We report a case of salvage lymphadenectomy for an isolated metastatic lesion in the para-aortic lymph node (LN) in a 49-year old woman with a history of cervical cancer, initially treated with radical hysterectomy and adjuvant radiotherapy. Preoperative 3-dimensional (3D) computed tomography (CT) angiography clearly revealed a huge retro-crural metastatic LN with distinct demarcation. A metastatic lesion, more than 10 cm in size, was located behind the vena cava, aorta, and left kidney, encompassing the left renal and lumbar arteries. The metastatic LN was excised along with the left kidney. On histologic examination, the tumor was found to have invaded the pelvis of the left kidney. Compared with conventional imaging techniques, 3D CT angiography can more clearly visualize such lesions. Thus, 3D CT angiography provides useful anatomical information, such as the exact size and location, and provides clear visualization and demarcation.
Angiography* ; Aorta ; Arteries ; Female ; Humans ; Hysterectomy ; Kidney ; Lymph Node Excision* ; Lymph Nodes ; Pelvis ; Radiotherapy, Adjuvant ; Recurrence ; Uterine Cervical Neoplasms*

OBJECTIVE: The purpose of this study is to know the pathological and clinical characteristics of granulosa stromal cell tumor of the ovary. METHODS: From January 1996 to December 2005, patients with granulosa cell tumor of ovary and ones with thecoma, which are included in granulosa stromal cell tumor of the ovary, treated in the Obstetrics and Gynecology, College of Medicine, the Kyungpook National University Hospital of Korea were identified and reviewed retrospectively for patient profiles, mode of therapy, length of survival and so on. RESULTS: There were 14 granulosa cell tumors, and 55 thecomas. The mean age of patients with granulosa cell tumor was 46.8 years old, and 7 women (50.0%) were menopausal. Bilaterality was absent, and mean size of tumor was 11.1 cm. The chief complaints of patients were 3 cases (21.4%) of abdominal discomfort or pain, 3 cases (21.4%) of vaginal bleeding and 4 cases (28.6%) of no symptom. Of 14 cases, total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed in 5 cases (35.7%). Chemotherapy was performed in 5 cases (35.7%), and regimen was combination of BEP (bleomycin+etoposide+cisplatin). According to FIGO staging, 10 cases (71.4%) were stage I. Second look operation was done in one case (7.1%). Among 14 patients of follow-up, one patient (7.1%) was expired. Surgical staging was associated with survival rate of patients. The mean age of patients with thecoma was 49.6 years old, and 28 women (50.9%) were menopausal. Bilaterality was 3 cases (5.4%), and mean size of tumor was 8.5cm. The chief complaints of patients were 14 cases (25.4%) of abdominal discomfort or pain, and 19 cases (34.5%) of no symptom. Of 55 cases, total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed in 21 cases (38.2%). Among 55 patients of follow-up, all patients survived. CONCLUSION: Thecomas are regarded as benign tumors but granulosa cell tumors are characterized by a long natural history with a significant capacity to recur years after apparent clinical cure. The patients with granulosa cell tumor should be followed up indefinitely.
Drug Therapy ; Female ; Follow-Up Studies ; Granulosa Cell Tumor ; Gyeongsangbuk-do ; Gynecology ; Humans ; Hysterectomy ; Korea ; Natural History ; Obstetrics ; Ovary* ; Retrospective Studies ; Stromal Cells* ; Survival Rate ; Thecoma ; Uterine Hemorrhage

Ascites following radical hysterectomy with retroperitoneal lymphadenectomy for invasive cervical cancer has been reported previously. Most of these reports described chylous ascites. The chylous ascitic fluid is milky; further, chylous ascites leads to nutritional problems. Authors present the case of a patient who developed serous ascites following radical hysterectomy with bilateral pelvic lymphadenectomy. The amount of ascites was approximately 18,000 ml over 52 days. The patient had no nutritional problems or complications. Although the etiology could not be determined, Authors surmise that the ascites may have been due to massive drainage from injured lymphatic channels below the cisterna chyli. Authors could not found any literatures which described massive serous ascites following surgery in gynecologic malignancy and reports this case with review of literatures.
Adenocarcinoma ; Ascites ; Ascitic Fluid ; Chylous Ascites ; Drainage ; Humans ; Hysterectomy ; Lymph Node Excision ; Thoracic Duct ; Uterine Cervical Neoplasms

The Yoon Soon (YS) knot is a laparoscopic extracorporeal slip knot that is easy to learn and apply. Our new technique, which uses the trocar as a knot pusher, is simpler, faster, and has more tension than conventional knot methods. The YS knot will help surgeons save operative time and perform tension-controlled knot-tying during laparoscopic surgery.
Laparoscopy ; Operative Time ; Surgical Instruments*

Adult granulosa cell tumors (AGCTs) presenting with massive ascites and elevated serum CA-125 levels have rarely been described in the literature. An ovarian mass, massive ascites, and elevated serum CA-125 levels in postmenopausal women generally suggest a malignant ovarian tumor, particularly advanced epithelial ovarian cancer. AGCT has low 18F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography due to its low metabolic activity. In the present report, we describe a case of an AGCT with massive ascites, elevated serum CA-125 level, and low 18F-fluorodeoxyglucose uptake on positron emission tomography/computed tomography.
Adult* ; Ascites* ; Electrons* ; Female ; Granulosa Cell Tumor* ; Granulosa Cells* ; Humans ; Ovarian Neoplasms

Indirect inguinal hernia containing an ovary is a rare condition, especially in adult women who do not have any other genital tract anomalies. In addition, inguinal hernia containing an ovary and endometriosis is exceedingly rare. In the present report, we describe a case of indirect inguinal hernia containing an ovary, fallopian tube, and endometriosis. Laparoscopic repair was performed successfully using polypropylene mesh for the treatment of the inguinal hernia.
Adult* ; Endometriosis* ; Fallopian Tubes* ; Female ; Hernia, Inguinal* ; Humans ; Ovary* ; Polypropylenes

OBJECTIVE: This study was designed to evaluate the survival benefit of laparoscopic surgical staging (LSS)-guided tailored radiation therapy (RT) in locally advanced cervical cancer (LACC). METHODS: We retrospectively reviewed 89 LACC patients' medical records who primarily received non-surgical treatment, of which pretreatment LSS was performed in 20 (LSS group) and primary chemoradiation therapy (CCRT) without LSS (CCRT group) was carried out in 69 from January 2000 to January 2006. We analyzed clinical characteristics, pretreatment imaging study results and survival outcomes including disease free survival (DFS) and overall survival (OS) to compare them between the two groups. RESULTS: There were as many as eight cases (40%) of LSS related complications. The mean time interval between LSS and RT or CCRT was 26.6 days (+/-18.8 days). Six out of twenty (30%) in LSS group and 10 out of 69 (14.5%) in CCRT group received extended field RT when paraaortic lymph nodes (LNs) were positive based on the pathologic findings after LSS and the results of imaging studies, respectively. Three-year DFS and OS were both better in 33 imaging-negative CCRT group patients than those in 4 imaging-negative/pathology-positive (false negative) patients after LSS (3-year DFS, 50% vs. 87%, p=0.022; 3-year OS, 50% vs. 84%, p=0.033). The 5-year DFS rates were 52% and 55% in LSS group and in CCRT group, respectively (p=0.28). The 5-year OS rates were 68% in LSS group and 62% in CCRT group without significant difference between the two groups (p=0.79). CONCLUSION: We found that LSS-based RT tailoring did not show survival benefit in LACC despite inaccuracy of imaging-based RT tailoring. Further studies are required to find new method to overcome this inaccuracy and improve survival outcomes.
Disease-Free Survival ; Humans ; Laparoscopy ; Lymph Nodes ; Medical Records ; Retrospective Studies ; Uterine Cervical Neoplasms

OBJECTIVE: We performed this study to evaluate maternal and fetal outcomes of pregnancies with IgA nephropathy. METHODS: We reviewed 20 pregnancies occurred in 14 women who were diagnosed as IgA nephropathy with the method of renal biopsy between 1997 and 2006. We used clinical and laboratory data from medical records and statistic analysis using SPSS 15.0. RESULTS: Of 20 prenancies, there were 17 live births and 3 spontaneous abortions. There was no stillbirth and congenital anomaly. We found severe preeclampsia in 47%, low birth weight in 53% and preterm birth (comprising medical indications) in 59%. But most were late preterm birth and all were alive. Blood pressure was elevated after delivery compared with pre-pregnancy. CONCLUSION: Although pregnancy is not contraindicated in IgA nephropathy, it is associated with significant complications comprising preeclampsia, preterm birth and low birth weight.
Abortion, Spontaneous ; Biopsy ; Blood Pressure ; Female ; Glomerulonephritis, IGA ; Humans ; Immunoglobulin A ; Infant, Low Birth Weight ; Infant, Newborn ; Live Birth ; Medical Records ; Pre-Eclampsia ; Pregnancy ; Pregnancy Outcome ; Premature Birth ; Stillbirth

Intrathoracic metastasis of ovarian cancer has poor prognosis regardless of treatment modality. Recent development of surgical techniques and the new concept of direct infusion of chemotherapeutic agents with hyperthermia could help with the treatment of disseminated diseases in ovarian cancer. Using video-assisted thoracoscopic surgery and intracavitary chemotherapy with hyperthermia, we tried hyperthermic intrathoracic chemotherapy for a case of stage IV high-grade serous ovarian cancer with pleural metastasis. There was no high-grade complication related to the procedure. The patient is alive without disease at 32 months after initial treatment.
Cisplatin* ; Drug Therapy* ; Fever ; Humans ; Neoplasm Metastasis* ; Ovarian Neoplasms* ; Prognosis ; Thoracic Surgery, Video-Assisted

Leiomyomatosis peritonealis disseminata (LPD) is a rare condition characterized by multiple subperitoneal nodules of benign smooth muscle. Wilson and Peale were the first to describe the multiple peritoneal leiomyomas, while Taubert et al. clearly delineated the features of the lesion and named it LPD. Approximately 100 cases of this disease have been reported in the world literature. High levels of exogenous and endogenous female gonadal steroids is associated with LPD, it suggests that estrogen and progesterone play important role in the pathogenesis of LPD. We report a case of leiomyomatosis peritonealis disseminata with review of literature.
Estrogens ; Female ; Gonads ; Humans ; Leiomyoma ; Leiomyomatosis* ; Muscle, Smooth ; Progesterone ; Steroids