Browsing by Author "Prorocic, M. (7801553581)"

This paper presents a case of carcinosarcoma localized in the endometrial polyp inside the uterus of a 74-year-old patient. This carcinosarcoma was diagnosed in the first clinical disease stage. Postoperative treatment was conducted but was not followed by additional chemo or radiotherapy due to the fact that the illness was in the first clinical stage. Secondary deposits in the abdomen and in the pelvis appeared exactly six months after surgery. Illness progression was sudden causing death three months after the appearance of secondary deposits or nine months after the illness was detected, despite attempts with Chemotherapie treatment. Although uterine carcinosarcomas account for three to seven percent of all uterine malignities while malignant polyp degeneration occurs in only 0.36% cases, treatment of this malignant disease is a special challenge to all those involved in oncological gynecological practice with the aim of prolonging the progression-free interval and the overall survival of patients suffering from this rare malignity.

This is the case of an advanced stage carcinosarcoma uteri, in a patient with limited therapy options. Carcinosarcomas (malignant mixed Mullerian tumors) are histologically composed of malignant epithelial and mesenchymal components. Sarcomatous component of this mixed tumor in the present patient was of heterologous-type chondrosarcoma. The primary treatment option for uterine carcinosarcomas is surgery, but adjuvant therapy is always necessary. The optimal treatment is still uncertain, as the histogenesis of this tumor remains controversial.

This is a case report of a diffuse malignant peritoneal mesothelioma in a 31-year-old woman. The patient presented with pains in the small pelvis followed by abdominal distension. By pelvic ultrasonography a tumorous mass of cystic architecture was verified in the small pelvis. She was submitted to laparoscopy. The diagnosis of the disease was established by histopathological examination of the material sample taken during laparoscopy. The patient was subsequently submitted to laparotomy upon which peritonectomy, omentectomy and appendectomy were performed. Postoperative combined chemotherapy was given. The patient has been well since completion of the treatment.

This is a case of invasive endometrial carcinoma with ovarian metastases incidentally detected in a 30-year-old infertile woman. The patient was asymptomatic. Carcinoma was discovered during hysteroscopy. She was submitted to surgical treatment involving total hysterectomy, bilateral salpingo- oophorectomy and dissection of the pelvic and paraaortal lymph nodes. Postoperative irradiation therapy was performed. Since treatment the patient has been well.

We present a case of pregnancy after complete conservative surgical treatment in a young woman with malignant mixed germ-cell tumor of the ovary. She was submitted to surgical treatment involving only unilateral salpingo-oophorectomy, with infracolic omentectomy and dissection of the pelvic and paraaortal lymph nodes. Three years after the operation and chemotherapy the patient spontaneously conceived and gave birth to a healthy baby. A patient who has malignant germ-cell tumor of the ovary in early stage, can successfully preserve fertility by conservative surgical treatment.

The authors present a case of a 33-year-old infertile woman with coincidental dermoid cyst and ovarian endometriosis in the same ovary. She was admitted to the Clinic because of cystic tumor of the left adnexa. Transvaginal ultrasound (TVUS) examination found a bilocular tumor of complex structure on the left ovary. Video-laparoscopy was also performed. On the left ovary, two adjacent cystic formations were found. Laparoscopic ovarian cystectomy was performed and a surgical specimen was sent for histopathologic analysis. The diagnosis was a dermoid cyst and ovarian endometriosis. Without complications, the patient was released from the hospital. The patient was treated with an analogue of gonadotropin releasing hormone (GnRH) for three months as a preparation for in vitro fertilization (IVF).

We present a case of successful pregnancy after effective uterovaginal anastomosis in a 26-years-old patient with congenital atresia of the cervix uteri. She spontaneously achieved pregnancy after four years of uterovaginal anastomosis. Gestation was at the eighth lunar month and the delivery was done by cesarean section due to rapidly progressing fetal asphyxia. The patient gave birth to a live healthy male, weighing 1,950 g, with an Apgar score of 5 and 8 at 1 and 5 min, respectively. The postoperative course was uneventful, and leakage of lochia was normal.

Fusion of the labia minora is a rare event in adult women and rarely seen as a clinical entity. We present a case of a 30-year-old woman with labial fusion, unmarried, a virgin, and sexually inactive with the complaint of discomfort during menstruation and difficulty in micturition since her puberty. The labia minora were fused in the midline with a pinpoint aperture for draining urine, while the clitoris could not be visualized. Previous history regarding a causal factor was perineal trauma in childhood. Effective surgical resection to separate the fusion was done by a radio frequency surgical knife. After the surgical separation, it was possible to expose the normal hymen behind the previously fused labia. We have shown that the separation of labial fusion in adult women with a radio frequency surgical knife, associated with topical application of estrogen cream, prevents re-fusion of the labia and leads to healing without scarring of the vulva.

We present the case of a 38-year-old woman who was treated for a heterotopic interstitial (cornual) pregnancy diagnosed at the 7th week of gestation. The intervention was performed via transvaginal ultrasound-guided aspiration and instillation of a hypertonic solution of sodium chloride into the cornual sac. The heterotopic cornual pregnancy was successfully aborted, and the intrauterine pregnancy was successfully maintained with delivery of a healthy newborn.