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Background Mature Cystic Teratoma (MCT) is a benign tumor that can lead to malignant transformation (MT) in 1–3% of cases. Management of MT is a big challenge for gynecologic oncologists due to the lack of specific diagnostic and treatment protocols. Case presentation We reported two Iranian cases of MT of MCT with two different stages and prognosis. Our both cases presented the same symptoms, including chronic abdominal pain and distention, loss of appetite, and weight loss. In case number 1, despite the large size of the tumor, the disease was at stage Ia and had a good prognosis; while, case number 2 was at stage IIIc of the disease with a poor prognosis. Conclusion The stage of the disease is the most important prognostic factor, and early diagnosis and treatment are very critical for better survival.

Background:Several studies indicated that there is a high prevalence of vitamin D deficiency in Middle East countries.Objectives:The aim of this study was to determine the prevalence and assess some risk factors of vitamin D deficiency among women attending our clinics in Tehran, the capital of Iran.Patients and Methods:Five hundred and thirty-eight women aged 20-80 years were entered in this cross-sectional study from 2011 to 2012. Serum 25-hydroxy vitamin D levels were measured in all participants after recruiting their demographic and anthropometric data and past medical histories. Deficiency was defined as levels less than 35 nmol/L and classified as mild (≥ 25 nmol/L), moderate (12.5-25 nmol/L) and severe (≤ 12.5 nmol/L).Results:The prevalence of vitamin D deficiency was 69%; mild, moderate and severe degrees were seen in %10.4, %38.3, and %20.3 respectively. Analysis of logistic regression shows that age (OR:0.96, CI: 0.93-0.97), menopause (OR: 0.44, CI: 0.21-0.99) and consumption of multivitamin supplements (OR: 2.67, CI: 1.4-5) were independent predictive factors for Vitamin D deficiency.Conclusions:This study showed a high prevalence of vitamin D deficiency among Iranian women especially in reproductive ages.

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C a s e R e p o r t e247 I NTRO D U C TIO NInflammatory disorders of the breast, including mastitis and breast abscesses, are generally benign diseases that rarely harbour malignancy. Although the occurrence of cancer is not anticipated in true breast abscesses in nursing mothers, it can occasionally happen. Herein, we present a rare case of adenosquamous carcinoma of the breast in a 33-year-old lactating woman who presented with a breast abscess. CA S E R EPO RTA 33-year-old lactating woman presented to our breast clinic with signs of inflammation in her left breast -the skin was largely erythematous and warm over a tender 10-cm fluctuating mass, and several soft, non-suspicious lymphadenopathies were observed in the left axilla. According to the patient, the inflammation began two months prior to presentation and temporarily subsided with the use of oral antibiotics; when the use of oral antibiotics was discontinued, the inflammation flared up. Ultrasonography performed one month prior to presentation showed a multiloculated 93-mm × 82-mm × 63-mm fluidcontaining cavity in the left breast, which was suggestive of a breast abscess, and large reactive axillary lymph nodes in the same side.Intravenous antibiotics were prescribed, lactation ceased, and the cavity was surgically drained, yielding more than 300 mL of diluted pus. As routinely done in our institution, multiple biopsies were performed using the tissue obtained from the abscess wall. of the chest, abdomen and pelvis, and a bone scan of the whole body, was negative. The patient had no family history of breast cancer, and no other known risk factor was detected.Before proceeding with cancer treatment, we had to first determine whether the abscess was an inflammatory carcinoma or an invasive noninflammatory carcinoma presenting as an abscess. Although the inflammatory signs of the breast were in favour of the former diagnosis, a mismanaged large and persistent breast abscess is not uncommon in milk-laden breasts. Hence, the possibility of a lactating abscess superimposed on a typical invasive tumour was considered. However, since the pathologist who reviewed the histology slides could not detect any cancerous involvement in the dermal lymphatics, it was decided that the disease would be treated as a large noninflammatory invasive breast cancer.Following the diagnosis, the surgical wound was immediately closed to allow rapid initiation of neoadjuvant chemotherapy, which involved four cycles of treatment with cyclophosphamide, epirubicin and 5-fluorouracil, followed by four cycles of treatment with taxotere. As the patient did not consent to a mastectomy, breast-conserving surgery with a wide normal margin and axillary dissection was performed. The postoperative course was uneventful. Postoperative radiotherapy consisted of a 5,000-cGy breast and regional lymphatic area irradiation and a 1,000-cGy irradiation boost to the tumour bed. ABSTRACT We report the case of a 33-year-old lactating woman who presented with a 10-cm breast abscess.Biopsy of the abscess w...

Background Among all ectopic pregnancies, between 0.5% and 3.5% are ovarian ectopic pregnancies, a potentially life-threatening condition when ruptured due to its serious potential for hemorrhaging. A majority of ovarian ectopic pregnancies are diagnosed by the 7th week of pregnancy when the patient becomes symptomatic, and ultrasound can be used to diagnose this condition. Case presentation We present the case of a 39-year-old Persian woman in the 12th week of gestation who presented with vaginal bleeding and abdominal pain and was diagnosed with ovarian ectopic pregnancy. Her notable laboratory finding was β-human chorionic gonadotropin > 15,000, which indicates definite pregnancy. Transvaginal ultrasound (TVS) revealed no evidence of intrauterine pregnancy, but a well-circumscribed gestational sac in the left ovary. The patient was successfully treated with resection of the gestational sac and partial left salpingo-oophorectomy. Histopathological studies confirmed the diagnosis of ovarian ectopic pregnancy. Conclusion The case emphasizes the ability of ovarian ectopic pregnancy to develop asymptomatically through the course of pregnancy and points to the necessity for high-quality prenatal care and the importance of determining the fetal site during pregnancy.

Study Objective: This study evaluated peritoneal washings for the detection of spindle cells (SCs) in laparoscopic and open myomectomies. Design: Prospective, nonrandomized clinical trial. Setting: An academic tertiary referral center. Patients: Women suspected of having benign uterine myoma undergoing laparoscopic or open myomectomy from October 2016 to April 2018.Interventions: Washing of the peritoneal cavity to detect SCs was performed twice during the laparoscopic myomectomy. The first washing was after the closure of the myometrial incision and before morcellation. The second one was performed after morcellation. The procedure was also performed once during the open myomectomy, after the completion of the myomectomy and the closure of the incision. After a peritoneal washing with 200 mL normal saline, 30 mL liquid was collected and sent to the laboratory for SC detection. Surgical parameters such as operating time, mean change in serum hemoglobin level, complications, length of hospital stay, and readmission were compared between the 2 groups. Measurements and Main Results: A total of 150 participants were included in the analysis: 78 in the laparoscopic group and 72 in the open myomectomy group. After morcellation, the incidence of SCs was 2.6% (n = 2) and 6.9% (n = 5) in the laparoscopic and open myomectomy groups, respectively (p = .204). Conclusion: SCs were observed in both the laparoscopic and open myomectomy groups. Thus, morcellation alone could not be the cause for SC dissemination, which might also be triggered by the manipulation of myoma(s).

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