amenorrhea, and an ovarian mass and uterus didelphys were discovered during examination. After right salpingo-oophorectomy, the tumor was confirmed as dysgerminoma, and a chromosome study revealed a normal female karyotype (46, XX). The patient completely responded to 6 cycles of chemotherapy. To our knowledge, this is the first reported case of dysgerminoma with uterus didelphys. Although gynecologic malignancies in patients with Müllerian anomalies are very rare, clinicians should be aware of the coexistence of gynecologic malignancies and uterine malformations.]]>
Adult ; Amenorrhea ; Congenital Abnormalities ; Drug Therapy ; Dysgerminoma ; Female ; Humans ; Karyotype ; Uterus

Acupuncture Therapy ; Adult ; Amenorrhea ; chemically induced ; drug therapy ; Antipsychotic Agents ; adverse effects ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Phytotherapy

Primary gastric choriocarcinomas are very rare, and their prognosis is extremely poor. A 37-year-old woman presented with amenorrhea, vaginal spotting and severe nausea, which mimicked a pregnancy and gestational trophoblastic disease. The serum level of the beta-subunit of human chorionic gonadotrophin (beta-hCG) was significantly increased. An endoscopic biopsy of the stomach mass showed the features of a choriocarcinoma, with marked anaplasia and necrosis. Immunohistochemical staining for beta-hCG showed positive results in the choriocarcinoma. Chemotherapy for the choriocarcinoma was administered, but she died 8 months following diagnosis.
Adult ; Amenorrhea* ; Anaplasia ; Biopsy ; Choriocarcinoma* ; Chorion ; Diagnosis ; Drug Therapy ; Female ; Gestational Trophoblastic Disease ; Humans ; Metrorrhagia ; Nausea ; Necrosis ; Pregnancy ; Prognosis ; Stomach

BACKGROUND: Primary ovarian failure is reportedly increasing in recent years. Environmental factors have been frequently implicated as responsible for this increase, However, only a few of the environmental factors have been proven to cause the ovarian failure in human. METHODS: In June 1995, 24 female laborers, who worked in a factory which used Solvent #5200 (with a main chemical component being 2-bromopropane), developed symptoms of amenorrhea or irregular menstruation. All subjects underwent laboratory tests including measurement of serum LH, FSH, and estradioL Magnetic resonance imaging and ultrasonography of the pelvis were performed in all subjects. Laparoscopic examination was performed in 6 out of 24 patients after obtaining informed consent and 4 of 6 underwent ovarian biopsy. RESULTS: One subject was excluded because she had undergone hysterectomy previously. Among the remaining 23 subjects, 14 and 9 complained of amenorrhea and irregular menstrual periods, respectively. When we defined primary ovarian failure as FSH>30mIU/mL, all of those 14 patients with amenorrhea could be classified as primary ovarian failure. On the other hand, those 9 patients with irregular menstruations had normal FSH levels. Pathologic examination of ovaries showed interstitial fibrosis, loss of primordial follicles, and development arrest of follicles in the group with amenorrhea, similar to what is found in those who received chemotherapy or were exposed to radiation. CONCLUSION: The female laborers who were exposed to the solvent with 2-bromopropane developed primary ovarian failure. This failure was associated with longer duration of exposure. To our knowledge, this is the first report in the world indicating 2-bromopropane as a possible agent for ovarian failure.
Amenorrhea ; Biopsy ; Drug Therapy ; Estradiol ; Female ; Fibrosis ; Hand ; Humans ; Hysterectomy ; Informed Consent ; Magnetic Resonance Imaging ; Menstruation ; Ovary ; Pelvis ; Ultrasonography

OBJECTIVETo study the therapeutic efficacy of bushui roumu recipe (BRR) combined medroxyprogesterone acetate tablet (MAT) in treating premature ovarian failure (POF).

METHODSTotally 90 POF patients of Shen deficiency Gan stagnation syndrome were assigned to 3 groups by random number table, 30 in each group. Patients in the treatment group were treated with BRR and MAT, those in the Chinese medicine group were treated with BRR, and those in the Western medicine group were treated with artificial period method. All patients were treated for 3 months. The menstrual improvement was observed before and after treatment. The therapeutic efficacy was assessed using modified Kupperman scoring standard. The serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) were observed before and after treatment.

RESULTS(1) In aspect of the menstrual improvement: In the treatment group 20 patients had menstrual onset during the treatment course. Ten had normal menstruation after discontinued medication. Of them one got pregnancy one month after treatment. In the Chinese medicine group 6 patients had menstrual onset during the treatment course. Two had normal menstruation after discontinued medication. In the Western medicine group 26 patients had menstrual onset during the treatment course. Twelve had normal menstruation after discontinued medication. Better effects on the menstrual improvement were obtained in the treatment group than in the Chinese medicine group (P < 0.01), but with no statistical difference when compared with the Western medicine group (P > 0.05). (2) There was statistical difference in modified Kupperman scores of the 3 groups between before and after treatment (P < 0.01). The improvement of total modified Kupperman score was better in the treatment group than in the other two groups (P < 0.01). The improvement of palpitation was better in the treatment group than in the other two groups (P < 0.05). The improvement of tidal fever and sweat was better in the treatment group and the Chinese medicine group than in the Western medicine group (P < 0.05). (3) After treatment all patients' serum E2 was higher than before treatment, serum levels of FSH and LH were lower than before treatment. Compared pre- and post-treatment, there was statistical difference (P < 0.01). The serum E2 level in the 3 groups was higher after treatment than before treatment with statistical difference (P < 0.01). The levels of FSH and LH were lower in the 3 groups after treatment than before treatment with statistical difference (P < 0.01). The improvement of E2 was better in the treatment group than in the Chinese medicine group (P < 0.05). The improvement of FSH and LH was better in the treatment group than in the Western medicine group (P < 0.05).

CONCLUSIONCombination of BRR and MAT could improve the clinical symptoms, menstruation, and serum reproductive hormones in POF patients of Shen deficiency Gan stagnation syndrome.

Adult ; Amenorrhea ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Medroxyprogesterone Acetate ; therapeutic use ; Phytotherapy ; Primary Ovarian Insufficiency ; drug therapy

Dysgerminoma developed in a 21-year-old phenotypic female patient with 46,XY pure gonadal dysgenesis, Swyer syndrome. This patient presented with pelvic mass associated with abdominal pain and primay amenorrhea. Clinical characteristics showed a typical stigmata of gonadal dysgenesis: primary amenorrhea, sexual infantilism, a small uterus and left streak gonad. A 46,XY karyotype was made by lymphocyte culture. The patient was counseled to undergo operation, chemotherapy and hormon therapy. She underwent bilateral gonadectomy with total hysterectomy, partial omentectomy and multiple pelvic wall random biopsy. Histological examination revealed dysgenetic gonads with dysgerminoma. After surgery, the patient received chemotherapy and also was started on hormone replacement therapy. She is currently alive with no evidence of disease after 19 months from surgery.
Abdominal Pain ; Amenorrhea ; Biopsy ; Christianity ; Drug Therapy ; Dysgerminoma* ; Female ; Gonadal Dysgenesis ; Gonadal Dysgenesis, 46,XY* ; Gonads ; Hormone Replacement Therapy ; Humans ; Hysterectomy ; Karyotype ; Lymphocytes ; Sexual Infantilism ; Uterus ; Young Adult

OBJECTIVETo observe the clinical effect of self-formulated Tongdatang serial recipe (TDT) in treating antipsychotic drug-induced galactorrhea-amenorrhea syndrome (GAS).

METHODSOne hundred female schizophrenic patients with antipsychotic drug-induced GAS were selected and equally assigned to the treatment group and the control group at random. Both received antipsychotic drug-therapy, but combined with TDT and placebo respectively. The efficacy was evaluated by determining prolactin level before, 4 and 8 weeks after treatment.

RESULTSThe treatment course was completed in 96% of patients. Therapeutic efficacy on the 49 patients of the treatment group was cured in 31 (63.3%), markedly effective in 11 (22.4%), effective in 4 (8.2%) and ineffective in 3 (6.1%), with total effective rate of 93.9%, while in 47 patients of the control group, the corresponding cases (%) was 0, 3 (6.4%) , 7 (14.9%) and 37 (78.7%), respectively, with the total effective rate of 21.3%. Prolactin levels in the two groups were insignificantly different before treatment, it reduced in the treatment group after treatment (P < 0.01), and the decrement in the treatment group was more significant than that in the control group (P < 0.05).

CONCLUSIONSatisfactory effect could achieved by using TDT for treatment of antipsychotic drug-induced GAS.

Adolescent ; Adult ; Amenorrhea ; chemically induced ; drug therapy ; Antipsychotic Agents ; adverse effects ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Galactorrhea ; chemically induced ; drug therapy ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Schizophrenia ; drug therapy ; Syndrome ; Young Adult

We report a successful pregnancy in a woman who at the age of 31years received chemotherapy for mucinous cystadenocarcinoma of the right ovary. She was treated with multiple chemotherapy including cis-platinum, cyclophosphamide, adriamycin, and oral melphalan. She had microscopic residual cancer at the opposite ovary at second-look laparotomy. She developed secondary amenorrhea with symptoms of menopause after commencing treatment which persisted on its completion. Biochemical investigations were consistent with ovarian failure, which was assumed to be chemotherapy-induced. She was given hormonal replacement therapy with a conjugated equine estrogen/medroxyprogesterone acetate combination, resulting in regular withdrawal bleeding. The patient conceived 5 years after completing chemotherapy and gave birth a normal infant at term.
Amenorrhea ; Cisplatin ; Cyclophosphamide ; Cystadenocarcinoma, Mucinous ; Doxorubicin ; Drug Therapy* ; Female ; Hemorrhage ; Humans ; Infant ; Laparotomy ; Melphalan ; Menopause ; Neoplasm, Residual ; Ovarian Neoplasms ; Ovary ; Parturition ; Pregnancy*

OBJECTIVE: We analysed the duration of ovarian dysfunction, amenorrhea and pregnancy rate of the patients who underwent the fertility preserving surgery and adjuvant chemotherapy at the reproductive age to identify the contributing factors of ovarian dysfunction and premature menopause. METHODS: We select the 25 patients (<40 years old at diagnosis) among the 270 patients with malignant ovarian tumor who undergone conservative surgery and platinum-based adjuvant chemotherapy between the year 1985 and 2001. All patient was disease free state. Method used for follow up were physical exam, tumor markers and ultrasonography. We analysed age at diagnosis, amenorrheic period, recovery of ovarian function whether hormonal agent was used or not, times of pregnancy, times of successful pregnancy, and times of pregnancy outcome with anomaly. RESULTS: In 25 cases, patients who became pregnant had a shorter period of amenorrhea of 2.55 months compared to 20.47 months of the rest. Total times (Kur) of chemotherapy shows no difference between two groups (6.45 vs 6.33). Average age show no differences between two groups (22.43 years vs 22.9 years), but amenorrheic period increased in proportion to age at treatment and times of chemotheapy, so we can guess that ovarian dysfunction is more serious with higher age at diagnosis and many times of chemotherapy. In the group who had been pregnant, successful outcome were 7 of 9 total times of pregnancy (abortion rate was 22%), and no baby had gross anomaly. CONCLUSION: So we can guess that ovarian dysfunction is more serious with higher age at diagnosis and more times of chemotherapy.
Amenorrhea ; Chemotherapy, Adjuvant ; Diagnosis ; Drug Therapy* ; Female ; Fertility ; Follow-Up Studies ; Humans ; Menopause, Premature ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Reproduction ; Biomarkers, Tumor ; Ultrasonography

PURPOSE: The purpose of this study was to assess the value of ovarian ablation using goserelin in premenopausal patients with stage II/III hormone receptor-positive breast cancer without chemotherapy-induced amenorrhea (CIA). MATERIALS AND METHODS: We retrospectively reviewed the data of breast patients treated between October 1999 and November 2007 without CIA. The Kaplan-Meier method was used for calculation of the survival rate. Log rank method and Cox regression analysis were used for univariate and multivariate prognostic analysis. RESULTS: The median follow-up period was 61 months. Initially, 353 patients remained without CIA after chemotherapy and 98 among those who received goserelin and tamoxifen (TAM). In univariate analysis, goserelin improved locoregional recurrence-free survival (LRFS) (98.9% vs. 94.1%, p=0.041), distant metastasis-free survival (DMFS) (85.4% vs. 71.9%, p=0.006), disease-free survival (DFS) (85.4% vs. 71.6%, p=0.005), and overall survival (OS) (93.5% vs. 83.5%, p=0.010). In multivariate analysis, goserelin treatment was an independent factor influencing DMFS (hazard ratio [HR], 1.603; 95% confidence interval [CI], 1.228 to 2.092; p=0.001), DFS (HR, 1.606; 95% CI, 1.231 to 2.096; p=0.001), and OS (HR, 3.311; 95% CI, 1.416 to 7.742; p=0.006). In addition, treatment with goserelin resulted in significantly improved LRFS (p=0.039), DMFS (p=0.043), DFS (p=0.036), and OS (p=0.010) in patients aged < 40 years. In patients aged > or = 40 years, goserelin only improved DMFS (p=0.028) and DFS (p=0.027). CONCLUSION: Ovarian ablation with goserelin plus TAM resulted in significantly improved therapeutic efficacy in premenopausal patients with stage II/III hormone receptor-positive breast cancer without CIA.
Amenorrhea* ; Breast ; Breast Neoplasms* ; Disease-Free Survival ; Drug Therapy ; Female ; Follow-Up Studies ; Goserelin* ; Humans ; Multivariate Analysis ; Premenopause ; Retrospective Studies ; Survival Rate ; Tamoxifen