An Unusual Case of Vulvar Schwannoma: A Case Report and Review of Literature

Background & aim: Schwannoma seldom occurs in female genitalia; with only a few cases being reported in the medical literature. This tumor can present on labia majora, labia minora, clitoris, and vagina. In this study, a case of vulvar schwannoma, which resembled a leiomyoma, is reported.Case report: A 44-year-old woman presented with a history of a small palpable mass located on the left labium. Ultrasonography showed a heterogeneous mass suggestive of a leiomyoma. Subsequently, the patient underwent surgical excision of the mass with clear margins. Histopathological examination confirmed the diagnosis of vulvar schwannoma. The patient was discharged in good condition following the excision.Conclusion: Schwannoma of the vulva represents a rare neoplasm that can be treated by surgical excision. The prognosis is excellent and recurrence is uncommon. Therefore, histopathological assessment is recommended for management of Schwannoma of the vulva

Sudden Bilateral Sensorineural Hearing Loss Following Postpartum Hemorrhage: A Case Report

The prevalence of bilateral sudden sensorineural hearing loss (SSNHL) is less than 5% and the etiology of most cases is unknown. Due to many structural and functional similarities between the kidney and inner ear, many conditions, diseases, and drugs have both renal and cochlear effects and toxicities. There are several reports of SSNHL in patients with CRF, uraemic patient, hemodialysis treatment, and ARF. Here, we report a rare manifestation of SSNHL following severe postpartum hemorrhage that has simultaneous renal failure and cochlear impairment. The patient was a 22-year-old primigravida woman with term pregnancy who after delivery and episiotomy hematoma and postpartum hemorrhage subsequently suffered from kidney failure, oliguria, and SSNHL that occurred after 3 days of delivery. In conditions such as severe postpartum bleeding leading to acute renal involvement, the possibility of simultaneous involvement of cochlea due to hypoxia or received drugs should be considered

Prevalence of endometrial cancer in young patients

Background: Cancer of the endometrium is the most common gynecologic malignancy in western and industrial countries, and is the second most common in developing countries, therefore it is of special importance. Adenocarcinoma of the endometrium is the most common type of uterine cancer. The prevalence of endometrial cancer in young women under the age of 40 in western country is very low and about 5 percent. The aim of this study was to determine the prevalence of endometrial cancer at age &le;40 years in our center during 4 years. Methods: In a cross-sectional study, all medical records of patients with endometrial cancer in Ghaem University Hospital, Mashhad, Iran was reviewed to identify women <40 years of age with endometrial cancer, over the course of 4 years, (from 2012 to 2015). The risk factors for endometrial cancer, such as obesity, polycystic ovary syndrome (PCO), infertility, and a history of cancer in the family or individual, were collected in each patient. Clinical features, histological type of endometrial carcinoma, and therapeutic action also were gathered. Results: A total of 119 patients with endometrial cancer that was admitted in our genecology oncology center were evaluated. 19 patients (15.9%) were younger than 40 years old. 16 cases (84.2%) with endometrial adenocarcinoma and 3 (15.7%) had endometrial stromal sarcoma. The youngest patient was 27 years old and the oldest was 39 years. Seven patients (8/36%) had infertility and we don&rsquo;t know about fertility condition in 3, because they were single. 12 cases (63%) were overweight (BMI&ge;35) and 6 cases (5/31%) had polycystic ovarian disease (PCOD). In 2 patients, there was concomitant ovarian and endometrial cancer. Histology report of both ovaries was endometrioid and both patients were overweight. Obesity, poly cystic ovary syndrome (PCOD) and Infertility were the most important risk factors for endometrial cancer in young patients. Conclusion: The prevalence of endometrial cancer in young women under the age of 40 in our country is so higher than the statistics provided in industrial countries

The role of para aortic lymphadenectomy in early stage of ovarian cancer

Background: Surgical staging is the standard treatment of ovarian cancer. Pelvic and para-aortic lymphadenectomy is the important part of the surgery. The aim of this study was to evaluate the effect of para aortic lymph node dissection in early stage of patients with ovarian cancer. Methods: This descriptive cross-sectional cohort study was performed on all stage I of ovarian cancer patients admitted in department of gynecology oncology of Ghaem Hospital, Mashhad University of Medical Sciences in November 2012 to March 2014. Every patient with clinical early stage of ovarian cancer candidate to surgical treatment selected. All cases underwent surgical staging surgery with concurrent systematic pelvic and para-aortic lymphadenectomy. In laparotomy after identification of left and right iliac artery, all lymph nodes have been properly exposed and dissected as a part of a staging laparotomy. The dissection was continued up to the nodal tissues surrounding the aorta, and inferior vena cava, until inferior mesenteric artery lymphadenectomy level. The procedure performed only by gynecologist oncologist. In addition, we assessed other parameters such as operation time, estimated blood loss, associated mortality and morbidity and vascular injuries. Finally, the effect of para aortic lymph node dissection in early stage of ovarian cancer evaluated. Results: Among a total of 57 ovarian cancer patients, 27 of them apparent stage I disease cases were selected. Surgical staging surgery with concurrent systematic pelvic and para-aortic lymphadenectomy was carried for all of them. Positive para-aortic lymph node was found only in one case. The average number removed para-aortic lymph nodes in the pelvis was 9 and in para aortic was 7, respectively. In addition, 20 minutes increase in total length of operation time was observed duo to para-aortic lymphadenectomy. Also the rate increase in intra-abdominal hemorrhage rate was estimated 60 ml. Conclusion: Lymph node dissection will produce a significant benefit in accurate and complete surgical staging. Staging surgery in addition to systematic pelvic and para aortic lymph adenoctomy in early stage ovarian cancer is preferred in gynecologic oncology centers