Cases reported "Endometrial Hyperplasia"

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1/7. Metastasis from squamous carcinoma of the cervix stage 1B to a borderline cystadenoma of the ovary.

    A case of metastasis from squamous carcinoma stage 1B of the cervix to a borderline cystadenoma of the ovary is described. In addition, the patient had atypical endometrial hyperplasia. The patient underwent a radical hysterectomy with no adjuvant postoperative treatment and has resumed work, with no sign of recurrence one year postoperatively. The aspects of the metastasis to the ovary, multiple tumors in the genital tract and tumor-to-tumor metastasis are discussed. Reports on ovarian metastasis in low-stage squamous carcinoma of the cervix are few and it still seems justified to spare the ovaries at surgery in the young patient.
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keywords = ovary
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2/7. Unusual presentation of a woman with polycystic ovaries and complex endometrial pathology.

    A 28-year-old woman with polycystic ovarian syndrome (PCOS) had attempted four assisted conception treatments, all of which were complicated by lack of response of the endometrium to the hypo-oestrogenic state induced with gonadotrophin releasing hormone analogue (GnRHa). Consequently, two treatment cycles were abandoned, one prior to the ovulation induction of a fresh IVF treatment and the other prior to oestrogen replacement for a frozen-thawed embryo transfer treatment cycle. Extended down-regulation eventually resulted in endometrial thinning and allowed completion of the other two treatments, but the outcome was negative. A targeted mid-cycle ultrasound scan in a natural cycle at follow-up showed thick, non-homogenous endometrium. A repeat hysteroscopy on this occasion showed abnormal endometrium with chalk-like deposits. Histological diagnosis was chronic endometritis and endometrial hyperplasia with focal atypia. Microbiological tests, including those for mycobacterium tuberculosis, were negative. Because of atypical endometrial hyperplasia, this patient is currently under close follow-up by the original referring team. This case highlights inherent endometrial pathology presenting as non-responding endometrium to hormonal down-regulation, the limitations of conventional ultrasound scans, and the complimentary role of concomitant hysteroscopy in the correct identification of endometrial lesions that may negatively affect the assisted conception treatments.
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keywords = polycystic
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3/7. pregnancy induced with menotropins in a woman with polycystic ovaries, endometrial hyperplasia, and adenocarcinoma.

    A 31-year-old woman is described with PCOD associated with endometrial hyperplasia and well-differentiated adenocarcinoma. Conservative treatment with ovulation induction was pursued for a total of 3 1/2 years. After CC treatment failed to achieve conception, treatment with menotropins resulted in a twin pregnancy that aborted spontaneously and a singleton term pregnancy. hysterectomy was performed 4 1/2 years after the initial diagnosis of well-differentiated endometrial adenocarcinoma was made. Histologic examination of the endometrium showed no progression of the disease. ovulation induction of patients with polycystic ovaries and well-differentiated and noninvasive endometrial adenocarcinoma may be justified in properly selected cases.
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keywords = polycystic
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4/7. Atypical ovarian hyperthecosis in a virilized postmenopausal woman.

    Ovarian venous concentrations of testosterone (18.7 ng/mL and 8.2 ng/mL) were three to six times higher than the peripheral concentrations (2.8 ng/mL) in a hirsute postmenopausal woman. She had cystic hyperplasia of the endometrium and atypical hyperthecosis of the ovary. Postoperatively, the testosterone levels returned to normal. From the results of the immunoperoxidase reaction, the luteinized stromal cells of the ovaries were the site of increased production of the testosterone and estradiol. By the same technic, these cells were negative for LH but strongly positive for FSH. From these data, the authors conclude that the luteinized cells were the primary source of the excessive testosterone, that the same cells were the direct and indirect (by peripheral testosterone conversion) source of estradiol, that LH was very likely not involved in the process of steroid hormone production, and that FSH may be the trophic stimulus responsible for the functional activity of the luteinized stromal cells in this virilized postmenopausal woman.
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keywords = ovary
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5/7. Ovarian Sertoli cell tumors: a report of 10 cases.

    Ten Sertoli cell tumors of the ovary, which occurred in patients from 2 to 62 years of age (average 38 years), are reported. Two prepubertal patients presented because of isosexual precocity, and there was evidence of estrogenic stimulation of the endometrium in two postmenopausal women. The tumors were all Stage Ia and ranged from 0.8 to 17 cm in diameter. On microscopic examination five of them contained tubules that were predominantly hollow, and five, tubules that were predominantly solid. Two of the neoplasms in the latter group were of the lipid-rich type. Seven tumors were well differentiated, two were of intermediate differentiation, and one was poorly differentiated. The last tumor, which metastasized widely and was rapidly fatal, was the only clinically malignant tumor in the series.
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ranking = 0.16666666666667
keywords = ovary
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6/7. Functional lutein cyst in a postmenopausal woman.

    A postmenopausal woman presented with enlarged breasts, increased vaginal mucus, and elevated serum estrogen and normal progesterone levels. A laparotomy was performed and revealed a cystic right ovary. Histologic examination of the ovary demonstrated a cyst lined by stratified lutein cells with abundant eosinophilic cytoplasm. The endometrium showed cystic and adenomatous hyperplasia. The diagnosis was functional lutein cyst. Removal of the cystic ovary reduced the estrogen levels, and the clinical picture reverted to that of a normal postmenopausal state.
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7/7. Origin of estrogen in a postmenopausal woman with a nonendocrine tumor of the ovary and endometrial hyperplasia.

    The origin and quantity of estrogen and androgen were measured in a postmenopausal woman with clinical signs of estrogen excess and a nonendocrine tumor of the ovary. The plasma androstenedione production rate was elevated 5-fold. The estrone production rate was also five times that normally expected for a postmenopausal women and could be accounted for totally by the extraglandular conversion of plasma and androstenedione. Following removal of the tumor, the concentration of plasma androstenedione and the estrone production rate fell dramatically to normal postmenopausal levels. It is concluded that this markedly increased androstenedione production was the result of excessive secretion of androstenedione by the hyperplastic stromal cells of the ovary containing the mucinous cystadenocarcinoma. The excessive prehormone production together with its normal extraglandular conversion to estrone resulted in the massive increase in endogenous estrogen formation.
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keywords = ovary
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