ADVANCES IN OBSTETRICS AND GYNECOLOGY
Online ISSN : 1347-6742
Print ISSN : 0370-8446
ISSN-L : 0370-8446
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Volume 64, Issue 4
Displaying 1-7 of 7 articles from this issue
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ARTICLES
Case Report
  • Fertility-preserving management of atypical polypoid adenomyoma (APAM) in 2 young women
    Kayo INOUE, Hiroshi TSUBAMOTO, Riichiro KANAZAWA, Okuto HONDA, Toru KA ...
    2012 Volume 64 Issue 4 Pages 483-489
    Published: 2012
    Released on J-STAGE: December 31, 2012
    DOIhttps://doi.org/10.11437/sanpunosinpo.64.483
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    We report 2 cases of young women diagnosed with atypical polypoid adenomyoma (APAM). [Case 1] A 29-year-old woman (nulligravida) with a chief complaint of menorrhagia was found to have a 2-cm tumor in the uterine body and referred to our hospital. Endometrial biopsy detected atypical endometrial hyperplasia, complex and transcervical resection (TCR) and dilation and curettage (D&C) procedures were performed. The final diagnosis was APAM. No residual tumor was found in a post-surgery hysteroscopic examination. 6 years later, MRI revealed a 2-cm tumor in the uterus and recurrence of APAM was diagnosed from D&C findings. The tumor grew to 4-cm in diameter within 3 months and TCR was performed. However, the tumor grew in size and she suffered from menorrhagia 6 months later. A laparotomy was performed to resect the tumor, with a negative resected margin. No recurrence was noted 10 months after the surgery. [Case 2] A 27-year-old woman (nulligravida) with menorrhagia underwent TCR to remove endometrial polyps in the fundus of the uterus and a biopsied specimen of the endometrium in the posterior isthmus of the uterus detected atypical endometrial hyperplasia, complex. A D&C procedure revealed no atypical endometrium findings and she was carefully followed. 2 years later, an ultrasound examination revealed a 1-cm tumor in the posterior isthmus of the uterus and biopsied endometrial specimens detected a well-differenciated endometrioid adenocarcinoma. In order to rule out myometrial and cervical invasion, TCR was performed and a diagnosis of APAM was established. No recurrence was seen 11 months after surgery. [Adv Obstet Gynecol, 64 (4) : 483-489 ,2012(H24.11)]
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  • A case of giant chorioangioma complicated with polyhydramnios and congenital fetal heart failure
    Tomoatsu JIMI, Satoshi NAKAGO, Takashi SHIBATA, Hisato TOKUDA, Aya YAM ...
    2012 Volume 64 Issue 4 Pages 490-494
    Published: 2012
    Released on J-STAGE: December 31, 2012
    DOIhttps://doi.org/10.11437/sanpunosinpo.64.490
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    Chorioangioma is the most common benign tumor of the placenta. However, chorioangioma larger than 15 cm are extremely rare. Studies have shown that a larger size of chorioangioma is associated with an increased likelihood of severe perinatal complications such as polyhydramnios and preterm delivery in mothers and heart failure, anemia, non-immune hydrops fetalis and intrauterine growth restriction in fetuses.Here, we report a case of giant chorioangioma complicated with polyhydroamnios followed by fetal heart failure at 29 weeks of gestation. A 17-year-old primigravida was transferred to our hospital for polyhydroamnios and frequent uterine contraction at 27 weeks of gestation. Color Doppler ultrasonography showed a hypervascular tumor (size, 91 x 63 mm) at the edge of the placenta. The fetus was carefully evaluated with ultrasonography, and the fetal heart rate was monitored; cesarean delivery was performed at 29 weeks of gestation due to nonimmune hydrops fetalis and fetal heart failure with cardiothoracic area ratio (CTAR) and inferior vena cava preload index (IVC-PLI) elevation. The size of the placental tumor increased to 18 x 13 cm at 29 weeks of gestation. The infant was discharged in fair condition at 96 days of age. Careful observation of the fetus for complications due to the giant chorioangioma and prompt treatment after diagnosis of fetal heart failure contributed to good prognosis of the infant. Thus, initiating appropriate treatment is important to manage cases of large chorioangiomas complicated with fetal heart failure during pregnancy. [Adv Obstet Gynecol, 64(4) : 490-494, 2012(H24.11)]
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  • Small cell carcinoma of the endometrium treated effectively with paclitaxel and carboplatin
    Mio NAKAGAWA, Hiroyuki HASHIMOTO, Takako ISHII, Susumu YOSHIDA, Mika O ...
    2012 Volume 64 Issue 4 Pages 495-499
    Published: 2012
    Released on J-STAGE: December 31, 2012
    DOIhttps://doi.org/10.11437/sanpunosinpo.64.495
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    Small cell carcinoma of the endometrium is a rare histological type and has a poor clinical course. This is a case report of advanced stage of small cell carcinoma of the uterine corpus, showing a remarkable response to chemotherapy. A 73-year-woman with inoperable stage IIIA corpus cancer histologically displayed an endometrial small-cell carcinoma. Immuno-histochemically, the tumor cells were positive for synaptophysin and neuron-specific enolase, but were negative for the chromogranin. She was treated with chemotherapy of paclitaxel and carboplatin (TC) regimen. After 5 courses of TC regimen, the tumor shrank remarkably and in surgery, hysterectomy and salpingo-oophorectomy could be performed optimally. After an additional 2 courses of TC regimen, the patient was discharged and no recurrence was shown for 3 years. In our case, the TC regimen seemed effective for small cell carcinoma of the endometrium, and it could be the first choice for chemotherapy in such cases. [Adv Obstet Gynecol, 64(4) : 495-499, 2012 (H24.11)]
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