Cases of cervical lesions have been rising steadily in the past decades. From inflammation to carcinogenesis, the cervix is never really spared of disease. In the presence of a cervical mass, malignancy is always a consideration. In this paper, we present three cases of cervical tuberculosis that were diagnosed in a tertiary private hospital in Pasay City. Women in their 3rd and 4th decade of life presenting with post coital spotting, copious vaginal discharge and amenorrhea were examined: The cervix was converted to a nodular friable mass, with extension to the fornices. On rectovaginal exam, both parametria were nodular but free from the pelvic sidewall. The primary consideration was a probable cervical carcinoma stage IIB. On tissue biopsy and further testing, cervical tuberculosis was confirmed. Quadruple anti-Koch’s therapy was initiated, to which clearing of the cervix with decrease discharge was noted.
Tuberculosis

Low malignant potential serous tumors are the most common subtypes of non-benign serous tumors in the young, usually confined to one or both ovaries. To preserve ovarian function and fertility conservative management can be performed. Although recurrence is higher than that after a completion surgery, the rate of recurrences continues to be debated. Most recurrent diseases are of the same histopathology as the initial tumor and adequate excision of the recurrent tumor can be done.

A 31-year old, primigravid underwent bilateral oophorocystectomy for serous borderline ovarian tumor stage IB. After 3 years she had tumor recurrence and another fertility-sparing surgery consisting of left salpingooophorectomy and contralateral cystectomy was done. Histopathology was a recurrent borderline ovarian tumor. Two years later, she had a spontaneous pregnancy and delivered to a live term baby. This is a reported case of a successful pregnancy after two fertility-sparing surgeries for borderline ovarian tumor.

Human ; Female ; Adult ; Pregnancy ; Cystectomy ; Conservative Treatment ; Ovarian Neoplasms ; Fertility ; Ovariectomy ; Neoplasms, Glandular And Epithelial

Collision tumors represent the coexistence of two or three adjacent but histologically distinct tumors, without histoiogic admixture in an organ. Collision tumors have been reported in various organs, but are rarely seen in the ovaries. Reported cases consisted of a benign mature ovarian teratoma and an ovarian cystadenoma or cystadenocarcinoma. Primary carcinoid tumors of the ovary, on the other hand, are uncommon, with a reported incidence of 0.3%. They are usually unilateral and are found in association with mature cystic teratoma, forming a solid nodule within it. Primary ovarian carcinoids rarely metastasize and are treated as ovarian tumors with low malignant potential. This is a rare case of a triple collision tumor of the ovary in a 63 year old multigravid who complained of a gradually enlarging abdominal mass. Total abdominal hysterectomy with bilateral salpingo oophorectomy and complete surgical staging was performed. Histopathology revealed coexistence of a mucinous tumor of low malignant potential, trabeculartype carcinoid tumor, and mature cystic teratoma in the right ovary. The possibility of the occurrence of such collision tumors must always be kept in mind intraoperatively and during pathologic examination to avoid misdiagnosis of these cases.

Human ; Female ; Middle Aged ; Diagnostic Errors ; Incidence ; Salpingo-oophorectomy ; Ovarian Germ Cell Cancer ; Ovarian Neoplasms ; Neoplasms, Glandular And Epithelial ; Teratoma ; Carcinoid Tumor ; Cystadenocarcinoma ; Cystadenoma ; Hysterectomy

OBJECTIVE: This prospective study was conducted to determine the correlation between preoperative serum CA 125 levels and the presence of surgicopathologic prognostic factors in endometrial cancer. Subsequently, the study also aimed to determine the CA 125 cutoff value which best predicted the prognostic factors to which it had a significant correlation.
METHODS: Patients diagnosed with endometrial cancer at a tertiary gynecologic oncology unit from October 2006 until July 2008 who were eligible for primary surgical treatment were included in this analysis. Blood was extracted for serum CA 125 determination using a chemiluminescent enzyme immunoassay (CLEIA) prior to surgery. All patients underwent exploratory laparotomy, peritoneal fluid cytlogy, extrafascial or radical hysterectomy with bilateral salpingooophorectomy, bilateral pelvic lymph node dissection and para-aortic lymph node sampling. All specimens were examined for tumor differentation, lymphovascular space invasion, depth of myometrial invasion, cervical, adnexal, and vaginal involvement pelvic and para-aortic lymph node metastases, and peritonneal fluid cytology. Statistical analysis was performed using the Pearson r correlation test to evaluate the correlation of preoperative serum CA 125 with the different surgicopathologic prognostic factors mentioned. A receiver operating characteristics curve (ROC) was used to determine the optimal cutoff value of preoperative CA 125. Sensitivity, specificity, accuracy and likehood ratios were calculated.
RESULTS: A total of 90 patients with endemetrioid type endometrial adenocarcinoma underwent co,plete surgical staging from October 2006 until July 2008. Of the different surgicopathologic prognostic factors, pre-operative serum CA 125 was demonstrated to be significantly correlated with deep myometrial invasion (correlation coefficient 0.24, p=0.02), adnexal metastasis (correlation coefficient 0.26, p=0.01), pelvic lymph node involvement (correlation coefficient 0.31, p=0.01) and para-aortic lymph node involvement (correlation coefficient 0.43, p 0.01. The test likewise significantly correlated with the presence of extrauterine disease with a coefficient of 0.26 (p=0.01). A cutoff value of 55 U/ml has been calculated to predict extrauterine spread with a sensitivity of 53.85% , specificity of 84.38%, and accuracy of 75.56%. Using this cutoff, the odds of the positive test is 3.44, and the odds of negative test is 0.54.
CONCLUSION: Pre-operative serum CA 125 has a statistically significant correlation with the presence of deep myometrial invasion, adnexal metastasis, pelvic and para-aortic lymph node involvement, and extrauterine disease at a determined cutoff value of 55U/mL. It is recommended that serum CA 125 determination be adopted as an integral part of the routine pre-operative work-up of patients with endometrial cancer.

Human ; Ascitic Fluid ; Laparotomy ; Prognosis ; Endometrial Neoplasms ; Lymph Node Excision ; Lymphatic Metastasis ; Lymph Nodes ; Hysterectomy ; Immunoenzyme Techniques ; Adenocarcinoma

Leiomyosarcomas are rare uterine neoplasms that exhibit a highly malignant behavior. More commonly, these tumors arise de novo from the myometrium. A very small percentage is said to develop from a pre-existing leiomyoma. However, the latter condition of a malignant transformation is unusual. Only a handful of cases have been reported in literature. Perhaps due to its rarity, some gynecologists and pathologists do not even believe of its existence. Presented herein are two cases of leiomyosarcomas, which have, in all probability, arisen from a leiomyoma which underwent a sarcomatous change. (Author)

Human ; Female ; Leiomyosarcoma ; Leiomyoma