Three level spinal dysraphism: Multiple composite Type 1 and Type 2 split cord malformat?on

It has reported an uncommon case a 3 year-old girl a composite split cord malformation (SCM) with two different levels of SCM type1 and one level SCM type2, tight filum and sacral dermal sinus. The patient was admitted with a hypertrichosis and hyperpigmented patch. MRI of whole spine and brain was done. SCM type1 at T 7 and L2 levels and SCM typ2 at T11 level were removed then tight filum was cut and dermal sinus was excised at different sites during the same surgery

Three level spinal dysraphism: multiple composite Type 1 and Type 2 split cord malformation

İstanbul Bilim Üniversitesi, Tıp Fakültesi.It has reported an uncommon case a 3 year-old girl a composite split cord malformation (SCM) with two different levels of SCM type1 and one level SCM type2, tight filum and sacral dermal sinus. The patient was admitted with a hypertrichosis and hyperpigmented patch. MRI of whole spine and brain was done. SCM type1 at T 7 and L2 levels and SCM typ2 at T11 level were removed then tight filum was cut and dermal sinus was excised at different sites during the same surgery

Survival and prognostic factors in patients with recurrent low-grade epithelial ovarian cancer: An analysis of five prospective phase II/III trials of NOGGO metadata base

Objective: Low-grade epithelial ovarian cancers (EOC), constitute the minority among all epithelial cancers. Our study objective was to focus on low-grade recurrent EOC and compare the survival with high-grade disease, as well as in regard to “platinum-sensitive” and “-resistant” recurrences according to platinum-free interval. Methods: This is an exploratory analysis within the North-Eastern German Society of Gynecological Oncology (NOGGO) database including five randomized phase II/III trials comparing different chemotherapy regimens in recurrent EOC. We conducted survival analyses and cox-proportional regression models. Results: Out of 1050 patients having the first recurrence, 42 (4%) patients had low-grade and 1008 (96%) patients had high-grade disease. In the subgroup of platinum-sensitive recurrences, progression-free survival (PFS) (8.7 m vs 9.7 m, p = 0.7) and overall survival (OS) (23.9 m vs 24.8 m, p = 0.9) did not differ between low-grade and high-grade diseases. In platinum-resistant recurrences, patients with low-grade ovarian cancer had significantly better PFS (7.6 m vs 3.6 m, p = 0.03) and OS (41.9 m vs 9.5 m p = 0.002) in comparison to those with high-grade cancer. At low-grade EOC, there were no significant PFS (p = 0.91) and OS (p = 0.25) differences between platinum-sensitive and –resistant recurrences. Patients with low-grade non-serous histology had lower PFS with compared to those with low-grade serous histology (p = 0.004). At cox regression analysis presence of ascites and residual disease after secondary cytoreductive surgery were independently associated with poor PFS within low-grade recurrent EOC. Conclusion: Our study indicates, platinum-free interval does not have any prognostic significance at recurrent low-grade EOC and non-serous histology is associated with poorer outcome in recurrence. Secondary surgical cytoreduction to no-gross residual disease and ascites are independently associated with disease progression. © 201

Postmenopozal kadinda az diferansiye sertoli-leydig hücreli tümör [Poorly differentiated ovarian sertoli-leydig cell tumor in a postmenopausal woman: Case report]

70-75% of Sertoli-Leydig cell tumors (SLCT) are diagnosed at before age of 40, and less than 10% takes place before menarche and following menapouse. We report a case of right adnexal mass in a 59 year-old postmenapousal woman who presented with vaginal bleeding. Sex-cord stromal tumor was diagnosed at peroperative frozen section assesment. Staging surgery consisting of peritoneal biopsies, omentectomy and pelvic paraaortic lymph node dissection was performed. In histopathologic assesment of the slides which were prepared from solid-cyctic areas of the mass, revealed immature sertoli cells forming tubules and a wide sarcomatoid differantiation. Immunhistochemically, neoplastic cells stained strongly and diffusely positive with CD 56, focal positive with calretinin and inhibin. Poorly differentiated SLCT was diagnosed with the consideration of both histopathologic and immunhistochemical findings. Poorly differantiated SLCT are unusual sex cord stromal neoplasms of ovary of which differantial diagnosis should include spindle cell neoplasms. © Copyright 2016 by Türkiye Klinikleri

Serum human epididymis protein 4 can be a useful tumor marker in the differential diagnosis of adnexal masses during pregnancy: a pilot study

Purpose: The purpose of this study was to evaluate serum concentrations of human epididymis protein 4 (HE4) and cancer antigen 125 (CA 125) in healthy women and their pregnant counterparts to determine the influence of pregnancy on these biomarkers. Materials and Methods: Serum concentrations of CA 125 and HE4 were measured in 27 healthy non-pregnant women and 26 healthy pregnant women in the first and second trimesters. Results: Higher concentration of CA 125 was found in pregnants than in non-pregnant women (p = 0.002). There was no difference in CA 125 concentrations between first and second trimesters (p = 0.13). Serum HE4 concentration was not different in pregnant group compared to non-pregnant women (p = 0.510). Likewise, no difference was found in HE4 levels between the trimesters (p = 0.485). There was a positive correlation between increasing parity and CA 125 (p = 0.023), but not HE4 (p = 1.0). Conclusion: 11E4 serum biomarker is unaffected by pregnancy status and may be useful for evaluation of doubtful pelvic masses in pregnancy. Contrarily, increased serum levels of CA 125 could yield increased number of false-positiv