Effect of letrozole on endometrial histology in patients with disordered proliferative endometrium and simple hyperplasia

This is a preliminary study investigating the efficacy of aromatase inhibitor letrozol on endometrial histology in patients with disordered proliferative endometrium or simple hyperplasia. In a randomized clinical trial, 92 patients with abnormal uterine bleeding who had disordered proliferative endometrium or simple hyperplasia in endometrial biopsy, were randomized into case and control groups. patients received 2.5 mg of letrozole daily in case group [n=46] and 40 mg of megestrol acetate daily in control group [n=46] for 3 months. Endometrial biopsy was performed 3 to 4 weeks after completion of therapy to assess response. After intervention in letrozole group, response to treatment was seen in 93% cases [including endometrial atrophy in 58.7% cases and weakly proliferative endometrium in 34.78% cases] and in megestrol group response to treatment was seen in 85% cases [including endometrial atrophy in 41.3% cases and weakly proliferative endometrium in 43.47% cases]. The difference between two groups was not statistically significant [P=0.31]. The results of this study show that pre and post menopausal women with disordered proliferative endometrium or simple hyperplasia can be successfully treated with letrozole alone. However, due to the lack of significant difference between the two groups, further studies with larger sample size is recommended for better clearance of the topic

Paraovarian hydatid cyst mimicking acute abdomen

Echinococcosis is a parasitic disease that is produced by Echinococcus granulosus and still represents an important medical problem in many countries. Echinococcosis in extrahepatic sites is usually asymptomatic unless the cyst causes symptoms due to pressure, as in our case, or ruptures to the peritoneal cavity. Echinococcal cysts at unusual locations many times pose diagnostic dilemmas, and the diagnosis sometimes is made intraoperatively. Primary ovarian and paraovarian cyst hydatid disease is a very rare entity. In our case, a 25-year-old female gravida 1, para 1, was admitted to the emergency department of the Alzahra Hospital of Tabriz due to diffuse abdominal pain, nausea, abdominal distension and urinary frequency of ten-day duration and exacerbation of pain from a few hours before admission. Clinical examination revealed tachycardia of 105 per minute, normal body temperature and normal blood pressure. Abdominopelvic sonography revealed a mass with regular thick contour located in the left ovary suggestive of huge cystadenoma or carcinoma of the ovary. Emergent laparotomy was performed for suspected adnexal torsion. Intra operative findings were a large paraovarian mass with thick wall without any torsion. Mass was removed completely and sent for frozen section study. Pathological examination showed the diagnosis of hydatid cyst. The postoperative period was uneventful and the patient was discharged 3 days later, with the advice to receive Albendazole. The patient referred to a general surgeon for management of the hepatic cysts