Ovarian tumor in pregnancy is not rare and benign cystic teratoma is most common ovarian tumor in pregnancy. Most ovarian tumor in pregnancy is found at first and second trimester but sometimes found at third trimester and it is difficult to make a decision for management. Moreover physician should consider fetal age and mother's condition, and weigh outcome of operation for complicated ovarian tumor in pregnancy. Torsion of ovarian tumor is not an uncommon complication during first trimester of pregnancy and puerperium but rare occurs during the third trimester of pregnancy. We have experienced a case of torsion of benign cystic teratoma of ovary which occurred at 37 weeks gestation in a 25 year-old woman. So we report this case with a brief review of literature.
Adult ; Female ; Gestational Age ; Humans ; Ovary* ; Postpartum Period ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Pregnancy* ; Teratoma*

Carcinoma of the fallopian tube accounts for less than 1% of all cancers of the female genital tract. The histology and behavior of fallopian tube cancer are simillar to ovarian cancer; thus evaluation and treatment are also essentially the same. Unlike ovarian cancer, fallopian tube cancer begins in a hollow viscus, and early lesions may be less likely to be associated with extensive intraperitoneal carcinoma. Two postmenopausal women presented with a pelvic mass. Pathologic examination of the resected specimens revealed primary adenocarcinoma of the fallopian tube. We have experienced two cases of fallopian tube cancer and reported with brief review of literature
Adenocarcinoma ; Fallopian Tube Neoplasms ; Fallopian Tubes* ; Female ; Humans ; Ovarian Neoplasms

Vesicovaginal fistula is a uncommon status in the developed countries. In the past it was mostly by obstetric causes. But now a days, posthysterectomy fistulas are seen. Fistula is a discomfort to the patient because of urine leakage, odor, and its inconvenience. We have experienced one case of fistula after abdominal hysterectomy and have repaired it by Latzko partial colpocleisis. So we report a case with some references.
Developed Countries ; Fistula ; Humans ; Hysterectomy ; Odors ; Vesicovaginal Fistula*

PURPOSE: The detection of synchronous and metachronous colon cancer is important for the surgical treatment. The aim of this study is to review the clinicopathological characteristics of multiple colon cancers. METHODS: A retrospective analysis was performed with 43 patients with multiple colon cancers who underwent surgical treatment from June 1996 to May 2008. Patients with familial adenomatous polyposis and cancer from inflammatory bowel disease were excluded. RESULTS: There were 43 cases of multiple colon cancers. Synchronous colon cancers were present in 30 patients and metachronous colon cancers were present in 18 patients. The mean age was 61.33+/-11.44, and the male-to-female ratio was 23:20. The index cancer and the second cancers in synchronous colon cancers, as well as the first colon cancer in metachronous colon cancers showed, significantly more distal tumor locations. However, the second cancers in metachronous colon cancers showed no significant differences in tumor location. As for stage, a more advanced stage was noted in the index cancer than in the second cancers in synchronous cancer. However, an early stage was noted for the first colon cancer in metachronous cancers. Seventeen patients with synchronous cancer and 14 patients with metachronous colon cancer underwent a total or a subtotal colectomy. CONCLUSION: Detection of synchronous colon cancer was important for deciding the extent of surgical resection. Patients with colon cancer should be considered for frequent colonoscopy follow-up for early detection of metachronous colon cancer.
Adenomatous Polyposis Coli ; Colectomy ; Colonic Neoplasms ; Colonoscopy ; Colorectal Neoplasms ; Follow-Up Studies ; Humans ; Inflammatory Bowel Diseases ; Neoplasms, Second Primary ; Retrospective Studies

PURPOSE: Thrombocytosis is known to be a poor prognostic factor in several types of solid tumors. The prognostic role of preoperative thrombocytosis in colorectal cancer remains limited. The aim of this study is to investigate the prognostic role of preoperative thrombocytosis in stage II colorectal cancer. METHODS: Two hundred eighty-four patients with stage II colorectal cancer who underwent surgical resection between December 2003 and December 2009 were retrospectively reviewed. Thrombocytosis was defined as platelet > 450 × 10(9)/L. We compared patients with thrombocytosis and those without thrombocytosis in terms of survival. RESULTS: The 5-year disease-free survival (DFS) rates were lower in patients with thrombocytosis compared to those without thrombocytosis in stage II colorectal cancer (73.3% vs. 89.6%, P = 0.021). Cox multivariate analysis demonstrated that thrombocytosis (hazard ratio, 2.945; 95% confidence interval, 1.127-7.697; P = 0.028) was independently associated with DFS in patients with stage II colorectal cancer. CONCLUSION: This study showed that thrombocytosis is a prognostic factor predicting DFS in stage II colorectal cancer patients.
Blood Platelets ; Colorectal Neoplasms* ; Disease-Free Survival ; Humans ; Multivariate Analysis ; Prognosis* ; Retrospective Studies ; Thrombocytosis*

PURPOSE: Literature shows that low rectal cancer, that especially undergoing abdominoperineal resection (APR), is worse than mid or high rectal cancer. Two reasons have been proposed: diverse lymphatic channels in the low rectum, and technical difficulty in performing the APR. By comparison with the results reported in representative literature, we tried to find out whether low rectal cancer is really worse oncologically than high rectal cancer. METHODS: For 133 patients who underwent an APR from 1995 to 2005, we examined the pathological characteristics of the cancer, the recurrence, the metastasis, the survival rates, and the prognostic factors. RESULTS: The patient distribution according to stage was 15.9% in stage I, 33.6% in stage II, and 50.4% in stage III. The overall 5-year actuarial survival rate (5SR) of patients undergoing a curative resection (n=113) was 74.6%. Local pelvic recurrence was found in 11.5% of the patiennts, and systemic metastasis was noted in 14.2%. Among several prognostic variables, lymph node metastasis, the number of metastatic lymph nodes, adjuvant chemotherapy, and the distance between the tumor border and the dentate line were significant factors. In the multivariate analysis, lymph node metastasis was the most significant prognostic factor. CONCLUSIONS: It is true that a curative resection in low rectal cancer is difficult due to the anatomy of pelvis, so knowledge of the anatomic features of the pelvis and surgical skill are important. definitely, acceptable oncological results can be attamed if the rule of curative resection is obeyed. We also found that lymph node involvement was the most significant prognostic factor in low rectal cancer.
Chemotherapy, Adjuvant ; Humans ; Lymph Nodes ; Multivariate Analysis ; Neoplasm Metastasis ; Pelvis ; Rectal Neoplasms* ; Rectum ; Recurrence ; Survival Rate

PURPOSE: We performed a comparative analysis of the clinicopathologic features and oncologic outcomes of colorectal cancer patients with metachronous versus synchronous metastasis, according to the prognostic factors. METHODS: Ninety-three patients who underwent curative resection for distant metastatic colorectal cancer were included in the study between December 2001 and December 2011. We assessed recurrence-free survival and overall survival in patients with distant metastasis who underwent curative surgery. RESULTS: The most common site of distant metastasis was lung alone (n = 19, 51.4%) in patients with metachronous metastasis, while liver alone was most common in those with synchronous metastasis (n = 40, 71.4%). Overall survival rate was significantly different between patients with synchronous metastasis and metachronous metastasis (34.0% vs. 53.7%; P = 0.013). Incomplete resection of the metastatic lesion was significantly related to poor overall survival in both, patients with synchronous metastasis, and metachronous metastasis. CONCLUSION: Our study indicates that patients developing distant metastasis after initial treatment show a different metastatic pattern and better oncologic outcomes, as compared to those presenting with distant metastasis. Resection with tumor free margins significantly improves survival in patients with metachronous as well as synchronous metastasis.
Colorectal Neoplasms* ; Humans ; Liver ; Lung ; Metastasectomy* ; Neoplasm Metastasis* ; Survival Rate

PURPOSE: This study was conducted to determine whether a learning curve is necessary to obtain a successful total mesorectal excision (TME) for mid or low rectal cancer. METHODS: We retrospectively reviewed the records of 80 patients that underwent a total mesorectal excision for mid or low rectal cancer between 1994 and 1998 and between 1999 and 2002. We compared the results between the two period groups. Endpoints were postoperative urological functions and the local recurrence rate. RESULTS: There was no significant difference for age, gender, tumor differentiation and stage between patients in the two groups. Local recurrence (LR) developed in 23% of patients in the early group and 7.5% of patients in the late group. The cumulative LR risk at 60 months was 27.5% for the early period group and 9.9% for the late period group (P=0.082) and the difference between the two groups was significant for TNM III stage (29.8% vs. 9.8%, P=0.049). Postoperative urological complications were not significantly different between the two groups (P=0.75). CONCLUSION: Based on these results, TME seemed to require a learning curve. In clinical trials for rectal cancer surgery, the learning curve for qualified surgery from the standpoint of oncological outcome should be considered to minimize bias due to surgeon-associated factors. A more broad application of the TME concept to a larger number of patients with mid or low rectal cancer is warranted.
Bias (Epidemiology) ; Humans ; Learning ; Learning Curve ; Rectal Neoplasms ; Recurrence ; Retrospective Studies

PURPOSE: Adequate lymph node analysis is critical for appropriate staging in colorectal cancer. The aim of this study is to determine whether 12 or more nodes recovered in stage III rectal cancer results in improved oncologic outcomes. METHODS: Two hundred and forty-eight patients with stage III rectal cancer from 1995 through 2004 were reviewed. They were categorized into 2 subgroups by the number of nodes retrieved (<12 and > or =12), and oncologic outcomes in terms of 5-year overall and disease-free survival were analyzed for all patients, patients with American Joint Committee on Cancer (AJCC) N1 disease (N=145), and those with AJCC N2 (N=103). RESULTS: Five-year overall and disease-free survival was 79.0% and 58.4%, respectively. There was no significant difference in clincopathologic features between <12 retrieval group and > or =12 group. Although there was significant difference in overall survival and disease-free survival between the number (<12 and > or =12) of lymph nodes removed in N2 disease (P=0.043; P=0.022) in univariate analysis, the total number of lymph nodes retrieved was not a prognostic factor affecting survival in multivariate analysis. The N2 stage and lateral margin involvement were prognostic factors affecting survival in multivariate analysis. CONCLUSION: This study showed that the total number of lymph nodes analyzed for stage III rectal cancer is not a prognostic factor on overall or disease-free survival in multivariate analysis.
Colorectal Neoplasms ; Disease-Free Survival ; Humans ; Joints ; Lymph Nodes ; Multivariate Analysis ; Rectal Neoplasms

Purpose: There is a controversy about the treatment of left-sided obstructive colorectal cancer. Recently, experience using an expandable metallic stent for relief of the obstruction has been increasing, but its oncological safety has not been confirmed. Therefore, we designed this study to evaluate the oncological safety of a metallic stent for the treatment of left-sided obstructive colorectal cancer. Methods: Forty-six patients with left-sided obstructive colorectal cancer who underwent a curative resection from 1994 to 2004, were retrospectively evaluated. Nineteen emergency operations (1994~2003) and 27 metallic stent insertions (2000~2004) were compared based on clinicopathologic features, postoperative complications, recurrence rates, and survival rates. Results: There were no significant differences in age, location, sex, and recurrence rate between the two groups. The complication rate in the emergency group was higher than it was in the stent group, but this difference was not statistically significant (26.3% vs. 14.8%; P=0.33). The overall and the disease-free survival rates were not significantly different. Conclusions: Because there was no significant differences in survival rate and recurrence rate between the two groups, metallic stent insertion can be used safely in the preoperative treatment of obstructive left-sided colorectal cancer.