ABSTRACT
BACKGROUND: Ectopic molar pregnancy is a rare phenomenon and has not been reported in the presence of an intrauterine device (IUD). Clinical diagnosis of molar pregnancy is challenging and requires careful follow-up. CASE: A 25-year-old woman (gravida 2, para 0) with a copper IUD in place presented with a positive pregnancy test. Diagnosis of the complete hydatidiform mole was pathologically confirmed after surgery following clinical and sonographic investigations that identified a left-sided ectopic pregnancy. CONCLUSION: Gestational trophoblastic disease (GTD) presenting as an ectopic pregnancy is a very rare occurrence. This patient recovered without event through a combined management and follow-up for ectopic pregnancy and gestational trophoblastic disease. Appropriate identification and management of this clinical problem is essential in order to prevent initial complications as well as subsequent malignant sequelae.
Subject(s)
Hydatidiform Mole , Intrauterine Devices , Pregnancy, Ectopic , Rare Diseases , Uterine Neoplasms , Adult , Chorionic Gonadotropin, beta Subunit, Human/blood , Dilatation and Curettage/methods , Female , Gravidity , Humans , Hydatidiform Mole/blood , Hydatidiform Mole/diagnostic imaging , Hydatidiform Mole/surgery , Pregnancy , Pregnancy, Ectopic/blood , Pregnancy, Ectopic/diagnostic imaging , Pregnancy, Ectopic/surgery , Rare Diseases/blood , Rare Diseases/diagnostic imaging , Rare Diseases/surgery , Uterine Neoplasms/blood , Uterine Neoplasms/diagnostic imaging , Uterine Neoplasms/surgeryABSTRACT
A 13-year-old presented with malodorous, purulent, vaginal discharge following each menses for the last three months since menarche. This discharge resolved following antibiotic therapy but recurred with each menses. On exam, the patient was found to have a blind ending vagina with a small, midline perforation. Ultrasound and MRI examinations done prior to surgery did not identify the vaginal foreign body. She was taken to the operating room for examination under anesthesia and vaginoscopy. During surgery this area was found to be comprised of dense adhesions which nearly obliterated the distal vagina. The vaginal adhesions were lysed and a plastic foreign body was discovered in the upper vagina. After removing the foreign body the superior vagina was undermined, pulled down, and sutured to normal inferior vagina. A Mentor mold was placed in the vagina to maintain patency.
Subject(s)
Foreign Bodies/surgery , Vagina , Vaginal Discharge/etiology , Adolescent , Constriction, Pathologic/etiology , Female , Foreign Bodies/complications , Foreign Bodies/diagnosis , Humans , Magnetic Resonance Imaging , Tissue Adhesions/etiology , Tissue Adhesions/surgeryABSTRACT
There are currently no recommended screening tests for the early detection of ovarian cancer. Ovarian malignancies are most often discovered on bimanual exam at advanced stages, resulting in a high mortality from this disease. While the Papanicolaou (Pap) smear is not a reliable screen for the detection of ovarian cancer, abnormal cytology may be the initial indicator of ovarian malignancy. This is a case report of an invasive serous adenocarcinoma of the ovary that was discovered as the result of a clinical work-up for abnormal cytology reported on a Pap smear.
Subject(s)
Adenocarcinoma, Papillary/diagnosis , Ovarian Neoplasms/diagnosis , Papanicolaou Test , Vaginal Smears , Adenocarcinoma, Papillary/drug therapy , Adenocarcinoma, Papillary/surgery , Female , Humans , Middle Aged , Ovarian Neoplasms/drug therapy , Ovarian Neoplasms/surgeryABSTRACT
In the United States, an estimated 15.3 million new cases of sexually transmitted infections (STIs) occur each year. Approximately two-thirds of people who acquire STIs in the U.S. are younger than 25 years of age. In addition, approximately 57% (3.1 million) of all pregnancies in the United States are classified as unintended. It is only logical that the consequences of high-risk sexual behavior (unintended pregnancy and contraction of an STI) would most affect those who exhibit high-risk sexual behavior. Thus, one would expect to find high-risk sexual behavior in the same populations that have high rates of STIs and unintended pregnancy. The purpose of this study was to survey freshman students living in the residence halls at a local college to assess their knowledge and the prevalence of high-risk sexual behavior, and give feedback to the participating institution about these results. The survey was designed to answer two questions: (1) What is the current level of high-risk sexual behavior at a small private Midwestern College? (2) What is the current level of knowledge about high-risk sexual behaviors of those surveyed? A total of 38 men and 131 women participated in the survey. Forty-seven percent of men and 41% of women respondents reported having sexual intercourse at least once in their lifetimes. Of those respondents who were sexually active, 67% of men and 54% of women reported that they "always use a condom" with sexual activity. Fifty-six percent of men and 51% of women that were sexually active reported that they were "not at all concerned" about contracting an STI. Twenty-two percent of men and 17% of women answered that they were "not at all concerned" about pregnancy. Three true/false questions about STIs were answered correctly over 95% of the time by those surveyed. Seventy-nine percent of respondents reported never having attended educational opportunities about STIs and safe sexual practices at the college.
