1/17. Recurrent metastatic fallopian tube carcinoma in pregnancy.BACKGROUND: Fallopian tube cancer is the rarest of all gynecologic cancers. An extensive literature search on medline reveals no previous case reports of fallopian tube carcinoma in association with a term pregnancy. CASE: A woman with surgical stage IIB fallopian tube carcinoma was treated with limited staging laparotomy, as per the patient's fertility wishes, followed by adjuvant cis-platinum and paclitaxel (Taxol). One year following chemotherapy, she conceived. She was noted to have an asymptomatic intraabdominal recurrence at 16 weeks. The patient completed 37 weeks of pregnancy without further therapy according to her wishes. She subsequently underwent a cesarean section with optimal tumor reduction surgery. carboplatin and paclitaxel were reinstituted, achieving partial response. She is presently alive with stable disease status 6 months after completing her salvage chemotherapy. CONCLUSION: This is the first case report of recurrent fallopian tube cancer in pregnancy.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
2/17. Maternal and fetal outcomes in pregnancy complicated with acute leukemia: a single institutional experience with 10 pregnancies at 16 years.The incidence of acute leukemia in pregnancy is low and the management of acute leukemia during pregnancy is difficult. We have observed a total of 10 pregnancies in 8 patients. Six of the patients had acute myeloblastic leukemia (AML) and two of them had acute lymphoblastic leukemia (ALL). Three of the pregnancies were diagnosed when the leukemia was in remission, six at the time of leukemia diagnosis and one at the time of leukemic relapse. Six of the pregnancies were found in first trimester, three in the second and one early in the third. Three pregnancies ended with spontaneous abortion, three with intrauterine death and three with medical termination. One of spontaneous abortions and one intrauterine death developed during combination chemotherapy (daunorubicin, cytarabine). Only 1 healthy baby survived from the 10 pregnancies and this child was the not exposed to chemotherapeutic agents. None of the cases had gynecologic and obstetric complications. Five of eight pregnant women with leukemia died because of the primary disease.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
3/17. lung cancer during pregnancy involving the products of conception and a review of the literature.Approximately 1 per 1,000-1,500 pregnancies is complicated by maternal malignancies. Metastatic involvement of the products of conception is a rare event. There have been 62 cases of placental and/or fetal metastatic involvement originating from maternal cancer reported since 1866. Only 14 cases of lung cancer associated with pregnancy have been documented. We report on an additional case involving the products of conception, and the management of lung cancer in pregnancy is discussed based on an extensive review of the literature. The case of a 29-year-old woman presenting during the 31(st) week of gestation with metastatic non small-cell lung cancer to the placenta, liver and bone is described. The mother was delivered by caesarean section of a healthy baby girl during her 32(nd) week of gestation. The mother's postpartum course was complicated by disseminated pulmonary and bony metastases and malignant pericardial and pleural effusions causing the patient's death within 1 month after lung cancer was diagnosed. Malignancies spreading to the products of conception are melanoma (32%), leukemia and lymphomas (15%), breast cancer (13%), lung cancer (11%), sarcoma (8%), gastric cancer (3%) and gynecologic cancers (3%), reflecting malignancies with a high incidence in women of reproductive age. All lung cancers were diagnosed with widely disseminated, inoperable neoplastic disease, including distant metastases in 46%. The mean age was 35.1 years (range, 30-45 years) and 60% of patients had a history of tobacco use. The mean survival was 7.5 months (range: 1-42 months). placenta involvement was present in 7 out of 15 cases. Fetal involvement was reported in only one case. Because there is no evidence of a direct adverse effect of pregnancy on the course of lung cancer, we recommend delivery at a time when enough fetal maturity can be assumed and the subsequent treatment of the mother.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
4/17. ifosfamide alone and in combination in the treatment of refractory malignant gestational trophoblastic disease.OBJECTIVE: We attempted to evaluate the use of ifosfamide either alone or in combination in patients with refractory malignant gestational trophoblastic disease. STUDY DESIGN: Our study comprised, in part, a phase II multiinstitutional trial of ifosfamide in refractory gynecologic malignancies and, in part, a review of institutional experience with ifosfamide in combination chemotherapy. RESULTS: Single-agent ifosfamide produced a significant response in titer in one of two patients with refractory choriocarcinoma. ifosfamide with etoposide and cisplatin (also known as VIP) resulted in significant response in human chorionic gonadotropin titers in three patients with highly refractory metastatic gestational trophoblastic disease and one cure in this group of patients. CONCLUSION: ifosfamide has activity in refractory choriocarcinoma and, when combined with etoposide and cisplatin (VIP), may be curative.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
5/17. Implementation of assisted reproductive technologies following conservative management of FIGO grade I endometrial adenocarcinoma and/or complex hyperplasia with atypia.OBJECTIVE: The objective was to report a series of infertility therapy outcomes following conservative management of endometrial adenocarcinoma and/or complex hyperplasia with atypia. methods: A retrospective review of the University of iowa assisted reproductive technology database was performed. All women presenting with International Federation of obstetrics and gynecology (FIGO) grade I uterine adenocarcinoma and/or complex hyperplasia with atypia were assessed for type and duration of medical management, initial, interim treatment, and preinfertility treatment endometrial biopsy (BX) findings. Assessment of infertility treatment outcomes and postinfertility endometrial biopsy findings were performed. All of the pathology samples were re-reviewed at the Gynecologic Oncology Tumor Board to confirm the diagnosis by a pathologist with a particular expertise in gynecologic pathology. RESULTS: Four infertile women, three nulligravid and one primigravid, were evaluated with the diagnosis of FIGO grade 1 endometrial adenocarcinoma and/or complex hyperplasia with atypia desiring to preserve fertility. Two women with FIGO grade 1 endometrial adenocarcinoma were successfully treated with high-dose progestational agents resulting in normal proliferative endometrium. In addition, both women with complex hyperplasia with atypia were successfully treated with progestins and/or ovulation induction. Successful pregnancy outcomes were achieved for three of the four women with assisted reproductive technology. A total of five successful pregnancies and eight healthy live-born infants were achieved among three women. One of the four women was unable to conceive despite three cycles of in vitro fertilization. hysterectomy was performed for recurrent complex hyperplasia with atypia. In our series, we found it can take 3-10 months (mean, 6.25 months; median, 6 months) to obtain benign endometrium preceding infertility therapy. CONCLUSION: This report demonstrates that conservative management of well-differentiated endometrial adenocarcinoma and/or complex hyperplasia with atypia followed by aggressive assisted reproduction is an option to highly motivated and carefully selected women.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
6/17. Two successful spontaneous pregnancies in a patient with a primary primitive neuroectodermal tumor of the ovary.OBJECTIVE: To describe a patient with primary primitive neuroectodermal tumor of the ovary with two successful spontaneous pregnancies. DESIGN: Case report. SETTING: Tertiary center for gynecologic oncology. PATIENT(S): A 25-year-old woman with two spontaneous pregnancies 5 months after and 2 years after conservative treatment of International Federation of gynecology and obstetrics stage IC primary primitive neuroectodermal tumor of the ovary. INTERVENTION(S): Assessment of extraovarian spread with staging laparotomy. Four courses of BEP (bleomysin, etoposide, cisplatin) and, for recurrent disease, six courses of salvage VIP (vinblastin, iphosphamide, mesna, cisplatin) chemotherapy. MAIN OUTCOME MEASURE(S): Two successful deliveries and no residual ovarian cancer. RESULTS(S): A healthy, normal female infant weighing 3600 g was delivered by cesarean section at 38 weeks' gestation. Sixteen months later another infant, a healthy, normal male weighing 3500 g, was delivered by cesarean section at 38 weeks' gestation. No residual cancer was detected at follow-up 12 months after the last delivery. CONCLUSION(S): Conservative fertility-preserving treatment might be considered in patients with primary primitive neuroectodermal tumor of the ovary. Without any assisted reproductive technologies, spontaneous pregnancies might occur.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
7/17. Malignant female adnexal tumor of probable wolffian origin relapsing after pregnancy.BACKGROUND: female adnexal tumors of probable wolffian origin (FATWO) represent a rare gynecologic tumor and display in the majority of cases a benign behavior. CASE: A 27-year-old woman underwent a laparotomy for a left adnexal mass. Pathologic examination showed a FATWO. Three years later, 1 month after a vaginal delivery, a recurrence of the disease was observed. immunohistochemistry revealed the presence of progesterone receptors that may explain recurrence after pregnancy. CONCLUSION: In light of this case, hormone dependency of FATWO may be suggested.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
8/17. A rare case of pregnancy and delivery of a healthy neonate by a woman with microprolactinoma and review of the literature.A rare case of a term-pregnancy and delivery in a patient with microprolactinoma is presented. The patient had been treated with bromocriptine since she was 17 due to primary amenorrhea for 60 months with short intervals. Pharmacological tests with dopamine antagonists and X-ray diagnostics revealed the presence of microprolactinoma. The patient was constantly under specialist endocrinological care and the level of prolactin in her blood serum was continuously being monitored. After getting pregnant she was placed under strict gynecological scrutiny with special attention devoted to the developing fetus and possible congenital defects. The patient continued receiving bromocriptine therapy up to the 16th week of pregnancy. In the course of pregnancy in the 26th week, a circular suture was placed on the uterine cervix due to symptoms of isthmus-cervical insufficiency. In the 38th week of pregnancy a cesarean (C) section was performed and a healthy child in good general condition (apgar score 10) was born. The child weighed 2,900 grams.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
9/17. Cystic degeneration of a leiomyoma masquerading as a postoperative abscess.Leiomyomas are common tumors that usually have a typical sonographic appearance. With degeneration, however, the sonographic findings may be completely uncharacteristic. We report a case of a multicystic anterior uterine wall mass detected at antenatal sonography in an asymptomatic patient. Differential diagnosis included myoma, varicosity, hematoma, abscess, uterine anomaly, and pelvic neoplasm. At cesarean section, the mass was confirmed to be a myoma. Postoperatively, an ultrasound was performed by the radiology service during evaluation of suspected endometritis and the mass was interpreted as an endometrial abscess. This case illustrates that myomas can present with sonographic features consistent with a number of pathologic disorders. This variable pattern of echogenicity may sometimes create difficulty in establishing a correct diagnosis. The case also demonstrates the importance of communication between services and the need for not only antenatal but also postpartum and gynecologic ultrasound studies to be performed by physicians trained in sonographic findings of the abnormal uterus.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
10/17. pregnancy complicated by carcinoma of the colon above the rectum.Although rare during pregnancy, colorectal carcinoma is one of the leading three types of cancer in women. In the medical literature, there are only 28 reports of carcinoma of the colon above the rectum concurrent with pregnancy. During the last 8 years in our community, four pregnant women have received care by us for this usually lethal disease. These cases are presented and the pertinent considerations of this pregnancy complication based on the entire collected experience are reviewed. The possibility of this disease must be considered in the obstetric as well as the gynecologic patient.- - - - - - - - - - ranking = 1keywords = gynecologic (Clic here for more details about this article) |
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