RESUMO
BACKGROUND: A 16 week pregnant woman presented with massive theca-lutein cysts requiring bilateral oophorectomy. Pregnancy progressed uneventfully and spontaneous lactation ensued after delivery. METHODS: To study the role of the ovary on the hormonal profile at the end of gestation and in post-partum, we measured FSH, estradiol (E2), unconjugated estrone (E1), unconjugated estriol (E3), sex hormone-binding globulin, progesterone, dehydroepiandrosterone sulphate and prolactin at 37 weeks gestation and at 8 h, 4 days, 5 weeks, and 2 months post-partum. RESULTS: These hormones were within the range expected for ovary-intact pregnant and puerperal women until 4 days post-partum. At 5 weeks post-partum, FSH increased to a peri-menopausal range (31.4 IU/l) while estrogens remained within the normal puerperal range (E2=239 pmol/l; E1=102 pmol/l), contrasting with their rapid changes in non-pregnant women after bilateral oophorectomy. At 2 months, while partially breastfeeding, FSH, E2 and E1 were closer to menopausal range (68 IU/l, 136 and 70.2 pmol/l respectively), and hormone replacement was started. CONCLUSIONS: We conclude that the ovary is not required to maintain a normal hormonal profile in late pregnancy and early puerperium. However, the increase in FSH to peri-menopausal levels at 5 weeks post-partum, despite breastfeeding, suggests that the ovary is needed to maintain low FSH concentrations during lactation.
Assuntos
Hormônios Esteroides Gonadais/sangue , Cistos Ovarianos/cirurgia , Ovariectomia , Complicações na Gravidez/cirurgia , Adulto , Sulfato de Desidroepiandrosterona/sangue , Estradiol/sangue , Estriol/sangue , Estrona/sangue , Feminino , Hormônio Foliculoestimulante/sangue , Humanos , Lactação/sangue , Cistos Ovarianos/sangue , Período Pós-Parto , Gravidez , Complicações na Gravidez/sangue , Terceiro Trimestre da Gravidez/sangue , Progesterona/sangue , Prolactina/sangue , Globulina de Ligação a Hormônio Sexual/metabolismoRESUMO
A six years old girl consulted due to mammary development. On physical examination, clitoris enlargement and a tumor localized in the abdominal-pelvic region were observed. Hormonal study disclosed elevated testosterone and estradiol levels. On exploratory laparotomy, a right ovarian tumor was observed and a right salpingooophorectomy was performed. The contemporary biopsy informed a disgerminoma, leading to a surgical staging of the tumor. The definitive pathological diagnosis was a juvenile granular cell tumor, limited to the ovary. In the postoperative period, estradiol and testosterone levels returned to normal values and the pseudopuberty reverted. The patient did not receive adjuvant treatment and after three years of follow up, there is no evidence of tumor recidivism.
Assuntos
Tumor de Células da Granulosa/complicações , Neoplasias Ovarianas/complicações , Puberdade Precoce/etiologia , Criança , Feminino , Tumor de Células da Granulosa/patologia , Tumor de Células da Granulosa/cirurgia , Humanos , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/cirurgia , Puberdade Precoce/patologia , Puberdade Precoce/cirurgiaRESUMO
Se presenta el caso clínico de una paciente de 73 años sometida a una laparotomía exploradora con el diagnóstico de un tumor anexial derecho y el hallazgo al ultrasonido de un endometrio engrosado para la edad. El diagnóstico histológico fue un rabdomiosarcoma pleomorfo del itsmo uterino. Se resume la evolución clínica, tratamiento y seguimiento posterior. A propósito de este caso se realiza una revisión del tema
Assuntos
Humanos , Feminino , Idoso , Rabdomiossarcoma/patologia , Neoplasias Uterinas/patologia , Seguimentos , Laparotomia , Estadiamento de NeoplasiasRESUMO
Se presenta el caso de una paciente de 27 años con diagnóstico de tumor trofoblástico del sitio placentario. Se incluye una revisión de esta poco frecuente enfermedad trofoblástica, junto al estudio histopatológico e inmunohistoquímico. Se destacan algunos hechos inusuales en la forma de presentación de este caso y se discute el tratamiento y seguimiento ofrecido a nustra paciente
Assuntos
Humanos , Feminino , Adulto , Tumor Trofoblástico de Localização Placentária/patologia , Aborto Espontâneo/complicações , Dilatação e Curetagem , Imuno-HistoquímicaRESUMO
Se presenta el caso clínico de una paciente de Ca de ovario operada, evaluada por second look usando laparoscopía