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Mature cystic teratomas, also named dermoid cysts, are the most benign ovarian germ cell tumors and can occur in any age group. Transformation of the mature elements within the dermoid cyst to the malignancy termed mature cystic teratomas (MCTs) with malignant transformation occurs in only 1-2 % of cases. Of these, squamous cell carcinoma (SCC) with 80% prevalence is the most common type. A 54-year-old perimenopausal woman -gravida 5, para 4, live 4, and abortion 1-presented to Omid Clinic of Ayatollah Rouhani Hospital in Babol, Iran, with a complaint of abdominal pain for about five months. Transvaginal ultrasonography revealed a mass with a diameter of 125-millimeter in the left adnexa with a complex appearance containing fine-echo liquid, solid internal component, and thickened wall. Spiral CT scan of abdomen & pelvis showed 147×121-millimeter bilocular lesion consistent with an ovarian dermoid cyst. Left salpingo-oophorectomy was performed, and a frozen section was requested during the surgery, which showed a malignant epithelial tumor consistent with squamous cell carcinoma arising in teratoma. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic lymphadenectomy, and partial omentectomy were done successfully. The patient was discharged from the hospital after two days without any complaints or adverse events. Regarding the rarity of MCT with malignant transformation, it is recommended to consider patient characteristics, preoperative imaging, laboratory evaluations, and the results of the frozen section during surgery since they can significantly change the treatment plan and the prognosis of the patient.

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Placental mesenchymal dysplasia (PMD) is an uncommon placental lesion, which may mimic molar pregnancy at gross and microscopic examination. PMD can be associated with fetal growth restriction, Beckwith-Wiedemann syndrome, intrauterine fetal death, and preterm delivery. Nonetheless, it may also be associated with a normal appearing fetus. We aimed to emphasize that clinicians, radiologists, and pathologists should be aware of PMD as one of the etiologies of intrauterine growth restriction (IUGR). We presented the case of a 27-year-old gravida 1, para 1 woman who was admitted to Ayatollah Rouhani hospital, in Babol, Iran, at 30 weeks of gestation due to severe IUGR and fetal tachycardia. Ultrasound examination showed uteroplacental insufficiency and increased resistive index (RI) of umbilical artery. At last, a normal female fetus (1320 g) with no definitive anomalies was delivered by cesarean section. Pathological examination revealed cystically dilated stem villi with peripherally located thick-walled muscular stem vessels, and also stromal fibroblasts overgrowth in some stem villi. None of the examined sections revealed trophoblastic proliferation or stromal trophoblastic inclusion. The findings confirmed the diagnosis of PMD. Careful radiological and pathological examination should be performed in the case of IUGR for ruling out the rare placental abnormalities, including PMD.

Introduction. Coronavirus disease 2019 (COVID-19) identified in December 2019 in Wuhan, China, is associated with high mortality rates worldwide. Hypothesis/Gap Statement. Thrombotic problems, such as coagulopathy, are common in COVID-19 patients. Despite anticoagulation, thrombosis is more common in patients in the intensive care unit and patients with more severe disease. Although the exact mechanisms of coagulopathy in COVID-19 patients are still unclear, studies showed that overactivation of the renin-angiotensin system (RAS), cytokine storm, endothelial damage, formation of neutrophil extracellular traps (NETs), and also extracellular vesicles (EVs) in response to COVID-19 induced inflammation can lead to systemic coagulation and thrombosis. Aim. The management of COVID-19 patients requires the use of basic and readily available laboratory markers, both on admission and during hospitalization. Because it is critical to understand the pathophysiology of COVID-19 induced coagulopathy and treatment strategies, in this review we attempt to explain the underlying mechanism of COVID-19 coagulopathy, its diagnosis, and the associated successful treatment strategies. Conclusion. The exact mechanisms behind COVID-19-related coagulopathy are still unclear, but several studies revealed some mechanisms. More research is needed to determine the best anticoagulant regimen and to study other therapeutic options.