A CASE OF GASTROINTESTINAL STROMAL TUMOR PRESENTING AS A TUBOOVARIAN ABSCESS

A gastrointestinal stromal tumor (GIST) is a rare tumor of the gastrointestinal tract. Although stomach is the most frequent site of occurrence, GISTs can arise from anywhere in the gastrointestinal tract. The most common symptoms are vague and nonspecific abdominal pain or discomfort. We would like to present a GIST case with the complaint of acute abdominal pain and fever due to an accompanying complex adnexial mass. A 47-year-old female patient with sudden onset abdominal pain and fever applied at our clinic. A 8 cm diameter sized, complex, solid mass on the ultrasonografic examination was found. Her temperature was 38.6 degrees C and on her laboratory examination, leukocyte and CRP values were 27.400 and 254, respectively After an initial diagnosis of tuboovarian abscess, the patient was internalized. Abdominal CT revealed a solid lesion originating from small bowel resulting in signs of sepsis due to a closed perforation. Resection of the mass was performed and the postop pathology report was GIST. Patient had adjuvant imatinib therapy Although GIST's are mostly seen in stomach with vague symptoms, large sized GIST's which occur in the lower abdomen can be complicated and present as having a tuboovarian abscess clinic

EVALUATION OF OVARIAN RESERVE WITH ANTIMULLERIAN HORMONE AND ANTRAL FOLLICLE COUNT IN THE CASE OF CONSERVATIVE MANAGEMENT OF DELAYED TORSION OF OVARY

Ovarian torsion is a common gynecologic emergency. With early diagnosis and intervention, prevention of necrosis of affected ovary would be possible. There is limited data whether ovarian reserve affected when ovarian torsion is managed by conservatively with detorsion. In this case we aimed to evaluate the effect of ischemia-reperfusion injury by detorsion on the ovarian function with anti-mullerian hormone and antral follicle count

Extrapulmonary lymphangioleiomyomatosis mimicking lymphoma metastatic to uterus

Lymphangioleiomyomatosis is a very rare disease that primarily affects the lungs. The atypical smooth muscle cells in these tumors stain both with smooth muscle markers and melanocytic markers characteristically like their counterparts in other members of the PEComa family. Extrapulmonary lymphangioleiomyomatosis, especially without pulmonary involvement, is extremely rare. The clinical importance of lymphangioleiomyomatosis lies in the fact that it may mimic other malignant diseases, such as lymphoma or sarcoma. Here, we report a case of extrapulmonary lymphangioleiomyomatosis without involvement of the lungs, in a patient pre-diagnosed as having lymphoma metastasized to the uterus or uterine sarcoma

Four Synchronous Tumors in One Patient: Breast, Endometrium, Ovarian and Fallopian Tube Cancer: Case Report

Synchronous tumors in female genital tract are very rare and they account for 1-6% of all genital neoplasms. We present a 52-year old patient who was diagnosed and treated in our clinic and had synchronous breast, ovarian, endometrial and fallopian tube cancer. To our knowledge, this coincidence was reported for the first time in the literature. The patient was post-menopausal and presented with vaginal bleeding and a breast lump. She was subsequently diagnosed with endometrial cancer (stage 2B), ovarian or fallopian tube cancer (stage 3C) and breast cancer (stage 2A,T1c N0 M0). She received adjuvant chemotherapy and radiotherapy. On follow up after 2 years, she developed retroperitoneal, intraabdominal and hepatic metastatic lesions, therefore we planned to initiate systemic chemotherapy again. Synchronous gynecological malignancies were reported to have better prognosis in the literature, however as the tumors were at advanced stage in our patient, the recurrences developed earlier in the course. Therefore, close follow-up is recommended in patients with synchronous tumors in whom any of the tumors are at advanced stage

Four Synchronous Tumors in One Patient: Breast, Endometrium, Ovarian and Fallopian Tube Cancer: Case Report

Synchronous tumors in female genital tract are very rare and they account for 1-6% of all genital neoplasms. We present a 52-year old patient who was diagnosed and treated in our clinic and had synchronous breast, ovarian, endometrial and fallopian tube cancer. To our knowledge, this coincidence was reported for the first time in the literature. The patient was post-menopausal and presented with vaginal bleeding and a breast lump. She was subsequently diagnosed with endometrial cancer (stage 2B), ovarian or fallopian tube cancer (stage 3C) and breast cancer (stage 2A,T1c N0 M0). She received adjuvant chemotherapy and radiotherapy. On follow up after 2 years, she developed retroperitoneal, intraabdominal and hepatic metastatic lesions, therefore we planned to initiate systemic chemotherapy again. Synchronous gynecological malignancies were reported to have better prognosis in the literature, however as the tumors were at advanced stage in our patient, the recurrences developed earlier in the course. Therefore, close follow-up is recommended in patients with synchronous tumors in whom any of the tumors are at advanced stage

Impact of premature ovarian failure and hormone replacement therapy on androgens and bone mineral density in karyotypically normal (46,XX) patients

Aim. In this study, our aim was to evaluate the impact of premature ovarian failure and hormone replacement therapy on androgens and bone mineral density in karyotypically normal (46,XX) patients. Methods. Forty-six patients with a diagnosis of POF were selected for this cross-sectional study. All patients were karyotyped as 46,XX. Fifteen young women in reproductive age served as the first control group and were matched by age. Fifteen healthy women in natural menopause served as the second control group. Both lumbar spine (L2-L4) and the total femur were chosen as measurement sites for BMD. Cross-linked N-telopeptides of type I collagen (NTX) was measured as a marker of bone resorption. Results. There was a significant difference in E2 and FSH levels between groups. There was also a significant difference in lumbar spine and total femur scores. Patients with POF were stratified by age and HRT. DHEA-S level was significantly higher in patients who were younger than 30 years old and using HRT (0.576±0.86 versus 1.78±1.22; P=0.04). When patients were compared according to age, there were significant differences in E2 level, FSH level, lumbar spine and total femur scores. Total testosterone correlated negatively with NTX and Beck score. BMI correlated positively with lumbar spine and total femur scores. Conclusion. The early detection of POF can provide an opportunity for timely therapeutic intervention. HRT is strongly advised, since early loss of sufficient estrogen production is associated with skeletal, cardiovascular and neuropsychological complications

Effect of Lymphadenectomy on Survival in Early-Stage Type II Endometrial Carcinoma and Carcinosarcoma

Purpose. We aimed to investigate whether systematic pelvic and paraaortic lymph node dissection delivers any survival advantage in a subgroup of patients with type II endometrial carcinoma and carcinosarcoma. Methods. We evaluated 135 patients with clinically early-stage (Stage I-II) type II endometrial carcinoma and carcinosarcoma who underwent systematic pelvic and paraaortic lymph node dissection or who did not undergo any lymph node dissection. Results. Overall survival (OS) and recurrence-free survivals (RFS) were significantly longer in the systematic lymph node dissection group (hazard ratio 0.28, 95% CI 0.13–0.62 p=0.002 for OS and hazard ratio 0.31, 95% CI 0.14–0.69 p=0.004 for RFS). Multivariate analysis showed that lymph node dissection, age, lymph node metastasis, and adjuvant therapy were independent prognostic variables of OS and RFS. Conclusions. Systematic pelvic and paraaortic lymph node dissection independently and significantly prolongs the survival of patients with early-stage type II endometrial carcinoma and carcinosarcoma

Primary Tubal Cancers: A Clinicopathological Study of Twenty Cases

Objective: Primary tubal cancers are rare malignant tumors that account for approximately less than 1% of all gynecological malignancies. We retrospectively analyzed the clinicopathological characteristics of twenty cases of primary cancers of the fallopian tube