Clinicopathological Experience on Ovarian Mass in Childhood and Adolescence / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to review the incidence, clinicopathological feature, treatment, outcome in the series of childhood and adolescence with ovarian mass PATIENTS AND METHODS: Retrospective reviews of the medical recordings for 116 patients with ovarian mass under the age of twenty years old who were admitted, operated and confirmed with histopatholgical study at the department of obstetric and gynecology, Gachon medical school, Inchon, Korea for 8 years from Jan. 1993 till Dec. 2000. RESULTS: Of 116 the patients who underwent surgical treatment, the incidence of malignant ovarian tumors was 15 cases(12.9%). If ovarian neoplasm alone are considered, the rate of malignancy increases to 17.6%. The frequency of ovarian malignancies correlated inversely with patient age. In the 0-10 age group ,40% had malignancies, as compared with 20.3% in the 11-15 age group and 15.3% in the 16-20 age group. On histopathological classification, the tumors originated from germ cell tumors were 55.2%, epithelial cell tumors were 40%, and sex-cord stromal tumors were 4.7%. According to FIGO classification of malignant ovarian tumor, stage I(80%) was most common, followed stage IV(13.3%), stage II(6.6%) and III(0%). 13 of the 15 malignant ovarian tumors, unilateral salpingoophorectomy was done in an attempt for reproductive organ conservation; 2 cases of stage IV disease were treated with hystrectomy, bilateral salpingoophorectomy and omentectomy. On follow up, only two ovarian malignancy stage IV died within 3 months and another is well. CONCLUSION: The frequency with which ovarian meoplasms malignancy in the under 20 age group is 17.6%. Because of their malignant potential in young girl, prompt evaluation and treatment is imperative.

The association between unexplained elevation of second trimester maternal serum beta-hCG and pregnancy outcomes / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to determine whether unexplained elevation of second-trimester maternal serum beta-human chorionic gonadotropin (beta-hCG) is associated with adverse pregnancy outcomes. METHOD: Between January 1998 and December 1999, we evaluated 2112 pregnant women undergoing second trimester triple marker screening test who delivered at our hospital. Inclusion criteria were singleton pregnancy, confirmed gestational age, and hCG level greater than 2.0 MoM. The exclusion criteria were fetal anomaly, abnormal karyotype, MSAFP level greater than 2.0 MoM, uE3 level less than 0.4 MoM, and referred patients with pregnancy-induced hypertension (PIH). A group of randomly selected women with normal maternal serum hCG and AFP levels served as control. RESULTS: Women with unexplained elevation of hCG level showed increased risks for PIH (p<0.001) and preterm delivery (p<0.003). There were no significant diffrences between study and control groups with respect to placental abruption, fetal distress, PROM, intrauterine fetal death, and apgar score. CONCLUSION: Pregnancies with unexplained elevation of hCG levels should be regarded as high-risk pregnancies and managed accordingly. The combination with these biomarkers such as VEGF, plasminogen activating factor I and AT-III as a screening test for PIH may be useful.

Clinical experiences of 7 cases of primary carcinoma of the fallopian tube / 대한산부인과학회잡지

OBJECTIVE: The aim of this study was to evaluate the clinical experiences of patients with the primary tubal cancer diagnosed and treated in the Department of Obstetrics and Gynecology, Gacheon Medical School from January 1996 to December 2000. METHODS: Age, symptoms, Pap smear, CA-125, preoperative diagnosis, mode of surgery, stage, additional pathologic finding, mode of adjuvant therapy and survival periods of patients were reviewed retrospectively. RESULTS: The mean age of patients was 57.4 years. The symptoms were vaginal spotting, leukorrhea and pelvic mass. Three patients were treated by simple hysterectomy and both salpingoophorectomy. Staging laparotomy was done in 4 patients. Three patients were in stage I, 2 patients were in stage II and 2 patients were in stage III. Endometrial adenocarcinoma was present in 1 patient and endometrial hyperplasia was present in 1 patient. The mean follow-up period of five patients were 25.4 months and 2 patients were lost for follow-up. Conclusions: The primary tubal cancer was rare gynecologic malignancy and the preoperative diagnosis was difficult due to non-specific symptoms and signs. Staging laparotomy and adjuvant chemotherapy should be done like in ovarian cancer. More studies may be needed for the associated endometiral diseases.