1/38. 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 = blood cell (Clic here for more details about this article) |
2/38. Plexiform leiomyoma of the uterus in a patient with breast carcinoma: case report and review of the literature.Plexiform leiomyomas of the uterus are incidental findings in hysterectomy specimens. Histogenetically, these rare tumors are classified as a variant of epithelioid leiomyomas. Most of the plexiform leiomyomas reported range in size from microscopically small lesions to less than 1 cm in largest diameter, and they macroscopically present as a nodular white-yellowish cut surface. Microscopically, the "Indian-file" pattern of epithelial-like tumor cells of plexiform leiomyomas may be confused with metastatic breast carcinoma, in particular lobular breast carcinoma, i.e.; one of the most frequent extragenital neoplasms metastasizing to the uterus. This report describes the occurrence of a large plexiform leiomyoma in a patient with a history of breast carcinoma, and draws attention to the histological differential diagnosis between these lesions. The results of immunohistochemical stainings for cytokeratin and smooth muscle actin confirmed the final diagnosis of plexiform leiomyoma.- - - - - - - - - - ranking = 0.28793161042524keywords = white (Clic here for more details about this article) |
3/38. Uterine metastasis from a heterologous metaplastic breast carcinoma simulating a primary uterine malignancy.OBJECTIVE: To describe the first distant metastasis of a heterologous metaplastic breast carcinoma in the uterus and discuss its differential diagnosis. methods: light microscopy, immunohistochemistry, and flow cytometry were used to evaluate the tumor. RESULTS: A 58-year-old woman underwent mastectomy for metaplastic breast carcinoma confined to the breast. She presented 4 years later with vaginal bleeding. The endometrial curettage showed a poorly differentiated carcinoma. She underwent hysterectomy and bilateral salpingo-oophorectomy as well as pelvic and periaortic lymphadenectomy. Clinical and intraoperative findings favored a primary uterine malignancy. The uterus was markedly distorted with multiple gray-white, solid subserosal, and intramural tumor nodules. The tumor diffusely infiltrated the endometrium sparing benign endometrial glands. The tumor nodules were distributed full thickness of the myometrium. These nodules were composed of high-grade malignant epithelial cells with areas of chondroid metaplasia. Extrauterine microscopic tumor was present in left ovary, pelvic, and periaortic lymph nodes. The histologic features and estrogen/progesterone receptors (ER/PR) as well as dna ploidy analysis of the uterine tumor showed striking similarity with those of the primary metaplastic breast carcinoma. A diagnosis of metastatic metaplastic breast carcinoma in the uterus was rendered. CONCLUSION: A metastatic heterologous metaplastic breast carcinoma with cartilaginous metaplasia should be considered in the differential diagnosis of heterologous uterine malignant mixed mesodermal tumor (MMMT) and high-grade endometrioid carcinoma with rare foci of cartilage.- - - - - - - - - - ranking = 0.28793161042524keywords = white (Clic here for more details about this article) |
4/38. Uterine adenolipoleiomyoma: a rare hamartomatous lesion.An apparently unique intramural uterine lesion is described for which we propose the name adenolipoleiomyoma. On gross examination, a well-circumscribed white intramural mass contained focal fatty areas. histology showed the mass to be composed of smooth muscle, adipose tissue, and endometrial, endocervical, and tubal type glands. The endometrial glands were surrounded by typical endometrial stroma. There was no evidence of adenomyosis in the uterus outside the lesion. This is only the second report of such a lesion within the uterus and the first with an intramural location. We believe it to be a benign hamartomatous lesion.- - - - - - - - - - ranking = 0.28793161042524keywords = white (Clic here for more details about this article) |
5/38. Uterine leiomyoma with massive lymphocytic infiltration simulating malignant lymphoma. A case report with immunohistochemical study showing that the infiltrating lymphocytes are cytotoxic T cells.Uterine leiomyoma with massive lymphoid infiltration is very rare and may simulate malignant lymphoma. To the best of our knowledge, this is the first description of such a lesion occurring in an Oriental, and the ninth case in the English literature. A 50-year-old Taiwanese woman had urinary frequency and nocturia because of a uterine myoma. The myomectomy specimen was identified as a well-defined tumor, 6.5-cm in diameter, the cut surface of which was pale, white and whorled. A massive lymphocytic infiltration accompanied by plasma cells and histiocytes was noted in the leiomyoma but not in the surrounding non-neoplastic myometrial fibers. Most infiltrating lymphocytes were positive for CD3 and T cell intracellular antigen-1, a cytotoxic marker. The postoperative course was uneventful, and the urinary symptoms improved within a 6-month follow-up period.- - - - - - - - - - ranking = 0.28793161042524keywords = white (Clic here for more details about this article) |
6/38. erythropoietin synthesis by tumour tissues in a patient with uterine myoma and erythrocytosis.We report a patient with uterine myoma (leiomyoma) and erythrocytosis in whom erythropoietin (Epo) production in the leiomyoma tissue was identified by reverse transcription polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA). A 48-year-old Japanese woman with uterine myoma showed marked erythrocytosis (haemoglobin: 20.2 g/dl, haematocrit: 61.1%, red blood cells: 6.51 x 10(12)/1). After hysterectomy, erythrocytosis rapidly disappeared. In the leiomyoma tissue collected from the patient, Epo mRNA expression was confirmed using RT-PCR. Furthermore, ELISA showed that the Epo protein level was significantly increased compared with those in control tissues. It is suggested that the pathogenesis of erythrocytosis in patients with uterine myoma involves ectopic Epo production by leiomyoma tissues.- - - - - - - - - - ranking = 1keywords = blood cell (Clic here for more details about this article) |
7/38. Uterine adenomatoid tumors confirmed by immunohistochemical staining.We present a 39-year-old nulliparous woman who consulted our clinic for an 8-year history of infertility with no notable symptoms. There apparent uterine leiomyomas were found incidentally on clinical examination and imaging. The surgically enucleated specimens were white in color with variable consistency poorly defined margins. The tissues stained positive for cytokeratin but were negative for CD34 antibodies, indicating a mesothelial origin. Staining for vimentin and HBME1 was also strongly positive, supporting a mesothelial origin of the tumors. The patient became pregnant 6 months after surgery. A healthy male infant was delivered at term. Immunohistochemical staining establish the diagnosis of benign adenomatoid tumors derived from mesothelial tissue.- - - - - - - - - - ranking = 0.28793161042524keywords = white (Clic here for more details about this article) |
8/38. Forceps delivery after molar malignancy in a woman with arteriovenous malformation. A case report.BACKGROUND: An arteriovenous (AV) fistula in the female pelvis is a rare finding. This report describes a successful pregnancy after selective embolization of a postmolar vascular malformation. CASE: At 5 weeks of pregnancy, a 27-year-old, white female, gravida 3, para 0, was discovered on ultrasound examination to have an AV malformation along with a fetal pole. The patient was asymptomatic and had previously received two courses of chemotherapy for a previous nonmetastasized malignant molar pregnancy. Doppler ultrasonography uncovered a vascular malformation extending from the margin of the fetal pole to the margin of the uterus. The pregnancy ended at 8 weeks with a spontaneous abortion. The patient underwent angiography and embolization of extensive right-sided uterine vessels. She resumed normal menstrual periods six weeks after the embolization and became pregnant. The pregnancy concluded in low forceps vaginal delivery of a healthy, female infant at 34 weeks. CONCLUSION: Vaginal delivery following postmolar pregnancy and a uterine AV malformation may be considered a viable delivery option.- - - - - - - - - - ranking = 0.28793161042524keywords = white (Clic here for more details about this article) |
9/38. A case report of early idiopathic portal hypertension.We report herein a case (46 years, female) of very early idiopathic portal hypertension. During an examination for in situ uterine cervical cancer, splenomegaly and hypersplenism were incidentally found. CT and MRI showed a nonatrophic liver with dilated portal veins and marked splenomegaly. The portal venous blood flow was increased, while portal venous blood pressure was not high. The spleen (1,220 g) showed hyperplasia of white pulp and congestion. The lobular architecture of the liver was well-preserved, and the subcapsular regions were not atrophic or dropped out. The portal tracts were not fibrotic, and portal veins were neither stenotic nor sclerotic. Instead, lymphoid cell infiltrations were found in about half the portal tracts, and there was subendothelial mononuclear cell infiltration of small portal vein branches. The hepatic lobules showed non-specific reactive change. This case suggests that early hepatic changes recognizable histologically in this disease are lymphoid cell infiltration of the portal tract and of subendothelial regions of portal vein branches, and nonspecific lobular hepatitis. These hepatic changes, as well as marked splenomegaly, may represent an altered immunophenomenon of this disease.- - - - - - - - - - ranking = 0.28793161042524keywords = white (Clic here for more details about this article) |
10/38. fibrosarcoma of the uterus: a case report.BACKGROUND: This case report presents the management of a patient with fibrosarcoma of the uterus. Until recently, no cases of fibrosarcomas of the uterus have been reported in the literature. CASE REPORT: A 40-year-old woman presented with complaints of slight vaginal bleeding, watery, white discharge and abdominal pain of 3 weeks' duration. The patient underwent total abdominal hysterectomy. Intraoperative findings included an enlarged irregular-shaped uterus with lots of leiomyoma nodules. The largest leiomyoma nodule was about 8 cm in size and contained an area classified as a fibrosarcoma, presenting cellular immature-appearing fibroblasts growing in a fascicular arrangement. Because of the limited extension of the fibrosarcoma, no adjuvant therapy was performed. After surgical therapy the patient was followed without any evidence of disease for five years. CONCLUSION: fibrosarcoma is a poorly-circumscribed infiltrative spindle soft tissue sarcoma, which is characterized by local growth and has a propensity for local recurrence. Metastases can occur, mostly to lung and bone. The treatment of choice is wide surgical excision usually followed by radiation therapy due to the high local recurrence rate.- - - - - - - - - - ranking = 0.28793161042524keywords = white (Clic here for more details about this article) |
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