A case of pembrolizumab and lenvatinib as an alterntive therapy for leiomyosarcoma.

•Research surrounding treatment of leiomyosarcoma (LMS) treatment remains sparse.•Pembrolizumab/lenvatinib has been reported as a therapy for endometrial cancer, though not yet as therapy for LMS.•This report demonstrates disease regression after use of pembrolizumab and lenvatinib in a patient with recurrent LMS.

Antegrade cystoscopy - An innovative approach to managing acute urinary retention following vulvar reconstruction flap stenosis.

Vulvar reconstruction can be performed following radical vulvectomy and is known to be associated with urologic complications. We describe the use of antegrade cystoscopy to manage acute urinary retention secondary to an obliterated urethral meatus following radical vulvectomy and reconstruction for radiation dermatitis. Antegrade cystoscopy was performed by applying the surgical concepts for suprapubic catheterization and general laparoscopy.

Serous carcinoma of a prolapsed fallopian tube: A rare cause of a vaginal apex mass.

Background: The differential diagnosis for women who present with a vaginal mass after undergoing a hysterectomy is dependent on the indication, type and timing of the hysterectomy. The differential diagnosis includes cervical dysplasia, malignancy, nabothian cysts, prolapsed endocervical polyp/fibroid, abscess, hematoma, granulation tissue, or dehiscence with organ evisceration.

Case: We introduce a case of a woman who presented with a vaginal apex mass and had a remote history of a total hysterectomy for an unknown indication.

Peritoneal Sarcoidosis Mimicking Peritoneal Tuberculosis and Advanced Ovarian Carcinoma.

Sarcoidosis is an inflammatory disease that affects one or multiple organs, most commonly the lungs and lymph nodes. This disease can present in a variety of ways which often makes diagnosis difficult. A 54-year-old postmenopausal African American female with a history of omental carcinomatosis of unknown origin was referred to the gynecology-oncology service at a local community hospital following a laparoscopic incarcerated hernia repair where multiple abdominal lesions suspicious of ovarian carcinomatosis were visualized.

Ex vivo Efficacy of Anti-Cancer Drug PNC-27 in the Treatment of Patient-Derived Epithelial Ovarian Cancer.

Objective: Despite an 80% response rate to chemotherapy, epithelial ovarian cancer has the highest case fatality rate of all gynecologic malignancies. Several studies have shown the efficiency of anticancer peptides PNC-27 and PNC-28 in killing a variety of cancer cells selectively in vitro and in vivo. The purpose of this study was to evaluate the efficacy of PNC-27 against human primary epithelial ovarian cancer.

Peripartum Primary Prophylaxis Inferior Vena Cava Filter Placement in a Patient with Stage IV B-Cell Lymphoma Presenting with a Pathologic Femur Fracture.

Background Pulmonary embolus (PE) remains a leading etiology of maternal mortality in the developed world. Increasing utilization of retrievable inferior vena cava (IVC) filter placement currently includes pregnant patients. Case A 22-year-old woman at 27 weeks' gestation was diagnosed with Stage IV high-grade malignant B cell lymphoma following pathologic femur fracture.

Extent of lymph node dissection and overall survival in patients with uterine carcinosarcoma, papillary serous and endometrioid adenocarcinoma: A retrospective cohort study.

Objective: To evaluate the interaction between extent of lymph node dissection (LND) and overall survival (OS) in patients with various histologic types of uterine cancer.

Methods: We retrospectively identified 834 patients who had primary surgery in our institution for uterine carcinosarcoma (CS), papillary serous (UPSC) and endometrioid adenocarcinoma between 1984 and 2009. Stage, grade, total lymph node count (LNC), positive LNC, adjuvant therapy, age, race and OS were collected.

Survival impact of cytoreduction to microscopic disease for advanced stage cancer of the uterine corpus: a retrospective cohort study.

Objective: To assess the impact of cytoreduction to no gross residual disease (R0) on overall survival (OS) in patients with stage III-IV uterine carcinosarcoma (CS), papillary serous/clear cell (UPSC/CC) and endometrioid carcinoma (EC).

Methods: We retrospectively identified 168 patients who underwent primary surgery for advanced uterine cancer between 1984 and 2009 in two teaching hospitals in Brooklyn, New York. Histology, stage, grade, residual disease (RD), adjuvant therapy, age, race and OS were collected.

Glassy cell carcinoma of the cervix: a systematic review and meta-analysis.

Objective: The purpose of this study is to summarize the data on the incidence, clinical behavior and overall survival of patients with glassy cell cervical carcinoma (GCCC).

Methods: Twenty-four case series and fifteen case reports identified by searching PubMed database qualified for inclusion in this study. The published cases were combined with data from a retrospective chart review of patients with GCCC in two major teaching hospitals in Brooklyn, NY.

Port-site recurrence in a patient undergoing robotic hysterectomy and lymph node dissection for endometrioid adenocarcinoma of the uterus.

•We present a case of port-site recurrence of endometrioid adenocarcinoma after robotic hysterectomy and staging.•Port-site recurrence is commonly an indicator of multifocal disease with poor prognosis.•Surgical techniques that decrease the risk of this complication should be implemented.

External validation of a nomogram for predicting survival of women with uterine cancer in a cohort of African American patients.

Objective: This study aimed to externally validate a nomogram for predicting overall survival of women with uterine cancer in an African American population.

Methods: After the institutional review board approval, data from the uterine cancer database from 2 major teaching hospitals in Brooklyn, NY, were analyzed. The predicted survival for each patient was calculated with the use of the nonogram; the data were clustered in deciles and compared with the observed survival data.

Medical management of recurrent endometrioma with long-term norethindrone acetate.

Purpose: Evaluate the efficacy of norethindrone acetate in the resolution of symptoms and regression of recurrent endometrioma.

Patients And Methods: Retrospective chart review at SUNY Downstate Medical Center of patients with a history of surgical excision of endometrioma (with histological confirmation) and recurrent endometrioma (demonstrated by strict sonographic criterion of endometrioma) who were willing to undergo follow-up. Patients were prescribed norethindrone acetate to be taken daily with follow-up sonograms until cysts regressed.

Invasive recurrence of serous borderline ovarian tumor as multifocal lymphadenopathy 25 years after initial diagnosis.

► We present the case with the latest reported recurrence of low malignant potential ovarian tumor. ► Borderline ovarian tumors have the potential for delayed recurrence that is not always salvageable surgically. ► Optimization of surveillance strategies and lifelong follow up is required for these patients.

FIGO staging for carcinosarcoma: can the revised staging system predict overall survival?

Objectives: The purpose of this study is to detect differences in overall survival between the 1988 FIGO staging and current staging of uterine carcinosarcomas to determine if revised 2009 staging accurately predicts actual patient survival.

Methods: From 1988 until 2010, patients with uterine carcinosarcoma were retrospectively identified from tumor registry records. Patients were grouped in both broad stages (1-4) and all FIGO substages in order to detect differences.

Sonographic Findings of Medullary Thyroid Carcinoma Leading to Diagnosis of Multiple Endocrine Neoplasia Type 2a during Pregnancy.

Multiple endocrine neoplasia (MEN) type 2a (Sipple's syndrome) is characterized by medullary thyroid carcinoma and pheochromocytoma, and in a smaller percentage of cases, multiglandular parathyroid hyperplasia. This autosomal-dominant syndrome is due to a mutation in the rearranged during transfection (RET) proto-oncogene located on chromosome 10cen-10q11.2 and rarely complicates pregnancy.

Hydronephrosis as a prognostic indicator of survival in advanced cervix cancer.

Objective: To determine whether hydronephrosis is an independent prognostic indicator of survival among patients with advanced cervical carcinoma. Moreover, we wanted to demonstrate the relationship between unilateral and bilateral hydronephrosis and overall survival.

Methods: Retrospective analysis of 197 patients with International Federation of Gynecology and Obstetrics (FIGO) stage IIIB cervical carcinoma or higher treated between 1990 and 2007 was conducted.

Sonographic and magnetic resonance imaging findings of pelvic abscess following uterine perforation sustained during office endometrial sampling.

Pipelle endometrial sampling, an outpatient, office-based procedure, provides comparative successful endometrial sampling in comparison with other techniques including conventional dilatation and curettage. We present an unusual occurrence in which office Pipelle endometrial sampling in a perimenopausal patient was complicated 10 days later by lower abdominal pain and intermittent fever. Sonography depicted findings consistent with a large pelvic abscess overriding the uterine fundus.

Transvaginal sonography of postabortal (Redo) syndrome.

Acute hematometra, also termed the postabortal syndrome or redo syndrome, is a rare immediate complication of suction curettage characterized by severe lower abdominal cramping in association with an enlarged and markedly tender uterus. We describe the transvaginal sonographic features of this syndrome.

Gestational diabetes leading to diagnosis and management of multiple endocrine neoplasia type 2a.

Background: Multiple endocrine neoplasia (MEN) type 2a is an autosomal dominant syndrome caused by specific proto-oncogene mutations characterized by medullary carcinoma of the thyroid, pheochromocytoma, and, occasionally, multiglandular parathyroid hyperplasia, which rarely complicates pregnancy. Secondary diabetes rarely has been reported in association with principal endocrinopathies complicating pregnancy.

Case: A 34-year-old primiparous woman with recently diagnosed gestational diabetes had repeated episodes of dizziness at 30 weeks of gestation, initially attributed to glyburide.

Advanced ovarian carcinoma following bilateral uterine artery embolization: a case report.

Background: Bilateral uterine artery embolization has become an accepted therapeutic modality in the management of patients with symptomatic uterine leiomyomata. Complications of bilateral uterine artery embolization, including rare cases of malignancies, have been reported following this procedure.

Case: We present a 46-year-old woman, gravida 3, para 1, who was treated with bilateral uterine artery embolization for symptomatic uterine leiomyomata following pelvic sonography and magnetic resonance imaging, which depicted bilateral normal adnexa.