[Fetal ventriculomegaly secondary to germinal matrix hemorrhage--case report]. / Wentrikulomegalia w nastepstwie przebytego krwawienia do istoty zarodkowej mózgu plodu--opis przypadku.

A germinal matrix is an area of the fetal brain where neuroblasts proliferate till the 20th week of gestation after which their migration takes place. Germinal matrix hemorrhage (GMH) is a frequent cause of fetal ventriculomegaly or hydrocephalus, yet the pathophysiological conditions of GMH remain unclear. A case of fetal ventriculomegaly resulting from GMH has been reported in the article. A prenatal ultrasonographic examination (US) carried out in the 30th week of gestation revealed enlarged ventricles. Utero magnetic resonance imaging (MRI) performed in the 34th week of gestation demonstrated asymetric ventriculomegaly and the changes suggesting the occurance of GMH and ependymal intraventricular hemorrhage. Fetal ventriculomegaly and hydrocephalus are commonly detected by ultrasonographic examination, but it is often difficult to determine the causes of the diseases by US. In these cases MRI allows to establish the final diagnosis.

[Peritoneal tuberculosis mimicking ovarian cancer--diagnostic difficulties. Two cases reports]. / Gruzlica otrzewnej czy rak jajnika--trudnosci diagnostyczne. Opisy dwóch przypadków.

Tuberculosis, and specially its extrapulmonary location still causes diagnostic difficulties. In 2007, in Poland 7.3% of newly registered cases of tuberculosis in Poland were located extrapulmonary. Peritoneal tuberculosis is often wrongly diagnosed as an ovarian cancer, it is due to similar symptoms like abdominal pain, abdominopelvic masses, ascites and elevated serum CA-125. Two patients who were admitted to our department with suspicion of ovarian cancer are presented. Subjective symptoms suggested the ovarian cancer, elevated levels of CA-125, chest x-rays without abnormal findings or with minimal fibrotic changes and uncharacteristic results of additional investigations were disclosed. A diagnostic laparoscopy was made to establish the diagnosis. Because of clinical and operative picture suggesting ovarian cancer in both cases resections were performed. The procedure consisted of total abdominal hysterectomy and bilateral salpingo-oophorectomy. Biopsy specimens were taken up and verified histopathologically. The peritoneal tuberculosis was recognized in both cases.

[Dermatofibrosarcoma protuberans of the vulva]. / Dermatofibrosarcoma protuberans okolicy sromu.

Dermatofibrosarcoma protuberans (DFSP) is a locally malignant neoplasm derived from fibrous tissue. Similar picture of such lesions to malignant tumors as well as to benign changes creates a risk of too gentle treatment and consequently of recurrence and malignant transformation of the lesions with possible remote metastases. Therefore accurate diagnosis and aggressive surgical treatment can prevent the recurrence of the tumor. Authors of the study present case report of 49-year-old woman with DFSP of vulvar area.

[Perinatal results of intrauterine open fetal surgery of fetuses diagnosed with myelomeningocoele--the clinical report of ten cases]. / Wyniki perinatalne wewnatrzmacicznej operacji zamkniecia przepukliny oponowo-rdzeniowej plodu. Raport kliniczny 10 przypadków.

The purpose of the study was to demonstrate our approach to qualification for open fetal surgery (OFS) and surgery techniques. We also tried to determinate the outcome of fetal surgical treatment. OFS was performed in 10 out of 15 cases with prenataly diagnosed myelomeningocele. Patients were qualified for the surgery on the basis of precisely determined inclusion criteria and after assessment by multidisciplinary team of specialists. Surgery was performed between 22nd and 29th week of pregnancy. Fist and second surgery were performed in 29th and 27th week of pregnancy, some patients have undergone the surgery before 26th week of pregnancy. Babies were delivered by cesarean section. Gestational age by the time of the delivery ranged from 25th and 37th and a half week of pregnancy. In two cases the delivery was at term. Main complications included: PROM, placental ablation and vaginal bleeding. In half of all the cases we did not observe hydrocephalus increase after the surgery. OFS can be beneficial but it can also carry certain amount of risk both for the fetus and the mother. Therefore, further randomized research deems necessary to better comprehend and determine the safety and effectiveness of such procedures.