Long-term disease free and successful pregnancy in a woman with gonadal dysgenesis and malignant germ cell tumor

To report a case of long-term disease free and successful pregnancy after fertility sparing staging surgery with adjuvant chemotherapy in a 46,Xy gonadal dysgenetic with malignant germ cell tumor. A case report from a university hospital about a 19-year-old female with 46,XY karyotype [Swyer syndrome]. The patient underwent bilateral gonadectomy and staging with uterus preservation. Six course adjuvant chemotherapy with VBP [Vinblastin, Bleomycin, Cisplatin] was given. The case got pregnant through IVF- embryo donation. Disease free period and successful pregnancy is reported. After treatment the patient is free of the disease after 11 years follow-up. She underwent in vitro fertilization treatment with oocyte donation and gave birth to a healthy ch. Improved multimodality treatment, allowance for consideration of fertility options for some women with gynecologic cancers. Since major concern in women with XY gonadal dysgenesis is ovarian malignancy, even with stage II dysgerminoma hysterectomy may not be required in some cases considering the opportunity for childbearing with the use of embryo transfer

Low grade endometrial stromal sarcoma of uterine: review of 17 cases

Endometrial stromal sarcomas [ESS] are the second most common uterine sarcomas. Endometrial stromal sarcomas account for 0.25% of all uterine malignancies. Uterine sarcomas most often affect postmenopausal women. The aim of this retrospective study was to review the experience in the treatment and clinical outcome of low grade malignant endometrial stromal sarcoma. Seventeen patients with histologically proven low grade ESS in department of Gynecologic Oncology of the Vali-e-Asr Hospital, Tehran-Iran, between 1999 and 2008 were included in the analysis. Demographics, pathology, treatment, time to recurrence, salvage therapy and survival information was collected. The median age of our patients was 45.35 +/- 6.8 [range 36-61]. The median parity of the patients was 5 [range 0-8]. Most patients were diagnosed at FIGO stage I. The mean survival for patients with stage I and II was 73.5 +/- 35.09 and 57.6 +/- 5.37 months, respectively, with mortality rate of 5.9% through a median follow-up time of 68.82 +/- 30 months. Of 17 patients, seven cases [35.29%] were disease free at 6 years after hysterectomy. Radiotherapy was administered to four patients [23.53%]. Only one patient recurred at 10th month after surgery. Surgeries not preserving ovarian function were helpful to decrease the risk of recurrence compared with those sparing ovarian function