Therapeutic effect and predictors of failure with single-dose methotrexate injection in ectopic pregnancy / 대한산부인과학회지

OBJECTIVE: To evaluate the therapeutic effect of single-dose methotrexate injection for ectopic pregnancy and determine the possible predictors of therapeutic failure. METHODS: We retrospectively reviewed 127 patients' records with methotrexate injection (50 mg/m2) for unruptured ectopic pregnancy from January 2001 to December 2006. The transvaginal sonographic findings in each case were analyzed according to the presence and size of an ectopic mass, endometrial pattern, amount of intraperitoneal fluid, presence of yolk sac and presence of pseudogestational sac. Patient's age, pretreatment beta-hCG levels and clinical symptoms were also recorded. Success of treatment was regarded only when single or another dose of methotrexate injection was needed to lower the beta-hCG levels to non-pregnant state (<5 mIU/ml). RESULTS: Of 127 patients, 65 cases (51.2%) succeeded with single-dose of methotrexate, 44 cases (34.6%) multi-dose of methotrexate, and ultimately 18 cases (14.2%) surgical procedures. Elevated pretreatment beta-hCG levels, size of an ectopic mass, trilaminar endometrial pattern, presence of yolk sac and vaginal bleeding were the main predictors of single-dose methotrexate treatment failure. CONCLUSION: Single-dose methotrexate injection was proved to be safe and effective method for ectopic pregnancy. Transvaginal sonographic findings could be important prognostic factors as well as pretreatment beta-hCG levels.

A Case of T/Natural Killer Cell Lymphoma of the Uterine Cervix / 대한산부인과학회지

Non-Hodgkin's lymphoma presented as a malignancy of the uterine cervix is exceedingly rare disease and accounts for approximately only 0.12-0.6% of extranodal lymphomas. Most reported cases were B-cell lymphomas and there is no consensus on the management and prognosis of the disease because of its extreme rarity. Primary T/natural killer (NK)-cell lymphoma arising from the uterine cervix is scarcely encountered that, in the review of literature, only 1 case has been reported by Mhawech et al. We encountered a woman with T/NK-cell lymphoma involving the uterine cervix that initially presented with severe vaginal bleeding. Therefore, we report the case with a brief review of literature.