Objective:To analyze the clinical materials of the patient with Van Wyk and Grumbach syndrome (VWGS),and to explore the pathogenesis,clinical characteristics,diagnosis,differential diagnosis and treatment method.Methods:The clinical data of a patient with VWGS was analyzed retrospectively.Results:The patient presented autoimmune thyroiditis, sever long-standing hypothyroidism, bilateral ovarian cysts, hyperprolactinaemia and a secondary pituitary adenoma. After thyroxine replacement treatment, the thyroid function and prolactin (PRL)level recovered to the normal levels and the ovarian cyst was shrunk within 1 month. Conclusion:The clinical manifestation of VWGS is special.And it’s easy to misdiagnose this syndrome as pituitary adenoma or ovary cyst and then operation is performed.Thyroid hormone replacement can completely resolve the symptoms and hormone abnormalities.Grasping the clinical characteristics of this syndrome and making correct diagnosis is critical to avoid unnecessary operation.

A 36-year old woman was admitted for menolipsis for 71 days and vaginal bleeding for 38 days and aggravation of vaginal bleeding with abdominal distension for 10 days. Gynecological examination revealed marked hysterauxesis without tenderness with a high HCG level. CT examination led to the misdiagnosis of trophoblastic tumor with lymph node metastasis of the left iliac vessels. The patient underwent subsequent laparotomy, and a huge pelvic hematoma with maximum diameter of 20 cm was found, for which left salpingectomy was performed. Pathologic examination of the surgical specimen supported the diagnosis of old tubal pregnancy. This case represents a rare clinical entity of old ectopic pregnancy manifested as a painless huge pelvic mass that can be easily misdiagnosed based on radiographical findings only.
Adult ; Diagnostic Errors ; Female ; Humans ; Pelvic Neoplasms ; diagnosis ; etiology ; Pregnancy ; Pregnancy Complications ; diagnosis ; Pregnancy, Ectopic ; diagnosis ; Ultrasonography

OBJECTIVE: To investigate the expression of high risk human papilloma virus (HPV) 16-E6 protein in non-neoplastic epithelial disorders of the vulva (NNEDV) and squamous cell carcinoma of the vulva (VSCC), and to explore whether HPV16-E6 protein is the etiological factor in NNEDV and its correlation with squamous cell carcinoma of the vulvae. METHODS: We detected HPV16-E6 protein expression in 15 normal vulvae cases, 40 NNEDV cases and 45 VSCC cases by immunohistochemistry SP method. RESULTS: The positive rate of HPV16-E6 in different vulva tissues: was 0% in the normal vulva, 30% in NNEDV and 66.67% in VSCC, respectively. The overall positive rate and two two comparison had statistical significance. In the NNEDV group, the positive rate of squamous hyperplasia type and lichen sclerosus type was 35% and 25%, respectively, with no statistical significance (P>0.05), but higher than that in the normal vulva skin group (P<0.05) and lower than that in the VSCC group (P<0.05). The positive rate of HPV16-E6 in VSCC was 66. 67%. The positive rate increased with the clinical stage. The positive rate between Phase I and Phase II, and that between Phase I and Phase III had statistical significance (P<0.017), but that between Phase II and Phase III had no statistical significance (P>0.017). The positive rate gradually decreased with the tumor differentiation. The difference in well-differentiated and poorly differentiated, moderately and poorly differentiated had statistical significance (P<0.017), but that of well-differentiated and moderately differentiated had no statistical significance (P>0.017). The positive rate of lymph node metastasis VSCC was significantly higher than that of non-lymph node metastasis VSCC (P<0.05). CONCLUSION HPV infection may be an etiological factor for NNEDV. The rise of HPV16-E6 positive rate may be related to the occurrence and development of vulvar squamous cell carcinoma.
Carcinoma, Squamous Cell ; metabolism ; virology ; Female ; Humans ; Hyperplasia ; Oncogene Proteins, Viral ; metabolism ; Papillomavirus Infections ; metabolism ; Precancerous Conditions ; metabolism ; virology ; Repressor Proteins ; metabolism ; Vulvar Diseases ; metabolism ; virology ; Vulvar Neoplasms ; metabolism ; virology

Huge primary teratoma in the preperitoneal space is an extremely rare clinical entity and can be easily misdiagnosed as tumors of the intraperitoneal or pelvic origin. We report a case of primary huge mature teratoma in the preperitoneal space in a 74-year-old women, and reviews the clinical data and the diagnosis and treatment of this case. The patient underwent complete resection of the teratoma, which was the optimal treatment option. The patient was followed-up for 10 months and no signs of recurrence were found, suggesting a favorable prognosis.
Aged ; Female ; Humans ; Peritoneal Neoplasms ; diagnosis ; therapy ; Prognosis ; Teratoma ; diagnosis ; therapy

Gestational trophoblastic tumors (GTTs) are malignant lesions that often cause abnormal genital bleeding and may present with hemoptysis, intraperitoneal bleeding or acute neurologic deficits. GTTs are generally highly chemosensitive with more favorable outcomes than other comparable malignancies. Here we report a rare case of invasive mole (FIGO stage IV, WHO score16) presenting with renal subcapsular hematoma due to bleeding renal metastasis. The patient had a pretreatment β-human chorionic gonadotrophin (β-HCG) level of 462 047 mIU/ml and received combined chemotherapy with etoposide, methotrexate, actinomycin-D, cyclophosphamide and vincristine with also adjuvant surgeries including hysterectomy and nephrectomy. The patient recovered well and the tumor has remained in complete remission for one year and a half.
Antineoplastic Combined Chemotherapy Protocols ; Female ; Hemorrhage ; etiology ; Humans ; Hydatidiform Mole, Invasive ; complications ; Kidney ; pathology ; Pregnancy ; Uterine Neoplasms ; complications

OBJECTIVE: To evaluate the genital human papillomavirus (HPV) infection in patients from gynecology clinic, and to investigate the association of persistent HPV infection with cervical lesions. METHODS: From January, 2009 to December, 2013, clinical data of 16 320 patients in Third Xiangya Hospital were collected. A retrospective analysis was carried out to evaluate the overall prevalence of HPV infection. The prevalence of HPV infection in different ages and subtypes were compared. The prevalence of persistent HPV infection and results of cervical cytology were analyzed. RESULTS: The overall HPV prevalence was 26.54%. The lowest overall and high-risk HPV prevalence were found in women at the age of 30-39 years old (P<0.05); the highest ones were found at the age of over 60 years old, with significant difference among the aged groups (P<0.05). There was no significant difference in low-risk HPV prevalence among the aged groups (P=0.693). The clearance rate of HPV was 87.65% one year later. There was no significant difference in high-risk and low-risk HPV infection between the non-persistent positive group and the persistent positive group (P=0.545), but the difference in single and multiple subtypes infection between these 2 groups was significant (P<0.05). In the persistent positive group, the most common genotypes were HPV 16, 52, 58, CP8304, and 33. The incidence of ASC-US, HSIL or SCC was significantly increased in the persistent positive group. CONCLUSION Persistent HPV infection mainly consists of multiple and high-risk HPV infection. It is necessary to focus on the prevention of HPV 16, 52 and 58 persistent infection in our region.
Adult ; Female ; Genotype ; Humans ; Middle Aged ; Papillomaviridae ; classification ; Papillomavirus Infections ; epidemiology ; Prevalence ; Retrospective Studies ; Vaginal Smears

Spontaneous severe ovarian hyperstimulation syndrome-complicated natural pregnancy (SOHSSp) is a rare clinical entity and can be easily misdiagnosed as ovarian tumors. We report a case of SOHSSp in a 26-year-old women with successful delivery, and reviews the clinical data and the diagnosis and treatment of this case. The patient underwent a diagnostic laparoscopy and was followed-up for 1 year with a favorable prognosis.
Adult ; Female ; Humans ; Ovarian Hyperstimulation Syndrome ; Pregnancy ; Pregnancy Complications ; Pregnancy Outcome

A case of primary yolk sac tumor of endometrium was retrospectively analyzed and relevant literature was systematically reviewed. We found that the primary yolk sac tumor of endometrium showed low incidence rate and was clinically characterized by abnormal vaginal bleeding, intrauterine lesions and significantly elevated alpha-fetoprotein (AFP) level. The final diagnosis should be confirmed by pathological examination. There is no guideline for the treatment of primary yolk sac tumor of endometrium due to its rareness. For now, surgery and chemotherapy are the major therapies and the curative effect is satisfactory in some cases.
Endodermal Sinus Tumor ; diagnosis ; epidemiology ; therapy ; Female ; Humans ; Incidence ; Retrospective Studies ; Uterus ; pathology ; alpha-Fetoproteins ; metabolism

We reported a case of giant solitary fibrous tumor of vagina and reviewed literature. The clinical features, diagnosis, and treatment schemes for the disease were summarized to improve the understanding of the disease. An elder female patient came to the Third Xiangya Hospital, Central South University, because of abdominal distention and pain for 5 days after menopause for 9 years. The patient was diagnosed as a solitary fibrous tumor of vagina by pathology and immunohistochemistry after complete resection. The tumor size of the patient was the largest according to reported literature, and the tumor recurred 10 months after surgery. The strong positive expression of CD34 and high Ki-67 proliferation index in tumor immunohistochemistry indicate that the prognosis of patients will be poor.
Aged ; Antigens, CD34 ; metabolism ; Biomarkers, Tumor ; metabolism ; Female ; Humans ; Immunohistochemistry ; Ki-67 Antigen ; metabolism ; Neoplasm Recurrence, Local ; metabolism ; Prognosis ; Solitary Fibrous Tumors ; metabolism ; pathology ; Tumor Burden ; Vaginal Neoplasms ; metabolism ; pathology

OBJECTIVE: To investigate the effect of nano-realgar on proliferation and apoptosis of cervical cancer cells.
 METHODS: Different cervical cancer cell lines (Caski/HPV16+, adeno carcinoma; Hela/HPV18+, squmous carcinoma; C33A/HPV-, adeno carcinoma) were incubated with nano-realgar at different concentrations (5, 10, 20, 40 mg/L) for different times (24, 48, 72, 96 h). The morphology was observed under phase contrast microscope. The cell viability and apoptosis were examined by MTT and flow cytometry, respectively.
 RESULTS: The inhibitory effect of nano-realgar on the proliferation of cervical cancer cells was in a dose-dependent manner, with a range of inhibitory rate from 9.02% to 49.06%. Taking the group (20 mg/L) for an example, the inhibitory rates for Caski, Hela and C33A were 39.15%, 36.17% and 30.56%, respectively. The results of flow cytometry showed that the nano-realgar induced apoptosis in a concentration-dependent manner, with a range of apoptosis rate from 19.29% to 99.54%. Also taking the group (20 mg/L) for an example, the apoptosis rates for Caski, Hela and C33A were (60.43 ± 2.88)%, (41.95 ± 3.01)% and (43.49 ± 2.19)%, respectively. High concentration of nano-realgar (20 or 40 mg/L) could induce block of Hela and Caski at G2/M stage.
 CONCLUSION Nano-realgar can inhibit the proliferation of different cervical carcinoma cell lines and can induce the cell apoptosis. The inhibitory effect on cell proliferation is strongest for Caski, followed by Hela and C33A. It can also induce G2/M stage block on HPV positive cervical cancer cells at high enough concentration.
Adenocarcinoma ; pathology ; Apoptosis ; drug effects ; Arsenicals ; chemistry ; Carcinoma, Squamous Cell ; pathology ; Cell Line, Tumor ; drug effects ; Cell Proliferation ; drug effects ; Female ; HeLa Cells ; drug effects ; Humans ; Nanoparticles ; chemistry ; Sulfides ; chemistry ; Uterine Cervical Neoplasms ; pathology