Azadeh Joulaee; Nasibeh Khaleghnejad-Tabari
Volume 2, Issue 4 , November and December 2017, Pages 1-3
Abstract
The majority of cases are very young, less than 40 years old, which means they are out of the screening age range. For older pregnant women, screening is not done both due to possible radiation exposure of fetus and low accuracy of mammographyin pregnancy-induced highly dense breasts. Therefore, all ...
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The majority of cases are very young, less than 40 years old, which means they are out of the screening age range. For older pregnant women, screening is not done both due to possible radiation exposure of fetus and low accuracy of mammographyin pregnancy-induced highly dense breasts. Therefore, all the patients are symptomatic at presentation. Mass or ulcer in the breast, nipple or axilla; skin or nipple retraction, nipple scaling, unilateral uniduct spontaneous nipple discharge with any color, unilateral breast edema without or with redness (Peaud’orange) are the symptoms that bring the patient to her obstetrician. Thus, all pregnant women must be informed by their obstetricians about the possibility of breast cancer occurrence during pregnancy as well as all signs and symptoms of breast cancer. It should be noted that, stage by stage, the prognosis is the same as that of non-pregnant patients. Among the three breast imaging modalities, sonography is the first imaging procedure used for symptomatic pregnant women. It can safely be done during all trimesters of pregnancy. As always, sonography can differentiate solid tumors from cysts. Simple cysts are always benign, although they may present as large masses. Since there is no possibility for malignancy in these simple cysts, there would be no need for further follow-up because during the follow-up, their size and number can change or they may disappear spontaneously. These findings do not change our approach. In the case of large painful cysts, they can be aspirated using a needle either by surgeons or under the guide of sonography by a radiologist. On the other hand, if any solid mass is seen in the wall of a cyst, it is no longer a simple cyst and is considered as suspicious, thus classified as at least breast imaging reporting and data system (BIRADS) 4 needing immediate tissue diagnosis. Sonography, also, gives important information about solid tumors. By the evaluation of margins, vascularity, and elasticity, it can differentiate possibly benign tumor defined as BIRADS 3 from suspicious ones defined as BIRADS 4 or 5 that, again, need immediate tissue diagnosis. Well defined round or oval masses with fine margins without vascularity by Doppler evaluation and elastic, not rigid in elastography, are considered as possibly benign tumors or BIRADS 3 and can be followed by sonography instead of tissue diagnosis because the possibility of malignancy though not zero, is less than 2%. Sonography can, also, evaluate the lymp nodes in the breast and axilla; and diagnose the suspicious ones (thick cortex, round rather than kidney shape). If an LN is suspicious, tissue diagnosis is needed by needle biopsy which is usually done at the same time as the breast biopsy.
Mojgan Karimi Zarchi; Soraya Teimoori
Volume 2, Issue 4 , November and December 2017, Pages 1-2
Leila Mousavi Seresht; Meysam Izadi; Zohreh Yousefi; Amir Hosein Jafarian; Nooshin Babapour; Laya Shirinzadeh; Zahra Rastin
Volume 2, Issue 4 , November and December 2017, Pages 1-3
Abstract
Introduction: In patients with female genital tract cancers, during treatment, differentiating between a tumor recurrence and a benign phenomenon is of great importance. This study aimed to report a case of retroperitoneal lymphocele in a patient with primary ovarian cancer.
Case Presentation: A 49-year-old ...
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Introduction: In patients with female genital tract cancers, during treatment, differentiating between a tumor recurrence and a benign phenomenon is of great importance. This study aimed to report a case of retroperitoneal lymphocele in a patient with primary ovarian cancer.
Case Presentation: A 49-year-old woman diagnosed with papillary serous ovarian carcinoma was referred to the oncology clinic in 2017. She was treated with an optimal surgical staging and underwent adjuvant chemotherapy. After 3 courses of chemotherapy, she complained of a large abdominal mass in the umbilical area. Evaluating the mass confirmed retroperitoneal lymphocele, which was treated with a non-surgical therapy.
Conclusions: Pelvic mass in patients with previous ovarian cancer is not necessarily due to the recurrence of the tumor and the possibility of lymphocele diagnosis should be considered. Since preventing the causes of lymphocele is very difficult, it is only necessary to carefully follow-up and provide essential consultations for high risk patients.
Behnaz Moradi; Fatemeh Shakki Katouli; Masoumeh Gity; Mohamad Ali Kazemi; Madjid Shakiba; Farzaneh Fattahi Masrour
Volume 2, Issue 4 , November and December 2017, Pages 1-8
Abstract
Objectives: The current study aimed at providing detailed information about the distribution, associated anomalies, and syndromes in Iranian fetuses with neural tube defects (NTDs).
Methods: The current study was conducted in Yas Females’ referral and teaching hospital in 18 months from 2014 to ...
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Objectives: The current study aimed at providing detailed information about the distribution, associated anomalies, and syndromes in Iranian fetuses with neural tube defects (NTDs).
Methods: The current study was conducted in Yas Females’ referral and teaching hospital in 18 months from 2014 to 2016. All fetuses with a prenatally detected neural tube defect were included in the study. Neural tube defect characterization, gestational age, maternal reproductive factors, maternal risk factors, and associated anomalies were recorded.
Results: Neural tube abnormalities were identified prenatally in 80 fetuses: 40 cases of ex/anencephaly, 22 cases of spina bifida, 13 cases of cephalocele and 5 cases of anencephaly /craniorachischisis. All the cases were detected before 21st week of gestation and 92.5% of the ex/anencephaly cases were diagnosed in the 1st trimester. Moreover, 40% of the open spina bifida cases in the current study were myelocele, while 75% of them referred only due to abnormal cranial findings. Incomplete consumption of folate was the most common associated risk factor (45%). Associated anomalies were recorded in 53 (66%) fetuses, with more prevalence in the fetuses with spina bifida (90%). Among the associated anomalies, central nervous system (CNS) anomalies were the most common type (26.26%). Chiari II was found in all the cases of open spina bifida and the ventriculomegaly rate was 30% in this group. Extremities anomalies and spine deformities were the 2nd and 3rd common associated findings, respectively. Limb-body-wall complex/amniotic band syndrome was the most common identified associated syndrome (6%).
Conclusions: Results of the current study confirmed the high prevalence of associated anomalies in neural tube defect cases and revealed the capability of detailed sonography to detect and define such abnormalities.
Azamsadat Mousavi; Mahshid Shooshtari; Setare Nassiri; Abas Ali Aipour; Setare Akhavan; Narges Zamani
Volume 2, Issue 4 , November and December 2017, Pages 1-5
Abstract
Background: Currently, the prevalence of borderline ovarian tumors (BOT) is increasing, and given the higher diagnosis in the third and fourth decades of life, fertility sparing procedures are widely used. There are important consequences in females with borderline ovarian tumors and number of effective ...
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Background: Currently, the prevalence of borderline ovarian tumors (BOT) is increasing, and given the higher diagnosis in the third and fourth decades of life, fertility sparing procedures are widely used. There are important consequences in females with borderline ovarian tumors and number of effective factors on recurrence and fertility rate.
Methods: In this cohort study, the required information was collected from a file of 43 patients with final pathologic diagnosis of borderline ovarian tumor, who had undertaken fertility sparing surgery at Imam Khomeini Hospital, Tehran University of Medical Sciences, and recurrence rate, fertility rate, and the effect of different variables were studied.
Results: There were significant correlations between oral contraceptive pill (OCP) consumption, serous pathology, micro invasion in pathology, advanced stages, and recurrence rate of BOT, while this relationship was not found between parity, surgical methods (laparotomy and laparoscopy), surgical techniques (cystectomy and USO), papillary projection, and recurrence rate.
Conclusions: Although the recurrence rate was higher in the current research when compared to other previous studies, yet only in one patient, the pattern of recurrence was invasive epithelial carcinoma, thus in the current study the overall survival did not seem to change. The results of this study on fertility rate are comparable to other studies on this issue. Therefore, these methods are recommended for young patients and emphasis should be place on follow-up.
Fakhrolmolouk Yassaee; Reza Shekarriz-Foumani; Shima Sadeghi
Volume 2, Issue 4 , November and December 2017, Pages 1-5
Abstract
Background: Women’s activity in many social and religious events necessitates them to have their menstruation suppressed, including in yearly Hajj rites for Muslim women. According to the Islamic religious set-ups, Muslim women must be physically and morally clean during the Hajj rites in Mecca. ...
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Background: Women’s activity in many social and religious events necessitates them to have their menstruation suppressed, including in yearly Hajj rites for Muslim women. According to the Islamic religious set-ups, Muslim women must be physically and morally clean during the Hajj rites in Mecca. In this research, the efficiency and side effects of extended consumption of hormonal agents in Iranian women during the Hajj rites in Mecca were examined.
Methods: The retrospective cross-sectional study involved a sum of 212 participants of pilgrim women recruited from 30 Sep. to 4 Nov. 2013, already prescribed with different types of hormonal agents for 35 - 36 days. Thereafter, they were assessed by questionnaires for the sake of success and side effects throughout the approach.
Results: Out of 212 subjects, 161 (75.9%) had experienced menstrual delay during Hajj rites with no spotting. Women taking combined oral contraceptives within the first half of their menstrual cycle had a significant postponement of menstrual bleeding.
Conclusions: Majority of the pilgrim women who completed the Hajj rites thoroughly with no spotting were satisfied with the extended consumption of hormonal agents.
Elham Keshavarz; Afarin Sadeghian; Ali Ganjalikhan Hakemi; Fatemeh Talei Khtibi
Volume 2, Issue 4 , November and December 2017, Pages 1-5
Abstract
Background: Pre-eclampsia complicates 5% to 8% of all pregnancies and annual incidence of pre-eclampsia is about 5% of all pregnancies around the world and is a significant cause of both maternal and fetal mortality and morbidity if left untreated.
Objectives: According to previous studies, blood supply ...
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Background: Pre-eclampsia complicates 5% to 8% of all pregnancies and annual incidence of pre-eclampsia is about 5% of all pregnancies around the world and is a significant cause of both maternal and fetal mortality and morbidity if left untreated.
Objectives: According to previous studies, blood supply distribution within the uterus is not similar in central compared with lateral sites, thus site of implantation and the resulting location of the placenta are likely to have a profound effect on the pregnancy outcome.
Methods: The researchers conducted a case-control study over 1-year period at a referral obstetric hospital in the south of Tehran. Overall, 121 females with three degrees of pre-eclampsia were considered as cases and 258 females with normal pregnancy were the controls. The females were aged 20 to 40 years old and their gestational age was between 14 and 26 weeks.
Results: The researchers recorded the participants’ blood pressures and locations of placenta during this period with consideration of their past and present obstetric history as well as medical and familial history. As a result, pregnancies complicated by pre-eclampsia were more commonly associated with lateral placentation in the second trimester when compared with non-pre eclampsia pregnancies.
Discussion: This study suggests that placental location, which is easily assessed at middle trimester of pregnancy by routine screening ultrasonography, is an ideal predictive test for evaluating the risk of developing pre-eclampsia.
Setareh Akhavan; Nadereh Behtash; Mohsen Esfandbod; Mitra Moddares Gilani; Azam-Sadat Mousavi; Shahrzad Sheikh Hasani
Volume 2, Issue 4 , November and December 2017, Pages 1-4
Abstract
Epithelial ovarian cancer (EOC) is the fifth leading cause of cancer death in women. Primary surgery, followed by adjuvant chemotherapy is the basis of treatment for this disease. A standard treatment includes primary surgery and if possible optimal debulking surgery (tumor residue of <; 1 cm), followed ...
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Epithelial ovarian cancer (EOC) is the fifth leading cause of cancer death in women. Primary surgery, followed by adjuvant chemotherapy is the basis of treatment for this disease. A standard treatment includes primary surgery and if possible optimal debulking surgery (tumor residue of <; 1 cm), followed by a chemotherapy; paclitaxel carboplatin is the standard regimen in ovarian cancer. Given that the main method of spreading this disease is in the peritoneal cavity, the systemic chemotherapy brings about numerous complications; moreover, as the method of prescribing a drug inside the peritoneum causes a high drug concentration in the peritoneal cavity, conducting an intraperitoneal chemotherapy has been examined clinically. In cases of ovarian cancer recurrence, performing a secondary cytoreductive surgery, in addition to hyperthermic intraperitoneal chemotherapy (HIPEC), has led to a good survival among patients. Currently, studies are ongoing to better explain the effects of this treatment method compared to previous methods.
