Mucinous cystic neoplasms (MCN) of the mesentery are rare tumors which are difficult to diagnose accurately preoperatively and carry the risk of being borderline or malignant. This is a case of a 37 years old female who was referred to a tertiary gynecological oncology center for a suspected ovarian tumor and was found to have a borderline MCN, originating from the descending and sigmoid colon mesentery. To the best of our knowledge, this is the largest borderline MCN of mesenteric origin reported in the literature so far and only the second case managed by a gynecologist. We are also presenting a literature review of the similar cases reported up-to-date.

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Introduction Combined nuchal translucency (cNT) screening was established within a 3000 delivery unit at a cost of £18000. The uptake, changes in sensitivity and specificity and effect on the rate of invasive prenatal testing were analysed. Methods NHS NT screening was introduced November 2009 over 3 months. A retrospective dataset was assembled from our central screening service, the regional cytogenetics laboratory and local databases over 3 financial years from April 2008 to March 2011. Results All comparison reflect 2008/2009 compared to 2010/2011. Global uptake of Downs screening increased from 62% to 72.9%. In 2008/2009 25% of Downs screening was carried out using private cNT compared to 2010/11 with 94% requesting NHS cNT. Screen positive (high risk) rates decreased from 2.9% to 1.8% with the number of invasive diagnostic procedures decreasing from 44 to 21. The proportion of these using chorionic villus biopsy increased from 2.6% to 41% (includes investigation of cystic hygroma). In 2008/9 1 Downs syndrome pregnancy was detected compared to 4 in 2010/11. All were detected following cNT. None following quadruple testing. In 2008/2009 1 Downs syndrome pregnancy occurred following a low risk result (quadruple testing) compared to 3 in 2010/2011 (2 cNT and 1 quadruple testing). Conclusion cNT is a cost efficient means of Downs syndrome screening that has reduced the rate of invasive testing. There appears to have a been a marginal improvement in detection rates but larger numbers are required for statistical analysis.