Cases reported "Ovarian Neoplasms"

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1/27. Ovarian cancer associated with ovulation induction: a case report.

    A case report of a 38 year old lady who developed ovarian malignancy following 3 cycles of ovulation induction therapy is presented. She was observed to have clinically normal ovaries at laparotomy for tubal infertility 12 months previously. Although direct causal link between ovarian stimulation and cancer has not been established yet, a case is made for increased monitoring of patients receiving ovulation induction medication by physicians.
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2/27. Spontaneous conception in the presence of stage IIIC endometrioid ovarian cancer.

    OBJECTIVE: To describe a rare case of spontaneous conception in a patient with a preexisting metastatic ovarian cancer. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 39-year-old Asian woman who conceived while undergoing an evaluation for primary infertility and newly detected bilateral adnexal masses. INTERVENTION(S): Staging laparotomy and total abdominal hysterectomy and bilateral salpingo-oophorectomy. MAIN OUTCOME MEASURE(S): Anatomic pathology diagnosis. RESULT(S): Blighted ovum and stage IIIC endometrioid adenocarcinoma of ovary. CONCLUSION(S): Metastatic ovarian cancer does not prevent either spontaneous ovulation or spontaneous conception.
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keywords = ovulation
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3/27. Synchronous endometrioid carcinoma of the ovary and endometrium associated with ovulation induction.

    Over the last 2 decades great concern about the possible association between ovarian cancer and ovulation induction has been raised. Between the first reported case in 1982 and the end of year 2000, there have been 44 cases of ovarian carcinoma reported to occur in women previously treated with ovulation induction drugs. Most of these tumors were of the serous type with low malignant potential. In the present case, the patient had secondary anovulatory infertility and previous left cystoophorectomy for ovarian endometrioma. She was treated with human menopausal gonadotrophin alone or in combination with clomiphene citrate for 13 cycles prior to presentation. Screening ultrasound revealed multicystic right ovarian mass (15 x 9 x 6 cm). hysterectomy and right salpingo-oophorectomy were carried out. Intraoperative and histological examinations showed stage 1A endometrioid ovarian cancer and well-differentiated endometrial adenoacanthoma with minimal myometrial invasion. A brief but critical review of published literature regarding the association of ovulation induction and increased risk of ovarian cancer is presented.
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4/27. Hyperandrogenemia associated with insulin resistance mimicking an androgen producing tumor.

    The finding of a serum testosterone level greater than 200 ng/dl in a woman with virilization raises concerns about an androgen producing tumor. This case report demonstrates that chronic annovulation in association with insulin resistance can cause significant elevations in the level of serum testosterone, and describes the therapeutic benefit of insulin sensitizing agents in reversing hyperandrogenemia.
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keywords = ovulation
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5/27. Androgenic function of a granulosa cell tumor.

    Virilizing granulosa cell tumors are uncommon and have not been well studied hormonally. A hirsute woman with a cystic granulosa cell tumor of the ovary is presented. plasma hormone levles obtained before and after surgery indicate testosterone production by the tumor with LH and FSH suppression. plasma testosterone (T) and T-index returned to normal after tumor removal, and ovulation resumed.
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keywords = ovulation
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6/27. Pseudo-isolated FSH deficiency caused by an inhibin B-secreting granulosa cell tumour: case report.

    Isolated FSH deficiency due to a mutation in the FSHbeta subunit is characterized by an extremely low serum FSH concentration. We report a patient who presented with an FSH of 0.8 mIU/ml and infertility associated with anovulation. Endocrinological assessment and immunohistochemistry revealed that a granulosa cell tumour was secreting inhibin B and suppressing FSH; however, LH and estradiol were within their normal ranges. Upon removal of the tumour, inhibin B decreased and FSH levels rose to normal values. The patient subsequently conceived and delivered successfully. Based on this case and on those previously described in the literature, we suggest that inhibin B levels should be evaluated in anovulatory patients having a clinical presentation consistent with functional hypothalamic amenorrhoea and very low to normal values of FSH.
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keywords = ovulation
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7/27. Assisted reproduction in patients with early-stage ovarian malignancies.

    OBJECTIVE: To determine the outcome of women with early-stage ovarian malignancies who subsequently underwent assisted reproductive technologies (art). DESIGN: Retrospective study. SETTING: Academic assisted reproductive technology program. PATIENT(S): Four infertile women who were previously diagnosed with early-stage ovarian malignancies. INTERVENTION(S): Controlled ovulation hyperstimulation, IVF, and/or gamete intrafallopian transfer treatments using clomiphene citrate and/or gonadotropins. MAIN OUTCOME MEASURE(S): Development of tumor recurrence and disease-free interval. RESULT(S): All four women remain free of disease for up to 15 years after treatment. Three of the four women achieved pregnancy. CONCLUSION(S): In patients with early-stage ovarian malignancies, conservative therapy followed by ovarian stimulation for assisted reproduction is an acceptable strategy.
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keywords = ovulation
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8/27. Synchronous mucinous adenocarcinoma of the endometrium and mucinous cystadenoma of bilateral ovaries presenting during fertility therapy.

    We describe a very rare case of synchronous mucinous tumor of the endometrium and ovaries presenting during ovulation induction. A 31-year-old woman received ovulation induction for 5-year primary infertility. ultrasonography revealed mucus retention in the uterine cavity and bilateral multicystic ovaries during ovulation induction. Atypical hyperplasia was diagnosed by endometrial curettage. Repeated procedures including ovarian cystectomy, endometrial curettage and in vitro fertilization combined with progestine therapy resulted in no pregnancy but rapid recurrences. She finally underwent simple hysterectomy and bilateral salpingo-oophorectomy. Microscopic examination revealed mucinous cystadenoma in the both ovaries and well differentiated mucinous adenocarcinoma of the endometrium.
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9/27. The steroid profile of a virilizing ovarian tumor.

    A case report of a 25-year-old female with a sex cord stromal virilizing ovarian tumor is presented. The pathway of ovarian steroid secretion in this tumor is elucidated with the dominant elements being pregnenolone, 17-hydroxypregnenolone, 17-hydroxyprogesterone, androstenedione, and testosterone. The tumor primarily made testosterone (T) with lesser elevations of androstenedione (A), dehydroepiandrosterone (DHEA), and dihydrotestosterone (DHT). Expert pathologic opinions differed whether this neoplasm was a Sertoli-Leydig tumor or a virilizing granulosa tumor; therefore, it was probably a gynandroblastoma. A unilateral salpingo-oophorectomy was performed and the patient promptly resumed normal ovarian function with ovulation.
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keywords = ovulation
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10/27. Ovarian carcinoma of low malignant potential, infertility, and induction of ovulation--is there a link?

    Three cases of ovarian carcinoma of low malignant potential associated with infertility and ovulation induction are reported. The natural history of ovarian epithelial tumors is possibly being interrupted with earlier intervention and diagnosis in patients who may have presented 10 to 15 years later with disseminated ovarian carcinoma.
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