RESUMO
A 20-year-old female with a diagnosis of autoimmune encephalitis against N-methyl-D-aspartate receptor was found to have a 13 mm teratoma in the left ovary. The tumor had undergone massive coagulative necrosis within a normal ovary, a previously unreported feature. Necrosis of a mature cystic teratoma is very rare in the absence of ovarian torsion. It is proposed that necrosis may have induced a massive liberation of neuronal antigens. The vast majority of the tumors associated with this newly described condition are ovarian teratomas containing neural tissues. In this paper, we review their different histopathological aspects that may explain the relative incidence of various tumor types associated to this form of encephalitis. Anti N-methyl-D-aspartate receptor encephalitis has now become the most frequent autoimmune disorder associated with ovarian teratoma.
Assuntos
Encefalite Antirreceptor de N-Metil-D-Aspartato/diagnóstico , Autoanticorpos/sangue , Neoplasias Ovarianas/patologia , Teratoma/patologia , Autoantígenos/imunologia , Biomarcadores Tumorais/metabolismo , Terapia Combinada , Feminino , Humanos , Imunossupressores/uso terapêutico , Imageamento por Ressonância Magnética , Necrose , Neoplasias Ovarianas/imunologia , Neoplasias Ovarianas/metabolismo , Ovariectomia/métodos , Receptores de N-Metil-D-Aspartato/imunologia , Teratoma/imunologia , Teratoma/metabolismo , Resultado do Tratamento , Adulto JovemRESUMO
BACKGROUND: The aim of this study was to determine the effects of a copper-releasing intrauterine device (IUD) on myometrial contractility midway through the menstrual cycle. STUDY DESIGN: Uterine peristalsis was studied midway through the cycle with transvaginal sonography in two groups of women, a control group and women in whom a copper-releasing IUD had been inserted. RESULTS: The results showed that 12 months after insertion, no uterine motility could be detected with sonography in any of the women with an IUD, but motility did occur in all the controls. CONCLUSIONS: Subendometrial-myometrial contractility midway through the menstrual cycle had been abolished in patients with a copper-releasing IUD. The loss of motility may inhibit sperm transport from the cervix to the oviduct and account for at least part of the contraceptive effect of these devices.
Assuntos
Cobre/administração & dosagem , Dispositivos Intrauterinos de Cobre , Menstruação/efeitos dos fármacos , Miométrio/efeitos dos fármacos , Miométrio/diagnóstico por imagem , Contração Uterina/efeitos dos fármacos , Feminino , Humanos , Ciclo Menstrual/efeitos dos fármacos , UltrassonografiaRESUMO
OBJECTIVE: This article presents and discusses a new surgical abdominal technique for the treatment of posthysterectomy vaginal vault prolapse. METHOD: It provides support of the peritoneal surface of the pelvic floor by means of a Gore-Tex mesh, which closes this space. The vaginal vault is fixed to the centre of the mesh. STUDY DESIGN: Descriptive study. RESULTS: Sixteen patients with vaginal vault prolapse were operated on and postoperative follow-up time ranged from 16 to 46 months. There was only one case in which the mesh had to be removed due to infection and posterior erosion of the vaginal wall, and no cases of recurrent vaginal vault prolapse. CONCLUSION: A Gore-Tex mesh, placed at the top of the vaginal vault and extending across the pelvic floor, can effectively treat posthysterectomy vault prolapse.
