Giant paratubal serous cystadenoma in an adolescent female: Case report and literature review.

Paraovarian/paratubal cysts constitute 5-20% of all adnexal lesions and typically originate from the paramesonephric or Müllerian duct. The primary epithelial tumors arising from paraovarian cysts account for 25% of the cases, but giant cystadenomas of paraovarian origin are extremely uncommon during childhood and adolescence with very few cases reported in the literature. We present the case of a 15-year-old female that presented with a bulky mass in the abdomen and pelvis. An initial clinical and radiological examination indicated an ovarian cyst measuring ∼25x20 cm. However, explorative laparotomy revealed a giant paratubal cyst that was successfully treated with complete excision using fertility-sparing surgery. Histopathological examination was consistent with a serous cystadenoma. The postoperative course was uneventful and the girl was discharged on the seventh postoperative day. At the follow-up of six months, the patient was doing well. Due to their rarity and enormous size, the proper diagnosis and adequate management of giant paratubal cystadenomas are challenging. A complete excision of cystadenoma with preservation of adnexa represents a desirable treatment modality in adolescent females and should be attempted whenever possible

Advanced adult granulosa cell tumor with prominent fibromatous stroma: A case report

To the Editor, Adult granulosa cell tumor (AGCT) is the most common sex cord–stromal tumor and accounts for about 1% of all ovarian neoplasms.1 It is derived from granulosa cells of the ovarian follicle that are responsible for estradiol production and are admixed with a variable population of fibroblasts or theca cells. AGCT usually affects perimenopausal women (mean age ∼50–55 years).2 The patients present with abdominal pain or estrogenic manifestations (e.g., uterine bleeding).2 AGCTs tend to be unilateral, with solid and/or cystic growth patterns. Most patients present with stage I disease, associated with a 10-year survival rate of 90–95% and a recurrence rate of 10–15%; the overall recurrence rate for all stages combined is 20–30%. Extraovarian spread includes the peritoneum and omentum and rarely to the liver, lungs or bone.2,3 Tumors have many histologic patterns, while their stroma varies from scanty to abundant, which can be fibromatous or thecomatous.1,4All performed procedures were done per the ethical standards of the 1964 Helsinki declaration. Institutional review board (IRB) approval was not requested for the case report.Scopu

Large uterine juvenile cystic adenomyoma in an adolescent

Juvenile cystic adenomyoma (JCA) is a rare uterine pathology with <40 cases reported in the current literature since 1996 when Tamura described it. We report a 13-year-old girl with a history of chronic pelvic pain and dysmenorrhea for 12 months. After diagnostic evaluation and identification of the cystic structure (∼6 cm) within the myometrium, fertility-sparing surgery was successfully performed. Histopathological examination of the uterine cyst was consistent with the diagnosis of JCA. The postoperative course was uneventful, and the patient was disease-free three years after surgery. JCA is a rare condition but should be considered in the differential diagnosis in adolescents with moderate to severe dysmenorrhea. Despite diagnostic advances, the awareness of the disorder remains low. Thus, our case report aims to increase awareness of this rare pathology with unclear etiology.The article-processing fee was covered by the Qatar National Library (QNL)

Ultrasound Measurement of Cervical Length as Predictor of Threatened Preterm Birth: a Predictive Model

INTRODUCTION: The incidence of preterm delivery has been increasing even in developed countries and remains a serious problem for fetuses and neonates. Although many predictors for preterm delivery have been proposed, complete prediction and prevention have not yet been established. AIMS: To examine the potential association between sonographic measurement of cervical length and threatened preterm birth (TPTB) in pregnant woman at 24-36 weeks of gestation. MATERIALS AND METHODS: A cross-sectional study included a total of 360 pregnant woman at 24-36 weeks of gestation categorized in two groups: TPTB group (n=160) and non TPTB group (n=200). The study was carried out at the Department of Obstetrics and Gynecology of the Clinical Center University of Sarajevo (KCUS). Sociodemographic and clinical characteristics of patients were obtained from medical records and physical examination by gynecologist. Transvaginal sonography was carried out by GE Voluson 730. RESULTS: There was a significant association between TPTB and sonographic measurement of cervical length <25 mm (P<0.001). The logistic regression model was statistically significant, x(2)(7) = 281.530, P<0. 001. The model explained 72.6% of the variance in TPTB and correctly classified 88.1% of cases. Sensitivity was 83.8%, specificity was 91.5%, positive predictive value was 88.7% and negative predictive value was 87.6%. Out of the 7 predictor variables only 5 were statistically significant: cervical length, cervical consistency, rupture of membranes, uterine contractions and amine odor test. CONCLUSION: The findings of this study suggest association between sonographic measurement of cervical length and TPTB