Browsing by Author "Mitrovic, M. (58615732600)"

Purpose: The purpose of this report was to confirm that endometriosis, although a benign gynecological disease, in some patients, can give rise to ovarian cancers. Case Report: The authors report a case of clear cell carcinoma in a patient suffering of endometriosis. The patient, a 38-year old nullipara, had a history of bilateral ovarian cysts diagnosed on routine check-up by ultrasound scan four years ago. After admission to hospital, due to cramping lower abdominal pain, MRI showed tumorous mass, with solid and cystic components, located between abdominal wall, lateral pelvic walls, and lumbosacral part of spine belonging to ovaries. The patient underwent appropriate extensive surgery. Histopathological investigation revealed ovarian clear cell adenocarcinoma Stage IIIa, along with endometriotic cyst found on the contralateral side. Conclusion: This report confirms the strong link between endometriosis and ovarian cancer and sends an appeal for urgent and precise definition of parameters relevant for determination of patients’ groups with the risk for malignancy. © 2019 S.O.G. CANADA Inc. All rights reserved.

Purpose of investigation: To determine whether in vitro fertilization/intracytoplasmatic sperm injection (IVF/ICSI) singleton pregnancies are at increased risk for maternal and fetal complications than spontaneous singleton conceptions. Materials and Methods: The pregnancy outcome of 634 singleton pregnancies after IVF/ICSI delivered at the Clinic for Gynecology and Obstetrics during the period January 2006 to January 2010 were compared to 634 matched singleton controls, matched one by one by age, parity, education, and body mass index (BMI). Differences in pregnancy outcomes between the groups were assessed using Student's t-test with Yates correction for continuous variables and Chi-squared test for categorical variables. Results: The mean gestational age at delivery of the IVF group was 38.13 ± 1.72 weeks, slightly shorter than spontaneously conceived singletons at 38.65 ± 1.79 weeks. The diagnosis of gestational diabetes mellitus (GDM) was frequently made in the IVF group (11.82% vs 8.35%, t = 2.052, p < 0.05). Total preterm delivery rate of IVF pregnancies was 9.30%, significantly higher than the controls 5.85% (t = 2.33, p < 0.05), especially at the 30-32 weeks gestation period. The predominant mode of delivery after IVF pregnancy was cesarean section (80.75% vs 31.38% at spontaneously conceived, t = 17.71, p < 0.001), while vaginal route was the choice for naturally originated pregnancies 68.6% vs 19.24% (p < 0.01). No differences were found in the average birth weights, LBW, VLBW, SGA, and LGA regarding the pregnancy origin. Perinatal mortality rates were comparable among singletons with different pregnancy origin. Conclusions: Singletons from IVF/ICSI pregnancies have poorer perinatal outcome associated with higher rates of cesarean sections, preterm birth and prematurity, fetal malpresentation (breech presentation), and the occurrence of maternal GDM in pregnancy.

A uterine tumor resembling an ovarian sex cord tumor (UTROSCT) shows a poly phenotypic immunophenotype with coexpression of epithelial, myoid, and sex cord markers, as well as hormone receptors. The authors present a case of a 59-year-old multiparous woman admitted to the Institute of Gynecology and Obstetrics Clinical Centre of Serbia in January 2010 due to prolonged vaginal bleeding and abdominal discomfort. The vaginal ultrasound showed an enlarged uterus size of 100 x 74 x 81 mm, with extended cavity with an unhomogenic content and myomas sized 54 x 69 mm located in fundus with secondary changes. She underwent abdominal hysterectomy with adnexectomy. Microscopic examination revealed submucosal uterine tumor with variabile histological organization that had anastomotic trabeculae with solid cellular grupations. Rare mitotic figures (2/10 HPF) were found. Additional imunohistochemistry showed immunophenotype: the sex cord areas were positive for vimentin(++), aSMA(++), AE1/AE3(+), PR(+), and ER(+). The poly phenotypic immunophenotype can be useful in differential diagnosis from other neoplasms but also suggests an origin of UTROSCT from uncommitted stem cell enabling for multidirectional differentiation.