Non-Epithelial Ovarian Cancers: How Much Do We Really Know?

Non-epithelial ovarian cancers (NEOC) are a group of uncommon malignancies that mainly includes germ cell tumours (GCT), sex cord-stromal tumours (SCST), and some extremely rare tumours, such as small cell carcinomas and sarcomas. Each of these classifications encompasses multiple histologic subtypes. The aetiology and molecular origins of each sub-group of NEOC require further investigation, and our understanding on the genetic changes should be optimised. In this article, we provide an update on the clinical presentation, pathology, genetics, treatment and survival of the main histological subtypes of the GCT and the SCST, as well as of ovarian small cell carcinomas. We also discuss miRNA expression profiles of NEOC and report the currently active clinical trials that include NEOC.

Multifocal Septic Arthritis Secondary to Infective Endocarditis: A Rare Case Report.

INTRODUCTION: Infective endocarditis (IE) is a rare cause of septic arthritis. We report a patient who presented with multifocal septic arthritis as a result of IE, which is an extremely rare condition. CASE REPORT: This 69-year-old gentleman presented to the emergency department (ED) with a 3-day history of acute right knee pain. Initial investigations demonstrated chondrocalcinosis on knee radiographs, acute renal failure with rhabdomyolysis and a CRP of 520. After treatment with intravenous fluid rehydration and analgesia, the knee aspiration grew a Group B Streptococcus, and the patient underwent arthroscopic washout. 48 h after admission the patient developed left wrist and right elbow pain. Further aspirations revealed Group B Streptococcus and the patient underwent further washouts. A multidisciplinary approach was used. Due to ongoing sepsis, an echocardiogram was performed identifying IE. The patient eventually died due to ongoing sepsis and duodenal ulceration. CONCLUSION: This case highlights the importance of considering a systemic cause such as IE for patients presenting with features of multifocal septic arthritis and ensuring all patients undergo a full medical examination as part of the clerking process. Furthermore, it emphasizes the need to adopt a multi-disciplinary approach when presented with complex patients so that the best medical care can be given to prevent morbidity and mortality.