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A 37-year-old Asian woman, gravid 0 para 0, was admitted to our hospital at 34 weeks and 5 days of her pregnancy for management of preeclampsia. A few days after admission, she recognized diminished fetal movement, and a non-stress test revealed a non-reassuring fetal heart rate pattern with decreased variability. A female baby weighing 1840 g was delivered by emergency cesarean section with Apgar scores of 5 and 5 at 1 and 5 min, respectively. Significant neonatal anemia with a hemoglobin level of 4.3 g/dL was observed. The elevated level of hemoglobin F (HbF) in the maternal blood accounted for 4.6% (normal≦0.5%), and was indicative of the presence of fetomaternal hemorrhage (FMH). Microscopic examination of the placenta revealed chorioangioma. We report here a rare case of FMH with intraplacental chorioangioma, and discuss the relationship between these two pathologies.

IntroductionBenign multicystic peritoneal mesothelioma is an extremely rare tumor that occurs mainly in women in their reproductive age. Its preoperative diagnosis and adequate treatment are quite difficult to attain.Case presentationOur patient was a 23-year-old Japanese woman who had a history of right oophorectomy and left ovarian cystectomy for an ovarian tumor at 20 years of age. The left ovarian tumor had been diagnosed on histology as a mucinous borderline tumor. Two years and nine months after the initial operation, multiple cysts were found in our patient. A laparotomy was performed and her uterus, left ovary, omentum and pelvic lymph nodes were removed due to suspicion of recurrence of the borderline tumor. A histological examination, however, revealed that the cysts were not a recurrence of the borderline tumor but rather benign multicystic peritoneal mesothelioma. There were no residual lesions and our patient was followed up with ultrasonography. She remains free from recurrence nine months after treatment.ConclusionWe report a case of benign multicystic peritoneal mesothelioma mimicking recurrence of an ovarian borderline tumor. Benign multicystic peritoneal mesothelioma should be suspected when a multicystic lesion is present in the pelvis as in the case presented here, especially in patients with previous abdominal surgery.

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We experienced the case of Low-grade appendiceal mucinous neoplasm treated with laparoscopic management, which was originally diagnosed as a right cystic adnexal mass. The case involved an 81-year old woman had undergone a total abdominal hysterectomy for leiomyoma of the uterus when she was 48 years old. She was refered to our hospital after being diagnosed with a cystic lesion of the pelvis at a local internal medicine clinic, with a dull pain in her right lower abdomen. We suspected a right ovarian cyst, but no conclusive evidence was found, so we performed exploratory laparoscopic operation. We found that the uterus and both adnexa had been extracted, and the cyst was derived from appendix, so we performed appendectomy. We made the diagnosis of a Low-grade appendiceal mucinous neoplasm after pathological examination. Cystic disease in the female pelvis is common. The majority of cystic pelvic masses originate in the ovary, but some other pelvic organs mimic this anomaly. It is important to understand the relationship of the cyst with its anatomic location, to identify normal ovaries at imaging, and to compare the findings with a patient's clinical history to avoid misdiagnosis.