Vascular endothelial cell growth factor (VEGF) polymorphisms and haplotypes in Korean women with advanced endometriosis / 대한산부인과학회지

OBJECTIVE: Endometriosis is the presence of normal endometrial mucosa (glands and stroma) abnormally implanted on the outside of uterus. The pathophysiology of endometriosis is not clear yet, but Sampson's theory of the transplantation of endometrial tissue onto the pelvic peritoneum via retrograde menstruation is most widely accepted. Vascular endothelial cell growth factor (VEGF) is involved in the pathophysiology of endometriosis via its angiogenetic property. This study was designed to investigate whether single nucleotide polymorphism and its haplotype and diplotype of VEGF genes are associated with the risk of advanced endometriosis or not. METHODS: This study investigated 260 patients of endometriosis; they underwent operation, and were diagnosed with endometriosis stage III, IV histopathologically. And control group of 199 women underwent surgery with benign ovarian cyst. The single nucleotide polymorphisms of VEGF gene were -2578C>A, 405G>C, 936C>T. They were analyzed by polymerase chain reaction and restriction fragment length polymorphism, and haplotype and diplotype analysis were done. RESULTS: The result of this study showed no association among -2578C/A, 405G>C, 936C>T single nucleotide polymorphisms and severe endometriosis. Haplotype and diplotype of -2578C>A, 405G>C, 936C>T in the VEGF gene were shown to have no association with endometriosis. We found no association between VEGF genetic polymorphism and risk of endometriosis. And haplotype and diplotype analysis also revealed no statistically significant value between VEGF polymorphism and endometriosis. CONCLUSIONS: So, the results of this study suggest polymorphism of VEGF gene may not be associated with risk of endometriosis in Korean women.

Two cases of paratubal cysts manifesting as huge pelvic masses in young women / 대한산부인과학회지

Paratubal cysts come from paraovarium of the broad ligament between the fallopian tube and ovary. Overall, these cysts constitute 10% of all adnexal masses and are commonly incidental findings upon surgical exploration for other reasons. They more commonly occur in women between 30 and 40 years of age. We report two cases of rapidly growing, huge paratubal cysts in young women, which are presented with brief review of literature.

Clinical significance of CA19-9 in mature cystic teratoma of the ovary / 대한산부인과학회지

OBJECTIVE: The aim of this investigation was to analyze the association between ovarian tumor markers and the clinicopathologic features of ovarian mature cystic teratoma. METHODS: The medical records of 195 patients whose pathologic diagnosis were made as mature cystic teratoma after surgery from June, 2000 to July, 2006 at Ewha Womans University Mok-dong Hospital were reviewed. The proportions of elevation of each tumor marker were evaluated in all patients and CA19-9 which showed the greatest elevation rate was selected as a promising relevant tumor marker. The patients were alloted to either Group I showing elevated CA19-9 or Group II showing normal level of CA19-9. The relationship between CA19-9 level and demographic data or clinicopathologic features were investigated by usual statistical method. RESULTS: The mean age of all patients was 35.4+/-12.8, and the average size of tumor was 7.1+/-3.5cm. Bilaterality of the mature cystic teratoma was 12.8%. The proportion of the patients showing elevated levels was greatest in CA19-9 as 33.3% (65/195), compared with 12.0% in CA-125, 5.8% in CEA, 1.1% in AFP. Significant difference between Group I and Group II were found in age, parity, tumor size, and bilaterality. Bilaterality and tumor size were greater in Group I, and age and proportion of parous women were lower in Group I. On the other hand, the rate of ovarian torsion or laparotomy conversion showed no difference. Likelihood ratio for bilaterality which may be clinically used during surgical procedure were 2.2 for CA19-9 suggesting its potential role in gynecologic practice. CONCLUSION: This study shows that CA19-9 may be a useful tumor marker associated with tumor size and bilaterality in ovarian mature cystic teratoma. Further confirmative study with larger sample size is in need in order to establish its definite clinical role in ovarian mature cystic teratoma.

A case of synchronous double primary vulvar cancer and PET-negative renal cell carcinoma / 부인종양

We report a case of synchronous double primary vulvar cancer and renal cell carcinoma. Kidney mass was incidentally detected during preoperative evaluation of vulvar cancer, and was finally confirmed as a renal cell carcinoma. Although the initial result of 18F-fluorodeoxyglucose positron emission tomography was negative for a renal malignancy, nephrectomy was performed under the radiological and urologic impression of renal cell carcinoma which was supported by computerized tomography findings. Histological analysis finally confirmed a renal cell carcinoma. This is the first case report of synchronous double primary vulvar cancer and renal cell carcinoma, which emphasizes multidisciplinary approach to unexpected lesions when the clinical experience of one specialist is limited.