Postpartum-urinary retention. A report of two cases and a review of literature

The urinary retention is rather banal during the postpartum: 0.45 to 17.9% and now we know the main risk factors: duration of labour, epidural, episiotomy. Diagnosed on time, the postpartum-urinary retention will not have any consequence; on the other hand, a delay in care can lead to a persisting urinary retention with possible long-term urinary sequels. This article, based on two cases reports and a literature review, shows the heterogeneity in medical care of the postpartum-urinary retention.     

Gliomatosis peritonei: a report of two cases and review of the literature

Gliomatosis peritonei is the implantation of miliary glial tissue within the peritoneal cavity of patients with ovarian teratomas. Up to now 86 cases of this rare entity have been reported. In addition to the small number of reported gliomatosis peritonei cases, a condition easily mistaken for peritoneal carcinomatosis, we report two further cases, one combined with endometriosis (fifth case published until now) and one without endometriosis. Both cases were followed up for more than 5.5 years. Thus, further data concerning biological behaviour and prognosis of this rare entity are made available. In addition, a review of all cases published until today is provided, thus summarising the data presently known.     

Urethral myomas: report of two cases and literature review

Leiomyomas of the bladder and urethra are extremely rare. Depending on their location and size, they can produce diverse clinical manifestations. At urethral level in particular, formed near the vaginal wall, symptoms include recurrent urinary tract infections, voiding dysfunction, foreign body sensation, heaviness and dyspareunia. We present two cases of urethral leiomyomas, one expressed during pregnancy, which resolved successfully with surgical resection without damage to the urinary tract and no recurrence so far.     

Verrucous carcinoma of the cervix: a report of two cases and literature review

Verrucous carcinoma of the cervix, like verrucous carcinoma of the vulva, is commonly misinterpreted as condyloma accuminata, resulting in a protracted delay of appropriate treatment. Since the correct diagnosis depends upon histological criterion which frequently belies the malignant nature of this lesion, conveyance to the pathologist of the history, physical findings, and clinical behavior of the lesion may facilitate early recognition. Aggressive surgical procedures including exenteration should be considered as primary treatment for large lesions and recurrent lesions when local excision fails. Radiotherapy is not usually an effective treatment for verrucous carcinoma and may induce malignant transformation. To date, 27 cases of verrucous carcinoma of the cervix have been reported. Two additional cases managed in recent years by the authors and a review of the world's literature about this uncommon lesion form the basis of this report.     

Incomplete prepenile scrotum: report of two cases and review of literature.

An incomplete prepenile scrotum is an unusual anomaly. Two cases of incomplete prepenile scrotum are presented here, both of which are associated with a small phallus, hypospadias and a bifid scrotum. No sex chromosome disorder or hereditary factors contribute to such a disorder. Early surgical correction is recommended.     

Primary peritoneal carcinoma: a report of two cases and a review of the literature

Primary serous peritoneal carcinoma (PSPC) is rare tumor histologically identical to epithelial ovarian carcinoma (EOC); it is differentiated from EOC based on the extent of gross ovarian involvement and microscopic invasion of the cortex. When this tumor involves the extraovarian peritoneum significantly and the ovarian surface minimally or not at all, it is generally considered to be of peritoneal origin. We report macroscopical and histopathological findings of 2 cases of PPC, which were diagnosed, in our Department. Total abdominal hysterectomy, bilateral salpingo-oophorectomy and omentectomy were performed in 2 patients. PPC is a rare tumor currently managed in the same way as ovarian cancer. Primary debulking surgery and chemotherapy represent the cornerstones of treatment. Considering the limited number of patients with PPC, no definitive conclusion can be drawn concerning the prognostic factors for survival.     

Placenta percreta: report of two cases and review of the literature

Placenta percreta is a serious complication of pregnancy. Two cases of placenta percreta confirmed histologically were treated by supravaginal hysterectomy. Case 1: A case of uterine rupture secondary to placenta percreta was diagnosed in a 29-year-old term primigravida during an elective abdominal delivery of a healthy fetus. Spontaneous rupture of the primigravid uterus due to placenta percreta without a history of trauma or infection is a very rare occurrence. Case 2: A 33-year-old previously healthy G4P2 woman was admitted at 29 weeks of gestation with acute abdominal pain and hemorrhagic shock. There was a history of one induced abortion and two cesarean section deliveries. A review of risk factors, diagnostic tools and treatment possibilities are given.     

Large cell neuroendocrine cervical carcinoma: a report of two cases and review of the literature.

BACKGROUND: Large cell neuroendocrine cervical carcinoma is a rare malignancy. These tumors appear to mimic the aggressive behavior of small cell neuroendocrine tumors. Metastasis and recurrent disease are common. Due to the low incidence of these tumors, optimal therapy has not been delineated. CASES: Two patients presented with large cell neuroendocrine cervical carcinoma, stage IB1 and IIA, at our institution from 1997 to 1999. We describe the clinical course for these two patients and review the relevant literature for the management of large cell cervical carcinoma. CONCLUSION: Unlike squamous cell carcinoma, early-stage large cell neuroendocrine tumors of the cervix are aggressive. Disease recurrences are frequent and distant metastasis is common. Multimodal therapy should be considered at the time of initial diagnosis.     

Lipomatous variant of angiomyofibroblastoma: report of two cases and review of the literature.

Angiomyofibroblastoma (AMF) is a rare, benign, mesenchymal tumor occurring mainly in the female genital tract. Some cases contain scattered mature adipocytes, but the lipomatous variant in which mature adipose tissue is prominent or striking is rare. Only five cases have been reported in the English literature. We report two more such cases that were composed of 70 to 80% and 30 to 40% adipose tissue, respectively. Immunohistochemical analysis showed that the tumor cells were positive for estrogen receptor, progesterone receptor, vimentin, and Bcl-2, and negative for cytokeratin AE1/1, EMA, and CD117. Tumor cells in the first case were positive for CD34 but not desmin and muscle-specific actin. The opposite expression profile of these three markers was observed in tumor cells in the second case: positive for desmin and muscle-specific actin and negative for CD34. Rare cells were positive for S-100 in adipose-rich areas in the first case. Our findings indicate that the tumor cells in the lipomatous variant have similar immunoprofile to those of usual AMF and support the concept that the lipomatous variant probably represents an extreme end of a wide spectrum of differentiation in AMF.     

Pregnancy complicated by herpes zoster. A report of two cases and literature review

Herpes zoster during pregnancy is rare, with only 13 reported cases. Although the prognosis is usually favorable, the disease can be associated with congenital malformations. We treated two pregnant women with herpes zoster at 25 and 31 weeks of gestation. The disease was diagnosed clinically and confirmed by serology and virus isolation. Both women delivered normal infants with normal development.     

Fatty liver in pregnancy. A report of two cases and medical literature review

Acute fatty liver of pregnancy is an uncommon and potentially fatal disorder usually found in the third trimester of pregnancy and the early days postpartum. It is characterized by a micro vesicular stheatosis of the liver, which is reversible with complete regression of the disease. We present two clinical cases, in the first one the patient developed encephalopathy and hypoglycemia in her third day post cesarean section; the patient underwent surgical exploration because of a subaponeurotic hematoma and the diagnosis was confirmed by liver biopsy. The patient presented spontaneous resolution of the disease and was discharged home on her 21st day after delivery. The second case was a patient on her 37th week of pregnancy that arrived to the emergency room complaining of malaise, nausea and vomit, her laboratory analyses were remarkable hypoglycemia and hyperbilirubinemia. She underwent elective pregnancy termination with a favorable maternal and fetal outcome towards spontaneous resolution. It is critical to diagnose and treat this disease in a expedite manner in order to have a favorable maternal and fetal outcome. The mortality rate has decreased dramatically from 80% in 1965 to 100% survival in 1999 according to the latest reviews. This regression of the symptoms and signs along with normalization of the laboratory values has driven some authors to call this disease as the "reversible peripartum liver failure".     

Endometriosis associated with appendiceal intussusception. A report of two cases

While endometriosis is a commonly encountered surgical problem, involvement of the gastrointestinal tract is infrequent and appendiceal involvement rate. Intussusception of the appendix is more frequent. Accordingly, the concurrence of appendiceal endometriosis and intussusception is remarkable. We treated two such patients. The clinical presentation of these patients is varied, with most having abdominal pain, nausea and diarrhea. Asymptomatic cases may be found at surgery for unrelated problems. Correct diagnosis preoperatively is uncommon and most likely when the patients also have a palpable mass.