Gonadoblastoma is an uncommon ovarian tumor arising primarily in females with gonadal dysgenesis and a 46, XY karyotype. Germ cell tumors arising within and/or overgrowing a gonadoblastoma have been reported. We report a rare case of a malignant mixed germ cell tumor (yolk sac tumor and choriocarcinoma) arising in a gonadoblastoma of the left ovary in a 19-year-old female with a 46, XX karyotype. The patient's initial α-fetoprotein level was 20 000 KIU/L. The patient underwent a laparoscopic unilateral salpingo-oophorectomy with omentectomy and peritoneal washing followed by adjuvant chemotherapy.

IntroductionComplementary and alternative medicine (CAM) therapies, used singularly or in combination with more conventional therapies, are routinely used by citizens of the Kingdom of Saudi Arabia (KSA) for medical care or seeking wellness. However, the prevalence of CAM therapies among Saudi psychiatric patients is not yet documented. To better understand the importance of CAM in today’s medical field, particularly within the KSA and for psychiatric patients, this descriptive study aims to characterize the use of CAM therapies by a sample of psychiatric patients in the KSA.MethodsThis cross-sectional hospital-based study describes the use of CAM therapies by Saudi psychiatric patients being treated at one of the largest government hospitals in the KSA. Using a pretested questionnaire, adult psychiatric patients waiting for their appointment or during their stay at a government hospital in Riyadh were interviewed regarding the use of CAM therapies after agreeing to participate.ResultsForty-five adult psychiatric patients agreed to participate in this study. The average age of the participants in the study was 35. Of the participants, 62% were females, 91.1% were outpatients, and 44.4% were diagnosed with depression. Moreover, 82.2% of the participants reported using one or more types of CAM therapies within the past year to address mental illness. Of those who used CAM therapies, 62.2% did so to improve their quality of life; 59.5% did so for treatment, supportive treatment, or both, and 54.1% used CAM therapies to help control symptoms. The most frequent CAM therapies used by psychiatric patients were spiritual therapies such as Quran recitation; body therapies, mainly exercise; and mind therapies, mainly relaxation techniques. These CAM therapies were used mainly as treatments or supportive treatments for depression. Most of the participants who used CAM therapies were satisfied with the use of these therapies (75.7%). Finally, 45.9% of the participants had not discussed the use of CAM therapies with their doctors, primarily because of their reluctance to share private information, especially spiritual matters, with the treating physicians.ConclusionsThe study results suggest a high prevalence of CAM therapy use among Saudi adult psychiatric patients, as well as a high level of satisfaction with such therapies. However, since about half of the patients had not discussed the use of CAM therapies with their physicians, and since some of the CAM therapies may cause unfavorable interactions when used alongside certain medications or medical interventions, healthcare providers should be diligent about inquiring of their psychiatric patients any use of CAM therapies, not only during the initial visit but also during the follow-up visits as well.

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Tumor location in right vs left sides of the colon has been identified as an independent prognostic factor for survival in metastatic disease (O'Dwyer et al., 2001). Two recent meta-analyses have clearly shown that right-sided colon cancer carries poorer prognosis compared to left-sided tumors, irrespective of the stage, race, adjuvant chemotherapy, number and quality of studies included

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