The dilution effect of high plasma volume contributes to a lower level of specific tumor marker such as prostate-specific antigen. To date, few studies have focused on this effect of other tumor marker levels. Therefore, we evaluated the dilution effects of a higher plasma volume on lowering the serum concentration of various tumor markers such as CA125 and CA19-9. Data from patients (age ≥40 years) visiting our public health center between March 2007 and March 2013 were gathered. A total of 19,439 male and 11,655 female native Koreans were eligible to have a serum CA125 and CA19-9 screening for ovarian and pancreatic cancer, respectively. CA125 levels in 11,234 women were analyzed. There was a statistically significant trend toward a lower likelihood of having a serum CA125 level >35 U/mL with increased body mass index (BMI), with obese men having a 53.1% lower likelihood than those with a normal BMI. After CA19-9 analysis in 29,978 participants, there was also a significant trend toward a lower likelihood of having a serum CA19-9 level >35 U/mL with increased BMI, with obese men having a 27.0% and obese women having a 32.7% lower likelihood than those with a normal BMI. These results might affect tumor screening efficiency for ovarian and pancreatic cancer using serum CA125 and CA19-9, respectively. Further studies are needed to better define these results in clinical practice.

Ectopic pregnancy accounts for approximately 2% of all pregnancies and is the most common cause of pregnancy-related mortality in the first trimester. Initial evaluation consists of β-hCG and pelvic ultrasonography. The fallopian tube is the most common location for an ectopic pregnancy. Other types of ectopic pregnancy include cornual, ovarian, cervical, scar, and abdominal pregnancy. In very rare cases, the abdominal pregnancy may be retroperitoneal. The diagnosis is seldom established before surgery and therapy is surgical resection of the ectopic mass. A 26-year-old woman visited our emergency department with sudden massive vaginal bleeding. She had undergone curettage 3 weeks before. But the transvaginal sonogram of the cul-de-sac revealed no fl uid collection. She failed variable-dose methotrexate therapy. On laparoscopic operation, we found a cystic, conception-like structure in the retroperitoneum. Histology of resected structure showed chorionic villi. We describe this case with a brief review of the literature.

This regulatory post-marketing surveillance study aimed to evaluate the therapeutic efficacy and safety of drospirenone (DRSP) 2 mg/estradiol (E2) 1 mg tablet in Korean postmenopausal women. A total of 4,149 patients were enrolled and the study was conducted at 207 clinical research centers. The patients' source data was collected between November 2006 and November 2012. More than 85% of patients experienced improvement of menopausal symptoms. The most frequently reported adverse events were vaginal bleeding and breast pain; most of the women suffering from these symptoms fully recovered. The incidence of adverse event was higher in patients of younger age (20 to 39 years), in patients with concomitant diseases, previous hormone replacement therapy in medical history, those treated with DRSP 2 mg/E2 1 mg for shorter duration (3 years or less) and in patients using concomitant medication. In conclusion, the results from this large post-marketing surveillance study confirm the efficacy and safety of DRSP 2 mg/E2 1 mg tablet in Korean postmenopausal women.

Papillary squamotransitional cell carcinoma (PSTCC) of vagina is not a common disease. Especially primary neoplasm, which is not associated with carcinoma of urinary tract is very rare. To our knowledge, there have been only three reported cases of primary vaginal PSTCC without the history of urothelial carcinoma. Here, we report primary vaginal PSTCC accompanied by cervical squamous carcinoma in situ without the history of urothelial carcinoma with brief review of literature.