Mohadeseh Karimi

Brenner tumor associated with mucinous cyst and endometriosis: a case report

Background: Brenner tumors are rare ovarian neoplasms that often coexist with other epithelial tumors, most commonly mucinous cystic neoplasms. The association of Brenner tumors with endometriosis is unusual and not well-documented in the literature. Case presentation: We describe the case of a 64-year-old postmenopausal woman presenting with abnormal uterine bleeding and a left adnexal mass. Histopathologic examination revealed the synchronous presence of a benign Brenner tumor, mucinous cystadenoma, and a microscopic focus of endometriosis, all within the same ovary. Discussion: The simultaneous occurrence of these three lesions is highly unusual. A potential shared histogenetic origin has been proposed for Brenner and mucinous tumors, while the coexistence of endometriosis raises further questions regarding hormonal or microenvironmental influences. Thorough histopathologic and immunohistochemical evaluation is essential in such complex presentations. Conclusion: This case underscores the importance of comprehensive pathologic assessment in ovarian masses, especially when multiple histologic components are present. Recognition of rare associations can prevent misdiagnosis and guide appropriate clinical management.

Clinicopathological Pattern of Endometrial Specimens in Women with Abnormal Uterine Bleeding and Ultrasonography Correlation

Background: Abnormal uterine bleeding (AUB) refers to any symptomatic deviation from normal menstruation. AUB is a common gynecological disorder in non-pregnant women of reproductive age, accounting for approximately 33% of gynecological outpatient visits. The early diagnosis and management cause of AUB is important because of increased incidence of endometrial carcinoma with rapid growth. Transvaginal ultrasound is non-invasive imaging technique used to find endometrial carcinoma before referring patients for invasive techniques. Dilatation and curettage (D&C) and endometrial biopsy are surgical procedures that scrape the endometrial lining of the uterus for diagnosis and treatment. The aim of this study is to describe the clinicopathologic pattern of endometrial specimens in women with AUB and ultrasonographic correlation. Methods: Tissues from endometrial biopsy and curettage of 411 patients with AUB who referred to Shahid Mohammadi hospital were prospectively selected from 2021 to 2023. Patients were divided into three groups based on age and menstrual status including: premenopausal (18-39 years), perimenopausal (40-49 years) and postmenopausal (≥50 years). The results were correlated to patient’s age and other data and evaluated with statistical analysis. Results: During the two-year study period, a total of 411 endometrial specimens with clinical diagnosis of AUB were submitted and the results were analyzed. The youngest patient presenting with AUB was 21 years old, while the oldest was 77 years old. The most common complaint was menorrhagia in 201 (48.0%) out of 411 patients. The most common pathology finding in three groups was polyp in 100 (24.3%) cases. Hormonal effect was the next commonly observed pattern seen in 70 (17.0%) cases. P value was calculated as 0.003 which was significant using chi-square for the trend seen in age. Conclusion: Endometrial sampling is a useful tool for evaluation of women with AUB and referring patients for treatment. Histopathological evaluation of the endometrium is very useful in detecting the etiology of AUB. Transvaginal sonography has high sensitivity in detecting polyps.

Partial hydatidiform mole coexists with a living fetus: a case report

Hydatidiform mole is a benign gestational trophoblastic disease (GTD) that is classified into two types: complete and partial. Partial molar pregnancy is usually presented as a missed or incomplete miscarriage in the first trimester of pregnancy. A partial molar pregnancy coexisting with living molar pregnancy fetus is a rare occurrence. A dead fetus and placenta product of normal vaginal delivery arrived at our hospital. This dead fetus belonged to the first pregnancy of a 21-year-old Persian woman, without gross anomaly, male gender, and was compatible with 5-6 lunar months of pregnancy. The placenta was intact with many grape-like vesicular cystic structures. Microscopic evaluation of the placenta showed large hydropic villi with cistern formation and peripheral trophoblastic proliferation mixed with normal and small-sized villi that were compatible with partial molar pregnancy. Partial molar pregnancy has a triploid karyotype. The diagnosis and follow-up of patients with molar pregnancy are important because it has been reported that the molar pregnancy can become an invasive mole or choriocarcinoma. Many pregnancies cannot continue. If the molar pregnancy continues, its management is challenging. The coexistence of a molar pregnancy with a live fetus is a rare condition, and it increases the risk of neonatal morbidity and mortality. To achieve good outcomes, close follow-up of both the mother and fetus is advised; however, the optimal approach remains unknown.