A Rare Case of Serous Cystadenofibroma in a Patient with Mayer-Rokitansky-Kuster-Hauser Syndrome

@#<p>Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is characterized by failure of embryologic growth of the mullerian ducts resulting to agenesis or hypoplasia of the uterus and upper part of the vagina while both ovaries and fallopian tubes are normal. Various associated malformation with MRKH syndrome are noted in literature, with a renal system anomaly as the most common. However, adnexal tumors in MRKH syndome are rare. To date there have been no reported cases of fallopian tube tumors in patients diagnosed with MRKH. This paper presents a case of an 18 year old nulligravida who presented with primary amenorrhea secondary to MRKH sydnrome, with an associated Papiliary Serous Cystadenofibroma of the right fallopian tube Management of the case as well as review of related literature are presented. </p>

Rectus Abdominis Endometriosis: A case report / Philippine Journal of Obstetrics and Gynecology

@#Abdominal wall endometriosis is suspected in patients who complain of cyclic tender mass within or adjacent to a caesarean section scar. Ultrasound, magnetic resonance image and computed tomography are helpful tools used to diagnose abdominal endometriosis however histologic examination is required for confirmation. The standard treatment for abdominal wall endometrioma is surgical excision. Proper surgical techniques could prevent abdominal wall endometriosis after uterine surgery. This is a case of a 30 G2P2 (2002) who presented with paraumbilical pain after 2 cesarean sections and previous excision of abdominal wall endometrioma. She underwent excision of the mass and histopath confirmed the presence of endometriosis in the rectus abdominis muscle. Abdominal wall endometrioma is often found in the subcutaneous fatty layer. Its presence in the rectus abdominis is quite rare.

Uterine didelphys with unilateral cervicovaginal agenesis: A case report

@#<p style="text-align: justify;">Unilateral cervicovaginal agenesis in a didelphic uterus is an extremely rare congenital anomaly. Women born with this anomaly present with menarche associated with progressive dysmenorrhea and symptoms of worsening endometriosis. Presented here is a case of a 12 year old nulligravid who presented with progressive cyclic abdominal pain. Physical examination revealed a tender large right adnexal mass and presence of a vaginal canal and cervix tilted to the left. Sonography showed the presence of uterine didelphys, right hematosalpinx and hematocolpos. Preoperative impression was outflow tract obstruction probably due to Herlyn Werner-Wunderlich syndrome. However, intraoperatively, it was discovered this was a case of uterine didelphys with outflow tract obstruction of the right hemiuterus due to unilateral cervicovaginal agenesis and ipsilateral renal agenesis.</p>

Polycystic ovary syndrome and its association with immune reproductive disorders: A reproductive study

@#<p style="text-align: justify;"><strong>BACKGOUND:</strong> Polycystic ovary syndrome (PCOS) is usually present with reproductive dysfunction. Ovarian function of women with polycystic ovary syndrome might be disturbed, with resultant abnormal folliculogenesis and steroidogenesis. Although it is difficult to define the exact pathogenesis of anovulation, multiple other possible abnormalities have been postulated as contributory factors in the reproductive failure.</p><p style="text-align: justify;"><strong>OBJECTIVE:</strong> The study aimed to determine the association of polycystic ovary syndrome with immune reproductive disorder.</p><p style="text-align: justify;"><strong>MATERIALS AND METHODS:</strong> The study was carried out in a private institution from October 2017 to November 2017. A total of 192 patients were included in the study with ages ranging from 19-40 years old. Review of clinical charts and laboratory results were the primary mode of data gathering. The primary outcome of the study was the presence of immune reproductive disorders among women with and without polycystic ovary syndrome. The Rotterdam criteria were used for the diagnosis of polycystic ovary syndrome and positive results of immunoassays for the five categories were used for the basis for diagnosis of the immune reproductive disorder.</p><p style="text-align: justify;"><strong>RESULTS:</strong> A total of 102 patients were included in the first group and 90 were included in the second group. Out of 102 in Group A, 66 (64.71%) tested positive for immune reproductive disorder. On the other hand, out of 90 patients in Group B, 59 (65.56%) tested positive for immune reproductive disorder. The computed relative risk is almost 1, which means that there is no difference in the risk of having immune reproductive disorder for patients with or without polycystic ovary syndrome.</p><p style="text-align: justify;"><strong>CONCLUSION:</strong> Current evidence does not support a central role of autoimmunity in the pathogenesis of PCOS.</p>

A rare case of an Isochromosome Mosaic Turner Syndrome

@#Turner syndrome is characterized by a complete or partial absence of one X chromosome. The most common karyotype is 45,X0. A variant of Turner syndrome is Isochromosome Mosaic Turner syndrome which presents with an abnormality of the chromosome structure. This is a case of a 22 year old female who presented with short neck, widely spaced nipples, low posterior hairline, absence of nose bridge, minimal axillary hair and underdeveloped breasts. Ultrasound examination showed an infantile uterus with small ovaries. Her karyotype showed an isochromosome of the long arm of the X chromosome and the remaining eight cells showed a loss of one X chromosome, resulting in monosomy X (ISCN: 46,X,i(X)(q10)[42]/45,X[8]). Hormonal evaluation showed a hypergonadotropic and hypogonadism state. Test results for auditory, ophthalmologic, cardiac and renal functions were all within normal limits. The patient was diagnosed with isochromosome mosaic Turner syndrome and started on hormonal therapy.

Idiopathic central precocious puberty: A case report / Philippine Journal of Obstetrics and Gynecology

@#<p style="text-align: justify;">Central precocious puberty is characterized by early pubertal changes, acceleration of growth velocity, and rapid bone maturation. It is a relatively rare disorder, with an incidence rate of about 1:5000-1:10000 individuals in the general population; it is more frequent in girls than in boys. This is a case of a 7 year-old female complaining of onset of menstruation. Physical examination revealed advanced pubertal changes of Tanner stage 4-5 for breast and stage 3 for pubis. Diagnostic evaluation revealed well developed internal genitalia, markedly elevated LH levels, advanced bone aging and a normal cranial MRI. Based on clinical and diagnostic evaluations, a diagnosis of idiopathic central precocious puberty was made and the patient was started on GnRha therapy. It is important to initiate therapy early in patients with central precocious puberty so as to prevent compromised adult height and psychosocial embarrasment</p>

Mullerianosis of the urinary bladder: First case report in the Philippines / Philippine Journal of Obstetrics and Gynecology

@#<p style="text-align: justify;">Mullerianosis is a rare, benign, and morphologically complex, tumor-like lesion that consists of an organoid structure with normal Müllerian tissue. The diagnosis requires the presence of at least two of the three mullerian tissues: endometriosis, endosalpingiosis, and endocervicosis. There are only less than twenty (20) cases reported in literature. At present there is no published case report of mullerianosis here in the Philippines. This is a case report of a 30-year old Filipino woman who presented predominantly with lower urinary tract symptoms of severe dysuria, hematuria, and lumbar pain and was evaluated for a urologic problem secondary to a posterior bladder mass. Subsequent evaluations revealed the diagnosis of mullerianosis. This is where the interest in mullerianosis sets, its potential to mimic a neoplastic lesion of the urinary tract from clinical and diagnostic viewpoints. The clinical importance to diagnose this case correctly is of grave importance for appropriate management.</p>