Laparoscopic excision of pelvic masses during pregnancy.

Ovarian neoplasms are infrequently found during early pregnancy and are typically benign corpus luteum cysts that regress. When a large mass persists or enlarges, surgical evaluation is mandated, preferably in the second trimester. To prevent the morbidity of a laparotomy and minimize length of stay, operative laparoscopy was performed on two pregnant women, gestational ages 18 and 15 weeks, with large ovarian tumors ranging in size from 10 to 18 cm. Laparoscopic salpingo-oophorectomy was successful in both patients, and frozen section confirmed the benign nature of the tumors. There were no complications and both pregnancies were continuing at the time of writing.

Cellular fibroma of the ovary with Meigs' syndrome and elevated CA-125. A case report.

BACKGROUND: Cellular fibroma of the ovary is an uncommon benign tumor. When associated with Meigs' syndrome, it can produce a clinical picture similar to that of ovarian carcinoma. CASE: A 73-year-old nulligravida was admitted to the hospital with progressive cachexia, ascites, a right pleural effusion and a 15-cm pelvic mass. The serum CA-125 level was 1,780. Due to a high suspicion of ovarian carcinoma, the patient underwent exploratory laparotomy, total abdominal hysterectomy/bilateral salpingooophorectomy and surgical staging for a frozen section diagnosis of sarcoma. Permanent histology revealed the tumor to be a cellular fibroma, and the CA-125 levels fell to normal postoperatively. CONCLUSION: Since benign ovarian tumors may mimic carcinoma, laparotomy and appropriate surgical staging are essential for the final diagnosis.

Omental herniation through a 5-mm laparoscopic cannula site.

Herniation is a rare complication of laparoscopy, and has not previously been reported to occur through a 5-mm puncture site. A patient experienced an incarcerated omental prolapse through an incision for a 5-mm cannula 4 days after undergoing a laparoscopic radical hysterectomy. Based on our experience, we recommend fascial closure of all laparoscopic cannula insertion sites if possible, and emphasize the need for evaluating omental or enteric protrusions through even small fascial defects.

Tuberculous endometritis presenting as postmenopausal bleeding. A case report.

Genital tuberculosis presented as postmenopausal bleeding in a woman with third-degree procidentia. After two months of combination antimycobacterial treatment, she underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy followed by nine months of postoperative drug therapy.

Tumors originating in supernumerary ovaries. A report of two cases.

The supernumerary ovary is a rare gynecologic anomaly; 13 cases have been reported on since 1890. Three were associated with tumors arising in the ectopic ovarian tissue. We encountered two cases of benign neoplasms discovered to have originated in supernumerary ovaries.

Divergence in cholesterol biosynthetic rates and 3-hydroxy-3-methylglutaryl-CoA reductase activity as a consequence of granulocyte versus monocyte-macrophage differentiation in HL-60 cells.

Addition of dimethyl sulfoxide or phorbol myristate acetate (PMA) to HL-60 cell cultures induces granulocytic or monocyte-macrophage differentiation, respectively, in HL-60 cells. Dimethyl sulfoxide-induced granulocyte differentiation in HL-60 cells is associated with a decrease in cellular 3-hydroxy-3-methylglutaryl (HMG)-CoA reductase activity and with a decrease in the incorporation of [14C]acetate and mevalonate into products of the cholesterol biosynthetic pathway. PMA-induced monocyte-macrophage differentiation in HL-60 cells is associated with a rapid and profound fall in cell proliferation but nonetheless is accompanied by a dose-dependent increase in cellular HMG-CoA reductase activity and [14C]acetate incorporation into the cholesterol biosynthetic pathway. In addition, PMA induces an increase in [14C]mevalonate incorporation into cholesterol and its precursors, suggesting that post-HMG-CoA reductase events in cholesterol biosynthesis are also enhanced. Mature peripheral blood human monocytes possess an active cholesterol biosynthetic pathway, whereas mature human granulocytes are almost entirely lacking in the ability to synthesize post-squalene products. Our results with HL-60 cells indicate that this divergence in sterol-synthesizing ability between two cell lineages, which normally also derive from a common stem cell, can be observed as an early event in the differentiation process.