MIRROR SYNDROME : A CASE REPORT IN FETAL MEDICINE

peer reviewedMirror syndrome is a rare entity describing the association of foetal hydrops and maternal symptoms as general oedema and excessive weight gain mimicking preec- lampsia. We report the case of a patient who developed symptoms of oedema, weight gain, headache and biological hemodilution associated with foetal hydrops due to a com- plex congenital heart defect. This symptomatology spontane- ously resolved after foetal expulsion. Mirror or Ballantyne’s syndrome needs to be identified on time and well differenti- ated from preeclampsia. Its consequences may involve the maternal and foetal prognosis.Le syndrome miroir est une entité rare associant un fœtus en anasarque et une symptomatologie maternelle faisant évoquer une pré-éclampsie étant donné l’œdème et la prise de poids. Nous rapportons le cas d’une patiente présentant des céphalées, des œdèmes et une prise de poids avec une hémo- dilution biologique associés à un anasarque fœto-placentaire en relation avec une malformation cardiaque complexe. Cette symptomatologie s’est résolue spontanément après l’accouche- ment. Le syndrome miroir ou syndrome de Ballantyne doit être bien différencié de la pré-éclampsie. Il mérite d’être identifié à temps car ses conséquences peuvent mettre en jeu le pronostic fœtal et maternel

Primary diffuse large B-cell lymphoma of the gynecological tract: A diagnostic challenge

peer reviewedLymphomatous disease of the gynecological tract is rare and may be primary or secondary. Most of the time, these are non-Hodgkin's lymphomas of the diffuse large B-cell lymphoma type. The low incidence of this type of disease and its non-specific clinical and radiological presentation often lead to delayed diagnosis. Some radiological features are useful to know in order to evoke the possibility of gynecological lymphoma, thereby avoiding unnecessary surgery and the associated morbidity and mortality. Using a case report, we show the complexity of the diagnosis and the importance of imaging

Pre - Invasive Diseases of Vulva

editorial reviewe

Incidental primary peritoneal serous borderline tumor miming endometriosis during laparoscopy for chronic pelvic pain

peer reviewe

Curative effect of second curettage for treatment of gestational trophoblastic disease - Results of the Belgian registry for gestational trophoblastic disease.

peer reviewedOBJECTIVE: We assessed the curative effect of a second curettage in patients with persistent hCG serum levels after first curettage for a gestational trophoblastic disease (GTD). STUDY DESIGN: This prospective observational study used the data of the Belgian register for GTD between July 2012 and January 2017. We analysed the data of patients who underwent a second curettage. We included 313 patients in the database. Primary endpoints were need for second curettage and chemotherapy. RESULTS: Thirty-seven patients of the study population (12 %) underwent a second curettage. 20 had persistent human chorionic gonadotropin hormone (hCG) elevation before second curettage. Of them, 9 patients (45 %) needed no further treatment afterwards. Eleven patients (55 %) needed further chemotherapy. Nine (82 %) were cured with single-agent chemotherapy and 2 patients (18 %) needed multi-agent chemotherapy. Of the 37 patients, patients with hCG levels below 5000 IU/L undergoing a second curettage were cured without chemotherapy in 65 % versus 45 % of patients with hCG level more than 5000 IU/L. Of the ten patients with a hCG level below 1000 IU/L, eight were cured without chemotherapy. CONCLUSIONS: Patients with post-mole gestational trophoblastic neoplasia can benefit from a second curettage to avoid chemotherapy, especially when the hCG level is lower than 5000 IU/L

2022-RA-193-ESGO Cost-effectiveness of molecular profiling for endometrial neoplasia: a single institution experience

peer reviewe

Testing of membrane module for ultrafiltration

<div><p>ABSTRACT</p><p><b>Background.</b> To evaluate efficacy and toxicity of radio-chemotherapy (RCT) and MR-guided pulsed-dose-rate (PDR) adaptive brachytherapy (IGABT) for locally advanced cervical cancer (LACC).</p><p><b>Material and methods.</b> Between 2007 and 2014 85 patients with FIGO stage 1B1 N+ or ≥ 1B2 cervical cancer were treated with RCT+ IGABT. The treatment consisted of a pelvic± paraaortic external beam radiotherapy (EBRT) (45–50.4 Gy ± 10 Gy boost to primary tumor and/or to pathologic lymph nodes) with concurrent cisplatin followed by 25–35 Gy of PDR IGABT in 30–50 pulses. The ratio of 3D-CFRT/IMRT was 61/24 patients. Dose-volume parameters of high-risk clinical target volume (HR-CTV), intermediate-risk clinical target volume (IR-CTV) and D2cm³ organs at risk (OARs) were reported. Local control (LC), cancer-specific survival (CCS) and overall survival (OS) were analyzed actuarially and morbidity crude rates were scored using CTCAEv4.0.</p><p><b>Results.</b> Mean follow-up was 36 months (range 6–94). The mean D90 and D98 for HR-CTV was 84.4 ± 9 Gy and 77 ± 8.1 Gy, while for IR-CTV was 69.1 ± 4.3 Gy and 64.8 ± 4.3 Gy, respectively. The mean D2cm³ for OARs was the following: bladder: 77.3 ± 10.5 Gy, rectum: 65 ± 6.8 Gy, sigmoid: 63 ± 7.9 Gy and intestine: 64.0 ± 9.1 Gy. Three year LC, CSS and OS were: 94%, 85% and 81%. The three-year regional- and distant control rates were 95% and 74%. Node negative patients had significantly higher three-year CSS (100 vs. 72%, p = 0.016) and OS (92 vs. 72%, p = 0.001) compared to node positive ones. Three-year actuarial late Grade ≥ 3 morbidity was the following: GI: 8%, GU: 5%, Vaginal: 8%. The frequency of Grade ≥ 3 hematological toxicities including anemia/leukopenia/neutropenia/thrombocytopenia were 8.6%/34.7%/24.3%/24.3%, respectively.</p><p><b>Conclusion.</b> This large mono-institutional experience builds up further evidences that IGABT in conjunction with RCT should be the standard of care for patients suffering LACC.</p></div

Histopathological diagnosis of a type vii mucopolysaccharidosis after pregnancy termination.

Type VII mucopolysaccharidosis is a very rare recessive lysosomal storage disease. We diagnosed a type VII MPS in a case of severe fetal hydrops after pregnancy termination at 23 weeks of gestation. The diagnosis was suspected on histopathological examination by the presence of foam cells in many viscera and foamy placental Hofbauer cells. Enzyme assay on cultured amniotic cells showed a markedly deficient beta-glucuronidase activity, thus confirming the diagnosis. This report shows the importance of a precise necropsy diagnosis in nonimmune hydrops because of putative implications for genetic counseling and prenatal diagnosis in subsequent pregnancies