Search

Background: Uterine carcinosarcoma is rare neoplasm that mostly presents as metastatic disease. Stage is one of the most important prognostic factor, however, the management of the early stage uterine carcinosarcoma is still controversial. Aims: To evaluate prognostic factors, treatment options, and survival outcomes in patients with surgically approved stage I uterine carcinosarcoma. Study Design: Cross-sectional study. Methods: Data of 278 patients with uterine carcinosarcoma obtained from four gynecologic oncology centers were reviewed, and 70 patients with approved stage I uterine carcinosarcoma after comprehensive staging surgery were studied. Results: The median age of the entire cohort was 65 years (range; 39-82). All patients underwent both pelvic and paraaortic lymphadenectomy. Forty-one patients received adjuvant therapy. The median follow-up time was 24 months (range; 1-129). Nineteen (27.1%) patients had disease failure. The 3-year disease-free survival and cancer-specific survival of the entire cohort was 67% and 86%, respectively. In the univariate analysis, only age was significantly associated with disease-free survival (p=0.022). There was no statistical significance for disease-free survival between observation and receiving any type of adjuvant therapy following staging surgery. Advanced age (

Ectopic pregnancy is still one of the leading causes of maternal mortality. Due to the popularity of elective sterilization procedures, the incidence of ectopic pregnancies following tubal sterilization began to increase in recent years and post-sterilization ectopic pregnancies account more than 10% of all ectopic pregnancies. This case report describes a 41-year-old woman with a diagnosis of an ectopic tubal pregnancy 10 years after laparoscopic tubal sterilization who was successfully managed via laparoscopy. Also, the incidence and risk factors for tubal sterilization failures, mechanisms of failure, and outcomes of failed cases are discussed.

Although anogenital warts are the most common clinical manifestation of HPV infection, majority of infected individuals have subclinical disease which is important for transmission of infection. When such a transmission is seen in perinatal period, laryngeal papillomatosis may be seen during childhood. Affected infant may suffer from complications despite a quite bothersome treatment course. Therefore, transmission should be prevented if possible. Cesarean delivery may protect against transmission, but it is not routinely recommended in the presence of maternal genital warts. Gynecologic evaluation of all pregnant women to document genital infections is much more important. In cases with genital warts, follow- up should be performed more closely in order to make a decision of whether medical or surgical treatment of warts or cesarean delivery is needed. Also, the infant should be examined periodically after the delivery for the early detection of laryngeal papillomatosis. Here, a woman with undiagnosed genital HPV infection who transmitted infection to her infant is reported. Infection of infant caused recurrent laryngeal papillomatosis which necessitated repeated surgical procedures.

Fordyce spots are ectopic sebaceous glands which are most commonly seen on lips and oral mucosa. Patients are asymptomatic and do not require treatment unless cosmetic concerns arise. Fordyce spots can also be seen on vulva. However, in such patients, more common vulvar disorders including condyloma accuminatum may be considered clinically instead of Fordyce spots. Therefore, any vulvar lesion without typical appearance should be sampled and examined histopathologically before initiating treatment. A woman with vulvar Fordyce spots who was misdiagnosed to have condyloma accuminata is presented. The patient admitted to a gynecologist with a complaint of chronic vulvar pruritus. After vulvar inspection, topical imiquimod cream was given with a presumed diagnosis of condyloma accuminatum. The patient then admitted to our hospital without commencing therapy. She was subjected to biopsy after examination due to atypical lesions. Papules located on both labia minora were reported to be Fordyce spots and random biopsy was consistent with chronic inflammation. Therefore, she was given topical corticosteroid instead of imiquimod.

Widespread use of ultrasound examination during pregnancy caused an increase in the detection of adnexal masses during pregnancy. These masses, while being mostly functional ovarian cysts and resolve spontaneously, may represent a wide range of different pathologies including malignancy. Although most masses may be managed conservatively during pregnancy, some may necessitate surgical interventions due to complications or findings suggesting malignancy. In this article, the diagnosis and management of adnexal masses detected during pregnancy are discussed based on three cases and a short review of the literature.

Two cases of ovarian cystadenofibromas are presented. First case was a 33-year-old woman who was subjected to ovarian cystectomy during cesarean delivery. The cystic mass had solid papillary projections on gross examination and histopathological diagnosis was a benign mucinous ovarian cystadenofibroma. Other patient was a 63-year-old postmenopausal woman presenting with a pelvic mass. During exploratory laparotomy, left ovarian mass having both cystic and solid components was detected. Frozen examination revealed an ovarian cystadenofibroma with borderline foci. Therefore, a staging surgery was performed. Final pathologic examination revealed a stage 1a borderline ovarian cystadenofibroma. Ovarian cystadenofibromas are rare epithelial tumors with fibrous stroma being the dominant component of the lesion. They usually appear as multilocular cystic masses with solid components mimicking ovarian cancer both on imaging modalities and during surgical exploration. Therefore, accurate preoperative or intraoperative diagnosis is required to avoid excessive surgical procedures.

Context: Atypical glandular cells (AGCs) result in the Papanicolaou (Pap) smear may be associated with significant genital and nongenital neoplastic processes. Aims: To evaluate the underlying histopathology in women who had AGCs on Pap smears. Settings and Design: Retrospective cross-sectional study. Patients and Methods: Clinicopathological data of patients who had AGC on Pap smears and underwent histological workup between January 2004 and December 2014 were retrieved from the computerized database of a tertiary care center. Patients with a prior history of cervical intraepithelial neoplasia or gynecological cancer were excluded. Statistical Analysis Used: Chi-square test or Fisher's exact tests were used as appropriate. Results: Cytological examination of the uterine cervix was carried out in 117,560 patients. We identified 107 patients (0.09%) with AGC and 80 of those with histological follow-up were included in the study. The median age at diagnosis was 47 years (range, 18–79), and 32 women (40%) were postmenopausal, while 56 (70%) had gynecological symptoms. Significant preinvasive or invasive lesions on pathological examination were detected in 27 (33.8%) patients, including 12 endometrial adenocarcinomas (15%), 8 cervical carcinomas (10%), 3 cervical intraepithelial neoplasia II/III (3.75%), 2 ovarian adenocarcinomas (2.5%), and 2 metastatic tumors (2.5%). Univariate analysis showed that postmenopausal status (P < 0.001), age >50 years old (P < 0.001), having symptoms at the time of admission (P = 0.041), and AGC “favor neoplasia” smear results (P = 0.041) were the clinical factors associated with significant pathological outcome. Conclusions: Patients with AGC on Pap smears should be evaluated vigilantly with histological workup, especially if they are postmenopausal or symptomatic.

Placental adhesive disorders involve the growth of placental tissue into or through the uterine wall. Among these disorders, placenta percreta is the rarest one. However, it may cause significant complications. This report aimed to report a neglected patient with placenta percreta who developed uterine rupture with life-threatening late postpartum intra-abdominal hemorrhage. On admission, the patient had acute abdomen with moderate abdominal distention and was subjected to emergency laparotomy. A full-thickness defect of the anterior uterine wall involving the hysterotomy site was seen. Placental tissues occupied both sides of the incision and posterior bladder wall was also invaded by placenta. Total abdominal hysterectomy with partial resection of the posterior bladder wall was performed.

Optimum therapeutic approach in vaginal agenesis has always been an area of extensive controversies. Although surgical management gained priority due to the evolution of techniques, there is currently no consensus in the literature regarding the best type of surgical approach. The most commonly preferred surgical procedure among gynecologists is McIndoe operation which involves the creation of a space between bladder and rectum, insertion of a mold covered with split-thickness skin graft into that neovaginal space, and use of postoperative vaginal dilation to avoid stenosis. However, many modifications have been introduced in time in an attempt to increase the success rates. In this paper, we describe two cases with vaginal agenesis with functioning uterus who were subjected to surgery by combined abdominal-perineal approach. The surgical technique also included the use of a specially designed vaginal mold made up of polymethyl methacrylate and use of Hyalobarrier gel which is an adhesion-preventing agent.