A case of an intact primary ovarian pregnancy with ultrasonographic demonstration of heart motion following ovarian stimulation is presented. After preoperative ultrasonographic confirmation of an extrauterine pregnancy, proof of the ovarian localization was achieved by intra-operative ultrasonographic visualization during a diagnostic laparoscopy on post-menstrual day 48. A moderate ovarian hyperstimulation syndrome with a concomitant increase in size, vulnerability and vascularity of the ovaries presented an additional challenge for the surgical approach. However, thanks to the early diagnosis of the ectopic pregnancy localization, a laparoscopic organ-preserving removal of the intact ovarian pregnancy was successfully performed. In this way, the fertility of the patient, who had previously undergone contralateral ovariectomy, was preserved. To our knowledge, this represents the first such treatment to be reported in the medical literature. Improvements in diagnosis and therapy of ovarian pregnancy are reviewed.

Tamoxifen (TAM) is known to be associated with several types of endometrial pathologies, e.g. hyperplasias, polyps and endometrial carcinomas, sometimes of special histologic type. Here we report a rare case of endometrial metastasis from a breast carcinoma (ductal carcinoma) discovered during TAM therapy. This occurrence does not suggest that TAM treatment causes endometrial metastases of breast cancer. However, clinicians should be aware of this possibility and provide patients receiving TAM therapy with close gynecologic follow-up using liberal indications for endometrial biopsies.

As of now, the digitally reconstructed anatomical illustrations have achieved the best image resolution and quality regardless of the position of the plane in the examination volume. The standardised course of the gynaecological ultrasound examination can serve as a basis for the improvement of training quality and the evaluation of a general gynaecological ultrasound screening.

In this prospective study 571 patients with postmenopausal bleeding/discharge (group I) and 300 patients without symptoms (group II) were ultrasonographically examined. The sonographic findings were compared with those of histology to evaluate the value of ultrasonography in endometrium diagnosis. The main parameters which we considered in the diagnosis of malignancy of the endometrium, were the thickness of the endometrium, the boundary of the endometrium, homogeneity and collection of fluid in the uterine cavity. However, the size of the uterus and the central endometrial echo were found not to be sensitive signs of malignancy. The sensitivity of sonography in group I was 86.3% higher than group II which is 75%. The rate of false-positive and false-negative in the total study population was 7.1%. We believe that ultrasonography is the easiest, most painless out-patient based and non-invasive diagnostic method in comparison to all other endometrium diagnostic measures, and is an advance towards better approach in the early diagnosis of endometrial carcinoma.

Myxoid leiomyomas of the uterus are uncommon. They are characterised by a myxoid stroma, no mitotic activity and a myogenic phenotype. We present a case with focal lymphangioma-like pattern. The solid compartiment showed positive immunoreactivity with muscular markers and but no CD 34-immunostaining. Contrary, the endothelial-like cells of the cystic part were positive with antibodies against CD 34, CD 31 and factor VIII, indicating vascular differentiation. The lack of infiltrative growth patterns excluded myxoid leiomyosarcoma as the major differenzial diagnosis.

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In a 32 year old patient 14 eggs were harvested and inseminated with donor semen. Six embryos were transferred resulting in a triplet-pregnancy. In spite of a septic disease three preterm but healthy children were born by caesarean section 199 days after ET (male 1620.0; female 1180.0; male 1560.0). Up to nowadays there is not any handicap. We don't know a general but safe method for avoiding multiple pregnancies.