RESUMO
The authors present a case of choriocarcinoma of the fallopian tube. The patient was enrolled in an IVF program and to our knowledge this is the first report of a choriocarcinoma following treatment with clomiphene citrate and hMG. The possible role of superovulation in inducing the tumour is discussed. The patient was treated by conservative surgery only and is in remission 1.5 years after the event.
Assuntos
Coriocarcinoma/etiologia , Neoplasias das Tubas Uterinas/etiologia , Ovulação , Superovulação , Adulto , Coriocarcinoma/patologia , Coriocarcinoma/cirurgia , Clomifeno/efeitos adversos , Neoplasias das Tubas Uterinas/patologia , Neoplasias das Tubas Uterinas/cirurgia , Feminino , Fertilização in vitro , Humanos , Menotropinas/efeitos adversos , Indução da Ovulação , GravidezRESUMO
A patient with clinical manifestations of the incomplete androgen insensitivity syndrome was studied with respect to peripheral blood levels of steroids and steroid sulphates before, during and after gonadectomy. Steroid and steroid sulphate concentrations were also analyzed in spermatic venous blood and gonadal tissue collected during surgery. The metabolic capacity of gonadal tissue was also studied in vitro using progesterone, dehydroepiandrosterone sulphate and oestrone sulphate as substrates. Profound differences between the two gonads were noted with respect to both steroid content and release into pampiniform veins and to in vitro conversion of progesterone and oestrone sulphate. Histological examination revealed the presence of seminiferous tubules with carcinoma in situ in both gonads. It is suggested that the differences between the gonads may be due to an autonomous steroid production in the right gonad in spite of adequate or even elevated gonadotrophic stimulation resulting in a steroidogenic situation resembling the complete androgen insensitivity syndrome, while the conditions found in the left gonad more resembles the incomplete form of the disease.
Assuntos
Síndrome de Resistência a Andrógenos/patologia , Gônadas/patologia , Receptores Androgênicos/metabolismo , Adenoma/metabolismo , Adenoma/patologia , Adulto , Síndrome de Resistência a Andrógenos/metabolismo , Carcinoma in Situ/patologia , Feminino , Disgenesia Gonadal 46 XY/metabolismo , Disgenesia Gonadal 46 XY/patologia , Hormônios Esteroides Gonadais/sangue , Gonadotropinas Hipofisárias/sangue , Gônadas/cirurgia , Humanos , Células Intersticiais do Testículo/patologia , Masculino , Túbulos Seminíferos/patologiaRESUMO
25 patients with symptoms of non-specific vaginitis have been treated with metronidazole either 2000 mg in a single dose or 400 mg three times daily for 5 days. Diagnosis was settled by 1) identification of G. vaginalis in culture of vaginal secretion, 2) the observation of clue cells in wet smear, 3) a positive amine test on application of potassium hydroxide, and 4) increased pH in the vaginal secretion. Most patients' symptoms and complaints disappeared and at the same time most of the tests used changed from abnormal to normal findings. No side effects were recorded. It is concluded, that metronidazole in either dose was a useful treatment of non-specific vaginitis.
