A 44‑year‑old woman presented with an abnormal vaginal discharge. She was initially diagnosed with cervical intraepithelial neoplasia‑1 through Papanicolaou smear and was managed with cryotherapy and completed human papillomavirus vaccinations. Nine years later, gynecologic examination showed a cervical mass, and biopsy revealed a signet‑ring cell‑type mucinous adenocarcinoma. Extensive systemic evaluation performed revealed no other malignancies. Radical hysterectomy was performed, and final pathology report showed a primary signet-ring cell cervical carcinoma stage 1B2. Concurrent chemotherapy with adjuvant external beam radiation therapy was then given. The patient has no evidence of disease for 24 months now since diagnosis. Primary signet‑ring cell carcinoma of the cervix is rare. It is diagnosed when no other tumor is found in extragenital sites, histology consists of signet‑ring morphology, tumor includes areas of adenocarcinoma in situ, and case has a prolonged survival. Overall patient education plays a vital role in management.
Papanicolaou Test ; Papillomavirus Infections ; Carcinoma, Signet Ring Cell ; Human Papillomavirus Viruses

Precocious puberty is the onset of pubertal development at an earlier age than is expected based upon established normal standards. The cause of precocious puberty may range from a variant of normal development (eg. premature adrenarche or isolated premature thelarche) to pathologic conditions with significant risk of morbidity and even death (eg. malignant germ-cell tumor or astrocytoma). A case of an 18 month old female presenting with vaginal bleeding following a previously noted breast enlargement was described. Initial assessment based on the patient's history and physical examination is suggestive of precocious puberty. Hormonal studies indicated normal levels of FSH and LH, with an elevation in estradiol. Radiographic analysis showed a normal bone age. Cranial MRI revealed no abnormal masses. Sonographic evaluation showed bilateral cystic masses in the ovaries. A diagnosis of peripheral precocious puberty associated with functional ovarian cysts was made, and the patient was monitored for progression of pubertal development.

Human ; Female ; Infant ; Familial Testotoxicosis ; Puberty, Precocious ; Estradiol ; Adrenarche ; Ovarian Cysts ; Gigantomastia ; Breast ; Hypertrophy ; Astrocytoma ; Neoplasms, Germ Cell And Embryonal ; Uterine Hemorrhage

Catamenial pneumothorax is defined as recurrent and spontaneous pneumothorax occurring within 48 to 72 hours of the onset of menstruation. The etiology is unknown but several theories have been proposed. This is the case of a 45- year- old G2P2 with an eight- year history of on and off chest pain and difficulty of breathing coinciding with menstruation that resolved spontaneously. On two occasions of intractable pulmonary distress during menstruation, diagnosed as spontaneous pneumothorax, thoracostomy, thoracotomy, and mechanical, and eventually, chemical pleurodesis were performed. With a clinical diagnosis of catamenial pneumothorax, continuous oral contraceptive pills were given while patient was being stabilized. When OCP's were discontinued 9 months after, the pulmonary symptoms promptly recurred. Total abdominal hysterectomy with bilateral salpingooophorectomy (THBSO) was finally performed. Patient has remained asymptomatic more than 2 years after surgery. The management of catamenial pneumothorax may be initiated based on clinical signs and symptoms in the face of possible catastrophic complications which in this case is spontaneous pneumothorax.

Human ; Female ; Middle Aged ; Catamenial Pneumothorax ; Pneumothorax ; Menstruation ; Thoracostomy ; Thoracotomy ; Pleurodesis ; Contraceptives, Oral, Combined ; Chest Pain ; Thorax ; Hysterectomy

A three-cell type malignant mixed germ cell tumor of the ovary is very rare neoplasm. Presently, there has been no reported incidence of the three-cell type mixed germ cell tumor in the literature. Malignant germ cell tumors comprise less than 5% of all ovarian neoplasms. Mixed germ cell tumors, most of which have only two elements.

This is a case report of a 22-year old, nulligravid, who presented with hypogastric pain and increased abdominal girth. Clitoromegaly was noted at puberty. Patient has normal secondary sexual characteristics and menarche. A large multi-separated cystic abdominopelvic mass was seen on ultrasound. Intraoperatively, the left ovary was transformed into a solid tumor measuring 13.5cm x 7cm x 7cm, dangling separately from the left fallopian tube, such that a left oophorectomy. The uterus was hypoplastic. A thin, white, fibrous tissue inferior to the right fallopian tube was seen, which may represent the right ovary, signifying gonadal dysgenesis. For the purposes of staging, peritoneal fluid cytology, bilateral lymph node dissection infracolic omentectomy, liverand para-aortic lymph node palpation were also performed. Final histopatholic diagnosis was malignant mixed germ cell tumor comprising three element, andodermal sinus tumor (70%), dysgerminoma (25%) and embryonal carcinoma (5%). Patients was diagnosed to have malignant mixed germ cell tumor, left ovary, stage IA; hypoplastic uterus; gonadal dysgenesis, right. Adjuvant chemotherapy was advised due to the aggressive nature of the predominant cell type. Reproductive function is further compromised in the presence of the hypoplastic uterus and gonadal dysgenesis.

Human ; Female ; Young Adult ; Dysgerminoma ; Carcinoma, Embryonal ; Gonadal Dysgenesis ; Ovarian Neoplasms ; Turner Syndrome ; Uterus ; Ovariectomy

A case of Androgen Insensitivity Syndrome in one of three sisters who presented with primary amenorrhea, female phenotype with fully developed female breasts, absent uterus and ovaries, a short blind-ending vagina, absent axillary hair, scanty pubic hair, and a male karyotype is presented here. Approach to correct diagnosis and differentiation of Androgen Insensitivity Syndrome from other causes of primary amenorrhea are discussed. Appropriate management including surgical, medical and psychological aspect and the option of eventually marrying and establishing a family of their own are also presented. Ethical issues regarding disclosure of the diagnosis to patients with Androgen Insensitivity Syndrome are also tackled. (Author)

Human ; Female ; Adult ; Androgen-insensitivity Syndrome ; Pseudohermaphroditism ; Case Reports