Primary hepatoid carcinoma of the ovary (HCO) is a rare type of ovarian tumor that resembles hepatocellular carcinoma both histologically and immunohistochemically in its staining for alpha-fetoprotein (AFP). We describe a 51-year-old woman who presented to our hospital complaining of abdominal pain. Computed tomography scan revealed a large tumor in the pelvis. She underwent total hysterectomy and bilateral salpingo-oophorectomy with tumorectomy. A right ovarian mass measuring 9×8×6 cm was found. Histological diagnosis was hepatoid carcinoma of the right ovary. But, immunohistochemically, tumor cells were not immunoreactive for AFP and there was no elevation of serum AFP level. This is the first report of an ovarian carcinoma with typical histologic features of HCO with negative staining for AFP and normal level of serum AFP in the world.
ObjectiveTo compare the efficacy of different add-back regimens on hypoestrogenic symptoms during postoperative gonadotropin-releasing hormone (GnRH) agonist treatment in endometriosis patients.MethodsThis prospective cohort study included reproductive-aged women who underwent conservative laparoscopic surgery for ovarian endometriosis and received add-back therapy during a 6-month course of GnRH agonist therapy after surgery. Participants received one of four different add-back regimens: 1 mg of estradiol valerate, 2.5 mg of tibolone, or a combination of 1 mg of estradiol and 2 mg of drospirenone or 0.5 mg of norethisterone acetate. Changes in quality of life, hypoestrogenic symptoms, and bone mineral density were compared according to add-back regimens.ResultsA total of 57 participants completed a 6-month course of GnRH agonist and add-back therapy. All components of quality of life did not differ across groups. However, within the same treatment group, social relationship factors decreased significantly with estradiol valerate and tibolone alone, and environmental factors decreased significantly with estradiol valerate alone. Menopausal Rating Scale score did not change significantly, but the incidence of hot flushes significantly decreased with a combination of estradiol and norethisterone acetate. Bone mineral densities at the lumbar spine declined significantly after treatment in all groups except with a combination of estradiol and norethisterone acetate.ConclusionThis preliminary study suggests that an add-back regimen containing estradiol valerate and norethisterone acetate may have better efficacy in terms of quality of life, hypoestrogenism-associated symptoms, and bone mineral density.
Gonadal dysgenesis occurs in rare case of ovarian tumor. Most tumors associated with gonadal dysgenesis were gonadoblastomas and dysgerminomas. In addition, premature ovarian insufficiency associated with these ovarian tumors in normal chromosomal type had not reported in many cases. A 29-year-old nulligravida woman who was concurrented with ovarian dysgerminoma and fibroma is presented. Measurements were made on serum lactate dehydrogenase, CA-125, CA 19-9 and pelvis ultrasonography and computed tomography. The clinical stage was IA and right salpingo-oophorectomy and wedge resection of the left ovary were done. On laboratory finding after operation on her serum follicular stimulating hormone was increased and E 2 was decreased. The result of chromosomal analysis was 46,XX, normal. We represent here with brief review of literature one case of gonadal dysgenesis in nulligravida woman, associated with dysgerminoma, with normal karyotype.
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