Benign metastatic leiomyomatosis (BML) is a rare disease characterized by smooth muscle cell proliferation in extrauterine sites including the lung, abdomen, pelvis, and retroperitoneum. Depending on location, BML is classified as intravenous leiomyomatosis and diffuse peritoneal leiomyomatosis. Pathogenesis of BML can be iatrogenic after previous myomectomy or hysterectomy, hormonal, or coelomic metaplasia. Treatment options are observation, hormonal suppression, and/or surgical debulking via laparotomy or laparoscopy. Laparoscopic surgery is gaining in popularity in the gynecologic field compared to laparotomic surgery and single-port laparoscopy has the benefits of cosmesis and early tissue extraction by transumbilical morcellation. We report a 39-year-old woman with BML who underwent single-port laparoscopy debulking surgery.
Abdomen ; Adult ; Female ; Humans ; Hysterectomy ; Laparoscopy ; Laparotomy ; Leiomyomatosis* ; Lung ; Metaplasia ; Myocytes, Smooth Muscle ; Pelvis ; Rare Diseases

OBJECTIVE: Notch is known as a transmembranous receptor family with four homologous forms - Notch 1, Notch 2, Notch 3, and Notch 4 and related to cell fate regulation and angiogenesis. The purpose is to investigate the effect of follicular stimulating hormone (FSH) on the Notch 1 expression and proliferation in ovarian cancer cells. METHODS: Human ovarian cancer cell line, SK-OV-3 and FSH were used. XTT cell proliferation and cell migration assay were carried out with FSH 100 mIU/mL and Notch 1 siRNA. Western blots and reverse transcriptase-polymerase chain reactions (RT-PCR) were carried out to determine the expression level of the Notch 1 protein and mRNA with FSH treatment in 0, 1, 5, 10, 100, 200, 300 mIU/mL concentrations. Immunofluorescent (IF) stains were performed in SK-OV-3 cell cultures with FSH 100 mIU/mL. Student-t tests were used in statistical analyses. RESULTS: The SK-OV-3 have Notch 1 receptors in their natural status. FSH stimulated SK-OV-3 cells in XTT cell proliferation and cell migration assays and notch 1 siRNA inhibited. The expression level of Notch 1 protein and mRNA were increased in a dose dependent pattern according to FSH concentrations compared to untreated cells. IF stains also showed brighter Notch1 expressions in the FSH treated cells compared to the control cells. CONCLUSION: FSH enhances proliferation & migration and Notch 1 signaling in SK-OV-3 cells. The Notch signaling probably supports one of the cell proliferating mechanisms of FSH in ovarian cancer cells.
Blotting, Western ; Cell Culture Techniques ; Cell Line ; Cell Migration Assays ; Cell Proliferation ; Coloring Agents ; Humans ; Ovarian Neoplasms ; RNA, Messenger ; RNA, Small Interfering

About 20~30% of benign or malignant tumors of ovarian origin arise from embryonic cells, and only 3% represent malignancy. But under age of 20, 70% of ovarian tumors arise from embryonic cells, and over 1/3 of them are malignant tumors. Over all the ovarian tumors arising from embryonic cells, immature teratoma is germ cell tumor, components include immature tissues and cells derived from ectoderm, mesoderm, and endomermal origins. Most of the immature tissues are from neuroectodermal origins. The immature teratoma of the ovary is a rare tumor, representing less than 1% of all ovarian neoplasm. These tumors typically present in young age woman (mean age 10~20 years) with pelvic and abdominal pain. Nowadays newly developed combination chemotherapeutic agents such as bleomycin, etoposide, cisplatin give us great survival and disease free prognosis than before. We have experienced two cases of immature teratoma so we report them with a brief review of concerned literatures.
Abdominal Pain ; Bleomycin ; Cisplatin ; Ectoderm ; Etoposide ; Female ; Humans ; Mesoderm ; Neoplasms, Germ Cell and Embryonal ; Neural Plate ; Ovarian Neoplasms ; Ovary ; Prognosis ; Teratoma

Pelvic actinomycosis is an infrequent chronic suppurative granulomatous disease, caused by a gram-positive bands Actinomyces israelii. It is often reported as a complicated case of an intrauterine device (IUD). Ureteral obstruction and subsequent hydronephrosis are rare complications of pelvic inflammatory disease. Sometimes pelvic actinomyosis is simulating ovarian malignancy. We report a case combined with hydronephrosis, multiple pelvic lymph nodes enlargements and elevated CA 125 as complications of pelvic actinomycosis.
Actinomyces ; Actinomycosis ; Female ; Hydronephrosis ; Intrauterine Devices ; Lymph Nodes ; Pelvic Inflammatory Disease ; Ureteral Obstruction

Pelvic actinomycosis is an infrequent chronic suppurative granulomatous disease, caused by a gram-positive bands Actinomyces israelii. It is often reported as a complicated case of an intrauterine device (IUD). Ureteral obstruction and subsequent hydronephrosis are rare complications of pelvic inflammatory disease. Sometimes pelvic actinomyosis is simulating ovarian malignancy. We report a case combined with hydronephrosis, multiple pelvic lymph nodes enlargements and elevated CA 125 as complications of pelvic actinomycosis.
Actinomyces ; Actinomycosis ; Female ; Hydronephrosis ; Intrauterine Devices ; Lymph Nodes ; Pelvic Inflammatory Disease ; Ureteral Obstruction

Lymphangioleiomyomatosis is a rare disease that is characterized by proliferation of abnormal smooth muscle-like cells, especially that which occurs in the pulmonary parenchyme. It primarily affects women of child-bearing age. The majority of primary lymphangioleiomyomatosis occurs in the lung, but there are a few reports of extrapulmonary cases. We experienced a rare case of lymphangioleiomyomatosis which originated in the pelvic cavity (in the posterior portion of the uterus), and report with brief review of literatures.
Female ; Humans ; Lung ; Lymphangioleiomyomatosis ; Pelvis ; Rare Diseases ; Uterus

In epithelial ovarian cancer, solitary metastasis to mesentary is rare in the absence of apparent disease in other sites. We experienced one patient who developed isolated, solitary mesenteric metastasis of epithelial ovarian adenocarcinoma and underwent segmental resection of small bowel including mesentary to remove the recurrent disease. Rising CA125 heralded the recurrence and the patient was subsequently documented by computed tomography (CT) and PET-CT of the abdomen and pelvis with a high signal density noted only in the mesentery. There was no major postoperative complicathion. Solitary recurrence of epithelial ovarian cancer can occur in the absence of other demomstrable metastasis, so we report with brief review of literature.
Abdomen ; Adenocarcinoma ; Humans ; Mesentery ; Neoplasm Metastasis ; Ovarian Neoplasms* ; Pelvis ; Recurrence*

The synchronous existence of endometrial cancer and cervical cancer is very rare. The reported frequency of concurrent gynecologic neoplasms has ranged from 0.7% to 4.3%, synchronous primary tumors of the female genital tract are relatively rare, comprising only 0.49% to 1.7% of all genital neoplasms. The majority of synchronous multiple primary neoplasm of female reproductive tract are of endometrial and ovarian origin. Multiple primary neoplams involving uterine cervix and endometrium were regarded as rare entity. We experienced a rare case of multiple primary neoplasm involving uterine cervix and endometrium and report with brief review of literatures.
Cervix Uteri ; Endometrial Neoplasms* ; Endometrium ; Female ; Genital Neoplasms, Female ; Humans ; Neoplasms, Multiple Primary ; Uterine Cervical Neoplasms*

OBJECTIVE: The "sentinel node" is defined as the first lymph node encountered by lymphatic vessels draining a tumor. We tried to examine whether pathologic status of sentinel nodes of cervical cancer patients represent metastatic status of pelvic and paraaortic lymph nodes and to investigate the correlation between sentinel node HPV status and lymph node metastasis and recurrence of cervical cancer patients. METHODS: From August 2001 to December 2003, 57 patients affected by stage IB-IIA cervical cancer had sentinel node biopsies performed during radical hysterectomy and pelvic and paraaortic lymphadenectomy. We performed sentinel lymph node pathologic examination by frozen section and HPV typing by oligonucleotide microarray. After two years of follow up, we analyzed the prognosis of patients. RESULTS: Sentinel nodes were identified in all of our patients. A total of 79 nodes were detected as sentinel nodes. Metastasis in the sentinel nodes were found in 10 patients by frozen section and 11 patients by permanent pathologic examination. The results of sentinel lymph node frozen biopsy were statistically significant for predicting the metastatic status of the pelvic lymph nodes (p<0.05), but showed one false negative case. HPV DNA was detected in the cervices of 55 patients (96.5%), 44 (80.0%) of whom were found to have HPV DNA in the sentinel nodes. HPV DNA was detected in sentinel nodes of 10 patients among 11 patients with lymph node metastases. After mean follow up of 31.7 months (range; 1-48), disease recurred in five patients and all of these patients showed HPV in sentinel nodes. Combination of sentinel node frozen biopsy and HPV typing showed negative predictive value of 100% in predicting lymph node metastasis and recurrence. CONCLUSION: Our result suggests the possibility that sentinel node HPV typing would play a supportive role to reduce false negative rate of sentinel node biopsy. Additional study will be needed to confirm the clinical application of sentinel lymph procedure and to reveal correlation between HPV status of sentinel nodes and lymph node metastasis and recurrence of cervical cancer patients.
Biopsy ; DNA ; Follow-Up Studies ; Frozen Sections ; Humans ; Hysterectomy ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Vessels ; Neoplasm Metastasis* ; Oligonucleotide Array Sequence Analysis ; Prognosis ; Recurrence* ; Uterine Cervical Neoplasms*

Uterine arteriovenous malformations are very rare but potentially life threatening lesions. These lesions may be congenital or acquired, but especially occur in patients with a history of curettage, abortion or pregnancy. Color doppler ultrasonography is the preferred method of diagnosing of arteriovenous malformations. In many cases, hysterectomies are performed. But if patients want pregnancies, embolization therapy and conservative treatment are effective therapy. We have experienced a clinical case of uterine arteriovenous malformation, which is presented with a brief review of literature.
Arteriovenous Malformations* ; Cesarean Section* ; Curettage ; Female ; Humans ; Hysterectomy ; Pregnancy ; Ultrasonography, Doppler, Color ; Uterine Hemorrhage* ; Uterus*