An unusual case of mammary gland-like carcinoma oi vulva: Case report and review of literature

PubMed ID: 26189264Introduction: Accessory breast tissue is a very rare finding in the general population with an incidence of one to two percent. An even rarer occurrence is accessory mammary-like tissue which developed breast carcinoma. The authors present a case of aggressive and metastatic carcinoma of vulvar originating from mammary-like tissue. Case: A 73-year-old Caucasian female presented with a lesion in her left vulva. The lesion was ulcerated and fragile. A dermatologist had evaluated the lesion and took a punch biopsy. Result was vulvar carcinoma. She was admitted to the gynecologic oncology clinic then after and was operated. After a radical vulvectomy and bilateral inguinal lymphadenectomy she received adjuvant radiotherapy because of lymph node metastasis. One year after the finish of radiotherapy patient was found to have lung and femur metastasis. She began to receive systemic chemotherapy for metastasis. Conclusion: Primary mammary-like adenocarcinoma of the vulva is exceedingly rare. There is no consensus about the diagnosis, treatment, and follow up of these patients in literature. However, given that histological data confirms these cancers are behaving like breast cancers instead of known patterns of vulva cancer, the best treatment practices for breast cancer may be applied to treat these vulvar carcinoma patients

Prenatal early diagnosis of dacryocystocele, a case report and review of literature [Dakriyosistoselin Prenatal Erken Tani{dotless}si{dotless}, Vaka Sunumu Ve Literatür Taramasi{dotless}]

Dacryocystocele (mucocele, amniocele) is a relatively rare variant of nasolacrimal duct obstruction which refers to the cystic dilatation of lacrimal pathway above and below the lacrimal sac. It is a benign pathology and can be treated successfully after birth, but its prenatal detection is important, because it may be seen in numerous syndromes and may serve as their marker. Bilateral cysts have the possibility for intranasal extension and an obstruction to the nasal passages may result in neonatal respiratory distress requiring surgical intervention Unilateral cases are important for the differential diagnosis with serious facial abnormalities. We present a case of early prenatal detection of a 28 year-old G: 1 P: 0 pregnant woman with bilateral dacryocystocele. She presented a live, normally developed singleton fetus on sonographic examination at 12, 16 and 22 weeks. At 25th weeks, we diagnosed a hypoechogenic mass, that was situated inferomedially to the eyes in the fetal face with 2 and 3-D ultrasound. A 3850-g live female infant was delivered by Cesarean section due to breech presentation at 39 weeks following preterm rupture of membranes. We report the case with intranasal components studied during fetal life by 2 and 3-D ultrasound and magnetic resonance (MR) imaging. © Copyright 2011 by the Turkish-German Gynecological Education and Research Foundation

C-reactive protein and lipoprotein-a as markers of coronary heart disease in polycystic ovary syndrome [Polikistik over sendromlu hastalarda koroner kalp hastali{dotless}klari{dotless}ni{dotless}n belirteci olarak c-reaktif protein ve lipoprotein-a baki{dotless}lmasi{dotless}]

Objective: The aim of this study was to investigate the risk factors of coronary heart disease, CRP and Lipoprotein-a in polycystic ovary syndrome patients. Material and Methods: Prospectively collected data of polycystic ovary syndrome patients (n=62) and control group (n=40) were compared. Results: PCOS patients had higher HOMA-IR, CRP, DHEAS, free testosterone, FAI, LH and prolactin levels when compared to the control group. Lipoprotein-a levels did not differ between the groups. The obese PCOS group had statistically significantly higher fasting blood glucose, total cholesterol, triglyceride, free testosterone, insulin, CRP and HOMA-IR and statistically significantly lower HDL and SHBG when compared to normal weight PCOS persons. Fasting blood glucose, total cholesterol, LDL, SHBG, CRP, Lipoprotein-a, FSH, LH, TSH, DHEAS and prolactin levels did not differ between the normal weight and obese control groups. Conclusion: CRP levels increase in polycystic ovary syndrome patients and can be used as a marker of coronary heart disease. Future studies can be directed at treatments to decrease CRP levels, including antiinflammatory treatments. ©Copyright 2012 by the Turkish-German Gynecological Education and Research Foundation

Reciprocal Action of Pentraxin-3 and CRP in Women with Polycystic Ovary Syndrome

The aim of this study was to investigate the relationship between pentraxin-3 and other biochemical parameters in women with polycystic ovary syndrome (PCOS). We compared 58 women with PCOS to 34 body mass index- and age-matched normally menstruating healthy controls. Women with PCOS had significantly higher DHEA-S, free testosterone, LH and FAI, but lower pentraxin-3 levels when compared to healthy controls (0.86±0.21 and 0.91±0.14 respectively, p=0.014). Levels of CRP and lipoprotein-a were higher in the PCOS group. Overweight PCOS had significantly higher insulin, HOMA-IR, FAI, free testosterone and CRP and statistically significantly lower HDL and SHBG levels when compared to controls. Pentraxin-3 levels of obese and normal weight PCOS were similar. CRP and pentraxin-3 might contribute reciprocally to metabolic events and chronic low-grade inflammation in women with PCOS

Serum visfatin levels do not increase in post-menopausal women withmetabolic syndrome

Background: The aim of this study was to determine the serum visfatin levels in post-menopausal (PM) women with and without metabolic syndrome (MS) and to understand the correlation between serum visfatin levels and various other hormonal and metabolic parameters. Materials- Methods: We conducted a prospective cross-sectional study including 17 PM women with MS and a control group of 51 PM women without MS. MS was defined according to the National Cholesterol Education Program Adult Treatment Panel III. Results: Women with MS had statistically significantly higher fasting blood glucose, HDL, triglycerides, insulin, homeostasis model assessment of insulin resistance, and SHBG levels when compared to women without MS. Estradiol, high sensitivity C-reactive protein, and free testosterone levels were higher in the MS group, but there was no statistically significant difference between the two groups. Visfatin levels did not differ between the two groups. There was no correlation between serum visfatin levels and other parameters. Conclusions: There was no association between serum visfatin levels and MS in PM women

Low second trimester estimated fetal weight as a predictor of small-for-gestational age neonates in patients with low first trimester serum PAPP - A levels

Objective: The aim of this study was to examine fetal growth in the second trimester and to detect its predictive value for delivering small-for- gestational age neonates in patients with low first trimester pregnancy associated plasma protein-A (PAPP-A) levels. Material and Methods: We searched the patient charts of our hospital for first trimester Down syndrome screening tests retrospectively (n=923), we identified patients with PAPP-A levels < 5th percentile (n=60) and then we searched their ultrasound records for second trimester estimated fetal weight (EFW) results (Hadlock) at 18-23 weeks. Results: The sensitivity of a low second trimester EFW for birth weights <5th percentile was 14.3%, specificity 90.7%, positive predictive value 33.3% and negative predictive value 76.4%. Conclusion: Combination of low second trimester EFW with low PAPP-A levels increase sensitivity and PPV of PAPP-A in detecting small-for-gestational age neonates. Copyright © 2013 by Tükiye Klinikleri

Borderline micropapillary serous tumor of the ovary detected during a cesarean section due to a transabdominal cervico-isthmic cerclage in a patient with congenital cervical hypoplasia: A rare case

PubMed ID: 21941979A young woman with polycystic ovary syndrome and congenital cervical hypoplasia conceived with clomifen citrate treatment after placement of a transabdominal cervico-isthmic cerclage. Her pregnancy successfully reached term and cesarean section was performed to preserve the cerclage for the next pregnancy; when the ovaries were explored an irregular structure was detected on the left ovary. A wedge biopsy was done and the pathological assessment of the specimen was borderline micropapillary serous tumor of the ovary. The patient wanted to preserve her fertility, therefore a fertility-sparing staging surgery was performed six months after the cesarean section.There was no residual tumor in the left ovary, but there was a borderline tumor in the right ovarian biopsy specimen (frozen section was negative). Two months after staging surgery the patient conceived with IVF and delivered twins at the 33rd week of pregnancy with cesarean section. At her second cesarean section the right ovary and abdomen appeared normal on inspection, but the cerclage tape was in the endocervical canal and was thus removed. To our knowledge this is the second reported case of transabdominal cerclage tape migration into the endocervical canal. The patient is clinically disease-free 18 months after her second cesarean section. The clinical findings, treatment modalities, management and prognosis are discussed together with a literature review of a patient with a serous borderline ovarian tumor and congenital cervical hypoplasia