Tropical Doctor

Navigating obstetric enigma: Placenta accreta spectrum masquerading as gestational trophoblastic neoplasia

Placenta accreta spectrum (PAS) represents a complex obstetric condition characterised by the abnormal invasion of anchoring villi and trophoblast into the myometrium. This case report explores two instances where the diagnosis of PAS was overlooked during antenatal care leading to significant complications during conservative management. Both patients presented with heavy menstrual bleeding and raised beta human chorionic gonadotrophin (β-hCG), mimicking gestational trophoblastic disease. The report delves into the clinical presentations, diagnostic challenges, and outcomes of two cases, shedding light on the importance of effective communication and follow-up in the management of PAS.

Beyond malignancy: Unravelling the Enigma of Meigs syndrome in ovarian fibroma

Meigs syndrome is characterised by the triad of ovarian fibroma associated with ascites and pleural effusion, the latter of which resolves after removal of the fibroma. This uncommon but important clinical entity mimics malignancy in postmenopausal females. We present two such cases.

Retrospective analysis of endometrial cancer among Afro-Caribbean women in Barbados 2008–2017

Endometrial cancer data amongst Barbadian women was collected, to inform screening and management in this under-studied population. We analysed all recorded primary cases between January 1st 2008, and December 31st, 2017. Age-specific incidence, and crude mortality rates were calculated. Descriptive statistics characterized demographics, risk factors, prescription data and histopathology. Log-rank tests assessed simple group differences by EC type. Survival analysis based on tumour type was plotted using Kaplein-Meir curves. There were 270 recorded cases of EC, averaging 66 (8.8) years old (SD 8.75), with parity of 3.60 (2.3). Cases were postmenopausal with 257 (95%) experiencing postmenopausal bleeding. Of the 270 cases, 113 (42%) had type 1 tumours and 157(58%) had type 2 tumours. Weak evidence suggests the latter imparted worse survival (log rank test = 0.02). Estimated crude incidence rate was 18.64 per 100,000 women. Crude mortality rate from EC between January 1st, 2008 and December 31st, 2019 was 27%.

Pelvic organ prolapse and cervical adenocarcinoma in a postmenopausal woman: A case report

The simultaneous occurrence of pelvic organ prolapse and cervical adenocarcinoma is rare and can pose diagnostic challenges owing to overlapping symptoms. We present the case of a 60-year old multiparous, postmenopausal woman with a six month history of vaginal prolapse involving a mass. After undergoing vaginal hysterectomy with pelvic floor repair, histopathological examination revealed the presence of stage 1A 2 endocervical adenocarcinoma. Post-operative imaging showed no metastasis or lymph node involvement.