Mitral valve thrombosis in term pregnancy: A case report and review of the literature.

OBJECTIVE: With this case report would like to emphasize the complexity that involves the management of pregnant women with mechanical heart valves. In that sense, an adequate interdisciplinary management of this potentially serious pathology is required for maternal and fetal well-being. CASE REPORT: A 32-year-old primipara, with a mechanical mitral valve replacement, was admitted to our emergency department at 37+1 weeks of gestation with acute dyspnea and presyncope. The patient was diagnosed with mechanical mitral valve thrombosis and, due to the appearance of hemodynamic instability, the patient underwent an uncomplicated emergency caesarean section and subsequent prosthetic mitral valve replacement. The patient was discharged six days after surgery, without any obstetric complication and with normal valve function. CONCLUSION: This case report shows that, despite strict control and optimal anticoagulation regimen, pregnant women with mechanical heart valves still have a high risk of developing valve thrombosis.

Cáncer de endometrio y trompa sincrónicos. Un reto diagnóstico / Synchronous endometrial and tubal cancer. A diagnostic challenge

Los tumores sincrónicos de endometrio y ovario son una entidad conocida y bien documentada, pero las series publicadas que recogen casos de cáncer de endometrio y trompa son mucho más limitadas. Dadas las implicaciones terapéuticas y pronósticas que se derivan de su distinción con la enfermedad metastásica es importante realizar una correcta valoración del cuadro. Presentamos dos pacientes con cáncer en endometrio y trompa simultáneos y cómo se llegó al diagnóstico de que uno de ellos se trataba de tumores sincrónicos y de metástasis el otro (AU)

Synchronous tumors of the endometrium and ovary are a well-known and well described entity. There are only a few cases in the literature of simultaneous endometrial cancer and fallopian tubes cancer. It is important to differentiate it from metastatic disease because their therapeutic and prognostic implications. We report two patients with concurrent endometrial and tube cancer and how the diagnosis was made: synchronic tumors in the first patient and metastases in the other (AU)

Descripción de un caso de un leiomioma quístico gigante que simula una tumoración ovárica / A case report of giant cystic leiomyoma mimicking an ovarian tumour

Paciente de 73 años remitida por hallazgo casual de una gran masa abdominal. En la ecografía abdominal se observó una tumoración mixta de predominio quístico que ocupaba todo el abdomen, desde la pelvis hasta el apéndice xifoides. La TC abdómino-pélvico informó de una masa quística que ocupaba todo el abdomen en relación con cistoadenoma/cistoadenocarcinoma mucinoso ovárico, por lo que se indicó tratamiento quirúrgico y el diagnóstico definitivo fue un leiomioma dependiente del útero con degeneración hidrópica. Los miomas uterinos son tumoraciones frecuentes en la mujer, sin embargo si presentan cambios degenerativos, puede ser difícil su diagnóstico inicial, al simular patología anexial (AU)

A 73-year-old woman was referred to our service due to incidental discovery of a large abdominal mass. Abdominal ultrasound showed a mixed tumour, predominantly cystic, occupying the whole abdomen from the pelvis to the xyphoid process. Abdominal and pelvic computed tomography revealed a cystic mass that filled the abdomen. The preoperative diagnosis was ovarian mucinous cystadenoma/cystadenocarcinoma. Surgical treatment was indicated. The definitive diagnosis was leiomyoma with cystic degeneration. Leiomyomas are common tumours in women but if they have degenerative changes they may cause confusion in the initial diagnosis, as they can simulate a cystic adnexal mass (AU)

Acetato de ulipristal en el diagnóstico diferencial de carcinoma de endometrio / Ulipristal acetate in the differential diagnosis of endometrial carcinoma

Los miomas uterinos son las tumoraciones genitales más frecuentes cuyo tratamiento más habitual es el quirúrgico. Actualmente existe un tratamiento médico eficaz para reducir su volumen y la clínica asociada que es el acetato de ulipristal (AU), que es un modulador selectivo de los receptores de la progesterona. A nivel endometrial puede ocasionar cambios histológicos que cuando son muy marcados plantean dudas diagnósticas. Se presenta el caso de una paciente con útero miomatoso sintomático bajo tratamiento con AU, la histología en las muestras de biopsia planteó el diagnóstico diferencial con adenocarcinoma de endometrio.

Uterine fibroids are the most common genital tumors and the most common treatment is surgery. Actually there is an effective medical treatment to reduce its volume and the symptoms. It is ulipristal acetate (UA), a selective progesterone receptor modulator. In the endometrium it can cause some peculiar histological changes. We present a patient with symptomatic uterine fibroid with UA, and it was difficult to make differential diagnosis with endometrial cancer.