The definition of a cesarean scar pregnancy (CSP) is the localization of the gestational sac (GS) in the cicatrix tissue, which is created in the front wall of the uterus after a previous cesarean section (CS). The worldwide prevalence of CSP has been growing rapidly. However, there are no general recommendations regarding prophylaxis and treatment of the abnormalities of the anterior wall of the uterus discovered in a non-pregnant myometrium, or how to deal with existing cases of CSP. We present the latest knowledge, a holistic approach to the biology, histology, imaging, and management concerning post-CS scars based on our cases, which were treated in the Department of Pregnancy and Pathology of Pregnancy in the Medical University of Lublin, Poland. In our study, we present images of tissue samples of areas with a cicatrix in the uterus, and ultrasound and MRI images of CSP. We discuss the advances in the biology of the post-CS scar tissue, the prevention techniques used to repair the scar defect (niche) before the pregnancy, and the treatment of different complications of CSP, such as the rupture of the gravid uterus or the dehiscence of the myometrium.
Neurofibromas of the stomach can occur in the course of Recklinghausen's disease. Sporadic gastric neurofibroma appears rarely. This tumour may look like an ulcer and can be a cause of abdominal pain, nausea, and bleeding from the gastrointestinal tract. We reported a 61-year-old women complaining of stomachache for several months. Gastroscopy revealed a tumour with ulceration in the prepyloric part of the stomach. Helicobacter pylori infection was also present. Helicobacter pylori eradication and prolonged treatment of proton pump inhibitors did not decrease the ailments or the size of the tumour. It was not possible to determine the nature and origin of the tumour by carrying out examinations such as endoscopic ultrasound and computed tomography of the abdomen. Only after surgery and histopathological examination with immunohistochemistry was this tumour identified as a neurofibroma. In order to differentiate the tumour the following immunohistochemical examinations were carried out: CD34 (slightly +), CD117 (–), S-100 (+), desmin (–), NSE (+), GFAP (–), SMA (–), bc12 (–), CD99 (–), ALK1 (–), and MiB (1–1.5%). In such cases excision of the tumour is the preferred treatment.
On the basis of our experience, conservative surgical procedure is sufficient for penile glomus tumors. However, each patient should be carefully examined for possible extragenital lesions.
This article has been peer reviewed and published immediately upon acceptance.It is an open access article, which means that it can be downloaded, printed, and distributed freely, provided the work is properly cited. Articles in "Ginekologia Polska" are listed in PubMed.
Pedunculated polyps of the esophagus containing elements of the mesenchymal tissue are benign tumors that occur in the cervical and upper thoracic esophagus, particularly in the region of the cricopharyngeus muscle. Large pedunculated tumors, can cause dysphagia, dyspnea, or sudden choking. Herein, we describe the case of a 70-year-old man initially diagnosed with a 21 cm giant pedunculated mixed mesenchymal tumor of the esophagus. Our case study demonstrates endoscopic evaluation and the successful surgical resection of the esophageal lesion.
Adenomatosis is a rare lesion of unknown etiology, defined as multiple (usually 5 or more) adenomas in one kidney. A case of renal adenomatosis in a 68-year-old woman treated previously for urolithiasis, who underwent nephrectomy because of the nonfunctional left kidney is reported. Apart from multiple adenomas, numerous hyperplastic lesions involving single tubules were present in the resected kidney. Both adenomas and hyperplastic lesions exhibited the expression of alpha-methylacyl-coenzyme A racemase (AMACR). Renal adenomatosis is worth special attention, since renal papillary adenomas are suggested as precursor lesions of papillary renal cell carcinoma that show similar AMACR expression.
A new case of intrapancreatic accessory spleen located in the tail of the pancreas in a premature male newborn is reported. The anomaly was unexpectedly found at the autopsy together with many other malformations including heart defects, polycystic kidneys, oxycephaly, facial dysmorphy, low set ears, webbing of neck and accessory fingers of right hand and foot. Microscopic examination of the pancreas revealed accessory spleen composed of red and white pulp. The spleen was partly well-demarcated but partly intermingled with pancreatic lobules. Many goblet cell-containing intralobular pancreatic ducts, some of them entrapped within spleen were noted. Splenopancreatic field abnormalities are known to be highly specific for trisomy 13 syndrome. Although karyotyping was not performed, on the basis of reveled malformations the syndrome can be suspected in the presented case.
Xanthogranulomatous inflammation of the urethra and the urinary bladder is a very rare pathological condition characterized by a chronic inflammatory infiltration composed mainly of foamy macrophages, with the presence of multinucleated giant cells. In a clinical examination, it can mimic urinary bladder carcinoma. This report presents the extremely rare case of a co-existing xanthogranulomatous urethritis and cystitis in a 64-year-old woman with recurrent dysuria, and with the suspicion of malignancy - as indicated on the basis of a cystoscopic examination. The standard treatment of this disorder is surgical resection, but in the presented case, only a diagnostic biopsy was performed. Because of the persistence of clinical symptoms, a cystoscopic examination and biopsy was repeated three times in a two year period. There was no malignancy seen in the repeated biopsies.
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