Primary Carcinosarcoma of the Vagina Associated With Differentiated Squamous Intraepithelial Neoplasia in a Patient With Complete Uterine Prolapse: Case Report and Review of the Literature.

Vaginal carcinosarcomas (VCSs) are rare and clinically aggressive neoplasms. Primary vaginal malignancies are among the rarest malignant tumors, so clear management guidelines and optimal therapy, especially in the presence of significant pelvic organ prolapse, has not been determined. Here, we present a case of primary VCS closely associated with differentiated squamous intraepithelial neoplasia (DSIN), from which it appeared to have arisen in a postmenopausal patient with complete uterine prolapse. The unusual presentation of our case with DSIN in the adjacent vaginal epithelium with possible diagnostic pitfalls emphasizes the need for systemic presentation of these cases to help pathologists and clinicians know that such lesions can initially present in a patient with complete uterine prolapse. To our knowledge, this is the first case of vaginal DSIN described in the literature to date.

[THE INCIDENCE OF PERIPARTUM HYSTERECTOMY IN FIVE CROATIAN HOSPITALS DURING A SIXTEEN-YEAR PERIOD]. / UCESTALOST PERIPARTALNIH HISTEREKTOMIJA U PET HRVATSKIH BOLNICA TIJEKOM SESNAESTOGODISNJEG RAZDOBLJA.

INTRODUCTION: Peripartal hysterectomy (PPH) is a life saving surgical procedure that is performed when conservative measures fail to control bleeding. According to literature data there is an increase in incidence among developed countries. AIM: To define the rate of PPH during two eight-year periods in five Croatian hospitals in respect to mode of delivery. METHODS: Patients data were collected retrospectively from the medical records of the five Croatian hospitals. We analyzed data from 1998 to 2013, and divided them in two eight-year periods. RESULTS: In 70 cases out of 153,302 deliveries urgent PPH was performed. PPH after vaginal deliveries was found in 0.21%o and 0.16%o and PPH after caesarean section was 1.91 %o and 2.04%o in the first and second period, respectively. DISCUSSION AND CONCLUSION: There is no increase of PPH rate in the two analyzed periods, although there is a statistically significant increase of caesarean section rate. Caesarean section presents higher risk for PPH.