An asymptomatic ovarian steroid cell tumor with complete cystic morphology: A case report

Steroid cell tumors of the ovary are extremely rare, accounting for only 0.1% of all ovarian tumors. Of these, steroid cell tumors, not otherwise specified (NOS) constitute about 56% of all steroid cell tumors. Most steroid cell tumors secrete steroid hormones, and only about 10% to 15% of patients are asymptomatic. The morphology of steroid cell tumors, NOS is predominantly reported to be solid, and a review of case reports from 1979 until now revealed only 5 cases that were mainly cystic tumors. The present case, in a patient who had undergone a previous hysterectomy and surgery for a peritoneal inclusion cyst, is reported due to its rarity and its unusual presentation, together with a brief review of the literature. The tumor showed no clinical signs and symptoms typical of a steroid hormone secreting tumor and had an atypical morphology, being primarily multi-septate cystic with a minor solid portion.

Mature cystic teratoma in a 5-year-old girl presenting as urinary frequency: A case report / 대한산부인과학회지

Ovarian tumors are rare in children. Their incidence is estimated to be about 2.6 cases per 100,000 girls per year. About 1/3 of all childhood ovarian tumors are reported to be malignant. Germ cell tumors are more frequent than epithelial and sex cord stromal tumors in children and teratoma is the most common germ cell tumor occurring in children. In most cases, the presenting symptoms in childhood included abdominal pain, an abdominal mass, abdominal distention and so on. These non-specific symptoms and low incidence lead to suspicions of more common diseases, so the diagnosis of ovarian masses in childhood is difficult. We experienced a rare case of mature cystic teratoma in a 5-year-old girl with urinary frequency without abdominal discomfort despite the large size. The pre-operative magnetic resonance imaging finding showed unusual characteristics, rising suspicion of malignancy. So, we present this case with a brief review of literature.

Epithelial ovarian cancer in patients under 20 years of age / 대한산부인과학회지

OBJECTIVE: Epithelial ovarian cancer is the most common cause of death due to gynecologic malignancies in adults, but is rare in children and adolescents. This is a report of series of such patients under 20 years of age documenting their presentation, histologic type, stage of disease, treatment, and outcome. METHODS: We collected data on 21 patients with epithelial ovarian cancer under 20 years of age between January 1990 and December 2005. Patient records and pathology were reviewed. RESULTS: Epithelial ovarian cancer under 20 years of age was 2.2% in overall ovarian cancer. Epithelial ovarian cancer was 42.0% among 50 patients under 20 years of age and the most common histologic type was germ cell tumors (54%). The median age at the time of diagnosis was 17.6 years (range, 13-20 years), and the median follow-up was 87 months (range, 4-175 months). There were seventeen (81.0%) mucinous tumors, four (19.0%) serous tumors. About thirty-eight percent were low malignant potential or borderline tumors. About Eighty-five percent (18 patients) of tumors were stage I disease and about fourteen percent (3 patients) were stage III disease at the time of diagnosis. Surgical treatment included conservative surgery in 18 patients (85.7%), total abdominal hysterectomy and bilateral salpingo- oophorectomy in 3 patients (14.3%). CONCLUSION: Epithelial ovarian cancers are rare in patients in children and adolescents. The majority of ovarian cancers in this age group are mucinous tumors, stage I at diagnosis and borderline ovarian tumor. Conservative management is feasible to achieve preservation of fertility.

A case of uterine angioleiomyoma causing severe anemia / 대한산부인과학회지

Angioleiomyoma is a benign mesenchymal neoplasm composed of smooth muscle cells and thick-walled vessels. It usually originates in the extremities or the head. Thus angioleiomyoma of the uterus is a very rare so that there were only 10 cases in the available English literature. Angioleiomyoma cause no serious problems with regard to diagnosis and are simply recognized as benign leiomyomas. These tumors happen to be found only after the surgery through histologic findings. It is therefore extremely difficult to diagnose angioleiomyoma by its shape through preoperative sonography test. We experienced a case of angioleiomyoma with massive vaginal bleeding causing severe anemia which seemed as a benign leiomyoma before the surgery. Hence, we report this case with a brief review of literature.

Malignant gestational trophobalstic tumor with markedly elevated serum hCG levels and negative urine hCG level / 대한산부인과학회지

Gestational trophoblastic disease comprises a spectrum of interrelated conditions originating from the placenta. Malignant gestational trophoblastic disease refers to lesions that have the potential for local invasion and metastasis. This compromises many histological entities including hydatidiform moles, invasive moles, gestational choriocarcinomas, and placental site trophoblastic tumors. Before the advent of sensitive assays for human chorionic gonadotropin (hCG) and efficacious chemotherapy, the morbidity and mortality from gestational trophoblastic disease were substantial. Currently, with sensitive quantitative assays for beta-hCG and current approaches to chemotherapy, most women with malignant trophoblastic disease can be cured. We present a case of malignant gestational trophobalstic tumor with serum beta-hCG concentration over 1million IU/L that metastaze to the lungs and have a hyperthyroidism, but negative urine hCG testing. We report a case with a brief review of literatures.

A case of treatment of cervical adenocarcinoma associated with pregnancy by zinc-citrate compound (SeLava(R)) / 대한산부인과학회지

Cervical carcinoma is the second leading cause of death from cancer in women worldwide. It is well known that human papillomaviruses (HPVs) is the etiologic agent of cervical neoplasia and cervical cancer. Zinc has been shown to inhibit the growth of malignant cell lines by inducing apoptosis and cell cycle arrest. Recently it was reported that zinc-citrate compound (CIZAR(R)) has a cytotoxic effect on choriocarcinoma cell line and ovarian adenocarcinoma cell line and suppresses its proliferation inducing apoptosis. CIZAR(R) prevents the proliferation by inactivation of m-aconitase activity and induces apoptosis by increasing Bax expression and reducing Bcl-2 expression and inactivation of telomerase. We report one patient of cervical adenocarcinoma with HPV infection, who desires to continue pregnancy, treated by daily topical application of SeLava(R) which contains zinc-citrate compound (CIZAR(R)). We followed up the cytologic, pathologic and coloposcopic changes of healing process.

Misplaced IUD / 대한산부인과학회잡지

Intrauterine device is one of the most used contraception in the world. One of the major complications of intrauterine contraception is perforation through the uterine wall into the pelvic or abdominal cavity. The currently accepted treatment of choice for displaced IUD is its removal of surgical laparoscopy or laparotomy. We report on three cases with misplaced IUD in pelvic or abdominal cavity, followed by a review of the literature.

Anti-tumor Effects of Epigallocatechin-3-gallate Extracted from Green Tea on Ovarian Cancer Cell Lines / 대한산부인과학회잡지

OBJECTIVE: A constituent of green tea, (-)-epigallocatechin-3-gallate (EGCG), has been known to possess anti-diabetes, anti-hypertension and anti-cancer properties. In this study, we investigated the anticancer effects of EGCG on human ovarian cancer cell lines. The growth inhibitory mechanism(s) and regulation of cell cycle-related proteins by EGCG were also evaluated. METHODS: To carry out cell counting assay to observe the anti-proliferative effects, we treated 25, 50, and 100 uM EGCG to both ovarian cancer cell lines SKOV-3 and OVCAR-3, respectively. Also, we treated EGCG to PA-1 cells with 6.25, 12.5 and 25 uM, respectively. Six days later, we examined the characteristics of apoptosis and changes in cell cycle regulation by cell counting assay, Annexin V-FITC staining and DNA fragmentation assay, and FACS analysis. In addition, protein and gene expression patterns in SKOV-3 cell were investigated by using cell cycle cDNA chip, RT-PCR, and Western blot analyses. RESULTS: Inhibition of cell growth by cell counts showed in SKOV-3 cells with 48.8%, 82.5%, 99.2% after six days of the treatment with 25, 50, 100 uM of EGCG, respectively. OVCAR-3 cells showed 53.9%, 84.8%, and 97.7% growth inhibition patterns. And PA-1 cells showed 17.1%, 48.4%, and 74.1%, as compared to control. When SKOV-3 cells were tested for EGCG-induced apoptosis, apoptotic cells were observed with 8.6, 11.4, and 23.3-fold at 25, 50, 100 uM EGCG, respectively. And PA-1 cells showed 1.7, 2.4, and 4.2-fold, as compared to control. In contrast, OVCAR-3 did not show EGCG-induced apoptosis. When SKOV-3 cells were tested for their gene expression using cell cycle cDNA chip after treatment with 24.5 uM of EGCG, up-regulations of p21, Bax and cyclin G were shown, while down-regulations of CDK6, E2F-4, and cyclin A were shown. In Western blot assay, up-regulations of Bax and p21 proteins were shown, while down- regulations of cyclin D1, Bcl-XL, Rb, CDK2, E2F-1, E2F-4, PCNA proteins were shown. CONCLUSION: These data support that EGCG can inhibit ovarian cancer cell growth through induction of apoptosis and cell cycle arrest as well as regulation of gene and protein expressions. Thus, EGCG likely provides an additional option for a new and potential drug approach for ovarian cancer.

Misplaced IUD / 대한산부인과학회잡지

OBJECTIVE: To study intrauterine or extrauterine misplacement of intrauterine devices in respect to their usage in diagnosis and therapy via retrospective analysis. METHODS: Data from 1993 to 2000 on a total of 32 patients from seven Catholic University branch hospitals who had been admitted to treat IUDs which had misplaced to intrauterine or extrauterine locations were analyzed for usage in a retrospective study. RESULTS: The data for intrauterine and extrauterine misplacement revealed no significant difference between from the statistical average in relation to age, parity and duration of insertion. In terms of removal method, all 15 patients with extrauterine misplacement underwent surgical extraction by open or laparascopic method under general anesthesia, but those patients with intrauterine misplacement had their device removed after cervical dilatation with a laminaria using local anesthesia. Concerning diagnosis, 81.2% of extrauterine misplacement were diagnosed using x-ray while 58% of intrauterine misplacement were diagnosed using vaginal US. The result of the Fisher's exact test showed a significant difference (p=0.043) in the rate of diagnosis for intrauterine and extrauterine misplacement of IUDs. Also, the results of multi-variable analysis performed for logistical regression analysis showed that intrauterine misplacement occurred 1.23 times more frequently than extrauterine misplacement. CONCLUSION: Further studies are required on a broader patient population, on more types of IUDs and with time variables taken into account. Despite more research, prevention of complications such as misplacement remains the most appealing situation, being influenced by such factors as technical skill of the physician inserting the IUD, appropriate duration of insertion and proper patient education.