Two cases of immature teratoma with positive reproductive outcomes.

The peak incidence of immature teratoma is in the early reproductive period of a woman's life and fertility preservation is an inevitable topic when discussing treatment options. We present two cases of immature teratoma with positive reproductive outcome. Our experience supports the standpoint that surgery alone is curative in most cases, irrespective of tumor grade. Bearing this in mind, the long-term effect of chemotherapy on ovarian function can be avoided and fertility, an important factor in the overall quality of life, can be preserved.

Treatment for infertility and risk of invasive epithelial ovarian cancer--a case report.

A 30-year-old women was admitted to the Institute of Gynecology and Obstetrics, Clinical Center of Serbia in April 2004 with the following diagnosis: adnexal mass soon after in vitro fertilization. Her history revealed salpingo-oophorectomy for mucinous cystadenofibroma of the left ovary eight years before and cystectomy of the right ovary three years before. At admission, the most remarkable findings were high temperature and elevated white blood cells with erythrocyte sedimentation rate. After the antibiotic treatment, laparatomy was performed and a multilocular right adnexal tumor was found. The right salpingo-oophorectomy was performed and pathological diagnosis was mucinous ovarian adenocarcinoma. Two weeks later, radical surgery was carried out and chemotherapy was applied. There is an urgent need for clear interpretation of the link between ovarian stimulation and ovarian cancer. An association between ovarian stimulation treatment and ovarian cancer has still not been completely proven.

Solitary ovarian metastasis from cutaneous melanoma--case report.

A 47-year-old patient with two previous deliveries and three deliberate abortions was admitted to the Institute of Gynecology and Obstetrics, Clinical Center of Serbia with the diagnosis of a uterine myoma and left adnexal mass. Five years previously, she had undergone excision of a malignant melanoma from her left leg. Pelvic exemination disclosed a left adnexal solid mass measuring about 100 x 80 x 80 mm and enlarged uterus 120 x 50 mm in size with myomatosus nodes on the posterior wall. After ultrasound and computed tomography examination, the patient underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, intracolic omentectomy and selective pelvic lymphonodectomy. The final histopathological diagnosis was metastatic amelanotic malignant melanoma of the left ovary and uterine myomas. After surgery the patient was transferred to the Institute of Oncology and Radiology where she received chemotherapy.

[Acute renal failure after cesarean section as a consequence of hematoma of the retropubic space of Retzius].

Acute renal failure is rare postoperative complication of cesarean section. Postrenal acute renal failure is corectible ant it shoud be done immediately in order to avoid secundary destruction of renal parenchim. Surgical techniques shoud be directed to achieve adequat haemostasis, espetialy at low transverse Pfannenstiel incision, as well as in tender manipuliating with tissues to prevent unnecessery formation of dead space and tissues devitalisation. Authors are presenting the case of acute renal failure after cesarean section as a consequence of hematoma of the retropubic space of Retzius and way of treatment.

Placental site trophoblastic tumor: a case report.

Patient K.N., age 30, nulliparous deliveries and with one miscarriage, was admitted to the Institute of Gynecology and Obstetrics, Clinical Center of Serbia, in December 2000 with the following diagnosis: Uterine myoma and adnexal mass.

[Surgical treatment of a 5 month pregnancy in the rudimentary uterine cornu].

Cornual ectopic pregnacy is rare clinical entity with high maternal mortality. In all cases surgical treatment is indicated, and taking care of most important complication--haemorrhagic shock. Therapeutic approach is individual and depending of simptomatplogy, gestational age of pregnancy and condition of the patient in time of diagnosis. Authors are presenting the case of cornual ectopic pregnancy of five months.

High-risk human papillomavirus (HPV) types in patients with squamous intraepithelial lesions (SIL).

The aim of the paper was to determine the probability of joined occurrence of certain HPV types, particularly those with high oncogenic risk and histopathological (HP) findings (LGSIL and HGSIL, i.e., micro invasive and invasive carcinoma) as well as to find out to what extent either presence or absence of HPV can be identified in HP findings. The investigation was carried out on 48 patients. Based on a suspected colposcopy findings, Papanicolaou (Pap) smear and biopsy were performed and a histopathological analysis of the sample was carried out. A cervical smear was made on all the patients for HPV detection and typing. The results in the group with HPV, which showed histological diagnoses of LGSIL in 80% of cases, revealed numbers significantly higher with respect to the same summing up in the group where HPV was not detected (66.6%). HP findings of HGSIL in both groups were diagnosed in almost the same percentage and it should be taken into account that there were 6.7% of patients with Ca in situ in the group of HPV-positive patients. Therefore, it can be concluded that if a diagnosis of LGSIL or HGSIL, in particular, has been made on the basis of HP findings there is a great probability that it is a case of infection by one or more joined types of human papillomaviruses. The presence of virus specific genes in one of the stages of tumor development at the beginning of the infection indicates the viral etiology of tumors. The presence of HPV genome was not proved in 21% of patients with HGSIL. A multiple infection with different HPV types is more often found in patients with LGSIL than in those diagnosed with HGSIL. This demonstrates the selection of high oncogenic types and their persistence during the course of carcinoma progression.

Correlation between atypical colposcopy findings and detection of human papillomavirus (HPV) infection of the uterine cervix.

Reports on the detection of genome human papillomaviruses (HPV) in genital neoplasia differ to a great extent either in the overall prevalence or in the frequency of certain types. The aim of the study was to determine the correlation between the HPV infection and the occurrence of premalignant and malignant diseases of the uterine cervix and to investigate the ratio between clinical features and infection findings starting from the assumption that infection by human papillomaviruses is a key factor in the occurrence of premalignant and malignant disease of the uterine cervix. The investigation was carried out on 48 patients who formed the study group (Group I). Based on suspicious colposcopy findings, a Papanicolaou (Pap) smear and biopsy were performed and a histopathological analysis of the sample was carried out. A cervical smear was done on all the patients for HPV detection and typing. The patients in whom HPV infection was not found formed a control group (C Group). In spite of certain divergences it has not been proved that the ratio between colposcopy findings and HPV type has any statistical importance (chi2 = 3.305; p > 0.05). The distribution of Pap smear results did not shown a significant difference with respect to HPV type (chi2 = 0.105; p > 0.05). When the data are analyzed the diagnosis of low-grade squamous intraepithelial lesions (LGSIL) is evident in 20% of the HPV cases whereas it is significantly lower with respect to the group where HPV was not detected (42.5%). Histopathological (HP) findings of a high-grade squamous intraepithelial lesions (HGSIL) in both groups are diagnosed in approximately the same percentage while 6.7% of cancer in situ was registered in the group of HPV positive patients. Based on this it can be concluded that if a diagnosis of LGSIL or HGSIL in particular has been made on the basis of HP findings there is a great probability that the infection was due to one or more joined types of human papillomaviruses.

[Health needs of adolescent girls in the area of reproductive behavior]. / Zdravstvene potrebe adolescentkinja u oblasti reproduktivnog ponasanja.

Most users (64.1%) of the Counseling Unit for the Young are unmarried girls aged 17 to 24, predominantly students and secondary pupils. Although more frequent in older girls (21-24 years old), pregnancy is highly undesirable both in younger (22.2%) and older (57.1%) ones. Since they are most often nulliparae, the underlying health problems are significant. The girls are considered to be pregnant before their coming to the Counselling Unit, because afterwards 83.0% of them start using contraceptives. The health service for adolescents is encountered with two tasks: (1) to get adolescent girls coming to the Counselling Unit before they experience pregnancy in a negative sense, and (2) to observe and analyse the efficacy and side-effects of contraceptives.