ملیحه حسن زاده مفرد

Mitotically active cellular fibroma (MACF) with Minor Sex Cord Elements is a extremely rare disease. Although imaging helps in the diagnosis to some extent, the final and definitive diagnosis is based on evaluation and histological studies. The main differential diagnosis of this tumor is ovarian fibrosarcoma, which has moderate to severe atypia and a poorer prognosis. In this study, a case of mitotically active ovarian cellular fibroma with minor sex cord elements is reported.

A 41-year-old woman referred to gynecologic clinic with abdominal pain and abnormal uterine bleeding in the form of spotting. Clinical findings had no signs for diagnosis. Serum Tumor markers including CA125 were within normal limit. Ultrasound and computed tomography (CT) were supportive of sex cord stromal tumors. After surgical procedures and pathologic evaluation, the patient was finally diagnosed as MACF with less than 10% sex cord elements.

Differentiating mitotically active cellular fibroma from fibrosarcoma which may have similar histological findings is important to prevent overtreatment of patient with cellular fibroma.

The staging of endometrial carcinoma is now performed based on postoperative pathological assessments. If the staging of the cancer could be possible with a preoperative non-invasive method, based on the International Federation of Gynecology and Obstetrics system, a more appropriate treatment protocol can be recommended for patients. This study was performed aimed to evaluate the diagnostic value of dynamic magnetic resonance imaging with diffusion-weighted imaging in the staging of endometrial carcinoma, based on the postoperative histopathological reference standard.

This prospective study was conducted in 2016-2021 on 35 patients with endometrial cancer referred to Ghaem Hospital in Mashhad. The staging of endometrial cancer was performed based on MRI findings and pathological samples. The diagnostic value of MRI was calculated to distinguish stages 1 from 2 and 1A from 1B . The lesion dimensions in the MRI and the pathological samples were compared using independent-sample t-test and the lesion dimensions between different stages using the ANOVA test by SPSS (version 17). P<0.05 was considered statistically significant.

According to the findings of MRI and pathology, the majority of patients (93.3%) were in stage 1, and 2 (6.7%) were in stage 2. The sensitivity, specificity, positive and negative predictive value in differentiating stage 1 from stage 2 was 100%, and the sensitivity, specificity, positive and negative predictive value of MRI in differentiating IA from IB was 100%.

It seems that dMRI by DWI method can be used in the staging of endometrial tumors in the initial stages (stage 1 from 2 and IA from IB) with diagnostic value.

One of the most important causes of cancer death in women is cervical cancer. Early detection of precursors or early stage disease is possible using low-cost and available screening approaches, and this is associated with a reduction in patients' mortality. This study was performed with aim to compare colposcopic findings and histological findings in colposcopic cervical biopsy specimens.

This cross-sectional study was performed in 2016-2017 on 200 patients referred to the gynecology and oncology clinic of Ghaem Hospital in Mashhad with colposcopic indications. These indications included abnormal Pop smear, post coital bleeding, abnormal appearance of cervix and vagina on examination, and existence of high-risk HPV virus in tests. If there was a history of abnormal Pap smear or biopsy due to suspected cervical lesions, the subjects were excluded from the study. Initially, the cause of colposcopy, Pap smear and HPV status were extracted using the information in the file. In the next stage, under the supervision of two gynecologists with oncology fellowship, colposcopy was performed and the findings during colposcopy were recorded. Finally, the data were analyzed with the pathological report. Data were analyzed by SPSS software (version 23).

Physician diagnosis at the end of colposcopy was abnormal in 162 patients (81.5%). As a result of colposcopic pathology, the results showed abnormal pathology in 120 patients (60%). The most common pathologies reported were CIN1 (87.4%), CIN2 (9.2%), and CIN3 (2.3%), respectively. There was a correlation between the colposcopic result and the pathological result in 21% of patients (n=42). The sensitivity of colposcopy compared to the pathological result was 89% and its specificity was 30%. The positive and negative predictive value of colposcopy was 65% and 64% compared to the pathological result.

Colposcopy has an acceptable sensitivity in the diagnosis of cervical pathological lesions, but has a low specificity. Therefore, this screening / diagnostic test can be used in one of the multi-stage screening stages (after the initial screening with Pap smear) and if there are any abnormalities during the colposcopy, biopsy be performed.

Frozen section (FS) is a valuable method with high sensitivity and specificity which allows the surgeon to choose a suitable therapeutic plan in a short time. High cost and inaccessibility are the most important limitations of this method in many pathology laboratories. Touch imprint (TI) is a rapid and inexpensive method in this field. This study was performed with aim to compare the frozen section and touch imprint methods for intra-operative differentiation of benign and malignant ovarian tissues.

In this cross-sectional study which was performed in 2012, 45 ovarian tissue samples which had been sent to the pathology department of Mashhad Ghaem hospital were evaluated by three methods of frozen section, touch imprint and permanent paraffin. Data analysis was performed using SPSS statistical software (version 16) and cross tab test. P less than 0.05 was considered significant.

Accuracy of FS and TI were 97.8% and 84.4%, respectively. Sensitivity and specificity was 95.7% and 100% for FS and was 69.6% and 100% for TI. Moreover, Positive and negative predictive value was 100% and 96.6% for FS and was 72.7%% and 75.9% for TI.

FS is a sensitive and specific method for evaluation of malignancy tissues. TI alone cannot be replaced by this method, but if FS was not accessible, IT could be used as a rapid method for intraoperative evaluation of tissue samples.

Cervical cancer is the second most common cancer in less developed countries. Chemoradiation is the standard treatment for advanced cervical cancer, but there is a lack of radiotherapy equipment in developing country. Therefore, this study was performed with aim to evaluate the pathologic response, treatment complication and survival rate of patients with locally advanced squamous cell carcinoma (SCC) of cervix who were not candidate for chemoradiation with use of chemotherapy before surgery.

In this single group, before-after randomized clinical trial, 24 patients with FIGO stages IB2, IIA2, and IIB squamous cell carcinoma (SCC), who were not candidate for standard chemoradiation due to different causes, received 3 courses of neoadjuvant paclitaxel (135mg/m2)+ Cisplatin (75mg/m2) chemotherapy regimen. Then, surgery was performed. Clinical response to neoadjuvant chemotherapy and treatment side effects were assessed after each course. Wertheim hysterectomy was done 4 to 6 weeks later in those with favorable response. In the absence of major risk factors in the surgical pathology, patients received 3 additional cycles of adjuvant chemotherapy. In high risk patients, adjuvant chemoradiotherapy was performed. Data was analyzed by SPSS software (version 21) and Chi-square, and Kaplan Mayer tests. P

Among 24 patients, 13 cases (54.2%) and 17 (73.9%) had FIGO stageIIB and gradeII tumors, respectively. Parametrial involvement was presented in 13 patients (54.2%). Seven patients were excluded. 17 patients underwent surgical resection. Four high risk patients and were candidate for chemoradiation. Clinical and complete pathological response rate were 17 cases (70.8%) and 8 cases (47.1%), respectively. With a median follow up of 18.5 months, mean of overall survival and disease free survival of patients treated with the study protocol were 24.51 and 25.71 month, respectively. The mean of overall survival of whole patients (24 cases) was 30.8 month (CI: 95%, 29/38-32/26).  

Neoadjuvant chemotherapy in patients with locally advanced cervical cancer despite acceptable pathologic response is not associated with survival advantage.

Surgical staging is the standard treatment of ovarian cancer. Pelvic and para-aortic lymphadenectomy is the important part of the surgery. The aim of this study was to evaluate the effect of para aortic lymph node dissection in early stage of patients with ovarian cancer.
This descriptive cross-sectional cohort study was performed on all stage I of ovarian cancer patients admitted in department of gynecology oncology of Ghaem Hospital, Mashhad University of Medical Sciences in November 2012 to March 2014. Every patient with clinical early stage of ovarian cancer candidate to surgical treatment selected. All cases underwent surgical staging surgery with concurrent systematic pelvic and para-aortic lymphadenectomy. In laparotomy after identification of left and right iliac artery, all lymph nodes have been properly exposed and dissected as a part of a staging laparotomy. The dissection was continued up to the nodal tissues surrounding the aorta, and inferior vena cava, until inferior mesenteric artery lymphadenectomy level. The procedure performed only by gynecologist oncologist. In addition, we assessed other parameters such as operation time, estimated blood loss, associated mortality and morbidity and vascular injuries. Finally, the effect of para aortic lymph node dissection in early stage of ovarian cancer evaluated.
Among a total of 57 ovarian cancer patients, 27 of them apparent stage I disease cases were selected. Surgical staging surgery with concurrent systematic pelvic and para-aortic lymphadenectomy was carried for all of them. Positive para-aortic lymph node was found only in one case. The average number removed para-aortic lymph nodes in the pelvis was 9 and in para aortic was 7, respectively. In addition, 20 minutes increase in total length of operation time was observed duo to para-aortic lymphadenectomy. Also the rate increase in intra-abdominal hemorrhage rate was estimated 60 ml.
Lymph node dissection will produce a significant benefit in accurate and complete surgical staging. Staging surgery in addition to systematic pelvic and para aortic lymph adenoctomy in early stage ovarian cancer is preferred in gynecologic oncology centers.

Cervical cancer is a major cause of women's mortality at reproductive age in developing countries and is the fourth malignant disease of women in the world. 95% of cervical cancers are related to HPV. This study was performed with aim to investigate the role of vaccine in preventing HPV and cervical cancer.
in this review article, the information was obtained through searching in databases of Pubmed, ISI, Scopus, Medline, Embase, and Google search by entering the keywords of virus or Human Papilloma Virus (HPV), HPV vaccine, and cervical cancer during 2004 to 2015. Inclusion criteria for entering the studies in this research included the searching keywords being mentioned in title or keywords of the articles. The articles with incomplete data and articles which were less relevant to the subject were excluded.
HPV is the most common sexually transmitted infection and is self-limiting. HPV causes oral-anal premalignant lesions in men and women which may progress to malignancy. HPV vaccination prevents from HPV infections that accompany the development of oral-anal cancer including cervical cancer and genital warts.
HPV vaccination has high effect and immunogenicity and causes acceptable safety. According to studies, the Gardasil vaccine can protect against cervical cancer up to 90%, while new nine-vaccine is effective up to 97% against high degree malignant cancers with a of cervical and vaginal vulva. The increasing knowledge about prevalence of HPV and transmission ways and pathology and treatment vaccine of this virus leads to an improvement in disease control and ultimately controlling the consequences of this virus and the possible eradicating of cervical cancer in the coming decades.

Vulvar cancer, primary or metastatic, is a rare tumor constituting Case report: A 56 years old woman with history of renal cell carcinoma with ulcerative vulvar mass referred. Biopsy of vulva reported metastasis of renal cell carcinoma. Patient underwent local resection of lesion and chemotherapy.
The high clinical suspicion for vulvar metastasis should be considered in women with history of cancer who refer with vulvar lesion. Early diagnosis and appropriate treatment can affect the prognosis of these patients.

Ovarian sex cord-stromal tumors (SCST) account for rare ovarian malignancy. These tumors are 5-8% of all ovarian neoplasms. The most common type of sex cord ovarian tumors is granulosa cell tumor (GCT). In this study our purpose was to have a look at some of clinicopathologic aspects and treatment results of these tumors. In a retrospective study, all documents of patients with SCST was referred to tumor clinics of Ghaem and Omid Hospitals, from 1998 to 2008. The data of patients were collected and analyzed. In 39 (5.9) of the 398 cases, ovarian malignancies was present in SCST. Eight Patients omitted from the study because there were not enough data for them. The commonest pathology was adult granulosa cell tumor in 25 patients (80.6%). Two patients (8.33%) had juvenile granulosa cell tumor, they were 25 and 38 years old. At time of diagnosis, 27 cases (87.1%) were in early stages (stage I). Mean age of patients was 41 years (range 16-76 years) at time of diagnosis of disease. Surgical staging of cancer was performed in 14 patients (46.7%). We did fertility sparing surgery in 12 patients (40%). Two patients were pregnant after surgery. 17 patients (54.80%) did not receive chemotherapy. Three patients (9.7%) received radiotherapy. Overall survival rates were 95% at both 2 years and 5 years. Longer survival had correlation with early stages of disease (P= 0.002). Age, conservative surgery and chemotherapy had no correlations with survival. The prognosis of SCST is almost good. Most of the patients were diagnosed in early stage of disease. In sex cord ovarian tumor, the only factor that have a full effect on survival, is stage of the disease. If the patients desire to preserve fertility, we can do fertility sparing surgery with minimal effect on survival.

The majority of adnexal tumors in pregnancy are benign. It is important to distinguish between benign and malignant ovarian tumors. Due to the sensitivity of pregnancy، especially malignant adnexal masses in pregnancy and the lack of accurate information from the prevalence of this malignancy، this study was performed with aim to evaluate the prevalence of adnexal masses in pregnancy.

This cohort study was performed on 53 pregnant women with adnexal mass who needed to surgery referred to gynecology oncology department of Mashhad Ghaem Hospital during 2010-2014. Evaluating variables included maternal age، gestational age، sonographic characteristics of tumor، clinical symptoms of patient، type of surgery، pathology status of tumor، performed chemotherapy and prognosis of mother and fetus. Data collection tool was a questionnaire. Data was analyzed by SPSS statistical software (version 16)، and Mann-Whitney and Kruskal-Wallis tests.

the prevalence of malignancy was 21% (11patients). The most frequent malignancy in adnexal masses and pregnancy was germ cell tumors. 55% of these tumors were in stage 3 and 4. Borderline tumors included 18% of malignant tumors. In this study، maternal mortality rate of 5. 6% and maternal mortality rate of 3. 8% was reported.

Adnexal masses in pregnancy should be evaluated with more care and sensitivity and in cases of suspected or stable tumors، it is better to perform surgery in gynecologic oncology centers.

Cesarean scar ectopic pregnancy (CSP) is a rare type of ectopic pregnancy، but is very important because of potentially dangerous complications. The patients complicated by this usually refer with abdominal pain or vaginal bleeding. The diagnosis is usually difficult and done by an experienced radiologist. This article presents a case of ectopic pregnancy in previous caesarean scar. Case report: in this study، the patient was a 36 years old woman with a diagnosis of ectopic pregnancy in previous cesarean scar who underwent laparotomy because of abdominal pain and bleeding، with regard to the patient''s tendency for fertility preserving، the pregnancy sac was resected and the myometrium was sutured in multi-layers، and fortunately، the uterus was preserved.

Because of the high prevalence of patients with previous cesarean section، it is very important to early diagnose the cesarean scar pregnancy، and the best diagnosis method is transvaginal sonography. According to the gestational age and the patient''s condition، treatment can be medical or surgical.

Cervical cancer is the second most common cancer in women and one of the leading causes of cancer-related death in developing countries. In cervical cancer patient، both surgery and radiation therapy can cause sexual dysfunction. Therefore، this study was performed with aim to survey sexual dysfunction in women with cervical cancer and a history of pelvic radiation therapy.

This study was performed on 176 women with cervical cancer and a history of pelvic radiation therapy referred to Ghaem and Omid hospitals in Mashhad who were selected using convenient sampling from 2009 to 2013. Research tools consisted of personal information form and ROSEN Female Sexual Function Index (FSFI). Data was analyzed by SPSS software (version 16. 5) and Spearman and Pearson correlation coefficient tests.

53 (30%) of women with cervical cancer and a history of pelvic radiation therapy had low sexual desire، 86 (49%) undesirable sexual arousal، 62 (35%) low lubrication، 74 (42%) undesirable orgasm. 70 (40%) of women complained of dyspareunia and 42 (24%) of Women were dissatisfied from sexual function. There was a significant correlation between sexual function with staging of cervical cancer (P= 0. 001، r= - 0. 25). There was a significant correlation between sexual desire (P= 0. 04)، sexual arousal (P= 0. 008)، lubrication (P= 0. 001)، orgasm (P= 0. 004)، sexual satisfaction (P= 0. 009) and dyspareunia (P= 0. 000) with staging of cervical cancer.

Sexual disorders in women with cervical cancer and a history of pelvic radiation therapy and correlation between sexual function with stage of cervical cancer reflects the fact that treatment، education and counseling programs is necessary for these women.

Hyperemesis gravidarum (HG) is a severe form of nausea and vomiting during pregnancy which occurs in 0.5 to 2% of pregnancies. Its etiology is unknown, hormonal and psychological factors are attributable to the condition. In the recent studies, helicobacter pylori infection has been proposed as possible factor. This study was performed with the aim to evaluate the relationship between helicobacter pylori infection and nausea and vomiting during pregnancy.

This prospective and case-control study was performed on 87 pregnant women referred to Ghaem and Imam Reza hospitals, Mashhad University of Medical Sciences from 2007-2008. Forty three pregnant women with hyperemesis gravidarum and forty four pregnant women without symptom were evaluated in terms of helicobacter pylori infection with serology of IgG antibody against Helicobacter pylori. Analysis of data was performed using SPSS statistical software (version 16) and chi-square and t-student tests.

In this study, 36 women of cases group (81.8%) and 25 women of control group (58.1%) had high serology of IgG antibody against Helicobacter pylori and this difference was statistically significant (P=0.016)

there is a significant relation between hyperemesis gravidarum and positive IgG antibody against Helicobacter pylori.

Gynecologic cancers can have profound effects on function of women''s life. In women with ovarian cancer، treatment leads to changes in the anatomy and function of the vagina. This study was performed with aim to evaluate sexual dysfunction in women with ovarian cancer.

This cross-sectional study was performed on 210 women with ovarian cancer admitted to Mashhad Ghaem and Omid hospitals and 130 healthy women who were matched with our patients in terms of age from 2009 to 2013. The subjects completed the form of sexual function questionnaire (FSFI) through an independent inquiry. Data was analyzed by SPSS software (version 16. 5).

31. 9% of patients were within 5 decades of life and had mean age of 48. 15 years. According to Pearson test، the prevalence of sexual dysfunction was 85. 7% in patients with ovarian cancer and 52. 9% in healthy women that the difference was significant (P< 0. 001).

Sexual dysfunction is more prevalent in patients with cancer compared to healthy subjects. Disorders were highly prevalent in the excitement and libido، vaginal moisture، orgasm and pain during intercourse.

Basic treatment of patients with cervical intraepithelial neoplasia is prevention of regress to invasive carcinoma. One of the treatment methods of these patients is conization. This study was performed with the aim to evaluate the related factors of remained dysplasia after treatment of cervical intraepithelial neoplasia (CIN) by cold knife conization. This Cohort study was performed on 25 patients with cervical dysplasia who were diagnosed in colposcopy and underwent cold knife conization with indication of conization in 2013. Based on the results of conization، hysterectomy was performed for the patients with high grade dysplasia، in-situ intraepithelial cancer، microscopic invasive cancer and positive margin specimens. Histology results of these patients were compared to pathologic result of the patients with dysplasia and negative margin conization who underwent conization for other reasons. Finally، the factors of remained dysplasia after treatment of CIN with cold knife conization were evaluated. Data was analyzed using statistical SPSS software (version 17) and T-test and Mann-Whitney test. P≤ 0. 05 was considered significant. Among 25 patients، only one case of conization specimen margin was positive for dysplasia that was appeared to be invasive Squamous cell carcinoma in performed hysterectomy. Other 11 patients who despite negative margin underwent hysterectomy، 4 patients (36. 3%) have high grade dysplasia (CIN III)، 1 patient (9%) have low grade dysplasia (CIN I) and 6 patients (54. 5%) were free of remained dysplasia in cervical pathology bioopsy after conization. The results showed that severity of cervical dysplasia with remained disease after conization is the factor of remained dysplasia after treatment of CIN. Severity of dysplasia is an effective prognostic factor patients in the possibility of remained dysplasia after conization in patients with cervical dysplasia، thus، close follow-up of these patients is recommended.

Vaginal atrophy (VA) causes by estrogen deficiency and occurs in postmenopausal women. Today، clinical signs and symptoms are used for detection of vaginal atrophy. Laboratory techniques are other methods that can be used. The aim of this study was to compare the clinical and laboratory indexes for the diagnosis of vaginal atrophy in postmenopausal women. This correlational study was conducted in 2013 on 100 postmenopausal women who had attended tohealth centers number 1 and 3 and gynecology clinic of Ghaem hospital of Mashhad، Iran. Data were gathered by a demographic information form and observation and examination of vaginal atrophy form. Data were analyzed by SPSS software version 11. 5، descriptive statistics and Spearman correlation coefficients. P value less than 0. 05 was considered significant. There was not significant correlation between vaginal dryness (p=0. 08)، elasticity of vagina (p=0. 26)، color of vagina (p=0. 14)، rugae (p=0. 68) and vaginal petechiae (p=0. 52) with vaginal maturation value but there was positive correlation between petechiae (p=0. 00) and color of vagina (p=0. 03) with vaginal PH. There are differences between the clinical and laboratory diagnosis of vaginal atrophy. Recognition of vaginal atrophy based on clinical signs and symptoms is not enough and according to the adverse effects of hormone therapy، it is recommended that definitive diagnosis of vaginal atrophy should be made based on laboratory evaluation.

Ovarian cancer is one of the most common gynecological malignancies with high mortality rate. This high mortality rate may be due to delay in diagnosis. Using tumor-specific markers that are sensitive in the early stages of cancer is very effective to improve results of therapy. The aim of this study was evaluation of the diagnostic value of serum levels of Heat-shock protein 70 and CA125 in patients with epithelial ovarian tumors. This analytical study was conducted on 37 patients with epithelial ovarian cancer and 35 patients with benign ovarian masses in 2011-2012. Blood samples were taken from all patients before the surgery. Patients with ovarian cancer underwent cytoreductive surgery and tumor staging. Also، patients with benign ovarian masses underwent cystectomy or oophorectomy. Serum levels of HSP70 and CA125 were measured by ELISA and RIA، respectively. Finally، HSP70 and CA125 levels were compared before surgery between two groups. Data were analyzed by SPSS software version 16 and Fisher، chi-square، t-student، Mann-Whitney، and ANOVA tests. P value less than 0. 05 was considered significant. Mean age of patients with malignant ovarian cancer was significantly higher than the benign ovarian masses group (p<0. 001). Pain was the most prevalent symptom in 62. 5% of cases in both groups. Mean levels of CA125 and HSP70 were respectively 672. 95±470. 55 and 0. 859±0. 461 in patients with ovarian cancer. The mean levels of CA125 and HSP70 in epithelial ovarian cancer was significantly higher than benign ovarian masses group (p=0. 025 and p=0. 001، respectively). HSP70 along with CA125 can be useful for early detection of malignant ovarian cancers.

The association of an ovarian tumor with Ollier’s disease (multiple encondromatosis) is a known entity but chondrosarcoma and ovarian tumors is rare. Only one case with Ollier’s disease was reported. In this clinical presentation we report a patient with granulosa cell tumor and chondrosarcoma Case Report: Our patient was a 20 year old woman with acute abdominal symptoms and adnexal mass. She had emergency surgery. Ovarian mass was removed and sent for pathologic study. Ovarian granulosa cell tumor was reported. In the next follow-up CTscan reported osteolitic mass of iliac bone. Biopsy was done and was compatible with chondrosarcoma of iliac. Then radical surgery and resection of iliac bon was performed. Due to the demand for fertility preservation, she was undergoing chemotherapy.

There is a risk of malignant change to chondrosarcoma or other bone tumours in Ollier's Disease. The attractive point of this patient is the association of ovarian tumor with primary iliac chondrosarcoma that has not been reported. Concurrent findings may help future research in finding the cause, early diagnosis and appropriate treatment of tumors.

Pelvic organ prolapse (POP) and stress urinary incontinence (SUI) are significantly increased in postmenopausal ages. The mechanism about relation between menopause and SUI is not clear. Perhaps decreased level of hormone induced these problems. Therefore, this study was carried out to assess the relationship between estrogen receptor (ER), progesterone receptor (PR), P53 and the development of SUI and to elucidate the bimolecular pathophysiology of SUI.

This is a case control study. Ten menopausal women with pelvic organ prolapse and stress urinary incontinence and 10 menopausal women without POP selected for hysterectomy entered into this study. The sample of anterior vaginal walls and uterosacral ligaments were obtained. The relative ER, PR and P53 levels in the samples were obtained by immunohistochemical staining.

The mean age (±SD) of the control group was 56.2±5.6 years and in the sample group it was 56.4±6.8 years. The mean age and the body mass index and the number of vaginal deliveries and the number of years of menopausal in two groups were similar. The P53 in the control group was 14±6.21 and in the sample group was 0.7±0.67. The ER level in the control group was 36±9.36 and in the sample group was 1.20 ±1.61. The PR level in the control group was 42.5±6.34 and in the sample group was 2±1.33. The result in the anterior vaginal wall and uterosacral ligament were similar. Expression of ER and PR and P53 was significant lower in the study group.

The expression levels of P53, estrogen receptor and progesterone receptor in patients with POP and SUI were significantly lower than the control group.

Female genital tract sarcomas are rare but most aggressive tumors of mesodermal origin. Little is known about the pathogenesis, risk factors, optimal treatment and outcome of these diseases. Therefore, we aimed to evaluate the clinicopathologic characteristics of patients with genital sarcoma. This is a retrospective, cross-sectional study. The medical records of 43 female patients with genital tract sarcoma, hospitalized during a 16-year period (from 1991-2007) were retrieved from the medical records office of Ghaem Hospital in Mashad, Iran.

Introduction & All cases of gestational trophoblastic tumors are curable if exact diagnosis and early treatment is done. The serum level of βHCG is a sensitive marker of the disease. In this study we intended to compare the "βHCG regression curves" in patients with molar pregnancy and trophoblastic tumor to determine which patients require chemotherapy and should start early treatment. Recorded data of 80 patients, consisting of 40 uneventful hydatiform mole cases and 40 trophoblastic tumor patients referred to Meshed Ghaem gynecology clinic were gathered and studied. Mean age was 26.7 years in the molar group and 27 in the gestational trophoblastic tumor group. There was a history of abortion in the past in 25% of the patients of both groups. 67.5% of patients were in the stage 1 and thus were 100% curable. The βHCG regression curve exceeded the normal range in the gestational trophoblastic tumors groups (P= 0.001). This study showed that βHCG regression curve can be used to diagnose these tumors much earlier (a few weeks after evacuation) and thus start treatment sooner.

Cervical cancer is the second most common of cancer between women, it has long phase of preinvasive lesion. The aim of screening is diagnosis and treatment of precancerous lesion before produce of cancer. This study has been designed to assess if visual inspection with acetic acid 5% (VIA test) is a useful alternative for cytology as an accepted screening test for cervical cancer. The study population included woman attending gynecological clinic in Ghaem Hospital in one year. After obtaining informed consent from each woman, pelvic examination and VIA was performed. One hundred woman with a positive VIA and one hundred with a negative VIA were randomly selected for this study. Cytology and colposcopy examination was performed for all 200 cases, and cervical biopsies were conduct for those individuals showing abnormal colposcopic findings. Those with CIN1 or worse lesions diagnosed by histology were considered true positive. Sensitivity, specifity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for each tests and compare. 69 women in VIA positive group and 61 women in VIA negative group had abnormal cytology. From biopsy examination 58 woman in VIA positive and 2 women in VIA negative group had final diagnosis of displasia, while they were 43 and 17 for abnormal and normal cytology respectively. VIA test sensitivity and specifity were 96% and 70% respectively, while they were 72% and 38% for cytology test. There was a positive predictive value of 58% for VIA and a positive predictive value of 33% for cytology. The result of this study indicates that VIA may be a useful and feasible alternative screening test for cervical precancerous and cancerous lesions.

Introduction & This study was performed to determine the role of frozen section examination (FSE) of the cone specimen in the evaluation of the resection margin status and to rule out invasion in patients with high-grade cervical intraepithelial neoplasia. Twenty patients with high grade intraepithelial neoplasia undergoing conization biopsy and frozen section examination were cross- sectionally studied from March 2008 until September 2009.The results of permanent paraffin sections were compared using FSE. In this cross-sectional study, 15 out of 20 cases (75%) showed the same results in frozen and permanent sections of cone biopsy specimen. Two patients out of the remaining 5 ones had higher grade of CIN in frozen section, 2 had lower grade and one was considered the same because CIN1 in FSE was normal in permanent sections.although The Paired Sample t-test showed no significant difference between the two groups of frozen and permanent section results (P-value=0.716, CI=95%). Frozen section evaluation of cervical cone biopsy specimens in patients with CIN II-III is accurate, efficient, and cost-effective.

Mature teratoma is the most common germ cell tumor(and the most common tumor) of the ovary,composing more than 20% of all ovarian neoplasms. Super infection of dermoid ovarian cyst is very rare.Case Report: A 72 year-old woman was admitted to the gynecological outpatient clinic because of lower abdominal pain and fever. Gynecological examination and ultrasonography revealed a heterogeneous cystic mass in the right ovary. Abdominopelvic CT scan revealed a right ovarian mass (15×15 cm) thought to be a dermoid cyst. Right adnexectomy was performed. The pathological evaluation suggested infected benign ovarian dermoid. They are the most common ovarian neoplasm found in adolescence and during pregnancy. Mature cystic teratoma may be complicated by torsion, rupture, and malignant change infection of a mature teratoma is a relatively uncommon event. However, based on our case and other cases, superinfection with abscess formation should be considered in the differential diagnosis whenever a patient with a documented pelvic mass and fever refers to gynecologists.