Benign peritoneal cystic mesothelioma is a rare benign tumor occurring in women of reproductive age. Acute presentation is even very rare and options of management are not established. A case of a 25-year-old woman with multiple episodes of hypogastric pain and dysmenorrheal is presented. Transvaginal US showed a cystic mass involving left flank to pelvis. The uterus and adnexae were congestive at laparoscopy. Both ovaries, Douglas sac and omentum had grape-like thin-walled cystic clusters. The patient was treated with total omentectomy and complete surgical resection of cysts. Histological analysis of the mass confirmed the diagnosis of benign peritoneal cystic mesothelioma.

Benign peritoneal cystic mesothelioma is a rare benign tumor occurring in women of reproductive age. Acute presentation is even very rare and options of management are not established. A case of a 25-year-old woman with multiple episodes of hypogastric pain and dysmenorrheal is presented. Transvaginal US showed a cystic mass involving left flank to pelvis. The uterus and adnexae were congestive at laparoscopy. Both ovaries, Douglas sac and omentum had grape-like thin-walled cystic clusters. The patient was treated with total omentectomy and complete surgical resection of cysts. Histological analysis of the mass confirmed the diagnosis of benign peritoneal cystic mesothelioma.

Omphalocele, cloacal exstrophy, imperforate anus and spinal anomalies complex (OEIS complex) is a combination of severe and extremely rare congenital malformations. Its incidence is estimated at 1 per 200,000 - 400,000 live births. The occurrence of cases is sporadic and has no known etiology. Some have been associated with environmental exposures, genetic causes, and in vitro fertilization procedures. The mechanism of development appears to be associated with alterations in early blastogenesis or defect in mesodermal migration during the embryonic period. Prenatal diagnosis can be made at 16 weeks of gestation, although earlier diagnosis is sometimes possible. Definitive diagnosis is made necropsy findings. Most surviving newborns require multiple surgeries with potential complications and the desired results are not always achieved. A case of prenatal diagnosis of omphalocele, cloacal ...

Musculoskeletal defects of fetal limbs are rare. Causes of these abnormalities include amniotic band syndrome, exposure to teratogenic agents, illicit drug use, diabetes, and autosomal recessive inheritance. Tetraphocomelia is a rare congenital musculoskeletal malformation characterized by total or partial agenesis of long bones of the extremities, causing that hands and feet to arise directly from fetal trunk. Its incidence is 0.62 cases per 100,000 live births. It can occur as an isolated defect, but also can occasionally be associated with craniofacial malformations and other systemic abnormalities. Prenatal ultrasound evaluation allows early diagnosis of all fetal abnormalities, including most musculoskeletal malformations. Diagnosis should be performed carefully and interpreted with caution, since the presence of other associated systemic abnormalities should be sought. A case of pr...

Torcular herophili thrombosis is a rare disease of unknown etiology. So far about 50 cases have been described in the literature. Ultrasound is an effective diagnostic method and is useful for follow-up. Characteristic sonographic findings include a well-defined triangular anechoic lesion in the occipital region with an echogenic structure within it which is the thrombus. Doppler ultrasound can help to establish the diagnosis more accurately. The prognosis is variable, as most cases have an irrelevant clinical course due to spontaneous resolution of the thrombus, while other cases may experience cerebral atrophy and death. A case of prenatal diagnosis of torcular herophili thrombosis is presented.

Intra-abdominal vein varix of fetal umbilical are rare entities characterized by focal aneurysmal dilatation. They account for approximately 4% of umbilical cord anomalies and are thought to be a developmental anomaly rather than a congenital malformation. Their clinical significance has not yet been clearly established. Prenatal diagnosis is made by conventional ultrasound in which the lesion appears as a round or fusiform cystic structure within the fetal abdomen. In addition, it is useful to establish the diameter and the presence of other associated fetal anomalies. Doppler evaluation allows identification of the type of intralesional flow. The perinatal prognosis is favorable when it is identified as an isolated finding. However, in those cases associated with other anatomical/structural alterations, the fetal and neonatal outcome is variable. A case of prenatal diagnosis of intra-a...

Benign smooth muscle tumors are the most common tumors in the female genital tract. Dissecting cotyledonal leiomyoma of the uterus is a rare variant of benign leiomyoma that has unusual growth patterns and shares some features with other variants of dissecting leiomyoma. It has an unusual growth pattern characterized by intramural dissection within the myometrium and with similar appearance of its extrauterine components to placental cotyledons. Its sarcomatoid appearance and unusual character give the impression of malignancy. The diagnosis is made by the characteristic histopathologic findings of the lesion. A case of cotyledonoid dissecting leiomyoma of the uterus is presented.

Small cell carcinoma accounts for 20% of lung cancers; it rarely occurs at other sites. Extrapulmonary small cell carcinoma is aggressive, with a propensity for regional and distant spread. This type of carcinoma is a rare breast neoplasm. Although the clinical appearance is nonspecific, it often responds well to therapy and has a good prognosis of survival. We present the case of a 50-year-old woman with extrapulmonary small cell carcinoma of the breast. Physical examination showed a 4 x 3 x 3 centimeters lesion confirmed by magnetic resonance imaging of the left breast. The diagnosis was made by biopsy showing characteristic small, round, lymphocyte-like cells with hyperchromatic nuclei and scant cytoplasm compatible with small cell carcinoma of the breast. The patient was treated with chemotherapy before undergoing total mastectomy and lymph node resection.

Primary spontaneous pneumothorax is an extremely rare condition duringpregnancy and can occur at any time. Rupture of an apical ampulla or subpleuralbulla is the most common cause in young pregnant women. It is thought to bedue to increased inspiratory activity associated with the peripartum period. Earlydetection and prompt diagnosis of this condition are important for the preventionof some serious complications. The therapeutic methods used in pregnancy do notdiffer essentially from those used in non-pregnant patients. Ambulatory drainage ofthe thorax has been recommended in treatment. Delivery in these women can beperformed vaginally, with a second phase of labor without effort. We present a caseof primary spontaneous pneumothorax that occurred at 35 weeks of gestation in ahealthy 34-year-old primigravida. Its onset was described as pleuritic chest pain anddyspnea of sudden onset. The...

Placental polyp is a tumor of placental tissue retained within the endometrial cavity.These retained placental tissue fragments, especially those of the hipervasculartype, are a possible cause of acute bleeding for an indefinite period after abortionor delivery. These retained placental tissue fragments, composed predominantly ofnecrotic and hyalinized chorionic villi, give it its hipervascular condition and can causeprofuse, life-threatening hemorrhage and require immediate intervention based onthe correct differential diagnosis. We present a case of a 45-year-old woman withgenital bleeding. The last pregnancy had been 6 years ago. Ultrasonography revealedan intrauterine and echogenic tumor measuring 3 x 2 x 1 centimeters with multiplecystic spaces inside. She underwent successful hysteroscopy-guided resection,and the pathological diagnosis was hipervascular placental polyp. Although ra...

Epithelioid sarcoma is a rare type of mesenchymal tumor. Proximal-type epithelioidsarcoma of the vulva is an extremely rare malignant tumor of the soft tissues withfrequent recurrences due to its aggressive behaviour. Because its characteristicsare similar to other benign lesions, this leads to diagnostic and therapeutic delays.Histologic features of this tumor include prominent epithelioid cells and theappearance of rhabdoid features with marked nuclear atypia. Due to its low incidence,there are no evidence-based diagnostic algorithms or published recommendationsfor treatment. The prognosis is generally poor. A case of proximal type epithelioidsarcoma of the vulva is presented.

Primitive neuroectodermal tumor of the ovary is a rare and aggressive small roundcell soft tissue sarcoma of neural origin that is usually associated with high morbidityand mortality. Immunohistochemistry is a useful adjunct in the differential diagnosis.We describe a case of a primitive neuroectodermal tumor of the ovary in a 21-yearold nulliparous patient who reported pain and increased abdominal circumference.Ultrasonography showed a solid-cystic heterogeneous tumor apparently originatingfrom the left adnexa. Magnetic resonance imaging confirmed the presence of atumor extending into the left iliac fossa without local organ involvement or regionalor distant metastases. Tumor markers were all within the normal range. Duringlaparotomy, a left ovarian tumor was observed with a normal right ovary. Leftsalpingo-oophorectomy was performed due the size of the tumor, right ovarianwedge resecti...

El carcinoma de células escamosas de ovario es una neoplasia maligna rara; su aparición es atribuible a la transformación maligna de un tumor ovárico existente. La variedad pura del carcinoma de células escamosas del ovario, en ausencia de lesiones ováricas preexistentes que incluyen quistes dermoides, tumores de Brenner o endometriosis, es extremadamente rara y se le considera una metaplasia del epitelio de superficie. Debido a su rareza, no se han establecido las características clínicas ni los tratamientos efectivos. La evaluación adecuada antes de la cirugía es fundamental para determinar el alcance de la cirugía y la terapia adyuvante. No existe acuerdo sobre la quimioterapia o radioterapia postoperatoria. El pronóstico de la enfermedad avanzada es generalmente pobre. Se presenta un caso de carcinoma de células escamosas primario puro de ovario.

Merkel cells were originally described in the stratum basale of the epidermis withneuroendocrine properties. Merkel cell carcinoma of the vulva is an extremelyrare and highly aggressive neoplasm. There are few cases of these tumors, mostof which have been considered neuroendocrine tumors. The histologic origin andetiology of this disease are controversial. It is known for his aggressive behaviorand propensity for early diffusion. Because of its rarity in this location, it is unclearwhether it behaves differently from similar skin carcinomas in other locations. A caseof primary vulvar Merkel cell carcinoma is presented. Excisional biopsy examinationrevealed a 4 x 3-centimeter tumor in the posterior third of the left labium majus of thevulva without lymph node involvement. The patient underwent radical vulvectomyand bilateral inguinal lymph node dissection. Postoperative histological evalu...

Neuroblastoma is an embryonal tumor arising from neuroblasts (pluripotentsympathetic cells) and is the most common malignant solid lesion in childhood. Thesetumors can arise anywhere in the fetal sympathetic nervous system, but the adrenalgland is affected in 90% of cases during the prenatal period. Cystic neuroblastomascomprise about 50% of all cases diagnosed in fetuses and their frequency is evenhigher in the postnatal period. Ultrasonography can be used to determine thesize, location, and sonographic features of the tumor. Fetal MRI can be useful forstaging and evaluation of metastases. Management of pregnancy is expectant andtermination of pregnancy is rarely indicated. A case of prenatal diagnosis of fetaladrenal cystic neuroblastoma is presented.

Hydrocele of canal of Nuck is a rare condition in adult women which can causeinguinal-vulvar swelling. It occurs due to failure of obliteration of the vaginal process,which is the extension of the parietal peritoneum accompanying the round ligamentof the uterus through the inguinal canal to the labia majora. Accumulation of serousfluid in the sac causes its appearance. Nonspecific clinical findings such as painless,fluctuating swelling extending from the superficial inguinal canal to the labiamajora do not allow a preoperative diagnosis of this condition. Ultrasonographyand magnetic resonance imaging can contribute to the diagnosis. The definitivediagnosis can only be made during surgery and with anatomopathological findings.Treatment consists of surgical resection of the lesion locally or laparoscopically. Acase of hydrocele of canal of Nuck is presented.

Pelvic fractures, either traumatic or atraumatic, are relatively rare and should be considered in the differential diagnosis of low back pain in women. Pelvic stress fractures related to pregnancy are even rarer and poorly understood phenomena that pose diagnostic and therapeutic challenges. These fractures are caused by insufficiency or fatigue. Those that result from bone insufficiency occur when normal stress is placed upon bone with decreased mineralization and elastic resistance. Those caused by fatigue occur when abnormal forces are applied to normal bone. Pregnancy and lactation are risk factors for pelvic stress fracture. Most cases occur postpartum and few cases during the third trimester. Pelvic fracture should be considered in pregnant women with severe back pain of insidious onset before or after delivery, usually in the absence of trauma. Plain films of the pelvis are often ...

Pelvic fractures, either traumatic or atraumatic, are relatively rare and should be considered in the differential diagnosis of low back pain in women. Pelvic stress fractures related to pregnancy are even rarer and poorly understood phenomena that pose diagnostic and therapeutic challenges. These fractures are caused by insufficiency or fatigue. Those that result from bone insufficiency occur when normal stress is placed upon bone with decreased mineralization and elastic resistance. Those caused by fatigue occur when abnormal forces are applied to normal bone. Pregnancy and lactation are risk factors for pelvic stress fracture. Most cases occur postpartum and few cases during the third trimester. Pelvic fracture should be considered in pregnant women with severe back pain of insidious onset before or after delivery, usually in the absence of trauma. Plain films of the pelvis are often ...

Pubic symphysis diastasis is rare in normal vaginal delivery. Etiology is not clear but it is associated with multiparity, macrosomia, physiological joint loosening and excessive force on the pubic area. Symptoms include pain around the pubic symphysis, hips, groin, lower abdomen and inner thighs, as well as tenderness over the area. Imaging shows distance between pubic bones. Management varies from case to case and outcomes are scarcely known. Delayed diagnosis has health implications for the woman in the short and long term. We report a case of postpartum pubic symphysis diastasis. An 18-year-old woman presented lacerating pain in the pubic area in the second day of the postpartum period, after a pregnancy of normal evolution and a spontaneous vaginal delivery, with a term live newborn and no apparent complications. On physical examination, we found moderate pain in the pubic region, w...

El hígado graso agudo del embarazo es una condición rara que ocurre más comúnmente en el tercer trimestre. Produce disfunción hepática severa asociada a alteración renal y tiempos de coagulación alargados. Se vincula a complicaciones hepáticas y extrahepáticas que pueden causar morbimortalidad materno-fetal significativa y el tratamiento definitivo es la interrupción inmediata del embarazo. Se presenta un caso de hígado graso agudo del embarazo en paciente de primigesta de 40 años, quien presentó epigastralgia de aparición súbita, junto con letargia, náuseas y vómitos. Los exámenes de laboratorio mostraron alteración de las pruebas de funcionalismo hepático y retal, junto con hipoglucemia, realizándose el diagnóstico de hígado graso agudo del embarazo. La paciente fue tratada para corregir las alteraciones metabólicas y se practicó cesárea, presentando mejoría...