Primitive Myxoid Mesenchymal Tumor of Infancy With Fatal Hemorrhage In Utero: A Case Report and Literature Review.

Primitive myxoid mesenchymal tumor of infancy (PMMTI) is a rare soft tissue sarcoma in childhood. We present the case of a newborn male who experienced a severe hemorrhage in utero from the tumor on the scalp. He died at the age of 24 hours owing to hemorrhagic shock. The tumor was posthumously diagnosed as PMMTI. A literature search indicated that cases of severe hemorrhage from soft tissue sarcomas in utero or at birth are limited to infantile fibrosarcoma. This is the first case of PMMTI with massive hemorrhage. Clinicians must be aware of hemorrhagic complications of PMMTI.

Yolk sac tumor of the ovary during pregnancy: a case report.

BACKGROUND: There is a therapeutic dilemma for the pregnant patient with malignancy requiring chemotherapy. CASE: We had a case of a 30-year-old pregnant woman with a yolk sac tumor who underwent right salpingo-oophorectomy at 22 weeks gestation. Chemotherapy during pregnancy was postponed because of concern with the risks of the chemotherapy to the fetus. After the operation, L2 fraction of alpha-fetoprotein (AFP) depending on the affinity for Lens culinaris agglutinin (LCA) as an indicator for a maternal source of AFP had been detectable since 30 weeks gestation and elevated rapidly with advancing gestation. Tumor recurrence was confirmed clinically at 34 weeks gestation. She was induced, delivering a healthy baby, and received seven complete chemotherapy courses (cisplatin, etoposide, and peplomycin). Currently, the mother (39 months after last chemotherapy) and child are doing well. CONCLUSION: AFP-L2 may be a sensitive indicator for a yolk sac tumor derived AFP, leading to an earlier detection of tumor recurrence during pregnancy.

Incarceration of the retroverted uterus at term gestation.

Incarceration of the retroverted uterus is a rare complication of pregnancy and rarely persists until term. The diagnosis is extremely difficult to make and a cesarean section should be performed in such cases. A 33-year-old Japanese woman was admitted at 40 weeks gestation for evaluation of preeclampsia. Vaginal examination revealed that the uterine cervix could hardly be visualized, although the fetal head was impacted in the pelvis. These findings suggested incarceration of the retroverted uterus. Magnetic resonance imaging (MRI) was performed and clarified the exact anatomical relationship and confirmed the diagnosis. She therefore underwent a cesarean section and a male infant weighing 3552 g was delivered with Apgar scores of 9 and 10 at 1 and 5 minutes, respectively. At surgery she was found to have an adhesion between the uterus and the pouch of Douglas. MRI is a useful tool in correctly making the diagnosis of uterine incarceration and facilitates preparation for a cesarean section.

Studies on the human leukocyte antigen class I antigens in Japanese patients with macroscopically diagnosed endometriosis.

An increasing number of reports suggest that endometriosis is associated with abnormal immune function, although the etiology of the disease remains undefined. The human leukocyte antigen system (HLA) is known to play a role in the etiology of a number of diseases. This study examines the possible association between the HLA system and endometriosis. Fifty-five patients diagnosed with endometriosis by laparoscopic examination were typed for HLA class I antigens - HLA-A, -B, and -C antigens - using the standard microlymphocytotoxity technique of Terasaki. The frequency of HLA-B 54 and that of HLA-Cw7 were significantly higher in the patient population than in the control population. No significant difference was found between the two groups in the frequencies of the other HLA-class I antigens. The results of this study may implicate the HLA system in the development of endometriosis.