Abstract. Atypical leiomyomas are histopathologically recognized by moderate to severe pleomorphic atypical tumor cells showing low mitotic counts without coagulative tumor cell necrosis. The histopathological features and clinical behavior of these tumors are unclear. The surgical management of these lesions includes myomectomy and hysterectomy. The current study presents 5 cases of women with atypical leiomyomas that were managed surgically. The clinicopathological characteristics of the patients and recurrences were analyzed. The median age of the patients was 43 years old. While 3 out of 5 patients were treated by hysterectomy (with or without salpingo-oophorectomy), the remaining 2 patients were treated by myomectomy. The median mitotic index was 3 mitotic figures/10 high-power fields. The post-operative course of all patients was uneventful, and there was no evidence of local or distant recurrence in a median follow-up time of 72 months. The treatment of choice for atypical leiomyomas is hysterectomy. However, myomectomy may be an option for fertility sparing cases. A thorough consultation with regard to the uncertain behavior of such tumors and a rigorous follow-up must be offered in such patients.

Abstract. Sertoli-Leydig cell tumors (SLCTs) are an uncommon subtype of sex-cord stromal tumors of the ovary, which most commonly arise in women of reproductive age, creating an issue with regard to the preservation of fertility. The clinical manifestation of SLCTs varies widely, ranging from an asymptomatic clinical profile to extreme virilization. Correct diagnosis of SLCT is crucial and is primarily based on histopathological results. The current study presents the case of a 20-year-old woman who underwent unilateral salpingo-oophorectomy and adjuvant chemotherapy due to the diagnosis of an SLCT of the left ovary. Almost 2 years after the initial surgery, during the follow-up period, the patient conceived normally. Pregnancy was uneventful and the patient vaginally delivered a healthy infant at 38 weeks of gestation. A total of 1 year after delivery (3 years after the initial diagnosis), follow-up of the patient did not reveal any disease recurrence. In conclusion, SLCTs may be adequately treated by fertility-sparing surgery and chemotherapy in young women who wish to preserve their fertility. Natural conception, an uncomplicated pregnancy and a vaginal delivery are possible. IntroductionSertoli-Leydig cell tumors (SLCTs) are an uncommon subtype of sex-cord stromal tumors of the ovary. The tumors account for <0.5% of all ovarian tumors and are most frequently located in one ovary (1,2). SLCTs may produce androgens or estrogens, and their prognosis is associated with tumor differentiation and disease stage (1).SLCTs are most commonly diagnosed in young women, creating an issue with regard to the preservation of fertility (3). Oncologists should consider the risk of infertility in women of reproductive age who undergo treatment for SLCTs. Patients must be thoroughly informed about the conservative treatment alternatives for genital tract preservation, as well as the potential risk of recurrent disease. The conservative management consists of unilateral salpingo-oophorectomy, usually accompanied by biopsy of the contralateral ovary. Hysterectomy and bilateral salpingo-oophorectomy comprise the radical treatment strategies (4).The current study presents the case of young female patient with a Sertoli-Leydig ovarian tumor, who underwent conservative management. The obstetric outcome following the conservative treatment approach is presented. A review of the relevant literature is additionally conducted. Case reportA 20-year-old woman was admitted to the 'Agios Dimitrios' General Hospital of Thessaloniki (Thessaloniki, Greece) in March 2013 for gynecological investigation due to abdominal pain. The patient mentioned no other symptoms or pathologies. The obstetric history consisted of one vaginal delivery of a live infant. Diagnostic exploration by intravaginal ultrasonography revealed a pelvic mass with a maximum diameter of 13 cm, which originated from the left ovary. These findings were additionally confirmed by computed tomography (CT), and no other pelvic or abdominal features were observed. Tumor serum markers...

Smooth muscle tumors of the mesentery are rare lesions with unpredictable, usually malignant, biologic behavior irrespective of their histologic appearance. Such case is presented here. We present a case of a large smooth muscle tumor located in the mesentery of a 48 years old patient. The histopathologic features of the surgically excised tumor were that of a benign-appearing smooth muscle tumor, either a primary mesenteric smooth muscle tumor of unknown biologic behavior or a parasitic leiomyoma. The patient was discharged 4 days after from the hospital without any early postoperative complication. Close followup was further decided. Nine months after her primary therapy, our patient is alive and with no evidence of recurrent disease. Increased awareness must be considered for large mesenteric smooth muscle tumors, because even when they present indolent histologic features, they usually behave aggressively.

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