Pub Date : 2025-11-29DOI: 10.1016/j.crwh.2025.e00770
Yuanhua Xiang, Wei Zhang, Dongmin Chen, Ting Luo
Complete hydatidiform mole with coexisting fetus (CHMCF) is an exceptionally rare and clinically challenging obstetric condition. Its diagnosis and management require a high index of suspicion and a multidisciplinary approach. This report presents the case of a woman in her 30s who presented for a routine prenatal examination at 15 weeks of gestation. Ultrasonography revealed a placenta with a mixed echogenicity area exhibiting a characteristic honeycomb-like appearance, alongside a coexisting viable fetus with normal biometry. Serum β-human chorionic gonadotropin (β-hCG) was markedly elevated at 259,762 mIU/mL. Through serial monitoring and multidisciplinary consultation, a diagnosis of CHMCF was suspected and later confirmed by postnatal genetic analysis. The pregnancy was complicated by persistent vaginal bleeding at 21 weeks, leading to termination following a comprehensive risk-benefit assessment. This case underscores the diagnostic challenges, the critical role of cytogenetic analysis, the importance of patient counseling regarding the significantly elevated risks of obstetric complications and gestational trophoblastic neoplasia (GTN), and the necessity for meticulous post-evacuation surveillance. This report aims to enhance clinical awareness and outline a structured management protocol for this rare entity.
{"title":"Complete hydatidiform mole with coexisting fetus: A case report","authors":"Yuanhua Xiang, Wei Zhang, Dongmin Chen, Ting Luo","doi":"10.1016/j.crwh.2025.e00770","DOIUrl":"10.1016/j.crwh.2025.e00770","url":null,"abstract":"<div><div>Complete hydatidiform mole with coexisting fetus (CHMCF) is an exceptionally rare and clinically challenging obstetric condition. Its diagnosis and management require a high index of suspicion and a multidisciplinary approach. This report presents the case of a woman in her 30s who presented for a routine prenatal examination at 15 weeks of gestation. Ultrasonography revealed a placenta with a mixed echogenicity area exhibiting a characteristic honeycomb-like appearance, alongside a coexisting viable fetus with normal biometry. Serum β-human chorionic gonadotropin (β-hCG) was markedly elevated at 259,762 mIU/mL. Through serial monitoring and multidisciplinary consultation, a diagnosis of CHMCF was suspected and later confirmed by postnatal genetic analysis. The pregnancy was complicated by persistent vaginal bleeding at 21 weeks, leading to termination following a comprehensive risk-benefit assessment. This case underscores the diagnostic challenges, the critical role of cytogenetic analysis, the importance of patient counseling regarding the significantly elevated risks of obstetric complications and gestational trophoblastic neoplasia (GTN), and the necessity for meticulous post-evacuation surveillance. This report aims to enhance clinical awareness and outline a structured management protocol for this rare entity.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"49 ","pages":"Article e00770"},"PeriodicalIF":0.6,"publicationDate":"2025-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145658696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-15DOI: 10.1016/j.crwh.2025.e00767
Derar I.I. Ismerat , Barah K.S. Alsalameh , Majd Oweidat , Karam M. Hmidat , Areen Sulaiman , Yara Atawneh , Baraa Z. Zawahra , Izzeddin A. Bakri , Hani Hour
Perivascular epithelioid cell tumor of the uterus is a rare mesenchymal neoplasm with variable malignant potential and nonspecific clinical and radiologic features, often mistaken preoperatively for leiomyoma. This report describes the case of a postmenopausal woman with seven months of persistent postmenopausal bleeding, pelvic pain, and symptomatic anemia. Pelvic ultrasound and magnetic resonance imaging demonstrated a markedly enlarged, irregular uterus with multiple masses interpreted as fibroids. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy for refractory bleeding and concern for occult malignancy. Histopathological examination revealed coexisting benign leiomyomas and a malignant perivascular epithelioid cell tumor involving the uterine wall with extension into the broad ligament. The tumor showed epithelioid morphology with brisk mitotic activity, necrosis, and dual myomelanocytic differentiation on immunohistochemistry (HMB-45 and desmin positive). Whole-body positron emission tomography demonstrated no metastatic disease. Complete resection followed by adjuvant radiotherapy was associated with resolution of bleeding and pain. This case highlights that malignant uterine perivascular epithelioid cell tumor can mimic benign leiomyoma, may coexist with a true leiomyoma, and should be considered in women with persistent postmenopausal bleeding and an enlarged fibroid-appearing uterus.
{"title":"Malignant uterine/broad-ligament perivascular epithelioid cell tumor (PEComa) coexisting with leiomyoma in a postmenopausal woman: A case report","authors":"Derar I.I. Ismerat , Barah K.S. Alsalameh , Majd Oweidat , Karam M. Hmidat , Areen Sulaiman , Yara Atawneh , Baraa Z. Zawahra , Izzeddin A. Bakri , Hani Hour","doi":"10.1016/j.crwh.2025.e00767","DOIUrl":"10.1016/j.crwh.2025.e00767","url":null,"abstract":"<div><div>Perivascular epithelioid cell tumor of the uterus is a rare mesenchymal neoplasm with variable malignant potential and nonspecific clinical and radiologic features, often mistaken preoperatively for leiomyoma. This report describes the case of a postmenopausal woman with seven months of persistent postmenopausal bleeding, pelvic pain, and symptomatic anemia. Pelvic ultrasound and magnetic resonance imaging demonstrated a markedly enlarged, irregular uterus with multiple masses interpreted as fibroids. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy for refractory bleeding and concern for occult malignancy. Histopathological examination revealed coexisting benign leiomyomas and a malignant perivascular epithelioid cell tumor involving the uterine wall with extension into the broad ligament. The tumor showed epithelioid morphology with brisk mitotic activity, necrosis, and dual myomelanocytic differentiation on immunohistochemistry (HMB-45 and desmin positive). Whole-body positron emission tomography demonstrated no metastatic disease. Complete resection followed by adjuvant radiotherapy was associated with resolution of bleeding and pain. This case highlights that malignant uterine perivascular epithelioid cell tumor can mimic benign leiomyoma, may coexist with a true leiomyoma, and should be considered in women with persistent postmenopausal bleeding and an enlarged fibroid-appearing uterus.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"48 ","pages":"Article e00767"},"PeriodicalIF":0.6,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145575908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-14DOI: 10.1016/j.crwh.2025.e00766
Laura Jore, Nneoma Edokobi, Ishani Deliwala, Marykate Potter, Meg Johnson, LucyBeth Nieves
Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal neoplasms. Approximately 25 % occur in the female reproductive tract. The treatment strategy suggested in the literature is largely limited to hysterectomy, with little consideration of fertility-sparing approaches in reproductive-aged patients. This report concerns the use of a fertility-sparing approach in the management of a nulligravid woman who presented with abnormal uterine bleeding. She was diagnosed with a cervical perivascular epithelioid cell tumor based on biopsy and immunohistochemical analysis. Imaging confirmed a localized cervical mass and an endometrial lesion. The patient underwent hysteroscopic removal of the endometrial mass. Loop electrosurgical excision was utilized for the cervical tumor. Pathology demonstrated a benign cervical perivascular epithelioid cell tumor and an endometrial polyp. The patient remained disease-free with negative pelvic magnetic resonance imaging at three, six, and twelve months. This case highlights a novel use of loop electrosurgical excision to preserve fertility in those with gynecologic tumors, although ongoing surveillance is essential to ensure long-term safety.
{"title":"Fertility-sparing management of perivascular epithelioid cell tumors: A case report and literature review","authors":"Laura Jore, Nneoma Edokobi, Ishani Deliwala, Marykate Potter, Meg Johnson, LucyBeth Nieves","doi":"10.1016/j.crwh.2025.e00766","DOIUrl":"10.1016/j.crwh.2025.e00766","url":null,"abstract":"<div><div>Perivascular epithelioid cell tumors (PEComas) are rare mesenchymal neoplasms. Approximately 25 % occur in the female reproductive tract. The treatment strategy suggested in the literature is largely limited to hysterectomy, with little consideration of fertility-sparing approaches in reproductive-aged patients. This report concerns the use of a fertility-sparing approach in the management of a nulligravid woman who presented with abnormal uterine bleeding. She was diagnosed with a cervical perivascular epithelioid cell tumor based on biopsy and immunohistochemical analysis. Imaging confirmed a localized cervical mass and an endometrial lesion. The patient underwent hysteroscopic removal of the endometrial mass. Loop electrosurgical excision was utilized for the cervical tumor. Pathology demonstrated a benign cervical perivascular epithelioid cell tumor and an endometrial polyp. The patient remained disease-free with negative pelvic magnetic resonance imaging at three, six, and twelve months. This case highlights a novel use of loop electrosurgical excision to preserve fertility in those with gynecologic tumors, although ongoing surveillance is essential to ensure long-term safety.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"48 ","pages":"Article e00766"},"PeriodicalIF":0.6,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145575907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vulvar varicosities occur in approximately 4 % of pregnant women and typically resolve within a few months postpartum without treatment. Careful intrapartum management is essential because of the risk of massive haemorrhage due to dilated veins. Only a few studies have documented detailed changes in vulvar varicosities during the antepartum, intrapartum, and postpartum periods. This report presents the case of a pregnant woman who developed large vulvar varicosities at approximately 20 weeks of gestation. The varicosities increased in size until 28 weeks of gestation and then remained stable until delivery. The patient underwent a successful vaginal delivery, with an estimated blood loss of 1070 mL. Postpartum haemorrhage due to uterine atony was confirmed, and uterine balloon tamponade was performed. Vulvar varicosities regressed rapidly after delivery and continued to diminish progressively over the postpartum period. Complete resolution had been achieved by 1 month postpartum. This report details the progression of vulvar varicosities during the antepartum, intrapartum, and postpartum periods, and highlights the need for appropriate delivery management to prevent complications.
{"title":"Severe vulvar varicosities in pregnancy with the detailed sequential clinical course and management considerations: A case report","authors":"Yuka Nomura , Kiichiro Furuya , Koki Hayashi , Airi Kuruma , Saya Yamashita , Yangsil Chang , Kayoko Shikado , Hiroaki Tsubouchi , Kazuhide Ogita","doi":"10.1016/j.crwh.2025.e00764","DOIUrl":"10.1016/j.crwh.2025.e00764","url":null,"abstract":"<div><div>Vulvar varicosities occur in approximately 4 % of pregnant women and typically resolve within a few months postpartum without treatment. Careful intrapartum management is essential because of the risk of massive haemorrhage due to dilated veins. Only a few studies have documented detailed changes in vulvar varicosities during the antepartum, intrapartum, and postpartum periods. This report presents the case of a pregnant woman who developed large vulvar varicosities at approximately 20 weeks of gestation. The varicosities increased in size until 28 weeks of gestation and then remained stable until delivery. The patient underwent a successful vaginal delivery, with an estimated blood loss of 1070 mL. Postpartum haemorrhage due to uterine atony was confirmed, and uterine balloon tamponade was performed. Vulvar varicosities regressed rapidly after delivery and continued to diminish progressively over the postpartum period. Complete resolution had been achieved by 1 month postpartum. This report details the progression of vulvar varicosities during the antepartum, intrapartum, and postpartum periods, and highlights the need for appropriate delivery management to prevent complications.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"48 ","pages":"Article e00764"},"PeriodicalIF":0.6,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145474281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-30DOI: 10.1016/j.crwh.2025.e00761
Kasra Akbari , Mansooreh Yaraghi
Colpocleisis is a procedure to safely manage advanced pelvic organ prolapse, particularly in older individuals and those who are medically compromised. An exceptionally uncommon and underreported infection-related complication following colpocleisis is postoperative pelvic abscess. This case series describes the clinical presentation and diagnostic challenges, along with the management approaches of this unusual complication. Three women in their early 70s, with prior comorbidities, developed pelvic abscesses 10–15 days after colpocleisis. All three presented with systemic inflammatory signs, including fever, leukocytosis, and elevated inflammatory markers. One of the women also developed a concurrent urinary tract infection. Diagnosis was confirmed by transperineal ultrasonography and contrast-enhanced computed tomography. Management involved surgical drainage through colpotomy with reopening of the obliterated vaginal canal. Purulent material was thoroughly evacuated. Cultures of abscesses revealed polymicrobial infections in all cases. One patient with septic shock had an additional positive bloodstream culture.
Pyocolpos is an uncommon yet serious infectious complication following colpocleisis that is more commonly observed as a consequence of post-hysterectomy vaginal cuff hematoma. Clinicians should be extremely cautious when examining postoperative febrile patients, even when common illnesses such as urinary tract infections are present. In this case series, surgical drainage and tailored antibiotic therapy resulted in full remission of all three patients without compromising prolapse repair or triggering recurrence. Future studies are required to guide the best course of management.
{"title":"Post-colpocleisis pyocolpos: Three case reports","authors":"Kasra Akbari , Mansooreh Yaraghi","doi":"10.1016/j.crwh.2025.e00761","DOIUrl":"10.1016/j.crwh.2025.e00761","url":null,"abstract":"<div><div>Colpocleisis is a procedure to safely manage advanced pelvic organ prolapse, particularly in older individuals and those who are medically compromised. An exceptionally uncommon and underreported infection-related complication following colpocleisis is postoperative pelvic abscess. This case series describes the clinical presentation and diagnostic challenges, along with the management approaches of this unusual complication. Three women in their early 70s, with prior comorbidities, developed pelvic abscesses 10–15 days after colpocleisis. All three presented with systemic inflammatory signs, including fever, leukocytosis, and elevated inflammatory markers. One of the women also developed a concurrent urinary tract infection. Diagnosis was confirmed by transperineal ultrasonography and contrast-enhanced computed tomography. Management involved surgical drainage through colpotomy with reopening of the obliterated vaginal canal. Purulent material was thoroughly evacuated. Cultures of abscesses revealed polymicrobial infections in all cases. One patient with septic shock had an additional positive bloodstream culture.</div><div>Pyocolpos is an uncommon yet serious infectious complication following colpocleisis that is more commonly observed as a consequence of post-hysterectomy vaginal cuff hematoma. Clinicians should be extremely cautious when examining postoperative febrile patients, even when common illnesses such as urinary tract infections are present. In this case series, surgical drainage and tailored antibiotic therapy resulted in full remission of all three patients without compromising prolapse repair or triggering recurrence. Future studies are required to guide the best course of management.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"48 ","pages":"Article e00761"},"PeriodicalIF":0.6,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145474279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This case report describes the management of fallopian tube cavernous haemangioma discovered at caesarean section, and provides insight to the literature on this extremely rare benign vascular tumor with regard to clinical recognition and management. A 39-year-old nulliparous woman with a history of endometriosis and adenomyosis underwent caesarean section at 42 weeks of gestation following in vitro fertilization conception. Intraoperatively, a brown-colored nodule measuring 1 × 1 cm was identified at the fimbrial end of the left fallopian tube. The lesion was excised and sent for histopathological examination. Microscopic analysis revealed dilated thin-walled vessels lined by flattened endothelial cells with focal fibrin thrombi, confirming the diagnosis of fallopian tube cavernous haemangioma. The patient remained asymptomatic throughout pregnancy and recovered well postoperatively. Fallopian tube haemangiomas are extremely rare benign vascular tumours. These lesions are typically asymptomatic and can be discovered incidentally during surgical procedures. Accurate intraoperative recognition is crucial, as misdiagnosis may lead to unnecessary extensive surgery with potential fertility implications, while failure to recognize malignancy could be life-threatening. To the authors' knowledge this represents the first reported case of fallopian tube cavernous haemangioma identified during pregnancy, highlighting the importance of careful histopathological evaluation of incidental adnexal findings.
{"title":"Fallopian tube cavernous haemangioma found during the caesarean section of a woman with a history of endometriosis: a case report and literature review","authors":"Konstantinos Malligiannis Ntalianis , Gladys Hulipas , Hemapriya Mohanraj , Christina Anastasia Resta , Anitha Nayar , Sahathevan Sathiyathasan","doi":"10.1016/j.crwh.2025.e00763","DOIUrl":"10.1016/j.crwh.2025.e00763","url":null,"abstract":"<div><div>This case report describes the management of fallopian tube cavernous haemangioma discovered at caesarean section, and provides insight to the literature on this extremely rare benign vascular tumor with regard to clinical recognition and management. A 39-year-old nulliparous woman with a history of endometriosis and adenomyosis underwent caesarean section at 42 weeks of gestation following in vitro fertilization conception. Intraoperatively, a brown-colored nodule measuring 1 × 1 cm was identified at the fimbrial end of the left fallopian tube. The lesion was excised and sent for histopathological examination. Microscopic analysis revealed dilated thin-walled vessels lined by flattened endothelial cells with focal fibrin thrombi, confirming the diagnosis of fallopian tube cavernous haemangioma. The patient remained asymptomatic throughout pregnancy and recovered well postoperatively. Fallopian tube haemangiomas are extremely rare benign vascular tumours. These lesions are typically asymptomatic and can be discovered incidentally during surgical procedures. Accurate intraoperative recognition is crucial, as misdiagnosis may lead to unnecessary extensive surgery with potential fertility implications, while failure to recognize malignancy could be life-threatening. To the authors' knowledge this represents the first reported case of fallopian tube cavernous haemangioma identified during pregnancy, highlighting the importance of careful histopathological evaluation of incidental adnexal findings.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"48 ","pages":"Article e00763"},"PeriodicalIF":0.6,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145474280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-25DOI: 10.1016/j.crwh.2025.e00760
Juan Sebastián Jiménez Rodríguez , Jairo Alonso Hernández , Paula Andrea Gallego , Carlos David Ramos Sarmiento
High-grade neuroendocrine carcinoma of the cervix is a rare and aggressive malignancy, accounting for less than 2 % of all cervical cancers. Its occurrence during pregnancy is exceptional, with only 21 cases reported in the literature to date. This report presents the case of a 25-year-old primigravida diagnosed at 29.5 weeks of gestation with a high-grade small cell neuroendocrine carcinoma of the cervix, confirmed by histopathology and immunohistochemistry. The patient was initially managed conservatively, but tumor progression prompted delivery by cesarean section at 31 weeks, followed by immediate modified radical hysterectomy, bilateral pelvic lymphadenectomy, and partial omentectomy. Adjuvant chemotherapy with cisplatin and etoposide was administered. Pathological evaluation confirmed the diagnosis, with no lymph node or omental metastases. A comprehensive review of the literature identified 21 similar cases, highlighting the lack of standardized treatment protocols for this population. Multidisciplinary coordination was essential for balancing maternal oncologic priorities with fetal outcomes. This case contributes to the limited data on neuroendocrine cervical carcinoma in pregnancy and reinforces the importance of individualized, team-based management.
{"title":"Prenatal diagnosis and management of high-grade cervical neuroendocrine carcinoma: A case report","authors":"Juan Sebastián Jiménez Rodríguez , Jairo Alonso Hernández , Paula Andrea Gallego , Carlos David Ramos Sarmiento","doi":"10.1016/j.crwh.2025.e00760","DOIUrl":"10.1016/j.crwh.2025.e00760","url":null,"abstract":"<div><div>High-grade neuroendocrine carcinoma of the cervix is a rare and aggressive malignancy, accounting for less than 2 % of all cervical cancers. Its occurrence during pregnancy is exceptional, with only 21 cases reported in the literature to date. This report presents the case of a 25-year-old primigravida diagnosed at 29.5 weeks of gestation with a high-grade small cell neuroendocrine carcinoma of the cervix, confirmed by histopathology and immunohistochemistry. The patient was initially managed conservatively, but tumor progression prompted delivery by cesarean section at 31 weeks, followed by immediate modified radical hysterectomy, bilateral pelvic lymphadenectomy, and partial omentectomy. Adjuvant chemotherapy with cisplatin and etoposide was administered. Pathological evaluation confirmed the diagnosis, with no lymph node or omental metastases. A comprehensive review of the literature identified 21 similar cases, highlighting the lack of standardized treatment protocols for this population. Multidisciplinary coordination was essential for balancing maternal oncologic priorities with fetal outcomes. This case contributes to the limited data on neuroendocrine cervical carcinoma in pregnancy and reinforces the importance of individualized, team-based management.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"48 ","pages":"Article e00760"},"PeriodicalIF":0.6,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145474282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Salmonella species are common causes of foodborne illnesses, typically resulting in self-limiting gastroenteritis. In rare cases, however, they can cause extraintestinal infections, including pelvic infections. This report concerns a rare case of Salmonella infection of bilateral ovarian endometriomas. A 29-year-old nulligravid woman with known bilateral ovarian endometriomas presented with persistent fever and lower abdominal pain, following symptoms of diarrhea. Computed tomography on admission showed moderate ascites and increased density of mesenteric fat, suggestive of peritonitis. Her symptoms and inflammatory markers persisted, despite 5 days of empirical antibiotic therapy for pelvic inflammatory disease (intravenous ceftriaxone 1 g/day, clindamycin 2400 mg/day, and oral doxycycline 200 mg/day). Repeat computed tomography showed worsening peritonitis and a new right-sided pleural effusion, prompting surgical intervention. Laparotomy revealed purulent material within both endometriomas and cultures confirmed Salmonella infection. Detailed history-taking indicated that the patient had ingested raw eggs before symptom onset. The patient made a full recovery after surgery and tailored antibiotic therapy adjusted according to the susceptibility. This case highlights the importance of considering Salmonella as a rare cause of tubo-ovarian abscess, especially in patients with a history of dietary exposure and pre-existing endometriomas. Prompt surgical drainage and appropriate antibiotic therapy are key to preventing complications and preserving fertility.
{"title":"Salmonella-induced ovarian abscess developing in bilateral ovarian endometriomas: A case report","authors":"Eriko Iito, Lifa Lee, Tomohito Kobiyama, Naho Tokunaga, Koki Yagi, Mao Sekimata, Naoki Abe, Sachino Kira, Sotaro Hayashi, Masamitsu Kurakazu, Satoshi Nishiyama, Hiroshi Tsujioka","doi":"10.1016/j.crwh.2025.e00758","DOIUrl":"10.1016/j.crwh.2025.e00758","url":null,"abstract":"<div><div><em>Salmonella</em> species are common causes of foodborne illnesses, typically resulting in self-limiting gastroenteritis. In rare cases, however, they can cause extraintestinal infections, including pelvic infections. This report concerns a rare case of <em>Salmonella</em> infection of bilateral ovarian endometriomas. A 29-year-old nulligravid woman with known bilateral ovarian endometriomas presented with persistent fever and lower abdominal pain, following symptoms of diarrhea. Computed tomography on admission showed moderate ascites and increased density of mesenteric fat, suggestive of peritonitis. Her symptoms and inflammatory markers persisted, despite 5 days of empirical antibiotic therapy for pelvic inflammatory disease (intravenous ceftriaxone 1 g/day, clindamycin 2400 mg/day, and oral doxycycline 200 mg/day). Repeat computed tomography showed worsening peritonitis and a new right-sided pleural effusion, prompting surgical intervention. Laparotomy revealed purulent material within both endometriomas and cultures confirmed <em>Salmonella</em> infection. Detailed history-taking indicated that the patient had ingested raw eggs before symptom onset. The patient made a full recovery after surgery and tailored antibiotic therapy adjusted according to the susceptibility. This case highlights the importance of considering <em>Salmonella</em> as a rare cause of tubo-ovarian abscess, especially in patients with a history of dietary exposure and pre-existing endometriomas. Prompt surgical drainage and appropriate antibiotic therapy are key to preventing complications and preserving fertility.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"48 ","pages":"Article e00758"},"PeriodicalIF":0.6,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-24DOI: 10.1016/j.crwh.2025.e00759
Morolayo Ilori , Saachi Mittal , Mousa Eissa
Cerebral venous sinus thrombosis (CVST) is a rare but potentially life-threatening cause of stroke, with increased incidence in pregnancy due to hypercoagulability, particularly during the third trimester and the postpartum period. First-trimester presentations are exceedingly rare. A 37-year-old woman, gravida 2, para 0, at 7 weeks of gestation, presented with severe, progressive headache, nausea, and vomiting. Her obstetric history was significant for intrauterine fetal demise (IUFD) at 22 weeks of gestation. Neurologic examination was nonfocal. Computed tomography venography (CTV), performed because magnetic resonance imaging (MRI) was contraindicated, demonstrated thrombosis of the left transverse and sigmoid sinuses extending into the left internal jugular vein. Therapeutic low-molecular-weight heparin resulted in clinical improvement. Evaluation during pregnancy was negative for acquired and inherited thrombophilias. The patient underwent an uncomplicated suction dilation and curettage and remained clinically stable on anticoagulation. This case illustrates the diagnostic challenges of CVST in early pregnancy and highlights CTV as a reliable alternative to MRI. Additionally, this case is notable for CVST presenting in the first trimester, a rare occurrence, with few cases reported in the literature. The combination of early pregnancy, prior IUFD without a known thrombophilia represents a unique risk factor constellation for CVST. Clinicians should maintain a high index of suspicion for CVST in patients presenting with severe, atypical headache in the first trimester, to enable timely diagnosis, anticoagulation, and optimized maternal outcomes.
{"title":"Cerebral venous sinus thrombosis in the first trimester of pregnancy: A case report","authors":"Morolayo Ilori , Saachi Mittal , Mousa Eissa","doi":"10.1016/j.crwh.2025.e00759","DOIUrl":"10.1016/j.crwh.2025.e00759","url":null,"abstract":"<div><div>Cerebral venous sinus thrombosis (CVST) is a rare but potentially life-threatening cause of stroke, with increased incidence in pregnancy due to hypercoagulability, particularly during the third trimester and the postpartum period. First-trimester presentations are exceedingly rare. A 37-year-old woman, gravida 2, para 0, at 7 weeks of gestation, presented with severe, progressive headache, nausea, and vomiting. Her obstetric history was significant for intrauterine fetal demise (IUFD) at 22 weeks of gestation. Neurologic examination was nonfocal. Computed tomography venography (CTV), performed because magnetic resonance imaging (MRI) was contraindicated, demonstrated thrombosis of the left transverse and sigmoid sinuses extending into the left internal jugular vein. Therapeutic low-molecular-weight heparin resulted in clinical improvement. Evaluation during pregnancy was negative for acquired and inherited thrombophilias. The patient underwent an uncomplicated suction dilation and curettage and remained clinically stable on anticoagulation. This case illustrates the diagnostic challenges of CVST in early pregnancy and highlights CTV as a reliable alternative to MRI. Additionally, this case is notable for CVST presenting in the first trimester, a rare occurrence, with few cases reported in the literature. The combination of early pregnancy, prior IUFD without a known thrombophilia represents a unique risk factor constellation for CVST. Clinicians should maintain a high index of suspicion for CVST in patients presenting with severe, atypical headache in the first trimester, to enable timely diagnosis, anticoagulation, and optimized maternal outcomes.</div></div>","PeriodicalId":9657,"journal":{"name":"Case Reports in Women's Health","volume":"48 ","pages":"Article e00759"},"PeriodicalIF":0.6,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145424594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-15DOI: 10.1016/j.crwh.2025.e00756
Kasra Akbari , Mansooreh Yaraghi
Peritoneal inclusion cysts (PICs) are mesothelial-lined cystic lesions that usually arise in reproductive-aged women after prior pelvic or abdominal surgery. Their diagnosis is often difficult, as they can mimic ovarian tumors or malignant pelvic masses. There are very few reports of PICs following pelvic reconstructive surgery. This report concerns the case of a 40-year-old nulliparous woman with a history of open sacrohysteropexy for stage IV pelvic organ prolapse who presented with progressive left lower quadrant pain and a vaginal bulge. Imaging revealed a large multilocular retroperitoneal cyst enveloping the left ovary and extending into the rectovaginal septum. Tumor markers were within normal limits. Due to the cyst's proximity to the bowel, ureter, and major vessels, and to avoid mesh erosion, a vaginal surgical approach was selected. Approximately 300 mL of serous fluid was drained, the cyst wall was excised under rectal guidance, and marsupialization was performed to the vaginal mucosa. Histopathology confirmed a benign mesothelial-lined cyst. At one-year follow-up, the patient remained asymptomatic with no recurrence evident on imaging. This is seemingly the first reported case of a retroperitoneal PIC following sacrohysteropexy. The case underscores the diagnostic challenges posed by PICs and highlights the role of individualized, minimally invasive management. Clinicians should maintain a high index of suspicion for PICs when evaluating postoperative pelvic or vaginal masses, particularly when imaging suggests a cystic lesion.
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