Jaya Kumari

Cervical Melanoma, a Rare Tumor with Poor Prognosis: Case Report and Review of Literature

Primary malignant melanoma of the female genital tract is very rare, and most of the melanomas reported till date are of the vulva and only less than 2% are accounting for cervical melanomas. The prognosis cervical melanoma is poor regardless of the stage at the time of diagnosis. There is no standard treatment; however, radical surgery is the cornerstone of treatment. We report a case of cervical malignant melanoma who presented with watery discharge per vaginum and occasional postmenopausal bleeding.

Melanoma of Vulva with Multiple Metastases: A Case Report and Review of the Literature

Malignant melanomas of the vulva and vagina are rare tumors located in areas of the body not exposed to ultraviolet radiation. Vulval melanoma is the second most common vulval malignancy after squamous cell carcinoma but represents less than 1% of all melanomas. Because of the overall poor prognosis, it represents a significant issue in women’s health. We present a case of a 40-year-old woman with malignant melanoma of vulva with spread to the inguinal lymph nodes, aortic lymph nodes, and secondaries in the lung.

Extra Uterine Choriocarcinoma Mimicking as Ectopic Pregnancy: A Rare Case Report

IntroductionChoriocarcinomas are germ cell tumours formed by trophoblastic elements (Mundkur et al., J Clin Diagn Res 9(1):QD01–2; 2015). Gestational choriocarcinoma can occur after molar pregnancy, tubal pregnancy or antecedent normal pregnancy. Primary extra-uterine choriocarcinoma is very rare.Case ReportWe report here a case of broad ligament choriocarcinoma who presented with a complaint of pain in lower abdomen off and on. She had a history of dilation and evacuation for spontaneous abortion 3 months back and then she had regular menses. Her transvaginal sonography revealed 42 x 35 mm size right adnexal mass which was more consistent with ectopic pregnancy and her serum human chorionic gonadotropin (β-Hcg) level was 1,76,075 mIU/ ml. Finally, patient was diagnosed as ruptured tubal ectopic pregnancy and thus, she underwent laparotomy. On laparotomy, there was purple colored broad ligament mass of size 5x6 cm with highly increased vascularity in right side which was removed with difficulty and massive bleeding occurred. So, total abdominal hysterectomy was done. Histopathological report showed choriocarcinoma of right broad ligament invading myometrium. The patient was given 6 cycles of EMACO regime. Serum β-Hcg levels of the patient gradually declined and eventually became negative after 2 weeks of 5th EMACO. With this case report, we aim to emphasize that while diagnosing the ectopic pregnancy, even very rare, the tubal choriocarcinoma should be kept in mind. We report a case of primary extra-uterine choriocarcinoma that was mistaken for an ectopic pregnancy.

Multiple Primary Malignancies of Cancer of Ovary and Cervix in A Young Woman: A Rare Case Report

Cancer is a growing and evolving epidemic. Multiple primary malignancies is a documented entity and can be synchronous or metachronous depending on the time of diagnosis of the two malignant tumors. We present a case of synchronous female gynecological malignancies involving the ovary (papillary serous adenocarcinoma) and cervix (squamous cell carcinoma grade III). The different histopathology of the two tumors and the tumor-free intervening endometrium, myometrium and fallopian tubes made it a clear diagnosis of two separate primaries. Thorough examination of all patients of cancer and keeping the possibility of such tumors in mind can help diagnose more such cases and study their pathogenesis and determine their risk factors.

Calcified Large Subserous Fibroid with Unusual Presentation

Calcified subserous leiomyoma is a benign tumour in postmenopausal age group. It causes diagnostic dilemma with solid calcified adnexal mass and large bladder calculi at the pelvic region. We present a case of calcified subserous fibroid in a postmenopausal woman. Clinical and radiological diagnoses were confirmed by histopathology of the hysterectomy specimen.

Uterine Carcinosarcoma in A Postmenopausal Woman: A Rare Case Report

AbstractUterine carcinosarcomas are rare tumors accounting for about 2–4% of all uterine cancer and with a poor prognosis with 5-year survival of only 21–39%. These are highly aggressive tumors and usually diagnosed with distant metastasis at the initial diagnosis. The origin of this tumor has been studied extensively, and these are now believed to be metaplastic carcinomas. The treatment of the early-stage disease is surgery, and in the late stages the role of adjuvant chemotherapy and radiotherapy is debated. We report here a case of the early-stage uterine carcinosarcoma in a postmenopausal woman.

Myths and Taboos: A Major Hindrance to Cancer Controls. “Inherited Knowledge” A Blessing or Curse. Surgery After 21 Cycles of Chemotherapy “A Surgeon’s Ordeal”

Abstract Myths, superstition, and taboos are prevalent in India and often guide the patient’s perceptions about the cause and treatment of diseases. The preformed firm notions make the patients unreceptive to counseling by doctors and often lead them to take wrong decisions from their end. We report a patient with cancer of the ovary who because of her misconception of cancer surgery chose to undergo 21 cycles of chemotherapy and eventually faced near fatal complication after surgery.

Fibroid Mimicking Ovarian Malignancy: A Rare Case Report

Uterine fibroids usually have typical appearance on imaging. However, when fibroids present in unusual locations or undergo degenerations, confusion in imaging studies may arise. Here, we present a case of a 47-year-old woman with a preoperative diagnosis of ovarian malignancy. Surprisingly, a large pedunculated uterine leiomyoma which had undergone extensive cystic degeneration was found on laparotomy. Pedunculated leiomyomas with extensive cystic degeneration should be considered in the differential diagnosis of adnexal mass.

Cutaneous Metastasis in Thigh from Vulval Carcinoma a Rare Case Report

IntroductionCancer of the vulva is the fourth most common malignancy of the female genital tract and is accountable for approximately 4% of all gynaecologic malignancies. Cutaneous metastasis is a rare and usually pre-terminal manifestation in malignancies. It has an incidence of 0.7%–9% and is usually seen in malignancies of the breast, followed by colorectal carcinoma, melanoma and ovarian carcinoma, respectively. Cutaneous metastases from vulvar cancer are very rare and have been reported in only eight cases till 2010.CaseWe report a case of squamous cell vulvar cancer with cutaneous metastasis in a 61-year-old woman.ConclusionThe appearance of metastasis to the skin from an underlying malignancy must be considered an ominous sign. Treatment can consist of radiation, excision and/or chemotherapy, but due to the limited number of cases, there is no well-established treatment or management of this condition.

A Large Leiomyoma of Round Ligament of Uterus Presenting as Ovarian Tumor: A Rare Case Report

IntroductionFibroid is the most common benign tumor of the uterus and occurs in 20–50% of women, mostly situated in the body of the uterus (Metzger et al. J Reprod Med 33:246–248, 1988). They rarely arise from extrauterine sites with round ligament which is very uncommon. Its incidence is not known exactly, and the mean age ranges from 13 to 70 years. However, by clinical examination and newer imaging modalities, we can easily know about size, number and origin of these tumors, and any anatomical distortion of surrounding vital organs, but sometimes, it is very difficult to differentiate preoperatively between large round ligament leiomyomas and ovarian/adnexal pathology especially if cystic degeneration or necrosis is present in leiomyoma.Case reportWe report here a patient with huge leiomyoma of round ligament which was diagnosed preoperatively as benign ovarian tumor. Laparotomy was done, and oval mass of size 20 × 18 cm with base originating from round ligament of right side was present. Mass was solid and firm in consistency. Postoperative period was uneventful. Patient is now under regular follow-up.ConclusionIn conclusion, leiomyoma of round ligament should be kept in the mind if different imaging report showing benign ovarian tumor along with intramural fibroid and serum tumor marker reports is within normal limit.