Pure Choriocarcinoma of the Ovary in Silver-Russell Syndrome

Pure ovarian choriocarcinoma is an extremely rare malignancy that can be gestational or non-gestational in origin. Silver-Russell syndrome (SRS) is a rare congenital developmental disorder characterized by pre- and postnatal growth failure, relative macrocephaly, a triangular face, hemihypotrophy, and fifth-finger clinodactyly. We report a rare case of pure ovarian choriocarcinoma occurring in a 19-year-old woman with SRS. Following surgery, multiple chemotherapy courses were effective and she was free of disease at the 10-month follow-up

The Combination of D-dimer and Glasgow Prognostic Score Can Be Useful in Predicting VTE in Patients with Stage IIIC and IVA Ovarian Cancer

Cancer patients have increased risk of venous thromboembolism (VTE) that must be assessed before treatment. This study aimed to determine effective VTE biomarkers in gynecologic cancer (GC). We investigated the correlation between D-dimer levels, Khorana risk score (KRS), Glasgow prognostic score (GPS), and VTE in 1499 GC patients (583 cervical cancer (CC), 621 endometrial cancer (EC), and 295 ovarian cancer (OC) patients) treated at our institution between January 2008 and December 2019. χ2 and Mann–Whitney U-tests were used to determine statistical significance. We used receiver operating characteristic-curve analysis to evaluate the discriminatory ability of each parameter. D-dimer levels were significantly correlated with KRS and GPS in patients with GC. VTE was diagnosed in 11 CC (1.9%), 27 EC (4.3%), and 39 OC patients (13.2%). Optimal D-dimer cut-off values for VTE were 3.1, 3.2, and 3.9 μg/ml in CC, EC and OC patients, respectively. D-dimer could significantly predict VTE in all GC patients. Furthermore, D-dimer combined with GPS was more accurate in predicting VTE than other VTE biomarkers in stage IIIC and IVA OC (AUC: 0.846; p<0.001). This study demonstrates that combined D-dimer and GPS are useful in predicting VTE in patients with OC

Invasive non-typeable Haemophilus influenzae infection due to endometritis associated with adenomyosis

Background The widespread administration of the Haemophilus influenzae type b vaccine has led to the predominance of non-typable H. influenzae (NTHi). However, the occurrence of invasive NTHi infection based on gynecologic diseases is still rare. Case presentation A 51-year-old Japanese woman with a history of adenomyoma presented with fever. Blood cultures and a vaginal discharge culture were positive with NTHi. With the high uptake in the uterus with 67Ga scintigraphy, she was diagnosed with invasive NTHi infection. In addition to antibiotic administrations, a total hysterectomy was performed. The pathological analysis found microabscess formations in adenomyosis. Conclusions Although NTHi bacteremia consequent to a microabscess in adenomyosis is rare, this case emphasizes the need to consider the uterus as a potential source of infection in patients with underlying gynecological diseases, including an invasive NTHi infection with no known primary focus.

Efficacy and safety of olaparib, olaparib plus bevacizumab and niraparib maintenance treatment in Japanese patients with platinum-sensitive advanced ovarian cancer

Objective: To investigate whether maintenance treatment could be safely and effectively performed with olaparib, olaparib plus bevacizumab and niraparib in platinum-sensitive advanced ovarian cancer at multiple institutions in Japan. Methods: We investigated progression-free survival and adverse events in 117 patients with platinum-sensitive advanced ovarian cancer treated with maintenance therapy. Results: The median progression-free survival of 117 patients was 20.1 months. Patients with germline BRCA pathogenic variants had a significantly better prognosis than the other groups (P Conclusion: Maintenance treatment was performed effectively and safely. Renal function deterioration is likely to occur during maintenance treatment, and careful administration is important in platinum-sensitive advanced ovarian cancer

胃十二指腸運動機能の推移が評価できたCeliac Artery Compression Syndromeの1例

症例は40歳代の女性.X-1年1月頃より食後の心窩部や左季肋部の痛み,張り感などが出現し,上部消化管内視鏡検査で症状の原因となる器質的疾患は指摘されないため,X年10月当科に紹介された.体外式超音波検査(US)で腹腔動脈(CA)の呼吸性変位が指摘され,CAの血流測定を行ったところCeliac Artery Compression Syndrome (CACS)と診断された.本人が手術を希望せず,約2年半経過した現在も上腹部症状に対して内服薬のみ投与している.症状に胃十二指腸運動機能異常の関与も疑われたため,US を用いた胃十二指腸運動機能検査は4回施行され,その結果は内服薬の選択に利用された.運動機能検査の結果は4回目が最も改善しており,同時に施行した症状問診票の腹痛症状は4回目が最も軽かった.比較的長期にわたり症状と消化管運動機能の推移を観察したCACS症例の報告は過去になく,本稿が最初の報告である.We reported a case of a woman in her 40\u27s with celiac artery compression syndrome (CACS). She presented a dull pain and fullness in the upper part of her abdomen during and soon after eating. Blood and urine examinations revealed no obvious abnormalities, and upper gastrointestinal endoscopy indicated no obvious causes for the symptom. After a routine abdominal ultrasound (US), measurement of celiac artery blood flow showed high bloodflow velocity, which met the US diagnostic criteria for CACS. The evidence of CACS was supported by contrast-enhanced computed tomography, showing an obvious narrowing of the celiac artery in the expiration phase. Since she did not accept surgical therapy, treatment using oral medicine continued for about 2 years and six months. Meanwhile, the US examination for evaluating gastro-duodenal motility was performed 4 times. This is the first report that showing long-term progress of the symptoms and gastro-duodenal motility in this CACS patient