Aspergillosis in a 24-week newborn: a case report.

Aspergillosis is an uncommon neonatal infection, diagnosed with an increasing frequency over the last two decades. We report a premature neonate who developed aspergillosis while receiving amphotericin B and fluconazole for candidiasis. Despite early recognition and diagnosis, the infant died. We review the clinical appearance of Aspergillus species, the distinctions between primary cutaneous aspergillosis and invasive aspergillosis, and advances in diagnosis and treatment.     

Extraskeletal myxoid chondrosarcoma: a report of a gynecologic case

BACKGROUND: Extraskeletal myxoid chondrosarcoma is a rare tumor that has been reported and discussed in neurosurgical, orthopedic, and otolaryngologic literature. We report a case of vulvar extraskeletal myxoid chondrosarcoma. CASE: This is a case of a 46-year-old woman who presented with a soft tissue mass in the left vulva and underwent local excision. Grossly, the tumors appeared to be leiomyomas. Pathology revealed an extraskeletal myxoid chondrosarcoma. CONCLUSION: We report the first case of an extraskeletal myxoid chondrosarcoma arising in the vulva.     

Hidropesía fetal secundario a hemangioma cavernoso y síndrome polimalformativo

We report a case of non-immune fetal hydrops diagnosed at 32 weeks of pregnancy that ended in foetal death. Following the autopsy an unknown malformation syndrome was found together with a liver tumour that invaded the chest cavity. We analyse the possible causal association of both findings.     

Estrogen secretion from a malignant sex cord stromal tumor in a patient with complete androgen insensitivity

We report on a 68-year-old patient with complete androgen insensitivity syndrome (testicular feminization syndrome) in whom an estrogen-secreting malignant sex cord stromal tumor developed in an intraabdominal testis. We believe this to be the first such case to document estrogen secretion by the tumor.(Am J Obstet Gynecol 1997;177:1541-2.)     

Successful pregnancy in a patient with a single ventricle.

Single ventricle is an uncommon form of congenital heart disease. We report a successful pregnancy and delivery in a mother with surgically confirmed single ventricle.     

Fibroid Arising in a Mullerian Duct Remnant and Presenting as a Pelvic Mass in a Patient with Vaginal Agenesis: An Unusual Finding

EDITORIAL COMMENT: We accepted this case because of its anecdotal interest and also to stress the message that a pelvic mass in a woman with known Mullerian tract anomalies merits an intravenous pyelogram to check on the presence and positions of kidneys and ureters before laparotomy is performed to remove the tumour. The histology report of the tumour gave the reviewer a moment of anxiety when 'the duct-like structure lined by tubal epithelium' was described!
Authors reply: The authors were well aware of the risk of pelvic kidney being involved. Unfortunately an adequate IVP was unable to be obtained in this particular centre. We improvised by identifying 2 kidneys in normal position by ultrasound scan.
Summary: We report a case of vaginal agenesis associated with a large fibroid arising from a Müllerian duct remnant. Vaginal agenesis is rare and infrequently encountered by gynaecologists. Its association with a pelvic mass is even more uncommon, and a medline search by the authors has failed to uncover another reported case. We provide the clinical details of this case and discuss the differential diagnoses.     

Giant pelvic epidermoid cyst: a rare observation

Epidermoid cyst is a frequent benign tumor. It gives rise to destruction of adjoining tissues, chiefly in the skull. The pelvic epidermoid cyst is rare. We report the second case of giant pelvic epidermoid cyst with a 25-year-old girl. Ultrasound exploration and computed tomography evoked an ovarian origin. The surgery discovers an epidermoid cyst under the peritoneum. Ovaries and uterus were undamaged. We realized an evacuation of cyst, which contained lamellas of keratin. Histology allowed confirmation of diagnosis. The patient is always observed after 18 months.     

The Irving sterilization technique: a report of a failure

The Irving sterilization technique is a very reliable method of surgical contraception, with only two prior mentions of failure in the literature. We present the third case of failure of an Irving operation. A discussion on the surgical aspects of the Irving technique is also presented.     

Fetal cardiac rhabdomyoma: a sheep or a wolf?

Rhabdomyoma is the most common primary cardiac tumor identified in utero and in infancy. Usually it has a benign course, which has prompted an expectant approach to its management. We report herein the cases of three patients who presented prenatally with cardiac rhabdomyomas. Only one of them had a benign course. The other two patients provided recognizable characteristics of rhabdomyomas with an unfavorable course and demonstrated that fetal rhabdomyomas can have a fatal outcome.     

Hematocolpos associated with a remote history of chronic vaginitis and a diagnostic vaginal biopsy: a case report

Bacterial vaginitis is commonly seen in the pediatric population. Severe or recurrent cases may be associated with ulcerative lesions. We report a case of vaginal biopsies of ulcerative lesions in a 9-year-old which led to severe vaginal adhesions, stenosis, and hematocolpos. A vaginoscopy and resection from below were not successful and an exploratory laparotomy with uterine perforation and sounding into the upper vagina were required to reopen the lower vaginal canal. We recommend the limited use of vaginal biopsies in the face of a typical vaginitis presentation, and aggressive treatment to promote mucosa healing when biopsies are required.     

Intraamniotic infection with Candida albicans associated with a retained intrauterine contraceptive device: a case report

Intrauterine infection with Candida albicans is a rare occurrence in pregnancy. We report the association of an intrauterine contraceptive device with such an infection in an asymptomatic patient. This infection, discovered incidentally at the time of genetic amniocentesis for advanced maternal age, resulted in a spontaneous abortion at 18 weeks' gestation.     

Scar endometriosis after a laparotomy for uterine perforation as a complication of dilatation and curettage

Background  Ectopic endometriosis is an uncommon disease. Abdominal scar endometriosis is especially rare. Case  A 38-year-old gravid 1, para 1 woman underwent dilatation and curettage due to an intrauterine infection. During the procedure, uterine perforation occurred and an emergency laparotomy was performed to provide hemostasis and suturing. Three years later, she complained of pain and swelling at the lower end of her abdominal scar during menstruation. A biopsy of the abdominal scar demonstrated endometriosis. The patient elected to receive conservative management rather than a surgical procedure. Therefore, hormonal therapy was initiated. The hormonal therapy provided symptomatic relief and reduced the size of the lesion. Conclusion  We reported an extremely rare case of scar endometriosis after a laparotomy for a uterine perforation that occurred as a complication of dilatation and curettage. We suggest that hormonal therapy using gonadotropin-releasing hormone agonist might be an alternative to surgical treatment for ectopic endometriosis.     

Tumor de Krukenberg secundario a adenocarcinoide apendicular

Ovarian metastasis from appendiceal neoplasms are rare. We present the case of a 38-year-old woman with bilateral ovarian tumors who underwent bilateral salpingo-oophorectomy, total hysterectomy, appendectomy and omentectomy. Pathological diagnosis was Krukenberg tumor from an occult appendiceal adenocarcinoid. We also review the literature on this topic.     

Tubal schistosomiasis as a cause of ectopic pregnancy in endemic areas?; a report of three cases.

Tubal schistosomiasis as a cause of ectopic pregnancy is uncommon. We are reporting three cases of tubal pregnancies in which the histopathological examination showed a bilharzial disease of the tube. Schistosomiasis to Schistosoma haematobium occurs in Gabon with an incidence of 8% to 44% of the adult population, and schistosoma ova have been found in 2.5% of histopathological examinations in removal of any genital tissue. Even if schistosomiasis was not the main causative agent of infertility, in this population which has the lowest fertility index in subsaharan Africa, it might impair an already altered tubal function by salpingitis. We suggest that parasitic examination should be made as a part of the management program of infertility and after an ectopic pregnancy in endemic areas.     

Maternal obesity and pregnancy complications: a review

Obesity in women of reproductive age is increasing at an unprecedented rate in western societies. Maternal obesity is associated with an unequivocal increase in maternal and fetal complications of pregnancy. Excessive maternal weight gain in pregnancy also appears to be an independent risk factor, regardless of prepregnancy weight. Few guidelines exist regarding appropriate weight gain in pregnancy in obese women. We review the association of maternal obesity with pregnancy complications. We also suggest that appropriate diet and lifestyle intervention can enable women with severe prepregnancy obesity to safely achieve quite strict targets for limited weight gain in pregnancy.     

Giant bladder leiomyoma presenting as a pelvic mass: a case report

We present a rare case of bladder leiomyoma with an unusual presentation as a pelvic mass. Bladder leiomyomas are very rare tumors, compromising less than 0.43% of all bladder tumors. Magnetic resonance imaging showed a 16 x 13 cm mass covering the entire pelvis and extending up to the umbilicus. There was a 20 x 20 x 11 cm immobile mass originating from the bladder at laparotomy. The mass was removed by bladder-sparing surgery and was reported to be leiomyoma. We conclude that bladder leiomyomas should be preoperatively recognized as a cause of pelvic mass in order to make the possible diagnosis.     

Pregnancy in a gerodermia osteodysplastica patient: a case report

Gerodermia osteodysplastica is a rare autosomal recessive connective tissue disorder included in the cutis laxa syndromes. We report the first case of pregnancy in a 26-year-old patient with gerodermia osteodysplastica, which terminated in successful cesarean delivery at term. The course, management, and potential concerns of such an extraordinary pregnancy are described.     

Teflonoma presenting as a cystourethrocele

We report an unusual case of teflonoma which appeared three years after teflon injection and presented as cystourethrocele. The pathology confirmed the presence of a giant cell reaction compatible with a teflonoma.     

Endometrial carcinoma in a young woman

Summary We present an unusual case of endometrial carcinoma which developed in a 22-year-old woman shortly after pregnancy.     

Branchial-cleft sinus presenting with a retropharyngeal abscess for a newborn: a case report

A retropharyngeal abscess rarely occurs in the neonate. We report a neonate without apparent trauma who presented with a left neck mass and respiratory distress at the fourth day of age. A lateral neck X-ray revealed a widened retropharyngeal space. A neck computed tomography (CT) scan revealed a space-occupying lesion with air content in the left retropharyngeal area, although direct laryngoscopy, endoscopy, and a pharyngoesophagogram did not demonstrate the presence of any fistula tract. Due to the high index of suspicion for an aero-digestive tract fistula, diluted contrast medium was injected into the cyst while performing a CT-guided aspiration, and opacification was found in the oropharynx, thus a branchial-cleft sinus appeared to be most likely. The follow-up neck CT scan revealed no evidence of any recurrence. We suggest that CT-guided aspiration and cystography are useful for the diagnosis and treatment of some neonatal neck cystic lesions.