Platinum based adjuvant chemotherapy is generally recommended for ovarian cancer to improve the survival rate. Intravenous route is commonly used, easily administered and less associated complications. However, intraperitoneal route is gaining its popularity as a single procedure or adjunctive to the intravenous route. Numerous questions on its eligibility and safety are still perplexed. A case review on a patient with non optimal debulking surgery of advanced ovarian cancer was studied. Intravenous platinum based chemotherapy combined with paclitaxel failed to bring her to clinical remission. Second line chemotherapy, gemcitabin rendered her to poor response with unresolved debilitating ascites needing recurrent drainage. Surprisingly, a trial of intraperitoneal chemotherapy with cisplatin revealed a great response with a complete clinical remission.

Adenomyotic cyst is a rare variant of adenomyosis. It is believed to arise from repeated focal haemorrhages resulting in cystic spaces filled with altered blood products. We present a rare case of a huge adenomyotic cyst in a 27-yearold primigravida, who was in her first trimester, complaining of sudden lower abdominal pain. Diagnostic laparoscopy performed to rule out other cause of acute abdomen. Her pregnancy went on smoothly. She delivered a baby girl of 2.82 kg via vaginal delivery at 39 weeks. Diagnosis and management of this rare clinical entity were reviewed and discussed.
Cysts ; Pregnancy

Administration of additional 'rescue' hCG immediately after IUI appeared to intensify considerably the pregnancy rate in IUI cycles. With a strong confirmatory result, it might eventually lead to avoidance of expensive artificial reproductive techniques i.e. IVF or ICSI in selected couples undergoing infertility treatment. 'Rescue' hCG post-IUI in couple with repeated failed conventional IUI may be recommended as it appeared to be safe with minimal detrimental effect.

Continued follow up of uncomplicated molar cases beyond obtaining one undetectable serum β-hCG level is not necessary in order to detect relapse of gestational trophoblastic disease

Renal angiomyolipoma is a rare disease seen during pregnancy. Rupture of renal angiomyolipoma could be catastrophic and might result in maternal and even perinatal mortality. Management includes conservative vs surgical approach. A 29-year-old woman Para 2 with history of bleeding renal angiomyolipoma in her first pregnancy at 11 weeks treated with selective arterial embolisation. The pregnancy was terminated. Even though having small residual tumour, her subsequent pregnancy progressed well with conservative management. Intervention is advisable in the presence of large or symptomatic renal angiomyolipoma prior to pregnancy in order to minimise potential lifethreatening haemorrhage during pregnancy. For those with small tumour of less than 4cm, perhaps conservative approaches i.e. frequent follow-up and close monitoring would assist in early identification of any rupture or bleeding.
Nephrectomy ; Pregnancy Women

We report a case of dislodged Levornogestrel-intrauterine system (LNG-IUS, Mirena®) without evidence of uterine perforation. A 37-year-old Para 4+1presented with 3 months history of lower abdominal pain. Examination and imaging showed that the device was not present in the uterine cavity. She underwent laparoscopic retrieval of Mirena®. There was no evidence of uterine perforation intra-operatively. This case illustrated the rare possibility of dislodged Mirena®intra-abdominally without evidence of uterine perforation. The management for missing IUS was reviewed.
Levonorgestrel