BACKGROUND: Polycystic ovarian syndrome (PCOS) is a prevalent condition affecting women of reproductive age, characterized by metabolic, endocrine, and reproductive disturbances including insulin resistance, abnormal uterine bleeding, infertility, and hyperandrogenism, and is associated with diabetes and cardiovascular disease. The etiology of PCOS is unclear and exposure to endocrine-disrupting chemicals (EDCs) present in everyday products may play a role by disrupting hormonal pathways. OBJECTIVES: To determine the association between exposure to EDC-containing products, sociodemographic factors, and PCOS diagnosis among nonpregnant reproductive-aged women. MATERIALS AND METHODS: A survey assessed the frequency of EDC exposure in homes and workplaces. The Rotterdam Criteria were used for the diagnosis of PCO features with clinical history and ultrasound. The association between PCOS and EDC exposure was determined using Chi-square and logistic regression analysis. RESULTS: The study identified significant sociodemographic factors associated with PCOS (P < 0.001) including age, civil status, and household income. Increased likelihood of PCOS was linked to frequent use of scented candles (odds ratio [OR] = 2.07), cleaning sprays (OR = 2.28), and floor polish (OR = 2.07), exposure to new upholstered furniture (OR = 4.00), thermal receipts (OR = 2.16), and consumption of microwaved and processed foods (OR = 2.60), as well as water sourced from wells (OR = 7.69). Additional associations were found with access to public markets (OR = 0.26) and the use of paper food wrappers (OR = 1.72). CONCLUSION These findings suggest that frequent exposure to EDC-containing products and certain sociodemographic factors may contribute to the development of PCOS among women of reproductive age. Results underscore the importance of reducing exposure to EDCs to prevent or mitigate the development of PCOS and other reproductive consequences.
Female

This paper will focus only on the recommendations or guidelines on the evaluation for female infertility. Most of the recommendations were based on the Fertility Assessment and Treatment for People with Fertility Problems Guideline by the National Institute for Clinical Excellence.
Human ; Female ; INFERTILITY, FEMALE

No abstract available.
Female ; Female* ; Genitalia, Female* ; Humans ; Incidence*

No abstract available.
Female ; Humans

Malignant tumors of the breast which contain stromal osteoclast-like, multinucleated giant cells are a rare entity of yet unknown clinical significance. These benign multinucleated giant cells are known to occur mostly in areas of prominent angiogenesis and in close association with tumor cells. Supplementary immunohistochemical and electronmicroscopic examinations indicate that the multinucleated giant cells are of histiocytic origin. We report on a case of infiltrating ductal carcinoma with stromal osteoclast-like multinucleated giant cells occurring in the right breast of a 37 year-old woman. Grossly, the tumor was characterized by a well-circumscribed dark brown, solid firm mass. Microscopically, multinucleated giant cells were found in the stroma intermingled with malignant tumor cells. The stroma showed only a small amount of mononuclear cell infiltration and a moderate degree of vascular proliferation. Immunohistochemical stains revealed the tumor cells to be positive for carcinoembryonic antigen, epithelial membrane antigen and cytokeratin while the multinucleated giant cells were positive for vimentin, CD68 and negative for all other stains tested. Ultrastructurally the multinucleated giant cells differed from tumor cells by having abundant cytoplasmic organelles such as rough endoplasmic reticulum, lysosomes, ribosomes, and vesicles but lacking desmosomes or other types of intercellular junctions. Other characteristic features of multinucleated giant cells included, indented nuclei and prominent cytoplasmic process.
Female ; Humans

Sertoli-Leydig cell tumors of the ovary are rare, accounting for no more than 0.5% of all ovarian neoplasms. These tumors occur predominantly in women 10 to 30 years of age. Heterologous elements are found in over 20% of the moderately and poorly differentiated Sertoli- Leydig cell tumors. The most common element is gastrointestinal mucin-secreting epithelium, found in approximately 20% of all cases. Approximately 4% of Sertoli-Leydig cell tumors contain immature skeletal muscle and/or cartilaginous elements. The origin of these neoplasms is regarded as neometaplasia of the mesodermal neoplastic element. While the degree of differentiation of Sertoli-Leydig cell tumors is probably of greater importance in determining prognosis than the presence of heterologous components, recent evidence does point to an unfavorable effect on clinical outcome when heterologous mesenchymal components such as cartilage and striated muscle are present. We experienced two cases of ovarian heterologous Sertoli-Leydig cell tumors with gastrointestinal type epithelium and striated skeletal muscle in 20 and 21 year-old females, respectively. One case involved a patient who had complained of amenorrhea for 3 years while the other case involved a patient who had complained of left lower abdominal tenderness and amenorrhea for one and one half years. It was determined by ultrasonography of the pelvis that the two patients suffered from right and left ovarian masses. Both patients underwent adnexectomy. These tumors were large with partly solid and partly cystic areas. Based on light microscopic examination one case was classified as an intermediate Sertoli-Leydig cell tumor with heterologous gastrointestinal type epithelium, while the other case was classified as a poorly differentiated Sertoli-Leydig cell tumor with heterologous striated skeletal muscle.
Female ; Humans

Synovial sarcoma most commonly affects the extremities, especially the lower thigh and knee region. However, a smaller number develops in a central or axial distribution, an area which encompasses the trunk, orofacial, cervical and parapharyngeal regions. The retroperitoneum is an extremely unusual site and has never been recorded in the literature as primary a site for synovial sarcoma. We investigated a case of retroperitoneal synovial sarcoma in a 40-year-old woman. The specimen consisted of fragmented large bulky multinodular masses separated by slit-like spaces. The tumor was 130 gm in weight. Microscopically, the tumor was composed of nests of plump ovoid to polygonal shaped cells and bundles of spindle shaped cells, which had vesicular nuclei and a small amount of cytoplasm. In some areas, there were cleft like spaces and pseudoglandular structures lined by flat or cuboidal cells. Myxoid change, collagen deposition, foci of calcification and osseous metaplasia were also present. Immunohistochemically, the polygonal cells and some of the spindle cells reacted positively for keratin. The spindle cells, especially in the perivascular area were positive for vimentin. S-100 protein and GFAP were negative in both type of cells.
Female ; Humans

A case of calcifying synovial sarcoma, occuring in the deep muscle fascia of the left thigh is reported. The presence of extensive calcification in synovial sarcoma is a favorable sign for prognosis. The patient was a 31-year-old female. The tumor mass had been present for 3 years, accompanying local tenderness. X-ray revealed a soft tissue tumor with central calcification, which was located between the adductor magnus and brevis of the left thigh. The tumor size was 7 x 5.5 cm. There was no connection with the knee joint or the femur. Grossly, the tumor was a relatively well circumscribed hard tumor with massive calcification. Microscopically, the tumor was composed of predominantly spindle cells with accompanying hyalinization, numerous spherical concretions and ossification. The epithelial component was not clearly noted. Mitotic figures were rarely noted in the densely cellular area. Immunohistochemical staining for EMA, S-100, vimentin, and carcinoembryonic antigen was negative while vimentin and cytokeratin were weakly and focally positive. EM study revealed multiple desmosome-like calcification intercellular junctions with a slit-like lumen and an incomplete basal lamina, which suggest that tumor show these cells were undergoing epithelia] differentiation. Above evidence suggest that this tumor is a synovial sarcoma associated with a large area of calcification, a so called calcifying synovial sarcoma. No recurrence was noted in one and half years of follow up.
Female ; Humans

Angiomyofibroblastoma of the vulva is a rare mesenchymal tumor. It has been diagnostically confused with aggressive angiomyxoma which has a somewhat different clinical course and therapy. Herein we report a case of angiomyofibroblastoma of the vulva in a 46-year-old female. Microscopically, there were alternating hypercellular and hypocelluar edematous zones in which abundant capillary blood vessels were irregularly distributed. Spindle, plump spindle, and oval stromal cells were concentrated around the blood vessels, or loosely dispersed in the hypocellular area. Immunohistochemically, the stromal cells were positive for desmin, vimentin, muscle-specific actin and weakly positive for S-100 protein. Ultrastructural studies showed well developed rough endoplasmic reticulum, abundant intermediate filaments, and pinocytic vesicles in the stromal cells.
Female ; Humans

PURPOSE: To report one case of lymphoproliferative disorder on the upper eyelid. METHODS: Primary CD30+ lymphoproliferative disorder on the skin is very rare. A 31-year-old female patient visited our clinic complaining of red, erosive papules on the right upper eyelid and on the left flank for two weeks. A 2.0 cm erythematous papule showed central ulceration. A 1.5 cm lymph node enlargement was palpated on the left groin. There was no abnormal finding on the slit-lamp test. Computed tomography showed a subcutaneous nodule on the anterolateral aspect of the flank and a lymph node enlargement on the left inguinal area. There was no evidence of other visceral involvement. Histopathologic finding showed diffuse infiltration of atypical cells with lobated nuclei showing multifocal positivity to CD30; a finding consistent with primary cutaneous CD30+ T-cell lymphoproliferative disorder and borderline lesion. RESULTS: This case seems to be a borderline case between CD30+ T-cell large cell lymphoma and lymphoid papulodesis. We are conducting conservative care and observing the progress on the skin lesion for further evaluation.
Female ; Humans