Ovarian fibroma with metaplastic bone tissue: Case report

Fibromas are benign tumors of the ovary and arising from the stromal component of the ovary. Nearly half of the cases (40%) have tumor bigger than 10 cm in diameter. Only one third of the cases have smaller than 3 cm and they are rarely bilateral (5% of cases) In microscopic examination fibromas consist of cellular bundles and intersecting strips of hyaline-appearing collagen and fibrous tissue. Mitoses are rare, but occasionally fibromas may be hypercellular and/or show substantial mitotic activity. Dystrophic calcifications, focal necrosis and hemorrhage are common. In this report we described a case of unilateral fibroma of ovary that was found incidentally by laparoscopic surgery for chronic pelvic pain with pathologically consisting metaplastic bone tissue. Copyright © 2011 by Türkiye Klinikleri

Prenatal diagnosis of caudal regression syndrome without maternal diabetes mellitus [maternal diabetes mellitusun eşlik etmedigi kaudal regresyon sendromunun prenatal tani{dotless}si{dotless}]

Caudal regression syndrome is a rare congenital malformation with varying degrees of early gestational developmental failure. It is also known as sacral agenesis or caudal dysplasia. The cause of this malformation is thought to be defects in neuralization around the 28th day of the gestational period. Although maternal uncontrolled diabetes, genetic predisposition and vascular hypoperfusion are the possible risk factors, actual pathogenesis is unclear. CRS is generally diagnosed at prenatal assessment, but also a varying number of new-borns with some degree of anomaly may be presented. In our case, we diagnosed a caudal regression syndrome fetus early in the second trimester. Determination of the pathology early in the gestational age gives parents a chance for termination of pregnancy. Although diabetes mellitus is the major risk factor for CRS, as in our case, sporadic presentations may occur. So clinicians should consider CRS when CRL is shorter than expected and incomplete vertebral ossification is observed both in gray scala and 3D imaging ultrasonography. © 2011 by the Turkish-German Gynecological Education and Research Foundation

Neural tube defect with parasitic rachipagus twin (heteropagus): Case report [Nöral Tüp Defekti ile Birliktelik Gösteren Rasipagus Parazitik Ikiz (Heteropagus)]

Conjoined twins are a congenital musculo-skeletal anomaly that can be seen 1/50.000-1/100.000. It occurs 12-13 days after fertilization via incomplete and late division of monozygotic embryonic disc. They can be named with depending on the anatomical location of the sticking points of twin pairs. Furthermore it may accompany other malformations. Parasitic twinning (heteropagus twinning) is a much rarer form of conjoined twinning. In this case report, a patient who was diagnosed with neural tube defect and rachipagus twinning at 19 weeks presented. Copyright © 2016 by Türkiye Klinikleri

Right endometrioma is related with more extensive obliteration of the Douglas pouch

PubMed ID: 22198847Objective To investigate that endometrioma is an asymmetric disease with left lateral predisposition as compared to other benign ovarian cyst and also, whether endometrioma side is related with endometriosis severity. Methods Operative and histopathologic findings of 340 women who underwent cystectomy for treatment of endometriotic (n = 239) and nonendometriotic ovarian cysts (n = 101) by laparoscopy (n = 268) or laparotomy (n = 72) between January 2005 and August 2009 were evaluated retrospectively. We compared left and right sided distribution of endometriotic and nonendometriotic ovarian cysts, and we also investigated the extent of endometriotic foci, obliteration of pouch of Douglas and endometriosis stage according to the revised American Fertility Society classification of endometriosis to assess whether endometrioma side is related with the severity of endometriosis. Results Of 239 women with endometriosis, endometrioma was found in the left ovary (n = 109), right ovary (n = 58) and bilaterally (n = 72). Of 101 control group women functional and dermoid cysts were found in the left ovary (n = 48), right ovary (n = 43) and bilaterally (n = 10). Among women with unilateral ovarian endometrioma (n = 167) a left cyst (63.3%) was found more frequently than a right cyst (34.7%) (P < 0.0001). In women with a left ovarian endometrioma pouch of Douglas was open in 99 (90.8%) cases. However, it was partially obliterated in 3 (2.8%) and completely obliterated in 7 (6.4%) cases. On the other hand, in women with a right endometrioma it was open in 44 (75.9%) cases and partially obliterated in 2 (3.4%) and completely obliterated in 12 (20.7%) cases. In women with a right endometrioma, the possibility of the pouch of Douglas obliteration is significantly higher than the women with a left endometrioma (P = 0.006). Conclusion Moreover, we also showed that in women with a right endometrioma, incidence of the pouch of Douglas obliteration is higher and the endometriosis tends to be more severe compared to women with a left endometrioma. Our most relevant observation is obliteration of Douglas pouch which was found to be more extensive in women with right ovarian endometrioma. Our results showing left lateral predisposition of endometriomas are in agreement with the previous reports and highlight the retrograde menstruation theory for the pathogenesis of this enigmatic disorder. © Springer-Verlag 2011

Effects of liver diseases on pregnancy and perinatal results: Comparison of 161 pregnant women with liver disease to 180 healthy pregnant [Karaci·ger hastaliklarinin gebeli·k ve peri·natal sonuçlar üzeri·ne etki·si·: 161 Karaci·ger hastalikli gebeni·n 180 saglikli gebe i·le karşilaş tirilmasi]

Objective: To determine the demographic properties, clinical features, laboratory findings and perinatal results of the patients who had liver diseases during their pregnancies. Material and methods: We retrospectively evaluated the medical records of 12241 pregnant women who had been treated in our clinic between January 2004 and July 2009. 161 of them (study group) had liver disease. For the control group, 180 patients, who did not have any problems on their routine controls, were chosen. Age, gravida, parity, gestational week, amnion fluid levels, birth week-weight-route, APGAR values of the first and fifth minutes, ALT, AST, ALP, GGT, total protein, albumin, globulin, total-direct-indirect bilirubin, INR, APTT, leucocyte, heamoglobuline, heamotocryte, platelets, blood urea, creatinine and sodium values were examined. Results: Demographic and clinical variables did not differ between groups. There was statistically significant difference in ALT, AST, ALP, GGT, total protein, albumin, total-direct-indirect billurubin, leucocyte, INR and creatinine values. We divided the study group in to 4 sub-groups; hepatitis B porters, cholestasis, asymptomatic liver function test abnormalities and others. We did not find any differences between groups in all parameters. Conclusion: The obstetrical complications of liver diseases in pregnancies may sometimes cause severe damages. With appropriate management and treatmant modalities, satisfying perinatal results could be gained

Hymen imperforate: A report of three cases [Hi·men i·mperforatus: Üç olgu sunumu]

Imperforate hymen is a congenital anomaly that is rarely seen in woman genital system. Imperforate hymen is reported %0,1 of all newborns and it is think that cause of imperforate hymen is congenital defect in the degeneration of central cells of hymen. Although it is generally isolated anomally, sometimes genitourinary anomalies may associate this defect. Patients who has this anomally are generally asymptomatic until puberty and in the period of adolescence, patients administer with a primary amenore and cyclic pelvic pain. History and pelvic examination are the main steps in diagnosis. To determine possible associated anomalies imaging studies are usefull. Treatment of this anomally consist of vaginal reconstrictive surgery. We presented three imperforate hymen cases with literature in this case report