Bruce P. Zummo

Spontaneous rupture of a primary carcinoma of the ovary complicating pregnancy.

Abstract 1. 1. Primary ovarian malignancy complicating pregnancy is uncommon. 2. 2. Nineteen authentic cases are reported in the literature; of these nine are sarcomas, the remainder being carcinomas. 3. 3. That herewith reported is the only case of ruptured ovarian malignancy associated with pregnancy. 4. 4. Ruptured ovarian malignancy may simulate abruptio placenta, ruptured uterus, and the other conditions associated with pregnancy causing an acute abdomen.

Lipomas of Gynecologic Interest

Summary and Conclusions 1. Although lipomas of the female genitals arc uncommon, they have been reported as occurring in every structure of the genitals other than in the utero-sacral ligaments. These tumors are of gynecologic import because they can interfere mechanically with the function of surrounding organs, and on occasion may become malignant. 2. The etiology and pathogenesis of pelvic lipomas are herewith reviewed. 3. Twenty-six cases of pure lipoma of the uterus are now recorded in the literature. None of these tumors have been diagnosed preoperatively. The usual mistaken diagnosis is fibroniyomas of the uterus. These lipomas have occurred in women who are usually in the menopausal or postmenopausal stage of life. 4. Six cases of malignant degeneration of uterine lipomas have thus far been reported. 5. Pain, with or without bleeding, is the outstanding complaint caused by lipomas of the oviduct. Bogetti, after a thorough perusal of the medical annals, was able to find only 6 cases. These patients have all been in the childbearing age. 6. Lipomas of the ovary are exceedingly rare. We have been able to find only 3 cases in the literature. 7. Lipomas of the broad ligament are characterized by the following traits: (a) their indolence, (b) their tendency to assume considerable volume, and (c) their progressive growth. The most common mistaken preoperative diagnoses have been: (a) ovarian cyst, (b) parovarian cyst, (c) chronic salpingo-oophoritis. 8. Lipomas of the broad ligament may extend into the perineal area. These tumors can extend downward alongside the vaginal canal and partially or completely occlude the passage. 9. Retroperitoneal lipomas are characterized by abdominal swelling, and are associated with minimal pain. Lockyer has subdivided these tumors clinically into the potentially malignant prevertebral types, and into the usually benign broad-ligament and omental types. 10. Lipomas of the round ligament may be intra- or extraperitoneal, depending on whether they are inside or outside the inguinal ring. 11. Lipomas of the external genitals are more common than those of the internal genitals. At least 67 cases of lipomas of the labia have thus far been recorded in the literature. The presenting complaint is that of a mass in the groin or labia, usually associated with pain. 12. A complete differential diagnosis of lipomas of the external genitals will include a consideration of ten different possible causes. 13. Only one case of lipoma of the clitoris has been reported. The case summary is herewith presented.

Sulfadiazine concentration in the blood and lochia

Abstract 1. 1. The sulfonamide concentration of the lochia paralleled the blood concentration in each instance. 2. 2. The sulfadiazine routine of 60 grains initially and 15 grains every four hours results in extremely variable blood and lochial concentrations. 3. 3. Ambulatory patients do not always reveal an increase in the amount of lochia. 4. 4. The lochial odor of these patients tended to be “sharper” than that of those nonmedicated.