Successful Myomectomy during Cesarean Section: Case Report & Literature Review.

Myomectomy is the most common surgery with cesarean section. There is controversy between obstetricians about doing myomectomy with cesarean section. A 29 years old primigravida patient presented with a large lower segment myoma (20 cm.

Risk factors and clinical aspects of recurrent invasive cervical carcinoma.

Objectives: Recurrence of cervical cancer is one of the important and plausible discussions in oncology especially in patients with advanced stages. The purpose of this study was to introduce probability invasive cervical carcinoma recurrence as well as determining characteristics and the prognostic factors of this entity.

Methods: A retrospective study was designed to identify risk factors and pattern of uterine cervical carcinoma recurrence evaluating the outcome of 36 registered patients.

The WHO score predicts treatment outcome in low risk gestational trophoblastic neoplasia patients treated with weekly intramuscular methotrexate.

Background: Gestational trophoblastic neoplasia (GTN) includes a spectrum of disease ranging from hydatidifrom mole to choriocarcinoma. Low risk GTN is defined as persistent molar pregnancy with a WHO score lower than seven. The optimal chemotherapeutic regimen still remains controversial.

Fertility sparing treatments in young patients with gynecological cancers: Iranian experience and literature review.

With increase in the marriage age some women experience gynecological cancers before giving birth. Thus fertility sparing in these patients is an important point and much work has been done on conservative management. We here report our experience on fertility sparing with cervical, endometrial and ovarian cancers and include a review of the literature.

Low grade endometrial stromal sarcoma of uterine: review of 17 cases.

Endometrial stromal sarcomas (ESS) are the second most common uterine sarcomas. Endometrial stromal sarcomas account for 0.25% of all uterine malignancies.

Major surgeries performed for gestational trophoblastic neoplasms in a teaching hospital in Tehran, Iran.

Objective: This study aim was to evaluate indications and outcomes of surgical interventions performed in patients with gestational trophoblastic neoplasm.

Methods: During January 1995 to December 2005, 110 patients with a diagnosis of persistent gestational trophoblastic neoplasm were treated in our Gynecologic Oncologic Department. Risk score calculation was carried out based on the revised FIGO 2000 scoring system for gestational trophoblastic neoplasm.

Assessment of gross examination and frozen section of uterine specimen in endometrial cancer patients.

Purpose: The accuracy of intra-operative gross visual examination of myometrial invasion of uterine specimen has been evaluated in several studies with controversial results. The intra-operative frozen section (IFS) analysis is used to identify patients at high risk for pelvic and para-aortic nodal metastasis in order to avoid lymphadenectomy in low-risk patients. However, there is still some controversy concerning the efficiency of IFS.

Can primary optimal cytoreduction be predicted in advanced epithelial ovarian cancer preoperatively?

Introduction: Prediction of optimal cytoreduction in patients with advanced epithelial ovarian caner preoperatively.

Methods: Patients with advanced epithelial ovarian cancer who underwent surgery for the first time from Jan. to June 2008 at gynecologic oncology ward of TUMS (Tehran University of Medical Sciences) were eligible for this study.

A favorable maternal and neonatal outcome following chemotherapy with etoposide, bleomycin, and cisplatin for management of grade 3 immature teratoma of the ovary.

Ovarian cancer rarely complicates pregnancy. Usually these malignancies consist of germ cell tumors. Preserving maternal safety along with favorable neonatal outcome is a subject of debate in the management of ovarian cancer during pregnancy.

Immediate grafting of transected obturator nerve during radical hysterectomy.

Background: Intraoperative injury of obturator nerve has rarely been reported in patients with gynecological malignancies who undergo extensive radical surgeries. Irreversible damage of this nerve causes thigh paresthesia and claudication. Intraoperative repair may be done by end to end anastomosis or grafting when achieving tension-free anastomosis is not possible.

Clinical outcome of Iranian patients with advanced ovarian cancer with neoadjuvant chemotherapy versus primary debulking surgery.

Objective: The aim of this study is to evaluate the results of neoadjuvant chemotherapy (NACT) and the impact of interval debulking surgery (IDS) on clinical outcomes of patients with advanced-stage ovarian cancer.

Methods: We performed a retrospective analysis on 92 patients with advanced ovarian cancer admitted to Vali-Asr Gynecologic oncology departments during 1996-2002. Comparison was made with results of neoadjuvant chemotherapy of 24 patients with unresectable advanced epithelial ovarian cancer treated with platinum- based NACT followed by IDS and clinical outcomes of 68 consecutive stage III and IV ovarian cancer patients treated with primary cytoreduction followed by platinum-based adjuvant chemotherapy.

Uterine sarcoma: clinicopathological characteristics, treatment and outcome in Iran.

Objective: Uterine sarcomas are rare and heterogeneous tumors with histopathological diversity characterized by rapid clinical progression and a poor prognosis. The aim of this study was to investigate clinical and histopathological characteristics together with treatment and outcome of Iranian patients with uterine sarcomas.

Materials And Methods: Records of 57 patients with histologically verified uterine sarcoma treated at the Vali-e-Asr Hospital were reviewed (1999-2004).

Nondysgerminomatous ovarian tumors: clinical characteristics, treatment, and outcome. A case-controlled study.

Objective: The aim of this study is to assess the response of patients with nondysgerminomatous ovarian germ-cell tumors (NDOGCT) to platinum-based chemotherapy and to determine association of prognostic factors to relapse of disease.

Methods: We retrospectively reviewed 21 patients who had surgical resection of nondysgerminomatous ovarian germ-cell tumors (NDOGCT) and received adjuvant chemotherapy in Vali-e-Asr Hospital, Tehran, Iran during 1997-2004. The median age at presentation was 18 years and the median follow-up was 20 months.

Results of cervical cone excision biopsy in iran.

Aims: The prevalence of cervical cancer in a developing country, and diagnostic therapeutic value of knife conization for CIN, indications, cytopathologic results and complications of conization, were evaluated.

Methods: This retrospective- descriptive study concerned 44 cases that underwent conization.

Results: The age range of patients was 18-75 (mean=43), and parity ranges were from 0-10 (mean 4-5), ten cases were post-menopausal.

Lower genital tract rhabdomyosarcoma: case series and literature review.

Objective: Rhabdomyosarcoma (RMS) of the lower genital tract is a rare tumor. It tends to occur in childhood in the vagina and in rare cases, RMS can originate in the uterine cervix, with a peak incidence in the 2nd decade.

Methods: A hospital-based tumor registry was searched to find all patients with female genital tract RMS, which were treated between 1999 and 2004.

Major labiaectomy as surgical management of vulvar lymphangioma circumscriptum: three cases and a review of the literature.

Background: Vulvar lymphangioma circumscriptum (LC) is a developmental defect of lymphatics in deep dermal and subcutaneous layers. The entity may be acquired that induced by surgical intervention and radiation therapy for malignancy or congenital. Lymphangiomas of the vulva are rare.

Radical hysterectomy in the elderly.

Background: The considerable increase in life expectancy on one hand and an increase in cervical cancer among Iranian patients on the other, brings out the importance of investigating whether radical surgery can be performed safely and effectively on patients above 60 years of age.

Methods: In a study of historical cohort, all 22 patients 60 years and above who have undergone a Wertheim radical hysterectomy for cervical cancer from 1999 to 2005 were compared with 128 matched cases under 60 years of age who had undergone a Wertheim hysterectomy during the same calendar year. All patients were analyzed for preexisting medical comorbidities, length of postoperative stay, morbidity, and postoperative mortality.

Surgical management of primary vulvar lymphangioma circumscriptum and postradiation: case series and review of literature.

Vulvar lymphangioma circumscriptum is a defect of lymphatics in the reticular dermis. It can occur as either acquired-induced by radical hysterectomy and pelvic radiation for cervical cancer-or congenital. Lymphangiomas of the vulva are rare.

Early onset of metastatic gestational trophoblastic disease after full-term pregnancy.

Choriocarcinoma is a curable malignancy that occurred approximately 50% after term pregnancies, and prognosis in this form of gestational trophoblastic Disease (GTD) is Poor. The earliest onset choriocarcinoma after term pregnancy in one study was reported 3 weeks after delivery, but in current study, choriocarcinoma was diagnosed 2 weeks after delivery. 28 years-old women gravidity 2, parity 2 delivered a healthy infant at term.

Assessment of the response to chemotherapy in gestational trophoblastic neoplasia with vaginal metastases.

Background And Goals: This study is designed to survey gestational trophoblastic neoplasia with vaginal metastases (GTN + VM) manifestations, prognosis and chemotherapy response in order to consider appropriate chemotherapy regimen for these patients. There have been just a few studies about treatment of GTN + VM.

Materials And Methods: Patients with Stage III GTN with or without vaginal metastases who had referred to Vali-e-Asr Hospital during 1996-2006 have been selected to take part in this study and the size of metastases was measured.

Intraoperative frozen sections for assessment of female cancers.

Frozen sections offer an important and helpful adjunct to intraoperative diagnosis and its use has greatly impacted on the care of gynecological oncology patients. Frozen section diagnosis is a reliable method for surgical management of gynecology oncology patients. Sensitivity of frozen section is acceptable and its specificity is almost perfect.

Ovarian carcinoma associated with pregnancy: a clinicopathologic analysis of 23 cases and review of the literature.

Background: The aim of this study was to analyze and describe cases of ovarian cancer in pregnant women treated at our center and to review the literature concerned, and to discuss the rationale for therapy.

Methods: Twenty-Three patients of ovarian malignancies during pregnancy were treated at Vali- Asr Hospital between 1991 and 2002. Data on treatment and follow-up were evaluated.

Female genital warts.

Genital warts are a clinical manifestation of HPV types 6 and 11, and are estimated to affect 1% of sexually active adults aged between 15 and 49. HPV leading to a broad spectrum of human diseases, ranging from benign warts to malignant neoplasms, depending on the location of the lesion, the immune status of the patient and the type of HPV. Current therapies for human papillomavirus-associated disease are based on the excision or ablation of involved tissue and are associated with a high frequency of recurrent disease, discomfort and costs.

Patients with presenting unusual manifestations with gestational trophoblastic neoplasm: case series and review of literatures.

Early recognition of gestational trophoblastic neoplasms (GTN) will maximize the chances of cure with chemotherapy but some patients present with many different symptoms months or even years after the causative pregnancy making diagnosis difficult. Clinicians should be aware of the possibility of GTN in any reproductive age woman with bizarre central nervous system symptoms, gastrointestinal symptoms or radiographic evidence of metastatic tumor of unknown primary origin. We reported two cases of metastatic gestational trophoblastic neoplasms with bizarre pulmonary symptoms, one patient with small bowel metastasis, and two patients with brain metastasis presenting with unusual manifestations.

Giant vulvar lymphangioma circumscriptum mimicking vulvar tumor: a case report and literature review.

Background: Lymphangioma circumscriptum (LC) is a benign dilation of lymph channels localized to the skin and subcutaneous tissues. Primary vulvar involvement is very rare, with only 34 cases reported.

Case: A 17-year-old girl presented with pain and an 18-cm mass of the right labium majus that started 4 years earlier.