Aim
To evaluate the clinical characteristics and outcome of ovarian Sertoli–Leydig cell tumors (SLCTs) managed at a single institution.
Methods
The hospital records of 17 patients with the diagnosis of ovarian SLCT between 1994 and 2018 were reviewed retrospectively.
Results
The median age of the patients was 30 years (range, 18–67 years). All the patients had unilateral tumors. All of the 17 were stage 1 tumors. Two (11.8%) patients were stage 1C1 and two (11.8%) patients were stage 1C2. Thirteen (76.5%) patients were stage 1A. Three (17.6%) of the tumors were well differentiated, 11 (64.7%) were intermediately differentiated, 1 (5.9%) was poorly differentiated, and the degree of the differentiation was not identified for 2 (11.8%) patients. One showed retiform pattern and one had heterologous elements at the histopathologic evaluation. Among the 17 patients, we identified structural/vascular renal and ureteral anomalies in 3 (17.6%) patients. Eight patients underwent total abdominal hysterectomy and bilateral salpingo‐oophorectomy, seven underwent unilateral salpingo‐oophorectomy or oophorectomy and two underwent cystectomy with or without additional surgical staging procedures. Four patients received adjuvant chemotherapy. All the 17 patients were alive and free of disease for 1–287 months after the diagnosis. Median follow‐up time was 78 months. None of the patients recurred.
Conclusion
Sertoli–Leydig cell tumors are rare ovarian malignancies with low recurrence rates and have a favorable outcome compared to malignant epithelial tumors of the ovary. Main treatment is surgical resection and it is appropriate to prefer fertility sparing conservative surgeries for young patients.
Esmolol treatment statistically significantly decreased troponin T, CK, CK-MB and NT-proBNP release as surrogate markers for myocardial injury in patients with STEMI. (Heart Rate Control After Acute Myocardial Infarction; DRKS00000766).
Patient age appeared to define the type of ocular involvement in BD. While anterior uveitis was the most frequent ocular finding in BD patients younger than 10 years, panuveitis was the most frequent in patients older than 10 years. As a family history of BD was more frequent among patients younger than 10 years, family screening for BD is considered critical for early and accurate diagnosis of BD, as well as for the control of its complications.
The objective of this article is to describe four rare cases of Actinomyces israelii canaliculitis and their surgical treatment in a case series consisting of four cases of Actinomyces israelii canaliculitis. Patient charts were reviewed retrospectively. All four patients presented with epiphora, recurrent conjunctivitis, swelling around the superior canaliculus, and mucopurulent punctal discharge persisting despite medical treatments. Two patients with large canalicular dilation were treated with canaliculoplasty and the other two patients with minimal canalicular dilation were treated with one-snip punctoplasty. The specimens that were evacuated were sent for microbiological and histopathological examinations. The results showed that Actinomyces israelii was isolated in all patients. After medical and surgical treatment, the patients experienced resolution of signs and symptoms. The disease did not recur during the 2-4-year follow-up period. In conclusion Canaliculoplasty with canalicular intubation and one-snip punctoplasty may be safe and efficacious techniques in largely dilated canaliculum and mildly dilated canaliculum, respectively, with no demonstrable risk of post-treatment epiphora in patients with Actinomyces canaliculitis.
Aim
The aim of this study is to evaluate the recurrence pattern and oncological outcomes in cervical cancer (CC) patients with lymph node metastasis.
Methods
This study included 224 International Federation of Gynecology and Obstetrics (FIGO) 2009 stage IB1‐IIIB CC patients with pathologically proven lymph node metastasis. Surgical intervention was grouped as hysterectomy performed/not performed. Adjuvant therapy decision was made by the tumor board. Radiotherapy was applied to all patients with lymph node metastasis.
Results
Only paraaortic lymph node metastasis was determined as an independent prognostic factor for recurrence. Presence of paraaortic lymph node metastasis increased the risk of recurrence more than two times (odds ratio: 2.129; 95% confidence interval: 1.011–4.485; p = 0.047). An independent prognostic factor for death because of disease was age only. Risk of death was nearly doubled with younger age (odds ratio: 2.693; 95% confidence interval: 1.064–6.184; p = 0.037).
Conclusion
The most of recurrences were located at distant sites and multiple regions. Paraaortic lymph node metastasis was the only independent prognostic factor for recurrence, in spite of that age was an independent predictor for risk of death in patients with early stage or locally advanced CC and also with surgically proven metastatic lymph nodes. Furthermore, the presence of the paraaortic lymph node metastasis was significantly associated with distant recurrence. Therefore, more appropriate and individualized therapy strategy focusing on intenser systemic chemotherapy options in addition to radiotherapy should be taken into consideration according to paraaortic lymph node metastasis and age.
This experience shows that balloon dilatation is a safe and effective treatment of congenital nasolacrimal duct obstruction as a primary procedure in children over 36 months of age and as a secondary procedure after failure of lacrimal system probing. As a result, balloon dacryocystoplasty can be an alternative treatment in older children and can be preferred to silicone intubation and dacryocystorhinostomy performed after unsuccessful probing.
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