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ABSTRACT: Rarely, excessively large, slow growing tumors are found to be malignant. One exception includes retroperitoneal tumors, which if considered a mass of pelvic origin, may be encountered by the gynecologic oncologist.
A post-menopausal female was referred for evaluation of a huge mass thought to arise from the pelvis. The patient underwent exploratory laparotomy and had resected a 50x48x45 cm, 103.6 lb. liposarcoma arising from the right retroperitoneum.
Rarely, large slow growing abdomino-pelvic masses may be malignant, and one should be prepared to perform an appropriate surgical resection. This case represents removal of the largest retroperitoneal liposarcoma reported.
Gynecologic Oncology 01/2007; 103(3):1152-4. · 3.89 Impact Factor
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ABSTRACT: We present a case of recurrent colon cancer detected by routine, annual Papanicolaou screening.
A 59-year-old African American woman who had been treated for T2N0M0 (stage II, Dukes A) colon cancer 2 years before to presentation had a Pap smear showing a high-grade squamous intraepithelial lesion with a normal cervical biopsy result. Because of this discrepancy, a loop electrosurgical excision procedure and endocervical curettage were performed and showed atypical glandular cells suspicious for adenocarcinoma. Subsequent colonoscopy showed recurrent adenocarcinoma of the colon. The patient underwent an en-block total abdominal hysterectomy and anterior-perineal resection showing invasion of recurrent colon cancer into the uterus and cervix.
In patients with a history of extrauterine adenocarcinoma, abnormal Pap screening may indicate recurrent or metastatic carcinoma.
Journal of Lower Genital Tract Disease 11/2005; 9(4):236-8. · 1.07 Impact Factor
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ABSTRACT: Heterotopic pregnancy has been traditionally considered a rare event; however, with the use of assisted reproductive technology, the incidence of heterotopic pregnancies is increasing. Diagnosing a heterotopic pregnancy can be challenging. This report describes a 30-year-old female at 11 weeks' gestation with an intrauterine twin pregnancy after gonadotropin stimulation and intrauterine insemination who presented complaining of left lower quadrant abdominal pain with constipation and cramps. The patient was empirically treated for diverticulitis but failed to respond to therapy. A heterotopic triplet pregnancy was ultimately diagnosed at laparoscopy. Heterotopic pregnancy must be considered in the differential diagnosis of abdominal pain in the first trimester, especially in patients who conceived by means of assisted reproductive technology. Surgical treatment is the most frequently used method of treatment.
Southern Medical Journal 09/2005; 98(8):833-5. · 0.83 Impact Factor
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ABSTRACT: In this study, the authors investigated sex preferences for gynecologists and surgeons among female patients, and explored potential contributing factors.
One hundred forty-six female patients were surveyed in a private practice office concerning their sex preferences and past obstetric/gynecologic care. For data comparisons, chi2 or Fisher exact tests were used.
Gynecologist sex preferences were similar between male (30%), female (35%), and no sex preferences (35%). Patients who had a female obstetrician at their first delivery or began their gynecologic care with a female were more likely to prefer a female gynecologist. Multiparous patients were more likely to state no preference for a gynecologist. There were no statistical differences in sex preferences when patients were stratified by age, race, educational background, age of first gynecologist visit, or the age at their first delivery. About half of the patients (51%) stated that they preferred a male surgeon; only 3% preferred a female surgeon, and 46% stated they had no preference.
Our investigation demonstrated that women's preferences for a gynecologist were divided equally between preferring a male, a female, and having no preference. Our study did find, however, that about half of the female patients preferred a male surgeon.
Southern Medical Journal 05/2005; 98(4):405-8. · 0.83 Impact Factor
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ABSTRACT: Endometrial carcinoma is the most common cancer of the female genital tract. Two histologic variants have been described: an estrogen-dependent form and a more aggressive, non-estrogen-dependent form, which includes uterine serous carcinoma.
Two cases of uterine serous carcinoma were confined to an endometrial polyp without myometrial invasion and were widely metastatic. One patient presented with abdominal pain and constipation, while the other patient was asymptomatic. Both patients had elevated CA-125 levels. At the time of surgery, these patients were found to have extensive carcinomatosis and underwent surgical staging procedures that required bowel resections. Pathology showed metastatic disease originating in a small focus of serous adenocarcinoma at the tip of an endometrial polyp. Combination chemotherapy was planned; but 1 of the patients died prior to its initiation.
These cases emphasize the aggressive nature of uterine serous carcinoma despite insignificant myometrial invasion.
The Journal of reproductive medicine 04/2005; 50(3):209-12. · 0.87 Impact Factor
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ABSTRACT: Although retroversion of the uterus is a common finding, incarceration of the gravid uterus is a rare complication. It occurs usually between the 12th and 16th weeks of gestation and can lead to severe complications. No case of incarceration has been reported before in a multifetal gestation resulting from in vitro fertilization.
A 35-year-old woman with a triplet pregnancy presented at 9 weeks' gestation with acute urinary retention and was diagnosed with uterine incarceration. This diagnosis was confirmed by ultrasound and was resolved using transvaginal pressure under epidural anesthesia.
This is the first reported case of uterine incarceration in a triplet pregnancy that resulted from in vitro fertilization. There is no universal protocol for treatment of incarceration, but several techniques have been described.
The Journal of reproductive medicine 01/2004; 48(12):992-4. · 0.87 Impact Factor
