Background: The reported incidence of GTD varies widely worldwide, from a low of 23 per 100,000 pregnancies (Paraguay) to a high of 1,299 per 100,000 pregnancies (Indonesia). The reported incidence of GTD in India is inconsistent therefore we planned to do an analysis of the GTD at our institute which is a referral tertiary center of Haryana.Methods: Records of patients of GTD admitted from January 2014 to June 2016 were analyzed and incidence per 1000 deliveries was calculated. The demographic profile, clinical presentation, management and complications were studied.Results: There were 38 patients of GTD with an incidence of 2.3 per 1000 deliveries. Out of 38 patients 33 (86.8%) were of molar pregnancy and 5 (13.16%) had GTN. Out of 33 molar patients 27 (81.8%) had complete mole and 6 (18.2%) had partial mole. All cases of GTN were low risk and received single agent methotrexate based chemotherapy. The mean age was 23.02±2.96 years and 47.4% were primigravida. The mean gestational age of presentation was 13.84 ± 3.24 weeks. There were no mortalities and no recurrences. Education in more than half i.e. 57.1% patients was below primary and 7 of the 19 patients with GTD, who could be followed telephonically, were found to have not followed the contraceptive advice and conceived within 6 months of the treatment of molar pregnancies, 5 had vaginal deliveries of live babies one of which was preterm and rest 2 had spontaneous abortions.Conclusions: In view of poor reporting from developing countries there is a need for a nodal centre exclusively for GTD in each state. Poor compliance and contraceptive practice due to uneducated population especially in rural India, warrants a need for prophylactic chemotherapy in high risk cases.
Introduction: Endometrial stromal sarcoma (Ess) is a rare malignancy arising from the endometrial stroma. the majority (90%) of patients present with abnormal uterine bleeding (AUb) followed by mass per abdomen and pelvic pain. However, rarity of this tumor limits the clinician to consider it even as a differential diagnosis despite of having its typical symptoms and only diagnosed by biopsy as a surprise. On analysis of age of presentation, clinical findings and various diagnostic modalities, endometrial stromal sarcoma (Ess) mimics other disorders such as leiomyoma, leiomyosarcoma and endometrial polyp. the diagnostic dilemma continues even on gross and microscopic features of Ess and above mentioned disorders. the role of immunomarkers like cD10, desmin, h-caldesmon, etc. has evolved for specific diagnosis. case report: A 60-year-old female was presented with a complaint of postmenopausal bleeding underwent hysterectomy with a provisional diagnosis of submucous myoma and histopathological examination revealed this as endometrial stromal sarcoma. conclusion: Endometrial stromal sarcoma is a rare
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