ABSTRACT
Neurofibromatosis within the female genital tract is uncommon. The vulva is the most frequent genital location, but it has rarely been reported in the context of the vagina, uterine cervix or ovaries. In spite of its rarity, neurofibroma is a neoplasm that should be considered in the differential diagnosis of pelvic masses, especially in patients with neurofibromatosis. In this paper we describe the case of a 71-year-old patient with pelvic pain and a uterine mass who underwent a hysterectomy after having been diagnosed with an 11-cm neurofibroma occupying the myometrium of the entire uterine corpus. There were no neurofibromas in the endometrium, serosa, fallopian tubes or ovaries. The patient had an unknown von Recklinghausen's disease.
Subject(s)
Neurofibromatosis 1/diagnosis , Uterine Neoplasms/diagnosis , Aged , Biopsy , Diagnosis, Differential , Female , Genital Neoplasms, Female/diagnosis , Genital Neoplasms, Female/pathology , Genital Neoplasms, Female/surgery , Humans , Hysterectomy , Myometrium/pathology , Neurofibromatoses/diagnosis , Neurofibromatoses/pathology , Neurofibromatoses/surgery , Neurofibromatosis 1/pathology , Neurofibromatosis 1/surgery , Ovariectomy , Salpingectomy , Treatment Outcome , Uterine Neoplasms/pathology , Uterine Neoplasms/surgeryABSTRACT
BACKGROUND: The aim of this study was to compare the performance of the Bishop score and transvaginal ultrasonography to predict successful labor induction, and to estimate the most useful cut-off points for the two methods. METHODS: The five components of the Bishop score were assessed by digital examination and cervical length was measured by transvaginal ultrasonography in 177 women with a single pregnancy, 36-42 weeks of gestation, and a live fetus in cephalic presentation before induction of labor. RESULTS: Multiple regression analysis showed that the Bishop score, cervical length, and parity provided independent contribution in the prediction of the likelihood of delivering vaginally within 60 h. The only component of the Bishop score that was independently predictive of the probability of vaginal delivery within 60 h was station. The best cut-off points for predicting successful induction using receiver operating characteristic curves were 24 mm for cervical length and 4 for the Bishop score. Cervical length was a better predictor than the Bishop score (sensitivity and specificity of 66 and 77% versus 77 and 56%, respectively). Kaplan-Meier survival curves showed that cervical length was the best discriminator of successful induction. CONCLUSION: Measurement of cervical length by transvaginal ultrasonography is a better predictor of success in labor induction with both topical prostaglandin and oxytocin.
