Primary Clear Cell Adenocarcinoma of the Uterine Cervix in a 14-Year-Old Virgin Girl: Case Report.

Cervical cancer is rare in adolescent and pediatric populations, with adenocarcinoma being the most commonly reported. Clear cell adenocarcinoma of the uterine cervix accounts for only 4% of all adenocarcinoma cases, and about two-thirds are associated with intrauterine diethylstilbestrol (DES) exposure. We report the case of a 14-year-old virgin girl who presented with a 1-month-long history of abnormal vaginal bleeding and lower abdominal pain. Transabdominal pelvic ultrasound examination revealed the presence of an irregular, homogeneous cervical mass that was 7 cm in size. Therefore, a magnetic resonance imaging (MRI) scan was performed to establish the origin of the tumor and its relationship to adjacent pelvic organs. Furthermore, a vaginoscopy was performed to identify the tumor, and a cervical biopsy was performed. Immunohistochemical and anatomopathological studies resulted in the diagnosis of non-HPV(Human Papilloma Virus)-related clear cell adenocarcinoma of the cervix. Following the oncological examination, she was admitted for radiotherapy. The patient had no maternal history of DES exposure in utero. Even though the number of cases in the literature is low, most of the virgin girls diagnosed with clear cell adenocarcinoma of the cervix have a fatal prognosis because of the delay in making a correct diagnosis.

Magnetic Nanoparticles and Magnetic Field Exposure Enhances Chondrogenesis of Human Adipose Derived Mesenchymal Stem Cells But Not of Wharton Jelly Mesenchymal Stem Cells.

Purpose: Iron oxide based magnetic nanoparticles (MNP) are versatile tools in biology and medicine. Adipose derived mesenchymal stem cells (ADSC) and Wharton Jelly mesenchymal stem cells (WJMSC) are currently tested in different strategies for regenerative regenerative medicine (RM) purposes. Their superiority compared to other mesenchymal stem cell consists in larger availability, and superior proliferative and differentiation potential. Magnetic field (MF) exposure of MNP-loaded ADSC has been proposed as a method to deliver mechanical stimulation for increasing conversion to musculoskeletal lineages. In this study, we investigated comparatively chondrogenic conversion of ADSC-MNP and WJMSC with or without MF exposure in order to identify the most appropriate cell source and differentiation protocol for future cartilage engineering strategies. Methods: Human primary ADSC and WJMSC from various donors were loaded with proprietary uncoated MNP. The in vitro effect on proliferation and cellular senescence (beta galactosidase assay) in long term culture was assessed. In vitro chondrogenic differentiation in pellet culture system, with or without MF exposure, was assessed using pellet histology (Safranin O staining) as well as quantitative evaluation of glycosaminoglycan (GAG) deposition per cell. Results: ADSC-MNP complexes displayed superior proliferative capability and decreased senescence after long term (28 days) culture in vitro compared to non-loaded ADSC and to WJMSC-MNP. Significant increase in chondrogenesis conversion in terms of GAG/cell ratio could be observed in ADSC-MNP. MF exposure increased glycosaminoglycan deposition in MNP-loaded ADSC, but not in WJMSC. Conclusion: ADSC-MNP display decreased cellular senescence and superior chondrogenic capability in vitro compared to non-loaded cells as well as to WJMSC-MNP. MF exposure further increases ADSC-MNP chondrogenesis in ADSC, but not in WJMSC. Loading ADSC with MNP can derive a successful procedure for obtaining improved chondrogenesis in ADSC. Further in vivo studies are needed to confirm the utility of ADSC-MNP complexes for cartilage engineering.

Clinical, imaging and histopathological correlations of gingival overgrowth: a retrospective analysis in northeastern Romanian population.

BACKGROUND: Gingival overgrowth refers to an increase in the size of the gingival tissue. The etiology varies, and is often a multi-factor issue; what may contribute to gingival enlargement are aspects, such as disease, local and systemic conditions and idiopathic factors. The aim of the present study is to analyze and to correlate the clinical, epidemiological, imaging and histopathological (HP) features of gingival overgrowth in northeastern Romanian population. PATIENTS, MATERIALS AND METHODS: We conducted a clinical, imaging, and pathological study on 98 patients with gingival overgrowth, who underwent a surgical intervention for a gingival biopsy in the Office of Oral and Maxillofacial Surgery, "Prof. Dr. Nicolae Oblu" Emergency Clinical Hospital, Iasi, Romania, during a 14-month period (January 1, 2018 to February 28, 2019). All patients with localized gingival overgrowth had clinical and imaging investigations done and then were referred to an oral and maxillofacial facility. A surgeon performed the excision of the gingival overgrowth and then sent the surgical specimens to the Laboratory of Pathology for HP examination. RESULTS: Local inflammation was found responsible for the gingival overgrowth in most of the cases, with the number of females outnumbering that of the males. A very good correlation was found between clinical and HP diagnosis when epithelial hyperplasia, peripheral giant cell granuloma and pyogenic granuloma were involved and a moderate one when fibrous hyperplasia was involved. CONCLUSIONS: These findings suggest that the occurrence of gingival overgrowth can have many causes, which highlights the importance of clinical pathology in assisting practitioners with making a better diagnosis.

Differential diagnosis difficulties related to infantile hemangioma - case report and literature review.

Infantile hemangioma is a benign vascular tumor that is often present in the cephalic region and can grow rapidly in size, causing serious complications. The hemangioma with oro-maxillofacial sphere localization may often pose differential diagnosis problems, requiring additional investigations. We present the case of a 3-month-old baby who was brought to the Emergency Room for acute respiratory failure and dysphagia caused by the rapid increase in size of a soft palate and lateral pharyngeal wall tumor. The clinical examination revealed a "wine stain" hemangioma in the inter-eyebrow and frontal areas, a hemangioma in the right genial area, 1∕1.5 cm in diameter, growing rather in depth than on the surface, and a purplish-blue tumoral mass with irregular edges, grown in the soft palate and in the right lateral wall of the pharynx, which impaired both eating and breathing. Obstructive phenomena have been aggravated by an acute respiratory infection. Due to the inconsistencies between different medical specialties about the nature of the tumor and the suspicion of malignancy, in order to establish the correct diagnosis and therapeutic management, urgent tumor biopsy was required. After starting oral treatment with Propranolol, the evolution was favorable. Infantile hemangiomas may sometimes be hard to diagnose, requiring additional imaging examinations, and sometimes-pathological examination. Since it may affect a vital function, or the patient's esthetic appearance, or if the tumor has ulcerated, bleeds or got infected, the certain diagnosis and the onset of treatment should be done as soon as possible.

Borderline ovarian cyst treated by laparoscopic surgery: clinical case report and literature review.

Borderline ovarian serous tumors are a rare distinct category of epithelial ovarian tumors, distinguished from both benign and invasive ovarian tumors. As borderline ovarian cysts are only a small part of the gynecological conditions of children, the therapeutic approach to this special type of tumor has not been standardized yet. Despite the technological breakthroughs that we have witnessed lately, the positive diagnosis of ovarian tumors is possible only by surgery and histopathological examination, and laparoscopic surgery has become the golden standard in the management of this condition. The aim of this case report is to demonstrate a very good long-term evolution after minimal invasive treatment and minimal damage to the reproductive apparatus in children with borderline ovarian tumors. The case reported in this paper is that of a 17-year-old adolescent with borderline serous papilliferous cystadenoma diagnosed by ultrasound and computed tomography (CT) scanning, whose CA-125 biomarker had normal values. As the purpose was to preserve the patient's reproductive function, we chose to remove and excise the cyst by laparoscopic surgery, without removing the ovaries. The patient's subsequent evolution was positive and at 19-year-old, she gave natural birth to a healthy baby girl. Nevertheless, as relapses are possible after many years, the patient's long-term monitoring is necessary.

Plurimalformative syndrome associating trisomy 18 and omphalocele. Case report and review of the literature.

Trisomy 18 or Edwards syndrome is a rare chromosomal anomaly, associated with mild to severe intellectual disabilities and multiple congenital anomalies. Trisomies 18 and 13 are lethal, only 5-10% of patients surviving the first year of life. Although prenatal biological and ultrasound investigations are mandatory and free and the detection rate of chromosomal abnormalities is high, the birth of children with no real chance at a normal life being thus avoided by therapeutic abortion, the parents of the here presented child did not benefit from medical examination or prenatal tests, unfortunately the case of many families in Romania. The policy of limiting medical intervention in newborns with Edwards syndrome due to the broad spectrum of severe congenital malformations, severe mental retard and reduced life expectancy is unanimously accepted, but yet difficult to apply from an ethical point of view. That is why very important for both healthcare providers and families to have accurate and detailed knowledge of survival, disease course, and quality of life so that they can make fully informed decisions regarding care of these babies. The particularity of this case is the association of multiple congenital anomalies in a male newborn with trisomy 18, almost all apparata and systems being affected, with the presence of an omphalocele and complete right labiopalatine cleft, which are less frequent at children with trisomy 18.

Nonclassical major histocompatibility complex I-like Fc neonatal receptor (FcRn) expression in neonatal human tissues.

The neonatal Fc receptor (FcRn) was demonstrated to play a role both in the recycling and thus the protection of immunoglobulin G (IgG) from catabolism and in the maternal-fetal transfer of IgG. The expression of this particular receptor was evidenced in a variety of cell types, but the endothelial cell was considered the main cell able to perform both recycling and IgG catabolism. Based on preliminary data obtained in adult human mammary glands and skin, this study focused on a number of neonatal human tissues, targeting FcRn expression mainly in epithelial versus endothelial cells. Our results demonstrate that in most of the investigated tissues, the neonatal Fc receptor is not detectable in the endothelial cells lining the capillaries, whereas most epithelial cells are positive. We could also observe the receptor's expression in most macrophages, smooth muscle cells, and neurons. Taken together, these data suggest that the main sites of IgG catabolism might in fact be other than endothelial cells in human neonates.