Practice guidelines for management of uterine corpus cancer in Korea: a Korean Society of Gynecologic Oncology Consensus Statement / 부인종양

Clinical practice guidelines for gynecologic cancers have been developed by many organizations. Although these guidelines have much in common in terms of the practice of standard of care for uterine corpus cancer, practice guidelines that reflect the characteristics of patients and healthcare and insurance systems are needed for each country. The Korean Society of Gynecologic Oncology (KSGO) published the first edition of practice guidelines for gynecologic cancer treatment in late 2006; the second edition was released in July 2010 as an evidence-based recommendation. The Guidelines Revision Committee was established in 2015 and decided to produce the third edition of the guidelines as an advanced form based on evidence-based medicine, considering up-to-date clinical trials and abundant qualified Korean data. These guidelines cover screening, surgery, adjuvant treatment, and advanced and recurrent disease with respect to endometrial carcinoma and uterine sarcoma. The committee members and many gynecologic oncologists derived key questions from the discussion, and a number of relevant scientific literatures were reviewed in advance. Recommendations for each specific question were developed by the consensus conference, and they are summarized here, together with other details. The objective of these practice guidelines is to establish standard policies on issues in clinical areas related to the management of uterine corpus cancer based on the findings in published papers to date and the consensus of experts as a KSGO Consensus Statement.

Pelvic actinomycosis with hydronephrosis and colon stricture simulating an advanced ovarian cancer / 부인종양

Pelvic actinomycosis is an uncommon disease in humans. It has nonspecific and variable clinical features, and thus it is difficult to diagnose. Moreover, appropriate management is delayed or overlooked because it can sometimes simulate advanced ovarian cancer. We report a case of pelvic actinomycosis which manifested with hydronephrosis and bowel stricture, lymph node enlargement and increased level of tumor marker caused by a large pelvic mass. Since this case showed clinical findings mimicking an advanced ovarian carcinoma, it was surgically diagnosed as actinomycosis after neoadjuvant chemotherapy.

A Case of Retroperitoneal Liposarcoma Presenting as Pelvic Mass / 대한산부인과학회지

Liposarcoma is the most common soft tissue sarcoma in adults and accounts for 9.8% to 16% in all soft tissue sarcomas. The common sites include limbs, buttocks, and retroperitoneum, et al. The early diagnosis of retroperitoneal liposarcoma may be difficult because of due to the late onset of symptoms and the tumors are frequently noted in a large size with the involvement of adjacent structures. Surgical therapy remains the most effective modality for the treatment of retroperitoneal liposarcoma. But, complete surgical resection of these tumors is often challenging and, at times, may be impossible. So, adjuvant radiation therapy is necessary for the improvement of prognosis in many cases. We report a case of retroperitoneal liposarcoma which was treated with complete surgical resection followed by adjuvant radiation therapy.

A Case of Vaginal Angiomyofibroblastoma / 대한산부인과학회지

Angiomyofibroblastoma is an uncommon mesenchymal tumor and was first described by Fletcher as a well-circumscribed, benign subcutaneous vulvovaginal tumor. The tumor occurs mainly, but not exclusively, in the vulva of premenopausal women. It can also arise in other sites such as perineum, inguinal area, fallopian tube, vaginal portion of cervix and vagina in females and scrotum in males. The importance of this entity is related to its potential mimicry of a more infiltrative and prognostically less favorable lesion found in the same anatomic area, namely aggressive angiomyxoma. The occurrence of angiomyofibroblastoma is uncommon and its vaginal presentation is exceedingly rare. We experienced a case of vaginal angiomyofibroblastoma in a 50-year-old female and present it with a review of literatures.

A Case of Early Fetal Testicular Regression Syndrome / 대한산부인과학회지

A 29-year-old phenotypic female with 46,XY genotype presented with primary amenorrhea, no breast development, no axillary hair, no pubic hair, and clitomegaly. The vagina was blind pouch. The vagina and urethra shared same outlet. Plasma follicle-stimulating hormone (FSH) was in the normal range for female subject. Plasma luteinizing-hormone (LH) and testosterone were elevated. Plasma estradiol (E2) level was markedly low. At laparoscopy, no uterus, only vestigial remnants of fallopian tube was seen and very small streak gonad was found. According to the pathologic report, they were remnant of Mullerian duct and salpinx ("right adnexa") and streak gonad with vas deference ("left adnexa"). On the basis of the clinical, genotypic, and endocrine feature, the patient was diagnosed as testicular regression syndrome. We present it with brief review of literature.

The Influence of Embryo Transfer Catheter on the Outcome of In Vitro Fertilization and Embryo Transfer / 대한산부인과학회잡지

OBJECTIVE: To compare the efficacy of two different embryo transfer catheters, Norfolk and Wallace, in terms of the outcome of in vitro fertilization and embryo trabsfer (IVF-ET). METHODS: One hundred and seventy-one IVF-ET cycles performed in 132 infertile couples were included in this retrospective study. The couples were subjected to two different embryo transfer catheter types: Norfolk catheter group (92 cycles) and Wallace catheter group (79 cycles). Controlled ovarian hyperstimulation (COH) was performed using step-down protocol with GnRH agonist or antagonist. Four or less embryos were transferred on day 2 or 3 after oocyte retrieval. The luteal phase was supported by intramuscular progesterone (Progest) or intravaginal 8% progesterone gel (Crinone). RESULTS: The pregnancy rate per ET and the implantation rate were significantly higher in Wallace catheter group, respectively (20.7% vs. 34.2%, p=0.047; 9.7% vs. 15.1%, p=0.047). No statistically significant differences were observed in the other parameters between the two groups. CONCLUSION: The Wallace catheter showed better IVF-ET outcomes when compared with the Norfolk catheter in our study. Further prospective randomized controlled studies in a larger scale will be necessary to confirm our findings.