Vulvar leiomyosarcoma is a rare smooth muscle malignant neoplasm but it is the commonest type of vulvar sarcomas. It may mimic benign tumors and misdiagnosis could delay proper management. We report a case of a 38-year-old pregnant woman with leiomyosarcoma of the vulva. The patient presented to her primary general practitioner with a small vulvar mass that she had first noticed one year prior. The tumor was suspected to be benign Bartholin's cyst and treated with antibiotics. The patient declined improvement and had many consultations to different clinics where she had been diagnosed and treated the same. The tumor size started to grow rapidly after she got pregnant, and the patient was referred to our hospital where she underwent tumor resection. Histopathology revealed leiomyosarcoma. The patient had further assessment and close follow-up and has had no recurrence for 12 months. There is little literature available on vulvar leiomyosarcoma, most of which are case reports, and most gynecologic oncologists will go through their whole careers without seeing a single case.
Objective:To determine modifiable hospital factors associated with survival of infants with GA ≤24 weeks and birth weight <500gm in the USA. And to assess the trend for the timing of postnatal mortality in these periviable infants.Design: National data were analyzed for the years 2010-2018. Hospitals were categorized according to delivery volume, US regions, and teaching status.Results: We identified 33,998,014 infants born during the study period; 76,231 infants were ≤24 weeks. Survival was greatest in urban teaching hospitals in infants <24 weeks and completed 24 weeks, respectively. The Northeast region has the lowest survival rate. There was a significant delay in the postnatal day of mortality in periviable infants.Conclusions: Hospital factors are associated with increased survival rates. Improved survival in large teaching hospitals supports the need for regionalization of care in infants born at the limits of viability. There was a significant delay in the postnatal mortality day.
Background Reports on survival of infants born at periviable gestation (GA ≤ 24 weeks and birth weight < 500gm) vary significantly. We aimed to determine hospital factors associated with their survival and to assess the trend for the timing of postnatal mortality in these periviable infants.Methods We utilized the de-identified National Inpatient Sample (NIS) dataset from the Healthcare Cost and Utilization Project (HCUP) from the Agency for Healthcare Research and Quality (AHRQ). National data were analyzed for the years 2010–2018. Hospitals were categorized according to delivery volume, USA regions, and teaching status.Results We identified 33,998,014 infants born during the study period; 76,231 infants were ≤ 24 weeks. Survival was greatest in urban teaching hospitals in infants < 24 weeks and completed 24 weeks, respectively. The Northeast region has the lowest survival rate. There was a significant delay in the postnatal day of mortality in periviable infants.Conclusions Hospital factors are associated with increased survival rates. Improved survival in large teaching hospitals supports the need for regionalization of care in infants born at the limits of viability. There was a significant delay in the postnatal mortality day.
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