Sertoli-Leydig cell tumor is a rare sex-cord stromal tumor of the ovary and accounts for less than 0.5% of all ovarian tumors. It is among the most fascinating from pathologic and clinical viewpoints in masculinization. We experience an unusual case of a poorly differentiated Sertoli-Leydig cell tumor in 60-year-old woman who showed masculinization and present it with brief review of literature.
Female ; Humans ; Middle Aged ; Ovary* ; Sertoli-Leydig Cell Tumor*

A case of mucinous cystadenocarcinoma arising from a mature cystic teratoma in the right ovary of a 37-year-old woman is reported. Malignant transformation of a mature teratoma is a rare event and the commonest malignant neoplasm to develop is squamous cell carcinoma.(83%) Adenocarcinoma occurs with less frequency.(6.8%) The patient was treated by staging operation followed by adjuvant chemotherapy. After six courses of combination chemotherapy, oncological investigations, including chest X-ray, abdominopelvic CT scan and tumor markers, all revealed no evidence of recurrence.
Adenocarcinoma ; Adult ; Chemotherapy, Adjuvant ; Cystadenocarcinoma, Mucinous* ; Drug Therapy, Combination ; Female ; Humans ; Mucins* ; Ovary* ; Recurrence ; Teratoma* ; Thorax ; Tomography, X-Ray Computed ; Biomarkers, Tumor

Choriocarcinoma is a relatively rare malignancy of which characteristic is rapid metastasis to the other organs. It is related to the previous gestation or originated from the teratoma. Choriocarcinoma is mostly originated from the intrauterine chorionic villi, but it is rarely originated from the utreine cervix, fallopian tube, ovary, vagina and pelvic cavity. Primary choriocarcinoma of the fallopian tube is exceedingly rare and it is originated from ectopic tubal pregnancy, tubal migration from the intrauterine pregnancy or intratubal teratoma. 9 Symptoms and signs of the choriocarcinoma originated from the ectopic pregnancy are abdominal pain, vaginal bleeding, palpable adnexal mass, positive pregnancy test and amenorrhea. Thus it is difficult to distinguish choriocarcinoma from ectopic pregnancy on the basis of symptoms before the microscopic diagnosis presented.20 Effective treatment of choriocarcinoma is chemotherapy. Additional operation is possible. B-HCG is a useful measure for the follow up. We experienced a 36-year-old multigravida Korean woman who was diagnosed as the rupture of ectopic pregnancy after left salpingectomy in our hospital and then confirmed primary choriocarcinoma of the fallopian tube without metastasis on microscopic finding. Postoperative chemotherapy was performed with methotrexate. The follow up of disease is still on going at two month intervals and she has remained healthy, We report this case with review of literatures.
Abdominal Pain ; Adult ; Amenorrhea ; Cervix Uteri ; Choriocarcinoma* ; Chorionic Villi ; Diagnosis ; Drug Therapy ; Fallopian Tubes* ; Female ; Follow-Up Studies ; Humans ; Methotrexate ; Neoplasm Metastasis ; Ovary ; Pregnancy ; Pregnancy Tests ; Pregnancy, Ectopic ; Pregnancy, Tubal ; Rupture ; Salpingectomy ; Teratoma ; Uterine Hemorrhage ; Vagina

Endometriosis is defined as the presence of endometrial tissue(gland and stroma) outside the uterus. The incidence of scar endometriosis is quite rare, and must differentiate with cellulitis and abscess. We have experienced one case of perineal endometriosis and one case of abdominal wall endometriosis at the site of postoperative wound scar. The possible pathogenesis of endometriosis and treatment were discussed.
Abdominal Wall ; Abscess ; Cellulitis ; Cicatrix* ; Endometriosis* ; Female ; Incidence ; Uterus ; Wounds and Injuries

OBJECTIVE: This study was done to assess long-term survival and risk factors for recurrence after neoadjuvant chemotherapy and radical hysterectomy for locally advanced cervical cancer patients. METHODS: Between August 19S3 and May 1990, 80 cervical cancer stage IB-IIB patients with tumor diameter 4cm or more received neoadjuvant VBP chemotherapy and radical hysterectomy. After follow-up more than 10 years for these patients, survival rate and risk factors for recurrence were analyzed. RESULTS: Seventy eight of SO patients were followed for 10 years. During this period, 20,5% patients(16/78) had recurrences and all of them died of recurrence. Five and 10 year survival rates were 82%(64/78) and 79.4%(62/78), respectively. High risk factor for recurrence was pelvic lymph node invasion. However, clinical stage, initial tumor mass size, number of neoadjuvant chemotherapy, clinical response, or residual tumor size were not clinically significant risk factors for recurrence. Initial tumor size was correlated with pelvic lymph node metastasis. In recurrent patients, site of recurrence was not different according to pelvic lymph node status. For node positive patients, combination of chemotherapy and radiation seemed to be more effective in reducing recurrence compared to chemotherapy or radiation only. CONCLUSION: For locally advanced stage IB-IIB cervical cancer patients who received neoadjuvani chemotherapy and radical hysterectomy, pelvic lymph node metastasis was high risk factor for recurrence and initial tumor size was closely correlated with pelvic lymph node invasion even after neoadjuvant chemotherapy.
Drug Therapy* ; Follow-Up Studies ; Humans ; Hysterectomy* ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm, Residual ; Recurrence* ; Risk Factors* ; Survival Rate ; Uterine Cervical Neoplasms*

OBJECTIVE: Although the use of cytology in screening has reduced morbidity and mortality from invasive cervical cancer, there has been limitation because of the low sensitivity and high false negative rate in the detection of preclinical or clinical disease of the cervix. This study was performed to explore the usefulness of Hybrid Capture System HPV DNA test as a diagnostic method of the cervical cancer. METHODS: Cervical cytology and Hybrid Capture System 1 (HCS1) HPV DNA test were performed in 1,023 women who visited Gynecologic Oncology Clinic in Guro Hospital, Korea University Medical Center. HPV DNA were retested by HCS1, HCS2 and Polymerase Chain Reaction(PCR), in randomly selected 200 women to compare these DNA tests. RESULTS: While the sensitivity and specificity of cervical cytology in detection of cervical lesion were 71.2% and 89.5%, those of HCS1 HPV DNA test were 63.0% and 86.9% respectively. There was significant difference in detection of cervical precancerous lesions between HCS1 and HCS2 (P<0.05), but not between HCS2 and PCR (P=0.14). And the sensitivity and specificity were improved with combining cytology and HCS1 HPV DNA test(82.2%, 86.9%~). CONCLUSION: HCS HPV DNA test may be considered as a useful adjunctive test with cervical cytology in cervical cancer screening.
Academic Medical Centers ; Cervix Uteri ; DNA ; Female ; Human Papillomavirus DNA Tests* ; Humans ; Korea ; Mass Screening* ; Mortality ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Uterine Cervical Neoplasms*

OBJECTIVE: In an effort to develop a more effective therapeutic strategy for ovarian cancer, we examined whether the restoration of the wild-type p53 gene can enhance the therapeutic effect of chemotherapy. METHODS: In this study, Ov-ca-2774 cells, which are known to have p53 point mutation and cisplatin-resistance, were selected and currently used chemotherapeutic agents including cisplatin, carboplatin, paclitaxel, etoposide, topotecan, and doxorubicin were added concurrently or sequentially with adenovirus-mediated p53 gene transfer (Ad5CMV-p53). RESULTS: Transfer of the wild-type p53 cDNA gene into Ov-ca-2774 cells showed 55% cell killing in vitro at a multiplicity of infection (MOI) of 40. Although the combination of carboplatin or paclitaxel followed by p53 gene transfer with an interval of 48 h manifested no enhanced cell killing compared with cells infected with Ad5CMV-p53 alone, the other combinations of chemotherapeutic agents and p53 gene transfer resulted in 15% to 37% further cell killing (P<0.05). Furthermore, p53 gene transfer followed by doxorubicin with an interval of 24 h and concurrent combination of etoposide with p53 gene transfer showed significant difference in cell killing in contrast to the other combination strategies in the respective chemotherapeutic agent exposure groups (P<0.05). CONCLUSION: Our data demonstrated that combination of p53 gene transfer and chemotherapeutic agents had higher cell killing than either of these two modality alone.
Carboplatin ; Cisplatin ; DNA, Complementary ; Doxorubicin ; Drug Therapy* ; Etoposide ; Genes, p53 ; Homicide ; Humans* ; Ovarian Neoplasms* ; Paclitaxel ; Point Mutation ; Topotecan

The incidence of brain metastasis from the ovarian cancer is increasing because of the increased survival rate of the ovarian cancer patients and new development of the diagnostic imaging study. The traditional treatment of the brain metastasis is whole brain radiation therapy and recent trend of the treatment is multidisciplinary treatment (radiation therapy, surgery, radiosurgery, and chemotherapy). Recently we experienced a case with multiple brain metastases from the ovarian cancer which were treated by a multimodality approach including gamma-knife radiosurgery. She was diagnosed as epithelial ovarian cancer, FIGO stage IIIc, and underwent 9 cycles of cisplatin based combination chemotherapy (cyclophospamide, THP, cisplatin) after optimal cytoreductive surgery with Hartmans operation. Complete remission was achieved, but multiple brain metastases were detected 56 months after the initial diagnosis of ovarian cancer. She had no recurrent lesion outside the brain, and underwent surgical resection of the one respectable lesion and then gamma-knife radiosurgery for another unresectable lesion. She remains in a disease-free state without any symptoms for 4 months. We report this case with a brief review of the concerned literatures.
Brain* ; Cisplatin ; Diagnosis ; Diagnostic Imaging ; Drug Therapy, Combination ; Humans ; Incidence ; Neoplasm Metastasis* ; Ovarian Neoplasms* ; Radiosurgery ; Survival Rate

Strumal carcinoid of ovary is an unusual form of monodermal ovarian teratoma with thyroid-like follicles admixed with typical carcinoid tumor pattern. Most of them arise in dermoid cyst or in mature solid teratoma. Recently we experienced a case of strumal carcinoid postoperatively and report this case with a brief review of the concerned literatures.
Carcinoid Tumor* ; Dermoid Cyst ; Female ; Ovarian Neoplasms ; Ovary* ; Teratoma

A case of intermediate differentiated Sertoli-Leydig cell tumor with elevated Alpha-fetoprotein (AFP) levels occurred in a 15-year-old girl. No germ cell component and no heterologous elements were identified. Secretion of AFP by Sertoli-Leydig cell tumor has rarely been mentioned previously, and its mechanism is difficult to explain. We present this case with review of related literatures.
Adolescent ; alpha-Fetoproteins* ; Female ; Germ Cells ; Humans ; Ovary* ; Sertoli-Leydig Cell Tumor*