Uterine cervix involvement by a distant primary tumor is a rare event. We report the following 2 cases of breast tumor metastasis to the uterine cervix with different presentations: case 1 is an isolated cervix metastasis and case 2 is a disseminated metastatic disease with cervix involvement. In both, clinical examination raised the suspicion of cervical tumor, which was confirmed to be a metastatic adenocarcinoma.The poor outcome and lack of symptoms suggest that although its rareness, all patients with breast cancer should undergo a careful routine gynecologic examination.
We describe a Herlyn-Werner-Wunderlich syndrome (HWWS) patient with previous history of infertility who got pregnant without treatment and presented a pyometra in the contralateral uterus throughout the gestational period, despite multiple antibiotic treatments. Due to the uterus' congenital anomaly and the possibility of ascending infection with subsequent abortion, this pregnancy was classified as high-risk. We believe that the partial horizontal septum in the vagina may have contributed to the closure of the gravid uterus cervix, thus ensuring that the pregnancy came to term, with an uneventful vaginal delivery.
A coexistent molar pregnancy with a normal fetus is rare, with an incidence of 1 in 22.000 to 100.000 pregnancies-only 200 cases reported in the last two decades. The ultrasound is essential for an earlier diagnosis, and the management of these cases is challenging due to the increased risk of obstetrics complications and the possibility of posterior gestational trophoblastic neoplasia. Here we describe a 33-year-old healthy woman with a first-trimester twin pregnancy, presented with a normal fetus and a heterogeneous and vacuolar structure suggestive of complete hydatidiform mole. The pregnancy was interrupted, and a histological diagnosis confirmed complete hydatidiform mole in dichorionic/diamniotic twin pregnancy at 14 weeks. Molar twin pregnancy is a rare condition, and do not exist any consensus protocol to guide the clinical approach, so the decision to continue the pregnancy depends on the couple’s desire and maternal and fetal complications.
Electronic poster abstractsMethods: A total of 87 patients were included in the study. Pattern recognition analysis and color Doppler blood flow location were used for establishing the initial diagnosis. Then the GI-RADS was used, with the following classifications: GI-RADS 1, definitively benign; GI-RADS 2, very probably benign; GI-RADS 3, probably benign; GI-RADS 4, probably malignant; and GI-RADS 5, very probably malignant. Patients with GI-RADS 1 and 2 tumors were treated expectantly and not included in the study. All GI-RADS 3, 4, and 5 tumors were removed surgically. Serum concentration of CA125 was measured for each patient before surgical operation. The definitive diagnosis of the adnexal pathology was confirmed by the pathological examination of the excised lesions. Results: The mean age of the patients was 44,5 years. Malignant disease was diagnosed in 17 cases (19,54%) and non-malignant disease was diagnosed in 70 cases (80,64%). The sensitivity GI-RADS and CA125 was 88,24% and 82,35% respectively. The specificity was 90% and 65,71% respectively. The positive predictive value was 68,18% and 36,84% respectively. The negative predictive value was 96,92% and 93,88% respectively. Conclusions: GI-RADS has higher sensitivity, specificity, positive and negative predictive values than CA125 in the preoperative assessment of adnexal tumors. P27.03Risk of malignancy index in pre-operative evaluation of borderline ovarian tumors Objectives: To assess the use of risk of malignancy index (RMI) in primary evaluation of patients diagnosed as having a borderline ovarian tumor (BOT). Methods: Retrospective study of RMI index of all patients histologically diagnosed as having a BOT in our hospital over a period of ten years. RMI was calculated using the product of the ultrasound score (U), the menopausal score (M), and the absolute value of serum CA-125 inserted in the following formula: RMI = U x M x serum CA-125. The ultrasound result (U) is scored 1 point for each of the following characteristics: multilocular cysts, solid areas, metastases, ascites and bilateral lesions. U = 0 (for an ultrasound score of 0), U = 1 (for an ultrasound score of 1), U = 3 (for an ultrasound score of 2-5). Postmenopausal status scored M = 3, while premenopausal condition scored M = 1. The absolute value of serum CA-125 was entered directly into the mentioned equation. A RMI cut-off level of 200 was accepted as positive for malignancy. Results: Twenty nine women were found to have BOT. Nineteen (65.5%) were premenopausal, and the majority of cases were unilateral (86.2%). In overall, the most frequent sonographic pattern associated to BOT was multilocular solid cyst (44.8%). Preoperative CA 125 levels were higher than 35 U/ml in 34.4% of BOT. When a cut-off value of 200 was used, RMI only detected 27.5% (8/29) of BOT (6/10; 60% of postmenopausal women and 10.5 % (2/19) of premenopausal ones). Conclusions: RMI is not a suitable tool for the detection of BOT.P27.04 A case of tubo-ovarian abscess in a pregnant woman Y. Kim, J. Kim, T. Song ...
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