autosominal, dominant ocular disorder and has been reported to be associated with ovarian dysfunction and premature menopause. We report a case of bilateral granulosa cell tumor associated with blepharophimosis syndrome. The combination of the long-term hypergonadotrophism and oocyte depletion associated with blepharophimosis syndrome may have contributed to the pathogenesis of the granulosa cell tumors. In female patients with blepharophimosis syndrome, close gynecologic surveillance should be instituted.- - - - - - - - - - ranking = 1keywords = menopause (Clic here for more details about this article) |
2/20. An earlier menopause as clinical manifestation of granulosa-cell tumor: a case report.We present a case of a granulosa-cell tumor, which can cause menopause at an earlier than normal age. The hormonal profiles were characterized by undetectable FSH levels associated with an estradiol level compatible with the level seen in perimenopausal women and by a significant increase in the inhibin level.- - - - - - - - - - ranking = 5keywords = menopause (Clic here for more details about this article) |
3/20. luteinizing hormone receptor expression in leiomyomatosis peritonealis disseminata.BACKGROUND: leiomyomatosis peritonealis disseminata has been attributed to estrogen stimulation and is seen only rarely in postmenopausal women. In such cases, pathogenesis is uncertain. CASE: leiomyomatosis peritonealis disseminata tumors were resected from a postmenopausal woman. She was receiving tamoxifen therapy for breast cancer and had bilateral ovarian Brenner tumors. Estrogen and progesterone receptors were detected. Immunohistochemical analysis indicated that LH receptors were present. CONCLUSION: luteinizing hormone receptors were identified in leiomyomatosis peritonealis disseminata in one woman. Levels of FSH and LH increase after menopause, and immunohistochemical analysis showed the presence of LH receptors, so gonadotropin rather than estrogen stimulation might have contributed to development of leiomyomatosis peritonealis disseminata in this uncommon case.- - - - - - - - - - ranking = 1keywords = menopause (Clic here for more details about this article) |
4/20. diagnosis and localization of testosterone-producing ovarian tumors: imaging or biochemical evaluation.OBJECTIVE: In the testosterone-secreting ovarian tumor (TSOT), the role of whole-body positron emission tomography (WBPET) with (fluorine-18)-2-deoxyglucose scanning (FDG) and/or [(11)C]acetate is unclear, although it presents a rationale that these functional tumors would be more active and have increased use of glucose and oxygen consumption than normal tissues. CASE: A 52-year-old woman had a history of steroid cell tumors of the right ovary (IIA) and she received staging surgery including total hysterectomy, salpingo-oophorectomy, and lymph node sampling. Reelevated serum levels of T (5.24 ng/ml) were noted 52 months later. The patient received serial preoperative examinations including WBPET with FDG and acetate, ultrasound, computerized tomography (CT), and magnetic resonance imaging (MRI) to evaluate her recurrence. A suspicious mass on the liver was found on ultrasound, CT, and MRI. The ultrasound-guided biopsy was performed three times, and each of them failed to provide any pathological confirmation. Functional imaging studies showed an abnormal uptake in WBPET using [(11)C]acetate but were negative using FDG. Because of the size of the tumor, the patient's hesitatancy toward an operation, and good previous response to gonadotropin-releasing hormone (GnRH) agonist treatment, the patient received a six-cycle GnRH agonist treatment. serum T levels returned to normal limits after administration of the first dose of GnRH agonist. At follow-up, serum hormone levels were all within the normal ranges consistent with menopause, but the size of the metastatic tumor was constant. The tumor was then completely excised pathologically proven to be a metastatic TSOT. CONCLUSIONS: Recurrent TSOT might be successfully detected using WBPET with [(11)C]acetate. In addition, GnRH agonist could be tried in patients with TSOT if initial responses were excellent and surgical intervention could not be performed.- - - - - - - - - - ranking = 1keywords = menopause (Clic here for more details about this article) |
5/20. Postmenopausal intravenous leiomyomatosis with high levels of estradiol and estrogen receptor.BACKGROUND: Intravenous leiomyomatosis is a rare variant of leiomyoma. CASE: The patient was a 49-year-old gravida 3, para 3 woman with menopause at age 46. She presented with a history of syncope. Vaginal examination revealed an enlarged and elastic-soft mass of the uterus. A pelvic ultrasound, computed tomography scan, and magnetic resonance imaging showed a heterogeneous, irregularly shaped 8- to 10-cm tumor. In addition, the inferior vena cava was almost completely occluded. Cardiac ultrasound demonstrated a mobile mass in the right atrium. The serum estradiol was 208 pg/mL (normal 0-59). Intravenous leiomyomatosis with cardiac extension was diagnosed preoperatively. A resection of the intracardiac and intracaval mass and a subtotal hysterectomy with bilateral salpingo-oophorectomy were performed. The uterine tumor weighed 600 g, and the cordlike intravascular tumor extending from the internal iliac vein into the right ventricle was 40 cm long and weighed 60 g. Pathologic examination confirmed intravenous leiomyomatosis with no evidence of atypia. The level of estrogen receptor in the tissue was 140 fmol/mg protein. The postoperative course was uneventful, and she has been in good health for 17 months after the operation. CONCLUSION: We report a case of intravenous leiomyomatosis extending into the right ventricle treated with a one-stage operation. It is possible that a high concentration of serum estradiol and high level of tissue estrogen receptor are related to the intravenous leiomyomatosis.- - - - - - - - - - ranking = 1keywords = menopause (Clic here for more details about this article) |
6/20. abdominal wall metastasis of a cervical adenocarcinoma at the laparoscopic trocar insertion site after ovarian transposition: case report and review of the literature.BACKGROUND: Laparoscopic ovarian transposition is currently used in the preirradiation management of cervical cancer in young women. This surgical technique helps avoid the short- and long-term complications of early menopause. Because there remains a risk of metastasis at the site where the laparoscopic trocar is inserted, more precise indications for this surgery are required. CASE: We report the case of a patient with an abdominal wall metastasis that followed laparoscopic ovarian transposition performed before radiation therapy and surgical treatment for a stage IIb cervical adenocarcinoma. Observations during the laparotomy nonetheless led us to resect the transposed ovary during the laparotomy. The pathology examination of the ovary found a microscopic metastasis. Several months later, a left abdominal parietal nodule, corresponding to a metastasis of the adenocarcinoma, was found on the site through which the trocar had been inserted during the laparoscopy and was probably associated with the ovarian transposition. CONCLUSION: This is the only published case to describe an abdominal wall metastasis due to laparoscopic trocar insertion during ovarian transposition. The decision to perform a laparoscopic ovarian transposition in cervical cancer must take into account the frequency of trocar site metastases, which seems to be higher with advanced-stage cervical cancers, in cases of lymph node involvement and especially in adenocarcinomas.- - - - - - - - - - ranking = 1keywords = menopause (Clic here for more details about this article) |
7/20. Ovarian thecoma associated in the first trimester of pregnancy.Ovarian thecoma is a relatively rare tumor which occurs before and after menopause. It is extremely rare that pregnancy is complicated with thecoma. diagnosis of ovarian tumors during pregnancy is highly problematic due to difficulties in obtaining clinical manifestations, and treatment of these tumors poses an even greater challenge. Our patient was found to have estrogen-producing thecoma accompanied by accumulation of ascites in an early phase of pregnancy. The patient underwent abdominal surgery to remove the tumor on the 13th week of gestation. This resulted in disappearance of the ascites and a favorable clinical course. diagnosis and treatment of ovarian thecoma occurring during pregnancy are discussed with relevant references.- - - - - - - - - - ranking = 1keywords = menopause (Clic here for more details about this article) |
8/20. endometriosis associated with ureteric obstruction.endometriosis and its complications are not uncommon in Malaysian women. Two cases of ureteric obstruction due to endometriosis are reported and the literature on ureteric obstruction and endometriosis reviewed. It is emphasized that the possibility of ureteric obstruction must be suspected when there is extensive endometriotic disease or if the patient presents with loin pain or pain on one side of the abdomen. Ultrasound scan of the kidneys and, if necessary, an intravenous pyelogram will have to be done on the slightest suspicion. patients with endometriosis will have to be followed up until the menopause or even later if they are on hormone replacement therapy.- - - - - - - - - - ranking = 1keywords = menopause (Clic here for more details about this article) |
9/20. Virilizing serous cystadenoma.A 71-year-old woman, 26 years post-menopause, presented with virilization. Facial hirsuties, non-hereditary frontal balding, voice changes, male escutcheon, and mild clitorimegaly accompanied a right adnexal mass. blood hormone studies showed testosterone 430 ng/dL, FSH 118 mIU/mL, and LH 210 mIU/mL. By ultrasound examination, the cystic adnexal mass involved the right ovary. An 18-cm, 1300-g, unicameral mass with 1200 mL of clear serous fluid and with smooth inner and outer surfaces was removed from the right broad ligament. Intraoperative testosterone levels were as follows: peripheral vein 285 ng/dL, left ovarian vein 301 ng/dL, and right ovarian vein 1635 ng/dL; tumor cystic fluid was 3032 ng/dL. Peripheral vein testosterone was 15 ng/dL 3 days postoperatively. Histopathologically, the tumor was a serous cystadenoma. No evidence of stromal luteinization, hyperplasia, or inflammation was found, and other virilizing lesions were not encountered in either ovary or in other tissues. epithelial cells constituting the tumor may have been the source of the excess testosterone in this unique case of virilizing serous cystadenoma.- - - - - - - - - - ranking = 1keywords = menopause (Clic here for more details about this article) |
10/20. Immature ovarian teratoma in a postmenopausal woman.We report the first case of immature ovarian teratoma occurring after menopause in a 57-year-old, 3 years postmenopausal woman. Within one year after resection of the teratoma she developed peritoneal botryoid rhabdomyosarcoma, which probably originated from initially unrecognized rhabdomyoblasts in the teratoma. The patient died 6 months later from progressive disease after a transient adriamycin-induced tumor response. The literature on ovarian immature teratoma and ovarian rhabdomyosarcoma is briefly reviewed, and the available treatment is discussed.- - - - - - - - - - ranking = 1keywords = menopause (Clic here for more details about this article) |
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