Abdominal wall endometriosis: case report.

Abdominal wall endometriosis, also known as scar endometrioma, is a rare condition, in most cases occurring after previous cesarean section or pelvic surgery. The incidence of scar endometrioma is estimated to 0.03%-1.5% of all women with previous cesarean delivery. The predominant clinical picture is cyclic pain. Due to a wide range of mimicking conditions and a relative rarity, a significant delay is often observed from the onset of symptoms to proper treatment. We report on a case of a 36-year-old patient with scar endometrioma after two previous cesarean deliveries. The possible diagnostic pitfalls and treatment options are discussed.

Detection of ovarian cancer by determination of CA 125 in different patohistologycal types of tumor according to age.

During the eighteen-year period in "Sestre milosrdnice" University Hospital Center, Zagreb, 271 women with ovarian tumor was studied. 229 women with ovarian cancer and 42 with borderline tumor. The pathohistological types of tumors were different. The age of the patients ranged from 20-83 years. In all patients the value of biochemical marker CA125 was determined. The aim of this study was to determine the usefulness of CA125 measurement in different age groups and in different patohistologycal forms of tumor. CA125 has proven to be positive in 89.1% of women with ovarian cancer and in 62% with neoplasm of low malignant potential. The higher values of CA125 were detected in younger women with low malignant tumor potential. Serous and metastatic tumor types were also associated with higher values of CA125.

Strumal carcinoid of the ovary: report of two cases.

Primary carcinoid tumors of the ovary account for 5% of ovarian teratomas. They are frequently components of mature cystic teratomas or, less commonly, mucinous cystadenomas. Most tumors are seen in peri- or postmenopausal women with symptoms of enlarging mass, or are incidental findings. Microscopically, there are four major variants of ovarian teratomas of carcinoid type: insular, trabecular, strumal and mucinous. One-third of patients with the insular type of carcinoids have symptoms of the carcinoid syndrome. Strumal carcinoid is an unusual form of ovarian teratoma composed of an intimate admixture of thyroid and carcinoid tissues that vary in their relative proportions. Two patients with ovarian tumors showing typical morphology of primary ovarian strumal carcinoid are described.

Prediction of ovarian tumor malignancy.

Ovarian cancer is the leading cause of mortality among gynecological cancers. The aim of the study was to form the decision rules for distinguishing benign from malignant ovary lesions. The research was conducted on 201 women with ovary tumor. Commonly used specific markers for ovarian cancer (biochemical marker Ca 125, ultrasound and vascular markers) were used. The significant difference in the presence of an ultrasound and vascular markers between benign and malignant ovary changes along with the significantly different level of Ca 125 is confirmed. To a specific marker certain score number was appointed and the scoring system was formed. The incidence of benign/malignant ovary changes was observed in the researched group regarding anthropometric parameters (age, marital and menopausal status and number of deliveries). There is also significant difference in the incidence of benign/malignant ovary tumor regarding these parameters. Based on combination of the scoring system and anthropometric parameters the decision rules for distinguishing benign from malignant ovary tumors were formed. The logistic regression method was used. We proved that this method has higher accuracy in prediction of malignancy in women with ovary tumors than using morphological, Doppler or anthropometric parameters separately.

Diagnostic approach for precancerous and early invasive cancerous lesions of the uterine cervix.

Invasive cervical cancer is second most common female cancer worldwide with about 493,000 new cases per year. About 273,000 women die from cervical cancer each year, 85% of which take place in developing countries. Cervical cancer has a slow progress, from pre-invasive cervical intraepithelial neoplasia (CIN) to invasive phases, meaning that the disease can be diagnosed while in the phase of pre-invasive lesion, and treated successfully thanks to the regular screening of asymptomatic women (the Pap smear). The authors review new possibilities of early detection of cervical cancer with emphasis on colposcopy. The role of colposcopy is discussed among possibilities of early diagnosis. The authors discuss additional diagnostic procedures for preinvasive lesions of the uterine cervix like DNA cytometry, (flow cytometry). This method can point to dysplasia which can progress to severe stages, such as HSIL (High grade Squamous Intraepithelial Lesion). If the level of chromosomal disturbance is higher (aneuploidy), it is more probable that HSIL will develop. Laser screening of cells extracted with modern cytologic screening LBC (Liquid Base Cytology) enables us to automatically measure ploidy (chromosome regularity, or irregularity) and PCR provides analysis of HPV types. These methods are recommended for a routine check-up of borderline cervical lesions in order to anticipate ones likely to regress or progress.

Antropologic factors in prediction of ovary cancer.

The aim of the study was to determine a combination of anthropometric variables that would enable better differentiation between benign and malignant ovarian masses. Prospective study has been performed in a two year period in which 208 women with ovarian lesions were analyzed and correlated with histopathologic surgical findings. We examined the relation between self-reported anthropometric and other variables (height, weight, body mass index--BMI, parity, marital status, education, age, rural versus urban residence, menopausal status) and incidence of ovarian cancer. Age, parity, marital status and menopausal status individually showed statistical significance.

Foetus body mass prepartal assesment in clinical practice.

The aim of study was to examine the importance of foetus body mass prepartal assessment in normal term pregnancy. The study comprised 254 pregnant women with single pregnancy, without congenital anomalies, residing in urban (Zagreb) and small towns (Samobor, Jastrebarsko). Higher birth mass was measured in male than in female newborns, and the difference was statistically significant (p < 0.05%, p = 0.002). Older pregnant women more often gave birth by Cesarean section then vaginally and, the difference was statistically significant (p < 0.005; p = 0.009). Smoking and parity did not influence birth mass. The results of the study showed good prepartal estimate of fetal mass in 207 (81.5%) and bad in 47 (18.5%) pregnant women. This study has confirmed the clinical value of ultrasound in prepartal treatment of pregnancy. Since the child gender was shown to have an impact on the assessment, it is well advised to determine the child gender as well.