Fat-forming solitary fibrous tumor (SFT) is a rare soft tissue tumor. Herein, we reported a 30-year-old woman was found to have a solid mass measuring 60×45 mm in the right kidney on an abdominal computed tomography scan. The tumor was well-circumscribed and composed of cellular nodules with the classic SFT admixed with clusters and lobules of mature adipocytes. Immunohistochemistry staining showed that the tumor cells were diffusely and strongly positive for CD34 and Bcl-2, focally and weakly positive for CD99 and EMA. Mature adipocytes were positive for S-100 protein. Ki-67 expression was found in approximately 2% of tumor cells. However, tumor cells were negative for cytokeratin, S-100 protein, HMB-45, Melan-A, SMA, and CD117. We made the pathological diagnosis of fat-forming SFT of the right kidney. The differential diagnosis includes angiomyolipoma, liposarcoma, spindle cell lipoma, sarcomatoid renal cell carcinoma, synovial sarcoma, and gastrointestinal stromal tumor. The patient was alive and well without evidence of recurrence or metastasis at 19 months after tumor resection.
The etiology of fetal limb abnormalities is very complex, involving different risk factors: chromosomal abnormalities, gene disorders, intrauterine factors, maternal diseases, or exposure to different risk factors. The prevalence of fetal limb anomalies is reported to be approximately 6 in 10,000 live births, and the impairments of the upper limbs seem to present a higher incidence in comparison to the inferior limbs, more often are affected unilaterally and on the right side in comparison to the left side, some being isolate or may associate other anomalies, as a part of an underlying syndrome. According to the current guidelines, the assessment of the fetal limbs should be performed in the late first and early second trimester. Three-dimensional ultrasound provides a better understanding of the fetal anomaly for the parents and helps a better counseling, and it is used to confirm the anomalies detected by the conventional ultrasound. In cases of treatable anomalies, a multidisciplinary approach involving an obstetrician, geneticist, neonatologist, pediatrician, and pediatric orthopedic surgeon is essential to improve the postnatal outcome. Ultrasound examination and genetic counseling for the parents has an important benefit since some conditions present a genetic inheritance, and the recurrence rate in further pregnancies is very high.
Objectives: Previous publications suggest that the cerebral-umbilical Doppler ratio (CPR) provided a better predictor of adverse perinatal outcome than either the middle cerebral artery (MCA) or umbilical artery (UA) alone at 30-41 weeks. The aim of this study is to assess if CPR is better than UA PI or MCA PI for the identification of fetal compromise in prolonged pregnancy. Methods: Women attending a dedicated post-dates clinic at 41 weeks were recruited for the study. UA PI and MCA PI were measured at the assessment at 41+3 weeks. Induction of labour was offered at 42 weeks to those women still undelivered. Unfavourable outcome was defined as cord arterial pH < 7.15 with a base deficit > 11 mM/L or operative delivery for abnormal intrapartum fetal ECG-ST segment analysis. UA PI over the 90 th centile, MCA PI and CPR below the 10 th centile were considered abnormal. Results: 355 women reaching a gestational age of over 41 weeks were eligible for inclusion in the study. The median gestational age was 294 days (range: 289 to 300 days). Objectives: Maternal IDD has a described impact on the fetal heart and blood rheology. A fetal diabetes-induced cardiopathy is described. The present study assesses the fetal cerebral perfusion on the middle cerebral artery (MCA) in pregnancies complicated by maternal IDD throughout the third trimester. Methods: Cross-sectional study including singleton pregnancies complicated by pre-gestational IDD after 20 weeks of gestation, followed-up in the National Inst. for Diabetes ''Nicolae Paulescu'' Bucharest and Cantacuzino Hospital-Prenatal Diagnosis Unit. Exclusion criteria: pre-eclampsia, IUGR < 10 • P and treatment with beta-mimetics or calcium channel blockers. Recorded data include: MCA PSV assessment with the method previously described by G. Mari (NEJM 2000), estimated fetal weight (EFW), amniotic fluid assessment, maternal HbA1c levels. Data were centralized on Astraia Software vers 1.20.1.Results: Twenty-one patients (n = 21), aged 24-35 years with pregestational IDD, with an onset 2-10 years prior to pregnancy, without specific diabetes complications were matched with 20 non-complicated pregnancies between 20-39 weeks. In diabetes, HbA1c levels were 5.54% ± 0.6%. Objectives: Previous studies examining the effect of maternal psychological distress on uterine artery (UtA) blood flow resistance measures in third trimester have found mixed results. Our aim was to further investigate this relation in a study population with a wide range of psychological distress, using several different psychometric measures. Methods: The prospective observational study was performed at a tertiary referral center for fetal medicine. Participants were 155 pregnant women around 30 weeks of gestational age (GA); 105 with uncomplicated pregnancies and normal ultrasound findings, and 50 with a known non-aneuploid fetal anomaly, detected between 3 and 20 weeks earlier (median 8.3 weeks). Psychological distress was assessed by self-report standardized psychometric questionnaires: general health questio...
M.N., a 21-year old female patient presented to the emergency room with a one-day history of lower abdominal pain and signs of hypovolaemic shock. The patient had underwent a dilatation and curettage (D&C) 11 weeks prior for elective pregnancy termination at another facility. Transvaginal ultrasound revealed a well-circumscribed anechoic collection measuring 10/16 centimeters in diameter in the Douglas pouch and a pregnant uterus carrying a 17-week fetus with cardiac activity. Upon emergency laparotomy, 1500 milliliters of blood were found, as well as a blackviolet-colored rudimentary hemi-uterus, covered with clots. Upon gentle maneuvers to remove the clots from the left hemi-uterine surface, spontaneous complete uterine rupture ensued with exteriorisation of a 17-centimeter fetus into the peritoneal cavity. Resistance was encountered upon attempt to detach the placenta, and upon a closer look, placenta accreta was diagnosed. Consequently, the left rudimentary hemi-uterus was excised with a hemihysterectomy. The patient's postoperative follow-up was uneventful and her prognosis is favorable from the perspective of fertility-conserving surgery. This is the third case reported in the world and the second case published since the new millennium of spontaneous complete uterine rupture during the second trimester in a primigravida with a rudimentary hemi-uterus.Keywords: complete rupture of the unscarred uterus, haemoperitoneum, second trimester, primigravida, rudimentary hemi-uterus, congenital uterine anomaly.
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