Leydig cell ovarian tumor - clinical case description and literature review.

Leydig cell ovarian tumors constitute not only a medical problem for clinicians but also a social problem - which is why women with symptoms of hirsutism relatively quickly contact physicians for medical consultation. Leydig cell ovarian tumor is a rare sex cord-gonadal stromal tumor which constitutes less than 0.5% of ovarian tumors. These cancers appear at all ages but the majority of the cases concern women in the perimenopause. In the majority of cases (70-85%), the growth is accompanied by androgen secretion, together with virilization and hirsutism. The presence of hormonally active ovarian cancers should be suspected in cases of rapidly growing symptoms of masculinization, especially when the level of free testosterone in the blood exceeds the upper limit for the given age more than three times. In diagnosing postmenopausal hyperandrogenism, it is necessary to take into account hormonally active ovarian tumors, as well as adrenal cancers. It is important to exclude other causes of hyperandrogenism, e.g. endocrinopathies (acromegaly or hypothyroidism), or iatrogenic and idiopathic factors. In order to make the diagnosis and implement the proper treatment method faster, an interdisciplinary team of physicians specializing in endocrinology, gynecology and oncology is crucial. This paper contains a study of two cases concerning Leydig cell ovarian tumors in women of postmenopausal age with symptoms of masculinization and hirsutism.

Basaloid squamous cell carcinoma of the uterine cervix coexisting with undifferentiated sarcoma.

Basaloid squamous cell carcinoma is uncommon tumor and has received little recognition, there are only a few cases in the medical literature. Correct diagnosis is important due to the high malignancy of this cancer and poor prognosis. We present a rare and interesting case of a basaloid squamous cell carcinoma of the uterine cervix in a 71-year-old female with prolapse of the uterus with co-existing atypical undifferentiated sarcoma.

Influence of diet on the risk of developing endometriosis.

Endometriosis is a hormone-dependent chronic inflammatory disease characterized by the presence of endometrium beyond the uterine cavity. The disease affects 5-15% of women of child-bearing age, 30-50% of whom suffer from infertility. Understanding the role of dietary factors in the development of endometriosis is critical to development of effective dietary instructions for prevention. Existing studies concerning nutrition and endometriosis suggest that diet is a potentially modifiable risk factor for endometriosis. Fruits and vegetables, fish oils, dairy products rich in calcium and vitamin D, and Omega-3 fatty acids are likely connected with a lower risk of developing endometriosis. Risk factors that increase the risk of endometriosis include consumption of products rich in trans-unsaturated fatty acids, consumption of fats generally, and consumption of beef and other kinds of red meat and alcohol. Currently, there are no clear correlations between par-ticular food products and the risk of endometriosis. Further research is needed in order to fully understand the influence of consumed food products on the risk of development of this disease.

Anti-Müllerian hormone dynamics during ovulation induction treatment with recombinant follicle-stimulating hormone in women with polycystic ovary syndrome.

INTRODUCTION: Anti-Müllerian hormone (AMH) has been suggested as a predictor of ovarian response to ovulation induction and controlled ovarian hyperstimulation. MATERIAL AND METHODS: Twenty-six women, wishing to become pregnant and who showed resistance to clomiphene citrate, were included in the study. All women received recombinant follicle-stimulating hormone (recFSH). RESULTS: In the group of good responders, luteinising hormone (LH) and oestradiol levels were lower than in the group of non-responders. Free testosterone levels, free androgen index, and insulin resistance were higher in the group of non-responders. In the group of good responders, AMH levels decreased on successive days of ovarian stimulation and a greater slope of AMH levels was observed in patients with a higher number of increasing follicles. PCOS patients have low FSH and high AMH levels. It could be suggested that the serum AMH decrease preceded growth of many follicles, which is a consequence of the FSH stimulation. In anovulatory PCOS women, gently increasing the serum FSH level reduces the AMH excess, thus relieving the inhibition from the latter on aromatase expression by selectable follicles and allowing the emergence of growing follicles. Patients with severe hyperandrogenism, insulin resistance and high level of LH do not respond to stimulation. CONCLUSIONS: The decrease of AMH levels in PCOS women after one week of ovarian stimulation is a practical, valuable indicator which could predict the patients with a high risk of ovarian hyperstimulation. Anovulating PCOS patients with severe hyperandrogenism, insulin resistance and hyperinsulinaemia should not be qualified for recFSH ovarian stimulation.