Giant mucinous cystadenocarcinoma of the ovary is rarely described. Huge ovarian masses are mostly benign, but malignancy should be ruled out by investigations and clinical assessment. Here, we present a case of a large mucinous cystadenocarcinoma of the ovary in a 48-year-old postmenopausal woman. Imaging examinations revealed a large cystic tumor that filled the whole abdominal cavity. Despite the difficulties presented by the size of the tumor and its malignant potential, laparotomy was carried out, which included bilateral salpingo-oophorectomy, total abdominal hysterectomy, exploration of other intra-abdominal organs, and pelvic lymphadenectomy. Histopathology indicated the presence of mucinous cystadenocarcinomas. Adjuvant chemotherapy was given post-operatively, and the patient maintained remission during follow-up. This case emphasizes the need for early detection by simple imaging modalities such as ultrasonography in cases of ovarian masses. Most adnexal masses, if detected early, are amenable to surgical management with a good prognosis. Large masses underline the need for a multidisciplinary approach to improve patient outcomes.

Uterine adenosarcoma remains a highly aggressive tumor and is less described in the literature, with an unfavorable prognosis and an increased risk of local and distant recurrence. However, surgery, chemotherapy, and radiotherapy offer local control of the disease, and overall survival remains reduced. We report the case of a 79-year-old patient with stage IIIB uterine adenosarcoma, confirmed by immunohistochemistry and initially diagnosed with postmenopausal metrorrhagia. The patient was managed through a multimodal treatment by conducting a multidisciplinary consultation.

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Metastases to the spleen from various non-hematologic malignancies are generally not a common clinical event and usually indicate the late dissemination of disease. Solitary splenic metastases from solid neoplasm are extremely uncommon. Furthermore, solitary metastasis to the spleen from primary fallopian tube carcinoma (PFTC) is extremely rare and has not been reported previously. We report a case of isolated splenic metastasis in a 60-year-old woman, occurring 13 months after a total hysterectomy, a bilateral salpingo-oophorectomy, a pelvic lymphadenectomy, a para-aortic lymphadenectomy, an omentectomy, and an appendectomy were performed for PFTC. The patient\'s serum tumor marker CA125 was elevated to 49.25 U/ml (N < 35.0 U/ml). An abdominal computed tomography (CT) scan revealed a 4.0 × 3.0 cm low-density lesion in the spleen that was potentially malignant, with no lymphadenectasis or distant metastasis. The patient underwent a laparoscopic exploration, and one lesion was found in the spleen. Then, a laparoscopic splenectomy (LS) confirmed a splenic metastasis from PFTC. The histopathological diagnosis showed that the splenic lesion was a high-differentiated serous carcinoma from PFTC metastasis. The patient recovered for over 1 year, with no tumor recurrence. This is the first reported case of an isolated splenic metastasis from PFTC. This case underlines the importance of serum tumor marker assessment, medical imaging examination, and history of malignancy during follow-up, and LS seems to be the optimal approach for isolated splenic metastasis from PFTC.

Morbid obesity, traditionally considered to be a contraindication to total laparoscopic hysterectomy, is now evolving into an indication. Innovations and advancements in minimally invasive surgical techniques have significantly improved patient morbidity and mortality rates, reduced operational costs, and provided patients with an overall safer surgical experience. Although the laparoscopic approach is associated with several physiologic and technical challenges in the morbidly obese, it is plausible that these patients stand to benefit the most from minimally invasive surgery. This report highlights the methods of preoperative optimization, intraoperative considerations, and postoperative management strategies employed to achieve a successful total laparoscopic hysterectomy, bilateral salpingo-oophorectomy and pelvic lymph node dissection in a patient with a BMI of 45kg/m2, diagnosed with grade 1 endometrial adenocarcinoma and several obesity-related comorbidities.

An abnormal blood collection in the uterus is referred to as hematometra. Obstruction of the genitourinary outflow system caused by earlier surgeries or congenital defects is most frequently related to this rare disorder. The symptoms of hematometra include acute pelvic pain and a history of absent menarche. Here is a case of a 42-year-old female who presented with complaints of severe lower abdominal pain, and pain during urination that was accompanied by vulval itching in June 2021. She had undergone two Caesarean sections and a myomectomy in the past. She was given three monthly injections of gonadotropin-releasing hormone (GnRH) analogue after receiving USG-guided drainage because of a diagnosis of hematometra in January 2021. However, in June 2021, she experienced a recurrence of the same symptoms, necessitating a total abdominal hysterectomy and bilateral salpingo-oophorectomy, which completely resolved the patient\'s complaints. For a deeper understanding of this issue, further case reporting is necessary.

Endometrial stromal sarcoma (ESS) rarely causes infertility in young women. We report a nulligravida in her 30s who presented with primary infertility of 15 years. Hysteroscopy revealed a submucosal necrotic fibroid polyp. Ultrasonography detected multiple intramural fibroids. Open myomectomy with polypectomy was performed. Histopathology revealed low-grade ESS (LGESS) within the fibroid polyp. Subsequently, the patient underwent completion surgery. Her final diagnosis was estrogen-receptor positive LGESS stage IIIB, and she was suggested anastrozole adjuvant therapy and long-term surveillance. ESS with abnormal perimenopausal bleeding, though the most common presentation, may not always observed. Hence, a high index of suspicion of ESS should always be kept as a differential diagnosis in uterine fibroid polyp, though rare. Considering the scarcity of more extensive studies on ESS, reporting of cases will aid in formulating management protocols.
Endometriyal stromal sarkom (ESS) genç kadınlarda nadiren infertiliteye neden olmaktadır. Çalışmamızda 15 yıllık primer infertilite ile başvuran 30’lu yaşlarında bir nulligravida sunmaktayız. Histeroskopisinde submukozal nekrotik fibroid polip saptandı. Ultrasonografi birden fazla intramural fibroid olduğunu ortaya koydu. Polipektomi ile açık myomektomi yapıldı. Histopatoloji, fibroid polip içinde düşük dereceli ESS (LGESS) ortaya çıkardı. Ardından hastaya tamamlayıcı cerrahi uygulandı. Nihai tanısı östrojen reseptörü pozitif LGESS evre IIIB idi ve hastaya anastrozol adjuvan tedavisi ve uzun süreli gözetim önerildi. Anormal perimenopozal kanamalı ESS, en yaygın semptom olmasına rağmen her zaman gözlenmeyebilir. Bu nedenle, nadir de olsa uterin fibroid polipinde ESS şüphesi yüksek bir ayırıcı tanı olarak daima akılda tutulmalıdır. ESS ile ilgili daha kapsamlı çalışmaların azlığı göz önüne alındığında, olguların raporlanması yönetim protokollerinin formüle edilmesine yardımcı olacaktır.

The dissertation presents a case of intravenous leiomyomatosis and conducts the literature review. A 31-year-old woman with a hysteromyomectomy history presented with abnormal uterine bleeding and anemia, a large pelvic tumor, underwent excision of the uterine and bilateral salpingo-oophorectomy. A pathological diagnosis determined it as intravenous leiomyomatosis. The patient recovered well, and no recurrence was noted after 1 year of follow-up. Intravenous leiomyomatosis is rare. Imaging is helpful, but the final diagnosis of intravenous leiomyomatosis is usually made following surgical excision and histopathology. Early surgical resection is a better treatment modality.

Ovarian cancer is the second most common gynecologic malignancy, but it is the deadliest of the gynecologic cancers. Out of 21,410 new cases of ovarian cancer in the United States in 2021, more than half were fatal. In this case study, a 53-year-old sexually active postmenopausal patient with a family history of breast cancer presented to her gynecologist for an annual exam. Given the patient\'s family history and breast cancer mutations, malignancy was a concern that had to be addressed. Elective bilateral salpingo-oophorectomy of the patient revealed ovarian serous carcinoma originating from the fallopian tubes. Historically, fallopian tube carcinoma was presumed to be rare, though many high-grade serous carcinomas previously classified as advanced ovarian carcinomas are now believed to have actually originated from the fallopian tubes. This case study adds to the body of evidence that many high-grade carcinomas have fallopian tube origins. This emerging perspective of ovarian cancer\'s origin provides healthcare workers and the scientific community a more complete picture of the etiologies and dissemination pattern of ovarian cancer. We hope this study will help physicians have a more extensive knowledge base of such a disease when looking for risk factors and taking care of their patients.

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