1/23. Delivery of a severely anaemic fetus after partial molar pregnancy: clinical and ultrasonographic findings.The incidence of a normal live fetus and a partial molar placenta is extremely rare. Although triploidy is the most frequent association, a fetus with normal karyotype can survive in cases of partial molar pregnancy. We report a case of partial molar placenta in which a live female baby was delivered at 32 weeks gestation by a 30-year-old woman. At the 18th week, ultrasonographic examination revealed a normal fetus with a huge, multicystic placenta. Chromosomal evaluation by amniocentesis revealed a normal female karyotype (46,XX), and serial biometric measurement of the fetus showed normal growth during pregnancy. There were no obstetric complications until the 32nd gestational week when preterm rupture of the membranes occurred. The electronic fetal heart beat tracing showed a repeated sinusoid pattern and late deceleration after admission. The patient underwent emergency Caesarean section and delivered a 1551-g, anaemic female baby with an apgar score of 1, 4 and 6 at 1, 5 and 10 min, respectively. The baby recovered within 2 weeks after respiratory support and transfusion of packed red blood cells. Although anaemia is one of the risk factors that jeopardize the fetus in the case of partial molar pregnancy, termination is not indicated when the fetus is normal and no complications have occurred.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
2/23. Alcoholization: the choice of intrauterine treatment for chorioangioma.Chorioangioma is a vascular tumor of the placenta. Most are small and asymptomatic, whereas the large tumors are clinically significant and often associated with polyhydramnios and fetal heart failure. To prevent fetal loss from these complications, many interventions have been proposed, including intrauterine transfusion in anemic cases and fetoscopic surgery to ablate the feeding vessels. The case presented herein had large chorioangiomas, 8 and 4cm in diameter, associated with polyhydramnios and early signs of hydrops fetalis, diagnosed at 27 weeks gestation. After extensive counseling, we performed alcohol ablation of the feeding vessel of the larger tumor. Signs of fetal heart failure and hydrops fetalis disappeared dramatically. The pregnancy was extended for 2 weeks, followed by premature rupture of the membranes and spontaneous labor at 32 weeks gestation and a surviving female baby, weighing 1360g, was delivered uneventfully. This preliminary experience suggests that alcoholization may be one of the best choices for this condition due to its high efficacy, simplicity, safety and very low cost. To our knowledge, this is the first report using alcoholization for the treatment of hydrops fetalis secondary to chorioangioma.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
3/23. Diagnostic aspects of hydatidiform mole with persistence of polymorphic trophoblastic hyperplasia.SUMMARY: The persistence of polymorphic trophoblastic hyperplasia in a hydatidiform mole is an extremely rare condition. Its early recognition is essential since such cases can transform into invasive types of tumors. MATERIALS AND methods: The biopsies were routinely processed in paraffin, embedded and stained with HE. Immunohistochemical staining reactions were performed with the following monoclonal antibodies for hydatidiform mole: beta-hCG, HPL, MIB1, CK18, HER-2/neu, p53 and carbohydrate antibodies, Thomsen-Friedenreich antigen, Glycodelin A, Mucl and Mucl-cor. RESULTS: Large villi and hydatidiform villi with wide-ranged syncyctio- and cytotrophoblasts were seen. Intervillous proliferating trophoblasts showed cell- and nuclear polymorphy with a wall invasion of the myometrium. The immunohistochemistry exhibited strong positivity for the membrane-associated HER-2/neu and for the beta-hCG in syncytiotrophoblast and in multinuclear giant cells of intervillus trophoblasts. A weakly positive reaction with hPL was seen in most cells of the trophoblasts. The rest of the immunohistochemistry served as a diagnostic support. CONCLUSION: A complete hydatidiform mole with hyperplasia and proliferation of polymorphic trophoblasts presents a high risk of developing a persistent (eventually metastatic) trophoblastic disorder and, in up to 15% of the cases, an invasive mole. In 2.5% of the cases it can transform into a choriocarcinoma.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
4/23. Submucosal leiomyoma of the uterus incorporated into the fetal membranes and mimicking a placental neoplasm: a case report.leiomyoma of the placenta is uncommon. We present a leiomyoma of the fetal membranes that was incidentally discovered on examination of a spontaneously expulsed placenta following Caesarean section. Although it is an uncommon entity, it is known that leiomyomas may arise from the vasculature nourishing the fetal membranes. The baby was male and genetic studies were performed to detect y chromosome in tumoral tissue. polymerase chain reaction technique demonstrated Y chromosome in placental tissue but not in tumour tissue. Thus the tumour was finally diagnosed as incorporated benign uterine leiomyoma.- - - - - - - - - - ranking = 6keywords = membrane (Clic here for more details about this article) |
5/23. Pseudotumors of the umbilical cord and fetal membranes.Antenatally diagnosed pseudotumors, i.e. non-neoplastic tumors, of the umbilical cord and fetal membranes may when scanned by ultrasound have an appearance leading to misdiagnosis. In the present cases, a hematoma in the fetal membranes was interpreted as a chorioangioma, and a cystic mass inside the umbilical cord caused by degeneration of Wharton's jelly was regarded as an omphalomesenteric or allantoic cyst. The two cases are presented. color Doppler evaluation seems advisable.- - - - - - - - - - ranking = 6keywords = membrane (Clic here for more details about this article) |
6/23. 'Ciliated' tumour cells in ascitic fluid from two cases of cystadenocarcinoma of the ovary.We report two cases of primary carcinoma of the ovary in which 'ciliated' adenocarcinoma cells were found in the ascitic fluid. Transmission electron microscopy revealed that these were not true cilia but rather a prolific growth of abnormal microvilli. The cytological findings were compared with the histological appearances of the primary tumour. No ciliated cells were seen in the primary tumour, suggesting that the formation of the microvilli represented an independent proliferation of the cells in the fluid. Special staining reactions for mucin, alkaline phosphatase and epithelial membrane antigen were identical in the primary tumour and the cells in the ascitic fluid.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
7/23. Coexistence of a prolapsed, pedunculated cervical myoma and pregnancy complications: a case report.BACKGROUND: Different types of fibroids may affect reproductive outcome to a different extent, causing infertility and pregnancy wastage. Rectosigmoid compression, prolapse of a pedunculated submucous tumor through the cervix, venous stasis, polycythemia and ascites are infrequently associated with leiomyomas. Uterine leiomyomas arefound in approximately 2% of pregnant women; 1 in 10 causes complications during pregnancy. CASE: A 37-year-old woman, gravida 3, para 2, abortion 0, at 18 weeks of pregnancy, arrived at our outpatient clinic with a complaint of leaking vaginal fluid. On examination, a prolapsed, pedunculated myoma, measuring 5 x 6 x 7 cm, and pooling of amniotic fluid in the vaginal fornix were detected. Antibiotics were started, but the amniotic fluid leak continued, and the fetal heart beat became undetectable after 12 hours of hospitalization. We tried to excise the myoma from the vagina but because it was very large, we could not reach the proximal point it originatedfrom. We dissected the posterior cervical channel, removed the myoma and performed a total abdominal hysterectomy. CONCLUSION: Vaginal myomectomy is recommended as the initial treatment of choicefor a prolapsed, pedunculated submucous myoma except when other indications necessitate an abdominal approach. Use of laminaria and hysteroscopic resection has been mentioned as other treatment choices. In our case a prolapsed, pedunculated cervical myoma was detected along with pregnancy complications, preterm premature rupture of membranes and fetal death. The cause-and-effect relationship between the prolapsed myoma and membrane rupture is unknown. We were unable to perform a vaginal or abdominal myomectomy because the myoma originated in the posterior cervical region, so we had to perform an abdominal hysterectomy.- - - - - - - - - - ranking = 2keywords = membrane (Clic here for more details about this article) |
8/23. Chemotherapy for ovarian mucinous cystadenocarcinoma during pregnancy: a case report.There is limited experience in the treatment of epithelial ovarian malignancy with chemotherapy during pregnancy. We present the case of a 36-year-old women with ovarian mucinous cystadenocarcinoma during pregnancy, on whom exploratory laparotomy was performed at the gestational age of 16 weeks. Afterwards chemotherapy with cyclophosphamide (500 mg/m2) and cisplatin (50 mg/m2) was administered beginning at the second trimester of pregnancy due to surgical Stage Ic. Although preterm labor and a prematurely ruptured membrane occurred at the gestational age of 29 weeks before the fourth course of chemotherapy, there was still a satisfactory outcome for mother and fetus after an emergency cesarean section due to breech presentation at the gestational age of 30 weeks.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
9/23. Intracerebral schwannoma clinically and radiologically mimicking meningioma.A case of intracerebral schwannoma (ICS) occurring in a 33-year-old woman is presented. The patient's history of headache, numbness, tingling and the recent development of weakness of the right upper extremity with right facial droop began during pregnancy. magnetic resonance imaging (MRI) showed a 4 x 2 x 2 cm heterogeneous, gadolinium-enhanced mass at the left frontoparietal junction, with peritumoral edema and a dural-based attachment. During her pregnancy, the mass increased in size. The surgically resected specimen consisted of lobulated, somewhat gelatinous soft tissue. Microscopically, the tumor demonstrated classic biphasic Antoni type A and B patterns, admixed with degenerative changes. Immunohistochemically, the neoplastic cells were positive for S-100 protein (diffuse and strong), CD34 (primarily in Antoni B areas), glial fibrillary acidic protein (GFAP; weak and diffuse) and calretinin (mainly in Antoni A areas), while none was positive for CD31, estrogen and progesterone receptors, bcl-2, or epithelial membrane antigen (EMA). Ultrastructurally, basal laminae and Luse bodies were identified. The differential diagnosis includes fibrous meningioma, solitary fibrous tumor, and ICS. Twenty-seven cases of ICS were reviewed in which the histological diagnosis was confirmed immunohistochemically or ultrastructually, and the cases were summarized (including the present case). A combined use of immunostains (S-100 protein, EMA, CD34, and maybe calretinin) is of great help in distinguishing ICS from its histological mimickers.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
10/23. Follicular carcinoma of the thyroid with aggressive metastatic behavior in a pregnant woman: report of a case and review of the literature.Distant metastases as initial presentation of follicular carcinoma of the thyroid is rare, especially in young patients. We report the clinical and pathological features of a 33-year old pregnant patient with follicular carcinoma of the thyroid who presented with widespread bone and lung metastases at the time of diagnosis. the resected tumor had a focal insular component that showed extensive vascular invasion spreading beyond the thyroid capsule, and was associated with widespread bone and lung metastases. Despite its aggressive behavior, the tumor had low mitotic activity and Ki-67 nuclear labeling index. tumor cells showed high microvascular density and down-regulation of E-cadherin, a calcium-dependent trans-membrane epithelial protein molecule known to promote intercellular adhesion. We suggest that architectural differentiation of the tumor and cell proliferation rate are not reliable markers of metastatic behavior in this particular thyroid neoplasm. Microvascular density and down-regulation of E-cadherin expression in the tumor should be included among histologic hallmarks of metastatic potential. the role of pregnancy in the aggressive behavior of this tumor is discussed along with a literature review.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
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