A rare case of cervical ectopic: potential life-threatening condition managed conservatively with uterine artery embolisation and Methotrexate

A case of cervical pregnancy managed successfully in Medical College, Kolkata by injection Methotrexate and uterine artery embolization. Cervix is a rare implantation site for ectopic pregnancy. Either during surgical management should be carefully considered due to the risk of severe hemorrhage. A 33 years old patient (P2+4 with 1 living issue) with USG diagnosed 6 weeks cervical pregnancy was admitted in Gynaecology and Obstetrics department of Medical College, Kolkata with slight bleeding per vaginum and pain abdomen. USG was repeated along with beta hCG quantification and other routine investigations. Following admission, the bleeding and pain subsided. Patient was counselled regarding the prognosis and management options available. The patient was desirous to preserve her fertility and as the patient was hemodynamically stable with low initial beta hCG of 5200 mIU/ml, we opted for a medical treatment with MTX and uterine artery embolization. Following treatment with 3 doses of weekly Methotrexate (50 mg/m2 each i.m.) and UAE the beta hCG reduced significantly. The patient was discharged with advice of weekly follow up with beta hCG report. Within 2 months of follow-up, ß-hCG level was <10 mIU/mL with TVS showing normal cervical canal and empty uterine cavity

Distinguishing ‘dual’ from ‘duplicated’ right coronary artery: Revisiting the nomenclature

We report a case of a 53-year-old man with a "short RCA" seen coursing within the proximal part of the right atrioventricular (AV) groove and terminating in the mid-portion of the right AV groove and a "long RCA" seen to have a proximal course outside the right AV groove, over the free wall of the right ventricle, where it gave rise to the right ventricular and acute marginal branches before returning to the right AV groove in its distal course. The discussion highlights the need for revisiting the nomenclature of "dual RCA and drawing a distinction between "dual" and "duplicated" RCA

A rare case of mixed germ cell tumor in a teenage girl: a case report

Germ cell tumors represent only 20% to 25% of all benign and malignant ovarian neoplasms. Mixed germ cell tumors are a rare variety of non–dysgerminomatous germ cell tumors. They contain two or more elements; the most frequent combination being a dysgerminoma and an EST (Endodermal Sinus Tumor). We present a case of malignant mixed germ cell tumor comprising of yolk sac tumor, embryonal carcinoma and choriocarcinoma. A 13-year-old girl presented with a huge 25 x 18 cm mass in abdomen with raised values of CA-125, hCG, AFP (alpha-feto protein) and LDH (lactate dehydrogenase). She underwent laparotomy followed by unilateral salpingoopherectomy and infracolic omentectomy. Histopathology report revealed malignant mixed germ cell tumor comprising predominantly of EST with elements of embryonal carcinoma and non-gestational choriocarcinoma. Following surgery, she was started on adjuvant chemotherapy (Bleomycin, Etoposide and Cisplatin regimen). Mixed germ cell tumor (YST/EST, non-gestational choriocarcinoma and embryonal carcinoma) is a very rare tumor. Careful initial surgery with adequate staging biopsies followed by combination chemotherapy can greatly improve the prognosis of these patient

A rare case of cervical ectopic: potential life-threatening condition managed conservatively with uterine artery embolisation and Methotrexate

A case of cervical pregnancy managed successfully in Medical College, Kolkata by injection Methotrexate and uterine artery embolization. Cervix is a rare implantation site for ectopic pregnancy. Either during surgical management should be carefully considered due to the risk of severe hemorrhage. A 33 years old patient (P2+4 with 1 living issue) with USG diagnosed 6 weeks cervical pregnancy was admitted in Gynaecology and Obstetrics department of Medical College, Kolkata with slight bleeding per vaginum and pain abdomen. USG was repeated along with beta hCG quantification and other routine investigations. Following admission, the bleeding and pain subsided. Patient was counselled regarding the prognosis and management options available. The patient was desirous to preserve her fertility and as the patient was hemodynamically stable with low initial beta hCG of 5200 mIU/ml, we opted for a medical treatment with MTX and uterine artery embolization. Following treatment with 3 doses of weekly Methotrexate (50 mg/m2 each i.m.) and UAE the beta hCG reduced significantly. The patient was discharged with advice of weekly follow up with beta hCG report. Within 2 months of follow-up, ß-hCG level was &lt;10 mIU/mL with TVS showing normal cervical canal and empty uterine cavity