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ABSTRACT: Malignant fibrous histiocytoma (MFH) is the most common soft-tissue sarcoma of late adult life occurring predominantly in the extremities and the retroperitoneum. MFH of the ovary is very rare, with only six cases previously reported. A 67-year-old woman with a right pelvic tumor highly suspicious of ovarian carcinoma was submitted to exploratory laparotomy. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, total omentectomy, pelvic and paraaortic lymphadenectomy with right hemicolectomy along with permanent cutaneous ileostomy were performed. Since a storiform-pleomorphic type of MHF was diagnosed from histopathological and immunohistochemical findings, chemotherapy was proposed as the postoperative treatment. Despite extensive surgery with negative surgical margins, the patient had recurrence of the tumor within four months, and was submitted to secondary surgery. A combination of chemo- and radiotherapy was performed postoperatively, but the patient developed respiratory problems and died one year later from the primary diagnosis.
European journal of gynaecological oncology 01/2012; 33(2):236-9. · 0.47 Impact Factor
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ABSTRACT: Krukenberg tumors are mostly found as metastatic signet-ring cell adenomucinous carcinomas in young, premenopausal women. They are bilateral in 80% of the cases, and thus can be expected in pregnancy. A 31-year-old female was diagnosed by explorative laparotomy at 27 weeks of gestation with a Krukenberg tumor due to bilateral adnexal masses and a large amount of ascites. At surgery cesarean section with total abdominal hysterectomy, bilateral salpingo-oophorectomy, total omentectomy and pelvic lymphadenectomy was performed. The neonate died 24 hours later due to prematurity and respiratory distress syndrome. The primary site of the cancer was detected metachronously two months after surgery and postoperative chemotherapy, as stomach adenomucinous carcinoma. In spite of surgery and postoperative multiagent chemotherapy, the patient died six months from the diagnosis of Krukenberg.
European journal of gynaecological oncology 01/2011; 32(3):356-8. · 0.47 Impact Factor
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ABSTRACT: Renal cell carcinoma is seen most frequently after childbearing years, but occasionally is diagnosed in pregnancy. The pregnancy demands special considerations in terms of the diagnostic evaluation and management. A case of a patient with renal cell carcinoma diagnosed in the first trimester of pregnancy, which suddenly enlarged at the end of the second trimester, is presented. She underwent radical nephrectomy after delivery. Since the mother's welfare is the primary concern, surgical management should not be delayed.
European journal of gynaecological oncology 02/2009; 30(3):347-9. · 0.47 Impact Factor
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ABSTRACT: Patient K.N., age 30, nulliparous deliveries and with one miscarriage, was admitted to the Institute of Gynecology and Obstetrics, Clinical Center of Serbia, in December 2000 with the following diagnosis: Uterine myoma and adnexal mass.
European journal of gynaecological oncology 02/2006; 27(1):98-100. · 0.47 Impact Factor
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ABSTRACT: A 30-year-old women was admitted to the Institute of Gynecology and Obstetrics, Clinical Center of Serbia in April 2004 with the following diagnosis: adnexal mass soon after in vitro fertilization. Her history revealed salpingo-oophorectomy for mucinous cystadenofibroma of the left ovary eight years before and cystectomy of the right ovary three years before. At admission, the most remarkable findings were high temperature and elevated white blood cells with erythrocyte sedimentation rate. After the antibiotic treatment, laparatomy was performed and a multilocular right adnexal tumor was found. The right salpingo-oophorectomy was performed and pathological diagnosis was mucinous ovarian adenocarcinoma. Two weeks later, radical surgery was carried out and chemotherapy was applied. There is an urgent need for clear interpretation of the link between ovarian stimulation and ovarian cancer. An association between ovarian stimulation treatment and ovarian cancer has still not been completely proven.
Clinical and experimental obstetrics & gynecology 02/2006; 33(3):190-1. · 0.43 Impact Factor
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ABSTRACT: Cervical carcinoma is the fourth most common malignant disease in women, after breast, lung and colon cancer. It is present in two-thirds of all malignant diseases of the genital tract. Although in most of Europe patients are subjected to regular health screening, diagnoses of severe life-threatening alterations are often made when they are already in late stages.
European journal of gynaecological oncology 02/2005; 26(5):551-2. · 0.47 Impact Factor
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ABSTRACT: Hydatidiform mole is a degenerative chorion disturbance of unknown etiology. It is characterized by a permanent whitish enlargement of the chorionic villi with a grape-like appearance and poor vascularization. The symptoms of a molar pregnancy are nausea and vomiting which are present in more than one-third of the patients. Other symptoms include an enlarged uterus and vaginal bleeding. Our patient was a 19-year-old primipara with a twin pregnancy where one embryo was molar. Diagnosis was confirmed by beta-hCG levels.
European journal of gynaecological oncology 02/2005; 26(5):545-6. · 0.47 Impact Factor
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ABSTRACT: Cystosarcoma phyloides is a breast cancer with deterrent features because of its size and fast growth. Borderline ovarian tumors comprise 10% to 15% of all epithelial tumors of the ovary. Regardless of the tumor type (serous, mucinous, clear cell, Brenner, mixed) they can be benign, borderline or malignant. There is a close physiological relation between the breasts and genital tract. By routine examination of girls in secondary schools, suspected ultrasonography findings were found in two out of 180 examinees.
European journal of gynaecological oncology 02/2005; 26(5):579-80. · 0.47 Impact Factor
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ABSTRACT: The purpose of this investigation was to determine if twin pregnancies induced by in vitro fertilization (IVF) are under greater risk of negative perinatal outcome than "spontaneous" twin pregnancies. The study included 240 patients with gemellar pregnancies. Each patient with a gemellar IVF pregnancy (120) was assigned to a pregnant woman with appropriate age, education and parity from the "spontaneous" group as a control. Pregnancies were followed clinically, with laboratory analyses and ultrasonography.
Clinical and experimental obstetrics & gynecology 02/2005; 32(1):65-7. · 0.43 Impact Factor
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ABSTRACT: By following Doppler flow of the small pelvis with laboratory parameters and anamnesis data, we obtained more precise diagnostic possibilities for timely discovering of malignant processes in adnexal region and fallopian tube. By following patients who had come for routine check ups, prompted by a positive family history for malignant processes, resistant indexes of blood vessels in the adnexal region and vascularisation pattern were determined. Out of 78 women observed in the postmenopausal period with diagnosed adnexal masses, we found two cases of fallopian tube cancer. Resistance indexes ranged between 0.20 and 0.30 during a one-month period. Hystopathological analysis pointed to fallopian tube cancer. Besides Doppler flow, only patient history of amber extract use was significant. By CA 125 marker analysis, we found an increased value but not signifiant enough. Both patients had a positive family history according to the female hereditary line.
European journal of gynaecological oncology 02/2005; 26(3):309-10. · 0.47 Impact Factor
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ABSTRACT: [corrected] Pregnant woman with fetal tachycardia have a risk of chorioamnionitis as cause of tachycardia. Different studies have supported or refuted the use of C-reactive protein (CRP) to diagnose chorioamnionitis. The goal of this study was to evaluate serial serum CRP levels for diagnosis of chorioamnionitis.
The study included 60 woman with chorioamnionitis confirmed after measuring the levels of CRP. Patients were monitored by CRP determination, white blood cell (WBC) count, maternal temperature, maternal and fetal heart rate.
Elevated CRP level was present in 93.33% of cases. Fetal tachycardia was present in 91,67 cases, all associated with elevated CRP level. Increased WBC count was present in 63.33%. A statistically significant difference was found in the level of CRP in pregnant women with increased WBC count compared with those without (p < 0.01).
Elevated C-reactive protein levels were more sensitive than other standard laboratory or clinical tests in predicting chorioamnionitis. Also, recent reports indicate that serial CRP levels during this interval may be useful for monitoring antibiotic treatment.
Clinical and experimental obstetrics & gynecology 01/2005; 32(2):114-6. · 0.43 Impact Factor
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ABSTRACT: Prevention of the permanent sequelae of fetal hyperinsulinemia, namely hypertension and obesity, in infants born to mothers with gestational diabetes mellitus (GDM) has remained unresolved. Efforts to reduce fetal macrosomia by attempting to maintain blood sugar within a certain range have certainly failed. We have tried to eliminate fetal macrosomia by accelerating fetal maturation and delivery before the 36th week.
Acceleration of fetal maturation was achieved by endogenous release of thyrotropin-releasing hormone brought about by periodic fluctuations in fetal oxygenation resulting from oxytocin-produced uterine contractions. Fifteen patients with GDM at 33-35 weeks, six of whom had previously given birth to a macrosomic fetus, agreed to participate in the study. Oxytocin was given for 6 h per day to produce regular contractions. In 13 patients it was given for 5 days, and in two patients for 7 days to reach a lecithin/sphingomyelin (L/S) ratio indicative of fetal maturity.
Eleven patients delivered vaginally after induction of labor and four delivered by Cesarean section. The mean Apgar score at 5 min was 9.13, and the mean birth weight was 2917 g (range 2100-3400 g). No newborn had respiratory difficulties, although four had short episodes of tachypnea. All were cared for in the regular nursery and all were discharged home with their mothers.
Acceleration of fetal maturation, and delivery between 34 and 36 weeks, appears to be a promising means to reduce or even eliminate the permanent sequelae of fetal hyperinsulinemia in pregnancies complicated by GDM.
Journal of Maternal-Fetal and Neonatal Medicine 08/2004; 16(2):111-4. · 1.50 Impact Factor
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ABSTRACT: A clinical study was initiated to demonstrate that blood pressure in the capillaries increases long before there is a rise in arterial blood pressure. Thus the diagnosis of capillary hypertension can be made much earlier, even before gross tissue edema is observed. Bearing in mind the pathogenetic mechanism of the development of pregnancy-induced hypertension (PIH) complicating the clinical picture, analyzed hematocrit had great statistical significance. Also, by following the diagnostic sequence, after hematocrit, Acidum uricum shows pathologic and protein loss values. Clinical application of this study would be in timely albumin administration and fast oncotic pressure regulation in order to avoid hypertension complications.
Clinical and experimental obstetrics & gynecology 02/2004; 31(4):287-8. · 0.43 Impact Factor
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ABSTRACT: Myomas during pregnancy must be evaluated carefully, especially in relation to possible premature delivery or spontaneous miscarriage. We wanted to find out whether the addition of Doppler assessment could help in the management of these cases. We found that from all cases of myomas during pregnancy, the most common association with impairment of the fetoplacental unit flow was found in the cases with submucous myomas and the subgroup of those with intramural myomes which show etc. growth during pregnancy. However myomectomy is generally not considered to be indicated to prevent pregnancy complications except for women with a history of myoma-related complications. In pregnancies with myomas, preserving the pregnancy is one goal but different risk factors have to be taken into account at the same time.
Clinical and experimental obstetrics & gynecology 02/2004; 31(3):197-8. · 0.43 Impact Factor
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ABSTRACT: We propose that hypoalbuminemia in preeclampsia is the result of reduced hepatic blood flow which is secondary to hypovolemia created by higher filtration pressure in the capillaries. Thus, hypoalbuminemia can be identified as an early sign in developing preeclampsia. We reviewed the medical records of 60 patients, aged 22-28, admitted with a diagnosis of preeclampsia during the third trimester of pregnancy. Normotensive patients served as a control group. Albumin levels were correlated with severity of the disorder. Levels between 3.0-3.5 g/dl were seen in both groups. All patients with severe preeclampsia had values below 3.0 gm/dl. Serum albumin levels may serve as an indicator of the severity of preeclampsia.
Clinical and experimental obstetrics & gynecology 02/2004; 31(3):209-10. · 0.43 Impact Factor
