Background: The aim of this study was to analyze and describe cases of ovarian cancer in pregnant women treated at our center and to review the literature concerned, and to discuss the rationale for therapy.

The good correlation between colposcopic impression and histological diagnosis by using Reid index in colposcopy would produce higher agreement and strength of the correlation. Therefore, the Reid index can be used as a reproducible technique which is easy to learn in colposcopic clinic.

Methotrexate and dactinomycin are efficient drugs in the treatment of patients with low-risk gestational trophoblastic neoplasia (LRGTN). To compare the effectiveness of these two drugs in LRGTN, 46 patients were randomised to receive weekly intramuscular methotrexate at 30 mg/m(2) (n = 28) or intravenous dactinomycin at 1.25 mg/m(2) every 2 weeks (n = 18). Fourteen patients (50%) in the methotrexate group and 16 patients (89%) in the dactinomycin group achieved complete response. Greater patient convenience and a lower number of required visits make dactinomycin superior to other alternatives.

Objective: After the improved long-term survival in young women with cancer undergoing chemotherapy, the preservation of their future fertility has been the focus of recent interest. We studied whether gonadotropin-releasing hormone (GnRH) analogs could prevent the early onset of ovarian insufficiency post-chemotherapy and protect fertility. Methods: The patients were divided into two groups. Group A consisted of post-menarche patients aged 12-45 years (n = 15), who received chemotherapy but no GnRH analog protection. Group B consisted of post-menarche patients aged 12-45 years (n = 15), who received chemotherapy with GnRH analog. The gonadotropin values in the two groups were checked. Both groups received a multi-agent chemotherapy regimen (bleomycin, etoposide, cisplation, Taxol, carboplatin), (Taxol, cisplatinum) and (vincristin, actinomycin, cyclophosphamide) In group B, the GnRH analog was diphereline (3/75 mg). It was administered each month before and during treatment with chemotherapy. The first dose was administered 7 days before starting chemotherapy. Result: In group A, five patients (33%) had amenorrhea and premature ovarian failure. The laboratory values in these five patients showed increased gonadotropin. In group B, the most of patient resumed menstruation after 2-4 months. All these patients had a normal titer of gonadotropin. Conclusion: The GnRH analog co-treatment should be considered in every woman of reproductive age receiving chemotherapy.

To report a case of FIGO stage III papillary serous carcinoma of ovary, diagnosed during pregnancy at 20 weeks of gestation and treated with unilateral salpingo-oophorectomy and surgical staging, then initial combination chemotherapy while preserving the pregnancy. The patient underwent cesarean section at 35 weeks after four courses of taxol plus carboplatin. She delivered a healthy baby. After that total hysterectomy, omentectomy, pelvic and para-aortic lymphadenectomies were carried out. The surgical resection was complete and no macroscopic residual diseases were seen. During histologic examination, traces of resistant disease were found. The patient underwent three postoperative courses of chemotherapy (carboplatin plus paclitaxel regimen). After 6 months follow-up, the patient remained in complete remission and the child's development was normal. Combination chemotherapy during pregnancy with preservation of the fetus could be considered, and should be discussed with caution in case of epithelial ovarian cancer diagnosed during the second trimester of the pregnancy.