rare case of bilateral ectopic pregnancy and differential diagnosis of gestational trophoblastic disease

Bilateral ectopic pregnancy is a rare condition and is divided in two subgroups, primary and secondary, based on history of assisted reproductive technology. Case Presentation: A 30 year old primigravid woman with history of infertility and ovulation induction presented to a hospital in Kashan in year 2013. She had vaginal bleeding, abdominal pain and ultrasound findings suggested early pregnancy. Due to high titer of beta -HCG, gestational trophoblastic disease was proposed and DandC was done in referral and admission to gynecooncology ward in Tehran. Repeat sonography suggested ectopic pregnancy in left side and repeat beta -HCG level showed an increase of 19435 mIU/ml. Laparotomy findings revealed bilateral ampullary ectopic pregnancy. Bilateral salpingostomy followed by one course of methotrexate was prescribed. Bilateral ectopic gestation should be considered as a rare differential diagnosis for ectopic pregnancy. In this study, bigger size and rupture in left side was observed

Comparison of age- standard incidence rate trends of gynecologic and breast cancer in Iran and other countries

Female cancer, especially breast and gynecologic cancers are considered multistage disease, highly influenced by risk and protective factors and/or screening preventive modalities. Consequences of all these factors result in the trend of change over time. In this comparative study, based on data of national cancer registry of Iran 2004 published by Iranian Ministry of Health, age - standard incidence rate [ASR] according to the world population was calculated in all reported gynecologic and breast cancers. Source of all subjects are pathologic based. In the next step, the calculated ASR of Iran and those of the other countries in 2004 were compared to GLOBOCAN ASR reports of 2008. In Iran ASR of breast cancer 2004 [24.93] changed to 18.4 in 2008. Ovarian cancer ASR of 2004, 3.07 was 3.1 in 2008. Endometrial cancer ASR in 2004 [2.29] was 1.7 in 2008. Cervical cancer ASR of 1.71 in 2004 was 2.2 in 2008. In Iran incidence trend of breast and endometrium are decreasing in the same direction of USA and Australia. Increasing trend of ovary and cervix ASR in Iran is in the inverse direction of USA and Australia which are decreasing. Future studies to find out the same trend or any changes, might develop these findings and improve consequent practical decisions based on results of this study and complementary future studies

Age - specific incidence rate change at breast cancer and its different histopathologic subtypes in Iran and Western countries

The aim of the present study was to determine the frequency and age-specific incidence rate of different histopathologic subtypes of breast cancer in Iran, and compare it to neighboring and Western countries and to discuss the probable effective main factors. National data from cancer registry for 6265 female breast cancer patients were studied in 10 histopathologic groups. The most common tumor was ductal carcinoma [89%]. The peak age - specific incidence rate of breast cancer in total, and for epithelial, non-epithelial and ductal carcinomas were all 50-59 years, and it decreased in older age. It is in contrast to US SEER report which shows the incidence increases in higher age. Three main factors including younger age of Iranian patients, probable more ERN tumors and different histopathological profile of breast cancer in Iran might be considered and studied to explain different slope of breast cancer after menopause compared to other countries

Clinical osteoporosis probability scoring system: selection of menopausal women for bone densitometry screening

To formulate a clinical scoring system for evaluating people at risk of osteoporosis before ordering Bone Mass Densitometry. Eighty two probable clinical osteoporosis related factors were checked in 325 females referred for Bone Mass Densitometry testing in Hamadan province, Iran. The statistical modeling resulted in a clinical osteoporosis probability [COP] scoring system based on 9 factors including: fracture history, drug therapy with thyroid hormone, corticosteroids, estrogen, ca-VitD, number of children, age, BMI and the number of menopausal years. Osteoporosis was found in 62.2%. The osteoporosis probability scoring system cutoff value of 26.8 was selected with 89% sensitivity, 63% specificity, Youden factor of 0.53 and LR=2.4. In this score, osteoporosis probability was 98%. Area under the curve in Roc curve of osteoporosis probability scoring system was 81.4%. Clinical Osteoporosis Probability scoring system with a 26.8 cutoff value is suggested for osteoporosis prescreening using Bone Mass Densitometry test

Crude and age-specific incidence rate patterns for histopathologic subtypes of ovarian cancer in Iran

The purpose of this study was to report age-specific incidence rates of histopathological subtypes of ovarian cancer in Iran. Data published by the pathology-based Cancer Registry, Iranian Ministry of Health and Medical Education for the year 2004, was utilized. This study included 793 new ovarian cancer cases which were analyzed by SPSS software [version 13]. There were 45 different histologies reported in 793 new cases which were categorized into ten major groups. Epithelial tumors displayed the highest age specific incidence rate, followed by germ cell tumors. Serous epithelial tumors were the most common in the epithelial group. The age-specific incidence rate of ovarian cancer varies based on histolo

Review of gray-scale ultrasonographic findings: a valuable guide to suspect adnexal torsion

To report preoperative gray-scale sonographic characteristics of adnexal Torsion. In a retrospective multi-centric study in 20 hospitals, 148 out of 3303 adnexal mass operations, proved histopathologically as Adnexal Torsion, were reviewed regarding age, involved side and gray-scale abdominal sonographic findings. Torsion occurred in 5% of benign adnexal surgeries. Mean age was 29 [SD=12], Mean mass diameter was 9 cm and they mostly revealed a cystic pattern [84%]. Free peritoneal fluid was seen in 29%. Right-sided involvement was shown in 62%. Gray-scale sonographic findings are valuable besides clinical findings to suspect adnexal Torsion