Germ cell ovarian tumor comprises of yolk sac tumor, embryonal carcinoma and immature teratoma: a case report

Yirmi bir yaşındaki hasta, karında şişlik ve ağrı nedeniyle polikliniğe başvurdu. Ultrasonografi muayenesinde orta hatta solid düzgün yüzeyli 12x12 cm boyutlarında adneksiyal kitle saptandı. Manyetik rezonans görüntülemede, batın orta hatta 12x12 cm boyutlarında sol over kaynaklı kitle izlendi. AFP: 702 idi. Laparatomi yapıldı ve sol overde 12x12 cm boyutlarında solid düzgün yüzeyli izlendi. Sol salpingooferektomi yapıldı. Patoloji sonucu %90 yolk sak tümörü, %5 embriyonel karsinom ve %5 immatür teratom geldi. Hasta ameliyat sonrası 4. kür BEP (bleomisin, etoposid, sisplatin) rejimi kemoterapisine devam etmektedir. Miks germ hücreli tümörler agresif seyirlidir ve yeni tedavi stratejilerine ihtiyaç vardır.Istanbul Tip Derg. Yıl: 2010 Cilt: 11 Sayı: 4 185-189 << Geri Yolk Sak Tümör, Embriyonel Karsinom ve İmmatür Teratomdan Oluşan Germ Hücreli Tümör; Olgu Sunumu Ramazan Özyurt1, Mehmet Aytaç Yüksel1, İlkbal Temel1, Remzi Abalı2, Ahmet Birtan Boran1 1İstanbul Eğitim Ve Araştırma Hastanesi, Kadın Hastalıkları Ve Doğum Kliniği, İstanbul 2Namık Kemal Üniversitesi Tıp Fakültesi, Kadın Hastalıkları Ve Doğum Anabilim Dalı, Tekirdağ Yirmi bir yaşındaki hasta, karında şişlik ve ağrı nedeniyle polikliniğe başvurdu. Ultrasonografi muayenesinde orta hatta solid düzgün yüzeyli 12x12 cm boyutlarında adneksiyal kitle saptandı. Manyetik rezonans görüntülemede, batın orta hatta 12x12 cm boyutlarında sol over kaynaklı kitle izlendi. AFP: 702 idi. Laparatomi yapıldı ve sol overde 12x12 cm boyutlarında solid düzgün yüzeyli izlendi. Sol salpingooferektomi yapıldı. Patoloji sonucu %90 yolk sak tümörü, %5 embriyonel karsinom ve %5 immatür teratom geldi. Hasta ameliyat sonrası 4. kür BEP (bleomisin, etoposid, sisplatin) rejimi kemoterapisine devam etmektedir. Miks germ hücreli tümörler agresif seyirlidir ve yeni tedavi stratejilerine ihtiyaç vardır. Anahtar Kelimeler: Embriyonel karsinom, miks germ hücreli ovaryan tümör; immatür teratom; yolk sak tümörü -------------------------------------------------------------------------------- Germ Cell Ovarian Tumor Comprises of Yolk Sac Tumor, Embryonal Carcinoma and Immature Teratoma: A Case Report Ramazan Özyurt1, Mehmet Aytaç Yüksel1, İlkbal Temel1, Remzi Abalı2, Ahmet Birtan Boran1 1Department Of Obstetrics And Gynecology, İstanbul Education And Research Hospital, İstanbul 2Department Of Obstetrics And Gynecology, Namık Kemal University Medical Faculty, Tekirdağ A 21-year-old patient, complaining abdominal pain and abdominal mass admitted to the clinic. Abdominal ultrasound examination revealed a solid, smooth shaped central mass, 12x12 cm in diameter. MRI confirmed the left ovarian lesion. Patients blood AFP value was 702. A laparotomy was performed and a left ovarian 12x12cm in diameter solid mass was seen. Left salpingo oophorectomy was performed. According to the pathologic examination, the constituent were; yolk sac tumor 90%, embryonal carcinoma 5%, immature teratoma 5%. Patient received chemotherapy consisting bleomisin, etoposid, cisplatin (BEP protocol) postoperatively. New treatment approaches for these agressive tumors are needed

A comparison of pelvic organ prolapse and sexual function after abdominal and laparoscopic hysterectomy

Objectives: Hysterectomy is one of the risk factors of pelvic organ prolapse (POP). There is no consensus on whether the route of hysterectomy affects the subsequent development of POP. The aim of the study was to assess POP and sexual function 1 year after a hysterectomy when comparing total abdominal hysterectomy (TAH) with total laparoscopic hysterectomy (TLH). The study applied the pelvic organ prolapse quantification (POP-Q) as the measure of POP and a short-form of the POP/Urinary Incontinence Sexual Function Questionnaire (PISQ-12).Material and methods: All patients that underwent either TAH or TLH due to benign causes between March 2016 and March 2017 at the tertiary hospital used for the study were included in our prospective cohort study. POP-Q measurements and PISQ-12 scores were assessed 1 year postoperatively.Results: We included 182 patients in the clinical examinations. There were no statistically significant differences in demographic characteristics between the TAH and TLH groups. Also, there we no differences observed in the objective POP measurements between the two study groups. Results of the two groups’ PISQ-12 scores were also similar. However, postoperative vaginal lengths were found to be significantly shorter in the patients who had undergone TAH compared with those who had undergone TLH.Conclusions: TAH and TLH are comparable regarding short-term objective pelvic organ prolapse. Although we foundstatistically a significant difference in vaginal lengths between the two groups, no clinical significance was found in terms of sexual function

Airway inflammatory markers in chronic obstructive pulmonary disease patients and healthy smokers

Background: Cigarette smoke with its toxic ingredients leads to chronic inflammations in the airways. Objectives: In this study, the effect of cigarette smoke on the levels of inflammatory markers, interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-alpha (TNF-) in induced sputum was investigated. Materials and Methods: Twenty patients with chronic obstructive pulmonary disease (COPD) (group I), 20 healthy smokers (group II), and 20 healthy nonsmokers (group III) were included in the study. The levels of IL-6, IL-8, and TNF- in induced sputum were measured in these groups, and comparison analysis between the groups and correlation analysis for smoking load (pack-years) and spirometric parameters were performed. Results: Mean age of the patients in groups I, II, and III were 61.2 1.7, 58.2 1.6, and 59.1 5.4 years, respectively (P > 0.05). Smoking loads of group I and group II were 38.6 2.1 and 29.5 2.3 pack-years, respectively (P < 0.05). All cytokine levels were significantly higher in group I than groups II and III (P < 0.05). In addition to this, mean cytokines levels were significantly higher in group II than group III (P < 0.05). Smoking load of group II subjects was positively correlated with IL-6, IL-8, and TNF- in induced sputum (P < 0.05). Conclusions: We found that inflammatory marker levels in induced sputum were significantly higher in COPD patients and smokers than nonsmokers. Moreover, there was a moderate positive correlation between IL-6, IL-8, and TNF- levels and smoking load in the healthy smokers. We think that further studies are needed to determine whether higher levels of cytokine levels in sputum might be helpful in predicting the healthy smokers who will develop COPD in future

Myomectomy for intramural fibroids during caesarean section: A therapeutic dilemma

The aim of the present study was to assess the safety of myomectomy for intramural fibroids during caesarean section. A retrospective study of 63 women who underwent myomectomy during caesarean section and 63 women who underwent caesarean delivery without myomectomy was conducted. The study group was divided into subgroups according to the volume of fibroids and total incision count. The volume of fibroids, the preoperative and postoperative haemoglobin values and the difference between them, incidence of haemorrhage and blood transfusion, duration of operation and postoperative fever of patients were investigated. Duration of operation was longer (p 50 cm3 group than volume <50 cm3 and control groups. These differences were statistically significant (p = .02; p = .001, respectively). Although intramural fibroids can be safely removed during caesarean section, large fibroids and extra incisions for myomectomy are risk factors for haemorrhage

Germ Cell Ovarian Tumor Comprises of Yolk Sac Tumor, Embryonal Carcinoma and Immature Teratoma: A Case Report

A 21-year-old patient, complaining abdominal pain and abdominal mass admitted to the clinic. Abdominal ultrasound examination revealed a solid, smooth shaped central mass, 12x12 cm in diameter. MRI confirmed the left ovarian lesion. Patients blood AFP value was 702. A laparotomy was performed and a left ovarian 12x12cm in diameter solid mass was seen. Left salpingo oophorectomy was performed. According to the pathologic examination, the constituent were; yolk sac tumor 90%, embryonal carcinoma 5%, immature teratoma 5%. Patient received chemotherapy consisting bleomisin, etoposid, cisplatin (BEP protocol) postoperatively. New treatment approaches for these agressive tumors are needed

Primary ovarian pregnancy: A report of four cases

Primary ovarian pregnancy is a rare form of ectopic pregnancy that constitutes 0.15-3 % of all ectopic pregnancies. Ovarian pregnancy results from the fertilization of trapped ovum within the follicle. Exact preoperative diagnosis is often difficult, and with a few exceptions, the initial diagnosis is made on the operation table and the final diagnosis only through histopathology. The treatment of choice for ovarian pregnancy is usually ovarian wedge resection or oophorectomy, also there is a place for medical treatment of selected patients. Between October 2005 and May 2010, four cases of ovarian pregnancy that were detected and treated during laparotomy for suspected rupture of ectopic pregnancy are described. Three cases were treated by ovarian wedge resection. In one case, a single dose of 50 mg/m2 methotrexate treatment was given, but the same mentioned surgical procedure were performed due to rupture of gestation. In all cases diagnoses were confirmed by pathologic examination. We aimed to discuss a rare form of ectopic pregnancy, primary ovarian pregnancy, and highlight the diagnostic criteria

Clinicopathological evaluation of cervical polyps

Amaç: Servikal polipli hastaların klinikopatolojik ve demografik özellikleri incelendi. Gereç ve Yöntem: İstanbul Eğitim ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum Kliniği’nde Ocak 2006 ile Aralık 2010 yılları arasında servikal polip nedeniyle tedavi edilen 381 hastanın verileri geriye dönük olarak incelendi. Hastalar yaşlarına göre dört gruba ayrıldı; Grup I: 55. Hastaların, polip çapları, semptomları ve histopatolojik tanıları karşılaştırıldı. Bulgular: Hastaların ortalama yaşı 50,36±9,36 idi. Poliplerin ortalama çapı; 12,46±8,31 mm idi. Nüks oranı %1,8 (7/381) idi. Poliplerin büyük çoğunluğu asemptomatikdi (%66,1). Servikal poliplerde primer malignensi saptanmadı. Dört grup arasında çap, semptom, nüks oranı ve histopatolojik tanı açısından istatistiki bir fark yoktu (p>0,05). Sonuç: Servikal polipler iyi huylu lezyonlardır. Çoğu servikal polipler asemptomatik olup rutin jinekolojik muayene sırasında tespit edilirler. Çıkarılmalarının kolay olması, diğer patolojileri ekarte etmek için patolojik değerlendirme gerekliliğinden dolayı rutin çıkarılması mantıklı olabilir.Objectives: The aim of this study was to evaluate the clinicopathologic and demographic features in patients with cervical polyps. Methods: We performed a search of the database to retrieve all cases with a cervical polyp who were treated in the Obstetrics and Gynecology Department of Istanbul Education and Research Hospital between January 2006 and December 2010. The patients&amp;#8217; symptoms and the size and histopathologic diagnosis of the polyp were reviewed. Patients were divided into four age groups as: Group I: &lt;30, Group II: 30-44, Group III: 45-55, and Group IV: &gt;55 years. Results: The mean age was 50.36&plusmn;9.36 years. The mean polyp size was 12.46&plusmn;8.31 mm and the recurrence rate was 1.8% (7/381). The majority of cervical polyps were asymptomatic (66.1%). Furthermore, there was no primary malignancy on the cervical polyps. There were no significant differences in terms of diameter, symptoms, rate of recurrence, and histopathologic findings between the four groups (p&gt;0.05). Conclusion: Cervical polyps are benign lesions. Many of them are asymptomatic and are found at the time of routine gynecologic examination. Routine removal of polyps is reasonable and easy; pathological evaluation is needed to rule out other possibilities

Clinicopathological Evaluation of Cervical Polyps

Objectives: The aim of this study was to evaluate the clinicopathologic and demographic features in patients with cervical polyps. Methods: We performed a search of the database to retrieve all cases with a cervical polyp who were treated in the Obstetrics and Gynecology Department of Istanbul Education and Research Hospital between January 2006 and December 2010. The patients' symptoms and the size and histopathologic diagnosis of the polyp were reviewed. Patients were divided into four age groups as: Group I: 55 years. Results: The mean age was 50.36 +/- 9.36 years. The mean polyp size was 12.46 +/- 8.31 mm and the recurrence rate was 1.8% (7/381). The majority of cervical polyps were asymptomatic (66.1%). Furthermore, there was no primary malignancy on the cervical polyps. There were no significant differences in terms of diameter, symptoms, rate of recurrence, and histopathologic findings between the four groups (p>0.05). Conclusion: Cervical polyps are benign lesions. Many of them are asymptomatic and are found at the time of routine gynecologic examination. Routine removal of polyps is reasonable and easy; pathological evaluation is needed to rule out other possibilities

Clinico-pathological evaluation of cervical polyps

Amaç: Servikal polipli hastaların klinikopatolojik ve demografik özellikleri incelendi. Gereç ve Yöntem: İstanbul Eğitim ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum Kliniği’nde Ocak 2006 ile Aralık 2010 yılları arasında servikal polip nedeniyle tedavi edilen 381 hastanın verileri geriye dönük olarak incelendi. Hastalar yaşlarına göre dört gruba ayrıldı; Grup I: 55. Hastaların, polip çapları, semptomları ve histopatolojik tanıları karşılaştırıldı. Bulgular: Hastaların ortalama yaşı 50,36±9,36 idi. Poliplerin ortalama çapı; 12,46±8,31 mm idi. Nüks oranı %1,8 (7/381) idi. Poliplerin büyük çoğunluğu asemptomatikdi (%66,1). Servikal poliplerde primer malignensi saptanmadı. Dört grup arasında çap, semptom, nüks oranı ve histopatolojik tanı açısından istatistiki bir fark yoktu (p>0,05). Sonuç: Servikal polipler iyi huylu lezyonlardır. Çoğu servikal polipler asemptomatik olup rutin jinekolojik muayene sırasında tespit edilirler. Çıkarılmalarının kolay olması, diğer patolojileri ekarte etmek için patolojik değerlendirme gerekliliğinden dolayı rutin çıkarılması mantıklı olabilir.Objectives: The aim of this study was to evaluate the clinicopathologic and demographic features in patients with cervical polyps. Methods: We performed a search of the database to retrieve all cases with a cervical polyp who were treated in the Obstetrics and Gynecology Department of Istanbul Education and Research Hospital between January 2006 and December 2010. The patients&amp;#8217; symptoms and the size and histopathologic diagnosis of the polyp were reviewed. Patients were divided into four age groups as: Group I: &lt;30, Group II: 30-44, Group III: 45-55, and Group IV: &gt;55 years. Results: The mean age was 50.36&plusmn;9.36 years. The mean polyp size was 12.46&plusmn;8.31 mm and the recurrence rate was 1.8% (7/381). The majority of cervical polyps were asymptomatic (66.1%). Furthermore, there was no primary malignancy on the cervical polyps. There were no significant differences in terms of diameter, symptoms, rate of recurrence, and histopathologic findings between the four groups (p&gt;0.05). Conclusion: Cervical polyps are benign lesions. Many of them are asymptomatic and are found at the time of routine gynecologic examination. Routine removal of polyps is reasonable and easy; pathological evaluation is needed to rule out other possibilities

Ovaryan dermoid kistlerde CA 19-9 seviyesinin de?erlendirilmesi]

Objective: We aimed to evaluate the CA 19-9 levels in ovarian dermoid cysts. Material and Methods: Tumor markers and clinicopathologic features of 114 patients, treated between 2006-2010 in Department of Obstetrics and Gynecology, Istanbul Education and Research Hospital were evaluated retrospectively. All patients pathology reports revealed mature cystic teratoma. Patients evaluated according to the CA 19-9 levels (group1: normal, group2: high). Age, tumors size, bilaterality and CA19-9 levels were studied. Results: Mean age of the patients was 40.7 ± 12.3 (20-75). Nine patients (%12.5) were at postmenopausal ages. Tumor diameters were between 2-25 cm. Mean serum CA 19-9 level was 39.2 ± 76.8 U/mL, mean serum CA 125 level was 23.8 ± 29.1 U/ml, mean serum AFP level was 1.8 ± 1.5 ng/mL, mean serum CEA level was 1.7 ± 1.5 ng/mL and mean serum CA 15-3 was 15.3 ± 6.7 U/mL. CA 19-9 levels were the highest marker among patients (%19.4). Differences in mean age, tumor diameters and tumor marker levels excluded CA 19-9, were not statistically significant between two groups. Conclusion: Ca19-9 is the most frequent tumor marker detected high in mature cystic teratoma patients. Yet it is not sufficient alone for diagnosis. Tumor size and bilaterality is not correlated to the tumor marker levels. Copyright © 2011 by Türkiye Klinikleri