Browsing by Author "Pažin, V. (24169602000)"

The following is a description of an extremely rare tumor of the uterus, malignant atypical polypoid adenomyoma (APA), admixed with well-differentiated endometroid carcinoma, in a 29-year-old patient previously treated for sterility in whom, due to the existence of a ten-millimeter sessile tumor on the uterine corpus, verified by transvaginal ultrasonography (TVUS), a hysteroscopic resection of the anomaly was performed. The patient underwent all requisite examinations and was referred to the malignant diseases panel for an examination and a decision on further treatment. As the patient wished to preserve fertility, the authors decided to continue performing regular controls at intervals of two to three months. The first subsequent control called for a TVUS examination or one using another imaging method, with a multiple endometrial biopsy with curettage of the endocervix. The results of the first examination promised that fertility could be preserved. Therapy with medroxyprogesterone acetate (MPA) in daily dosages of 200 to 500 mg was advised, which the patient intentionally did not take. A spontaneous desired pregnancy was verified following the first control.

This is a case report of a 36-year-old patient with an ectopic pregnancy located in the previous cesarean section scar following in vitro fertilization (IVF). The patient was treated by 50 mg of intrasacular methotrexate locally under ultrasound guidance. Transvaginal ultrasound (TVUS) confirmed that the pregnancy was no longer vital within 24 hours, dilatation and aspiration of the ovular tissue were performed after seven days and it was sent for pathohistological analysis. Eight hours after the procedure, the patient began bleeding abundantly and was consequently treated locally by 1 ml of Beriplast® P Combi set, human fibrinogen, and human thrombin set (CSL Behring). After the treatment, the patient was discharged in good health, with normal laboratory values. Her menstrual period resumed 35 days after the procedure.

During embryonic development, both glandular parenchyma of prostate in a male fetus and paraurethral Skene’s glands in a female fetus develop from pelvic urethra endoderm. This common embryological origin results in finding prostatic tissue even in the lower genital tract in women. Herein, the authors present a case of polypoid lesion in vagina consisting solely of glandular elements without squamous component, which stained negative for prostatic markers, but morphologically identical to normal prostatic tissue. A patient, 57-years-old came to the Clinic, with a cystic change in the petiole, which size being 30×17×15 mm, on the left vaginal wall adjacent to introitus. The cystic change was excised and a preparation was sent to a histopathological examination. The histopathological examination included serial Hematoxylin and Eosin stained sections, along with immunohistochemical panel. It was concluded that it was ectopic prostatic tissue or ectopic paraurethral gland tissue within vaginal mucosa. Partially, epithelium at the surface of our polypoid lesion showed immature squamous metaplasia, vaginal intraepithelial neoplasia - VaIN II/III, and transitional cell metaplasia. Gland formations having benign features were within base of the change, at the resection lines, while dysplastic epithelium was fully removed. © 2019 S.O.G. CANADA Inc. All rights reserved.

Epithelial ovarian cancer is the leading cause of mortality among gynecologic malignancies. It occurs more often in women in menopause, which facilitates the implementation of adequate surgical treatment. The aggravating approach arises when diagnosed with young patients who have not given birth. Approximately 10% of all epithelial ovarian carcinoma is diagnosed in women under the age of 40. In those cases, it is necessary to find a balance between adequate treatment and a strong desire for achieving progeny. Criteria guaranteeing safe fertility preservation are not cleary identified. Most studies recommend that fertility sparing surgery can be performed in all young women in whom ovarian cancer is detected as Stage IA grade 1. Here the authors report a preservation of fertility in 19-year-old patient with mucinous ovarian carcinoma. © 2019 S.O.G. CANADA Inc.. All rights reserved.

Primary fallopian tube carcinoma is a rare gynecological malignancy and it accounts for about 1% of all gynecological malignancies. Etiological factors are not sufficiently known, but most commonly specified are infertility, nulliparity, and pelvic inflammatory disorder. It is most often asymptomatic, although, a triad reported by Latzko including a vaginal watery discharge, colic like pelvic pain, presence of tumor mass in pelvis, is mentioned as pathognomonic. In the present case, it was primary fallopian tube carcinoma, in FIGO Stage IA. After complete abdominal hysterectomy with lymph node dissection, in line with the expert council’s decision, no adjuvant chemotherapy was administered. PET CT in June 2017, two years after the surgical treatment, presented both some metastatic changes in lungs and enlarged retroperitoneal lymph nodes and after this finding, and chemotherapy with carboplatin was begun. The therapy implies surgical treatment being hysterectomy with adnexectomy, but also retroperitoneal lymph node dissection as well, considering that it more often affects lymphatic glands than epithelial ovarian cancer (EOC). It can be misinterpreted with EOC in a pathological sense. In addition to a surgical treatment, the most common form of chemotherapy is platinum-combined with taxanes. © 2019 S.O.G. CANADA Inc. All rights reserved.