Appropriate monitoring of beta-hCG titers following conservative management of suspected ectopic pregnancy is important, not only to diagnose persistent ectopic gestation, but also to rule out the presence of malignant trophoblastic disease, albeit the latter is a rare diagnosis.

Benign metastasizing leiomyoma rarely follow TAH/BSO in patients with uterine myoma and estrogen replacement therapy may play a role in such occurrence. Despite surgery to remove these tumors, they can still recur; therefore, there is need for prolonged surveillance in such patients after resection.

No abstract

Hemorrhage continues to be a serious complication of both obstetrical and gynecologic surgeries. Physicians have used packing in cases of uncontrollable hemorrhage for many years, and this article reports on a modification of standard packing techniques that prevents some of the limitations of traditional packing. This technique was used in 1 patient after cesarean hysterectomy and 3 patients after debulking surgery for advanced gynecologic cancer. The pack consists of a wide piece of ribbon gauze and a Penrose drain. One end of the ribbon gauze is draped over a layer of surgicel (oxidized regenerated cellulose), while the rest is threaded through a 1-inch Penrose drain tightly folded several times to maintain pressure over the bleeding area. The other end of the Penrose drain, with the ribbon gauze visible within it, is inserted through a stab incision in the ipsilateral side of the lower abdomen. This technique allows for continuous bleeding assessment and easy removal of the gauze at bedside.

We conducted a systematic search for articles to enable a review of asymptomatic cases of ovarian and peritoneal cancer, which presented via abnormal cervicovaginal cytology. The mean age at presentation with peritoneal cancer was 47.8 years old, which is similar to that of ovarian cancer of 50.5 years. Staging was provided in 13 cases, 11 of which (85%) were at least stage IIIA or greater. In terms of age greater than 50 years old, cervicovaginal cytology interpreted as AGUS, having a negative initial work-up, and advanced disease stage at presentation, the two cases presented are consistent with the literature. Abnormal cervicovaginal cytology as a presenting diagnostic criterion of cancer of the ovary or peritoneum is often representative of advanced disease.