[Comparison of serum CA-125 level in ruptured and unruptured tubal pregnancies in Yazd/Iran during 2001-2006]

This study aimed to determine if serial measurement of serum CA-125 level could be used as a useful test in the differential diagnosis of intact and ruptured tubal pregnancies. In a single-blind prospective controlled clinical study, 59 women with tubal pregnancy of 6-12 weeks [26 women with ruptured tubal pregnancy, 33 women with intact tubal pregnancy and 59 women with normal intrauterine pregnancy of the same gestational age as control group] were studied prospectively. Serum CA-125 levels were measured in all women and compared among three groups. Demographic features [age, gestational age, parity and educational level] were not significantly different in three groups. CA-125 level in ruptured tubal pregnancy group was significantly higher than that in control group [P = 0.04]. Both these two groups had higher levels of CA-125 comparing to the intact tubal pregnancy group [P = 0.001, P = 0.006, respectively]. In intact tubal pregnancies managed with medical treatment, serial measurements of CA-125 could be a supplementary test for an early diagnosis of tubal rupture

[Fertility preservation in young women with endometrial carcinoma; report of three cases]

Although endometrial cancer is primarily a disease of the postmenopausal female, 25% of patients are premenopausal, with 3-5% in women 40 years old or younger. The younger group of women with endometrial carcinoma are frequently nulligravid with a history of infertility, and a strong desire to preserve fertility. This may pose a therapeutic dilemma for both patients and treating physician. We reported 3 young patients with atypical; complex hyperplasia or early stage endometrial cancer that treated with conservative hormonal therapy. Medical treatment of young patients with endometrial carcinoma and complex atypical hyperplasia who wish to preserve fertility is a reasonable and appealing option. A comprehensive evaluation prior to counseling the patient should include. A complete history and physical examination. A formal D and C with review of history with an experienced gyn-onc pathologist. Evaluation of the pelvic and abdomen preferably with contrast-enhanced MRI or transvaginal ultrasound. In patients found to have a clinical stage I grade I tumor and who want to preserve fertility, thorough counseling include risks and benefits, and explanation that the data is partial and incomplete due to the lack of appropriate controlled studies is mandatory. In patients considered for medical treatment, a high dose progestin regimen should be started with endometrial sampling every 3 months until complete regression of the tumor is documented. Although most responses are long standing, there is a small risk of progression during or after cessation of progestin therapy