In ectopic pregnancy, implantation of the zygote occurs outside of the endometrial cavity. Interstitial pregnancy has an incidence of 2-4% of all ectopic pregnancies. We present a clinical case of interstitial pregnancy. On 20.10.2023, a woman visited the University Hospital "St. Marina" - Pleven, Bulgaria, because of a positive morning pregnancy test. The patient was a 30-year-old woman. The last menstrual period was on 12.09.2023. Two consecutive vaginal ultrasonography were made every 10 days. No fetal sac was visualized in the uterine cavity. The second ultrasonography visualized a hyperplastic endometrium, 21 mm thick. A fetal sac located interstitially was found high in the right uterine horn. The ß-hCG values were 412 mIU/ml and 12490 mIU/ml, respectively. The patient was referred for a pelvic MRI, which confirmed the diagnosis. After discussion and informed consent signed by the patient, on 30.10.2023 at University Hospital "St. Marina" - Pleven, Bulgaria, under general anesthesia on 30.11.2023, a Laparotomia a modo Pfannenstiel. Resectio cornualis dextra. Extirpatio graviditas interstitialis dextra. Salpingectomia dextra. Sutura uteri. Lavage. Drainage. Abrasio probatoria was performed. The patient tolerated the surgical intervention well. The histological result proved interstitially located ectopic pregnancy. In cases of interstitial pregnancy, early diagnosis is crucial for successful treatment and health of the patient.
Abstract Aggressive angiomyxoma (AAM) is a rare and benign mesenchymal tumor that localizes predominantly in the female pelvis. Its invasive growth and local recurrence are challenging for professionals. Histologically, AAM is a tumor with a myxoid stroma that is highly vascular and hypocellular. The diagnosis is made relatively late due to nonspecific symptoms. Treatment of AAM is extensive local surgical excision with intact resection lines. Gonadotropin-releasing hormone agonists are added postoperatively. The prognosis is good and metastasis is rare. We present a case of an aggressive angiomyxoma located in the left greater labial area in a 50-year-old woman. After discussion and informed consent signed by the patient, on 27.01.2023 at the University Hospital “St. Marina” Pleven, the patient was admitted to the hospital. The tumor was extirpated under epidural anaesthesia on the date of the patient's informed consent. The patient was prescribed postoperative therapy with Zoladex 3,6 mg implant according to the schedule.The patient was subjected to monthly gynecological check-ups for one year after the surgical intervention. To date, no recurrence of the underlying disease has been detected. Long-term results show a good trend. In conclusion, we can say that the optimal treatment of AAM is wide local excision. It is not recommended to aim for radicality because of the risk of postoperative complications. Postoperative administration of GnRH-a is advisable to avoid recurrences. All patients undergo regular follow-up examinations for long-term follow-up.
Concepts of medical treatment are constantly evolving and improving. This opportunity provides treatment with High Intensity Focused Ultrasound (HIFU). In Europe and Asia more than 10,000 patients with uterine fibroids have been successfully treated with HIFU technology until now. This is completely innovative technology for non-invasive extracorporeal treatment of benign and malignant tumors. Neighboring healthy tissue is not damaged. The main indication in HIFU-Center in Pleven is uterine fibroid. It is the most common solid tumor in the female pelvis and is the leading cause of hysterectomy. The methods of treatment are hysterectomy, myomectomy or embolization of uterine arteries. HIFU-methodology allows non-invasive treatment of fibroids disease.
Uterine smooth muscle tumors /USMT/ are the most common tumors of the female reproductive system. The main aim of the clinical histological classification and the grading of MGMT is to predict their progression. The diagnosis of USMT has of the following stages: the determination of the direction of differentiation of the tumor and the defining the morphological features (the mitotic index, the tumor necrosis and the cellular atypia). In each of them there are specific problems. This indicates, that the USMT are therapeutic and clinical challenge.
In advanced cases of pancreatic cancer chemotherapy is a standard treatment method without significant benefits for the overall survival rates. Over the past 15 years, the technological advances in medicine led to the development of various ablative techniques. The purpose of this review was to look through the literature to find out if quality of life was investigated in patients with advanced disease after ablation. Poor quality of life, severe pain and the use of opiod analgesics with many side effects are essential problems which could be solved by a suitable method for local tumor destruction.
