Endometrioid carcinoma of the endometrium with choriocarcinomatous differentiation: a case report and review of the literature.

Objective: An endometrioid adenocarcinoma (EAC) with true trophoblastic differentiation is a rare event with a highly aggressive clinical course.

Case: We report an endometrioid adenocarcinoma of the endometrium in which there was a morphologically conventional-appearing EAC component admixed with multinucleated giant cells and large pleomorphic tumor cells that resembled a choriocarcinoma without an elevated serum level of human chorionic gonadotropin (hCG) in a 42-year-old unmarried woman with a history of abnormal uterine bleeding. A total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection were performed.

A probable secondary infertility due to osseous metaplasia of the endometrium.

Objective: Osseous metaplasia is a rare pathological entity that affects the uterus and usually appears following abortion, chronic endometritis, metabolic disorders or following LEEP excision of the cervix.

Case: Herein, we present the occurrence of osseous metaplasia in a 27-year-old patient with a history of an abortion 2 years ago and suffering infertility.

Conclusion: We suggest that the infertility in this patient may be caused by calcification and ossification of fetal tissue retained in the uterus after abortion.

Primary peritoneal serous psammocarcinoma with recurrent disease and metastasis: a case report and review of the literature.

Background: Psammocarcinoma is a rare variant of serous carcinoma arising from either ovary or peritoneum. Although behavior of tumor is uncertain, it has been suggested to be similar to serous carcinomas of low malignant potential.

Case: A 67-year-old woman was admitted with an abnormal vaginal bleeding and abdomino-pelvic pain.

The effects of post-surgical administration of goserelin plus anastrozole compared to goserelin alone in patients with severe endometriosis: a prospective randomized trial.

Background: Among patients using GnRH analogues for endometriosis it has been postulated that peripheral and inflammation-induced in-situ aromatization of adrenal androgens are probably the main reasons for the high rates of failure during follow-up. We hypothesized that in cases with premenopausal severe endometriosis, use of a combination of anastrozole and goserelin to achieve almost maximal endocrine blockade of estrogen synthesis after conservative surgery may increase the pain-free interval and reduce the recurrence rates as compared to goserelin alone.

Methods: In a prospective randomized trial, we evaluated the efficacy of using either a combination of anastrozole and goserelin for 6 months or goserelin alone for 6 months after conservative surgery for severe endometriosis.

Laparoscopic presacral neurolysis for endometriosis-related pelvic pain.

Background: Some patients with endometriosis are candidates for sympathectomy of the superior hypogastric plexus. The objective of this paper is to describe our technique of laparoscopic presacral neurolysis for sympathectomy and to report 1 year results of the first 15 cases.

Methods: To achieve this objective in a prospective observational study of 1 year follow-up; we performed laparoscopic presacral chemical neurolysis with phenol in 15 patients with pelvic pain and minimal-moderate endometriosis.