INTRODUCTIONLeiomyoma of the uterus is the most common type of tumor affecting the female pelvis and arises from uterine smooth muscle. The size of leiomyomas varies from microscopic to giant; giant myomas are exceedingly rare. We report an unusual case of a large, cystic, pedunculated uterine leiomyoma mimicking a primary malignant ovarian tumor on sonography and CT.PRESENTATION OF CASEA 58-year-old postmenopausal nulliparous woman presented with a history of lower abdominal pain and distension for a period of approximately 12 months. The patient's personal history revealed difficulty in walking, tiredness and recent weight gain of approximately 25 kg. Sonography and CT examination showed a large mass that filled the abdomen. A preoperative diagnosis of a primary malignant ovarian tumor was made. The patient underwent laparotomy, total hysterectomy and bilateral salpingo-ooferectomy. The histology revealed a leiomyoma with extensive cystic degeneration.DISCUSSIONThe current established management of uterine fibroids may involve expectant, surgical, or medical management or uterine artery embolization or a combination of these treatments. A surgical approach is preferred for management of giant leiomyomas.CONCLUSIONPedunculated leiomyomas should be considered in the differential diagnosis of a multilocular and predominantly cystic adnexal mass.
Objective: The reasons why endometriosis is more aggressive and invasive in some patients are unknown. Despite the importance of population-based clinically defined risk factors in the prediction of recurrence, biochemical markers obtained from the patient are more valuable for prediction on an individual basis. Therefore, the discovery of significant potential biomarkers could be useful to clinicians for shedding light on the pathogenesis of endometriosis and in the monitoring recurrence. Materials and Methods:This study included 50 patients who underwent surgery for ovarian cysts that were diagnosed as endometrioma. The age of the patients, stage of the endometriosis, diameter and localization of endometriomas, type of surgery, and pre-and postoperative cancer antigen 125 (CA125) levels were compared between patients with and without recurrence. The archived pathology slides were stained with Ki-67 and anti-urocortin antibodies for reevaluation. By comparing the pathology parameters of the patients with and without recurrence, the association between these parameters and recurrence was investigated.Results: The median Ki-67 proliferation index of the patients with recurrence (7.5±6.5) was statistically significant compared with that of the patients without recurrence (1±4) (p=0.003). The urocortin epithelial staining intensity and percentage were not found to be statistically significant in comparison. A statistically significant difference was determined between postoperative CA125 median levels of patients without recurrence (10±17.6) and those of patients with recurrence (29.9±18.1) (p=0.003). Conclusion:The Ki-67 proliferation index may be useful for predicting prognosis and recurrence risk.Keywords: Endometriosis, Ki-67 proliferation index, urocortin ÖZ Amaç: Endometriozisin bazı hastalarda neden daha agresif ve invaziv olduğunun nedenleri bilinmemektedir. Klinik olarak belirlenen risk faktörleri populasyon bazında rekürrens prediksiyonunda değerli olmasına rağmen kişi bazında prediksiyonda hastadan elde edilen biyokimyasal markerlar daha değerlidir. Bu nedenle, rekürrens açısından anlamlı potansiyel biyomarkerların keşfi endomeriozis patogenezine ışık tutabileceği gibi rekürrens takibinde klinisyenlere yardımcı bir parametre olarak kullanılabilir.Gereç ve Yöntem: Çalışmamıza over kisti nedeniyle cerrahi geçiren ve patolojik inceleme sonucunda endometrioma tanısı konmuş 50 hasta dahil edildi. Olguların yaş, endometriozis evresi, endometrioma çapı ve lokalizasyonu, cerrahi tipi, preoperatif ve postoperatif CA 125 düzeyleri kaydedildi. Olguların arşiv patoloji preparatları Ki 67 ve anti-urocortin antikor ile boyandı. Patolojik parametreler nüks olan olgular ile olmayanlarda kıyaslanarak bu parametrelerin rekürrens ile ilişkisi araştırıldı.Bulgular: Nüks olan olguların Ki67 İndeks medyanı (7,5±6,5) nüks olmayan olguların Ki67 İndeks medyan değerinden (1±4) daha büyük olup, istatistiksel olarak anlamlıydı (p=0,003). Olguların nüks olma durumu ile ürocortin epitel boyanma yoğunluğu ve yüzdesine göre da...
Double aneuploidy, the existence of two chromosomal abnormalities in the same individual, is a rare condition. Early diagnosis of this condition is important to offer termination of pregnancy in genetic counselling. Cytogenetic analysis with amniocentesis and ultrasound examination is valuable for diagnosis of double aneuploidy. In this report we present a case with the karyotype of 48XXY+21 diagnosed prenatally.
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