Uterine arteriovenous malformations (AVMs) are abnormal communications between arteries and veins with resultant high output flow and fibrous intimal thickening of aberrant vessels. Uterine arteriovenous malformations secondary to gestational trophoblastic neoplasia are rare. They commonly present with sudden or persistent vaginal bleeding, often diagnosed through ultrasonography and Doppler studies. Angiography remains to be the gold standard for the diagnosis of uterine AVMs. Definitive treatment is hysterectomy, however for patients who wish to retain their fertility, this should be the last option. This report describes a fertility-sparing surgical management of a uterine arteriovenous malformation in two patients previously treated for gestational trophoblastic neoplasia.

Human ; Female ; Adult ; Arteriovenous Malformations ; Hysterectomy ; Uterine Hemorrhage ; Angiography ; Gestational Trophoblastic Disease ; Arteries ; Ultrasonography

Lymphoma is the fourth most frequent malignancy diagnosed during pregnancy,occurring in approximately 1:6000 deliveries. In managing pregnant patients with Hodgkin's lymphoma, there are dilemmas to timely diagnosis and treatment, considering many of the diagnostic procedures and treatment options for the mother's condition may be harmful to the developing fetus. A 27-year-old G3P1 (1011) pregnant patient with a four-month history of anterior mediastinal mass, non-productive cough and low-grade afternoon fever, was initially treated as a case of community-acquired pneumonia. The patient was later admitted at our institution due to the persistence of symptoms, accompanied by dyspnea and chest pain. Biopsy done at 29 4/7 weeks age of gestational showed Hodgkins disease, lymphocyte depleted type (responsive to chemotherapy). At 31-32 weeks age of gestation, the patient started to experience dyspnea with intermittent low-grade fever. Chemotherapy consisting of doxorubicin 25mg/m², bleomycin 10u/m², vinblastine 6mg/m² and dacarbazine 375mg/m² was started. Radiotheraphy was deferred until after delivery. She underwent spontaneous vaginal delivery and delivered a live baby girl small for gestational age, with no congenital malformations. It is imperative that in pregnant patients presenting with anterior mediastinal masses, accompanied by systematic symptoms, timely histopathologic diagnosis through incision or excision biopsies should be obtained. Treatment options for these patients would differ based on the histology and stage of the disease and also the age of gestation of the pregnancy.

 

 

 

Human ; Female ; Adult ; Hodgkin Disease ; Vinblastine ; Dacarbazine ; Cough ; Lymphoma ; Bleomycin ; Biopsy ; Doxorubicin ; Chest Pain ; Dyspnea ; Pneumonia ; Lymphocytes ; Fetus