Acoustic streaming for assessing adnexal cysts / 대한산부인과학회지

OBJECTIVE: Acoustic streaming is movement of fluid or air due to a sound field. It is caused by a transfer of momentum form sound waves, and results in movement in the direction of wave propagation. While acoustic streaming has previously been noted in breast cyst fluid, the lateral ventricle of a premature infant and in blood, there has been very little evaluation of its clinical role. the purpose of this study was to determine whether acoustic streaming has clinical value in the differentiation between various ovarian and adnexal cysts. METHODS: We assessed 15 adnexal cysts, for which pathological diagnosis was available, for the presence of acoustic streaming during B-mode and color mapping evaluation. Case with totally solid lesions or cysts with anechoic contents were excluded. RESULTS: Acoustic streaming was detected in 5 (33%) of the cysts. Endometrioma (N=4) did not exhibit acoustic streaming in any case (P=0.004), while of the remaining 11 cysts 5 exhibited acoustic streaming. Dermoid cysts exhibited acoustic streaming in one of five (20%) cases. In addition acoustic streaming was noted in three of four (75%) mucinous cystadenoma, zero of one (0%) function cyst, one of one (100%) struma ovarii. CONCLUSION: Acoustic streaming is the first sonographic feature that may be able to exclude endometrioma as a possible diagnosis for an adnexal cysts.

Two Cases of Primary Ovarian Transitional Cell Carcinoma / 대한산부인과학회잡지

Primary ovarian transitional cell carcinoma (TCC) is extremely rare tumor and recently it has been recognized as one of histologic subtype of ovarian epithelial carcinomas. Primary ovarian TCC has been classified as a different subtype from malignant Brenner tumor for it's histologic and clinical characteristics. Several recent studies repoert immunohistochemical stains are helpful to differentiate this tumor from TCC of bladder. Primary ovarian TCC usually presents at an advanced stage and behaves aggressively however, these tumors appear to be more sensitive to chemotherapy than other ovarian carcinomas and may have a better prognosis. We experienced two cases where operation and chemotherapy have made for primary ovarian TCC patients and report our own case studies with a brief literature review.

A Case of Malignant Mixed Mullerian Tumor of the Uterus with Neuroendocrine Differentiation / 대한산부인과학회잡지

Malignant mixed mullerian tumor (MMMT) of the uterus are uncommon tumor and highly malignant containing epithelial and stromal components which is classified as homologous or heterologous based on the nature of sarcomatous component. It is highly malignant and the prognosis is poor due to frequent metastasis and recurrence, which most patients were associated with postmenopausal status. We experienced one case of malignant mixed mullerian tumor of uterus with neuroendocrine differenciation. So we report this case with a brief review of literature.

A Clinical Study of Peritoneal Inclusion Cysts / 대한산부인과학회잡지

OBJECTIVE: The aim of this study is to review 6 years' experience of peritoneal inclusion cysts at our hospital. METHODS: A retrospective study of 13 cases of peritoneal inclusion cysts between Jan. 1, 1996 and Dec. 31, 2001 was carried out and then clinical feature, radiologic finding, and treatment method were compared with previous reports. RESULTS: Most of patients were premenopausal. Chief complaints were lower abdominal pain or palpable abdominal mass, and so forth. The majority of patients had history of lapalotomy. Peritoneal inclusion cyst was diagnosed by ultrasonogrphy and CT. Most specific finding is that normal ovary is seen in the cysts. In the past, operation was the main treatment method. Recently sclerotherapy was introduced and available. CONCLUSION: Because peritoneal inclusion cyst is benign and uncommon disease, it had not been interesting part. So, preoperative diagnosis rate was low and surgical resection was main treatment method. Preoperative diagnosis rate has been higher after it's clinical feature and specific radiologic findings were reported. Recently, conservative treatment may substitute for operation.