No abstract

Introduction: Ectopic pregnancy (EP) is a life-threatening pregnancy complication and can cause maternal morbidity and mortality and early fetal death with the incidence rate of approximately 2% of all pregnancies. The rate of recurrence of EP increases in patients with a past history of EP. We present here two cases that have had three consecutive recurrent EPs during one year with different management. Case Presentation: Case 1: A 27-year-old woman gravida 3 Ep2 with 6 weeks gestational age was referred with abdominal pain. She had a history of two consecutive ectopic pregnancies 9 and 4 months ago that were treated with methotrexate (MTX) and right salpingectomy. Transvaginal ultrasonography showed left tubal ectopic pregnancy with intra-abdominal bleeding. Left salpingectomy was performed. Case 2: A 34-year-old women gravid 3 with a history of 2 consecutive Ep 11 and 6 months ago that were treated with left salpingectomy and MTX, was referred. She was treated with two doses of MTX. Conclusions: The rate of recurrent EP considerably rises in patients with a history of the previous EP and considering this medical history is highly recommended in future pregnancies for early diagnosis.

Introduction: In patients with female genital tract cancers, during treatment, differentiating between a tumor recurrence and a benign phenomenon is of great importance. This study aimed to report a case of retroperitoneal lymphocele in a patient with primary ovarian cancer. Case Presentation: A 49-year-old woman diagnosed with papillary serous ovarian carcinoma was referred to the oncology clinic in 2017. She was treated with an optimal surgical staging and underwent adjuvant chemotherapy. After 3 courses of chemotherapy, she complained of a large abdominal mass in the umbilical area. Evaluating the mass confirmed retroperitoneal lymphocele, which was treated with a non-surgical therapy. Conclusions: Pelvic mass in patients with previous ovarian cancer is not necessarily due to the recurrence of the tumor and the possibility of lymphocele diagnosis should be considered. Since preventing the causes of lymphocele is very difficult, it is only necessary to carefully follow-up and provide essential consultations for highrisk patients.

Background : Cesarean scar pregnancy (CSP) is the implantation of the gestational sac in the hysterotomy scar. The optimal treatment for a cesarean scar pregnancy is unclear and therapy should be selected according to the patients' clinical presentation. The aim of this study was reporting a successful medical treatment of a cesarean scar pregnancy with fetal heart activity and a very high level of beta human chorionic gonadotropin (β-hCG). Case Presentation: A 38-year-old woman referred for routine prenatal visit after 2 months of menstrual retard and positive pregnancy test. She had the history of 3 cesarean sections and a uterine curettage. Untrasonography revealed cesarean scar ectopic pregnancy. The serum level of β-hCG was 109063 mIU/ml. Two doses of systemic methotrexate therapy and intragestational sac injection of methotrexate and potassium chloride were administered. 8 weeks after the initial treatment, β-hCG level became undetectable. Conclusion: Combined medical treatment with local and systemic MTX administration may be a successful treatment with low complication even in the presence of high serum β-hCG level.

Abstract- Ovarian tumors are rare in childhood and adolescent age. A 14-year-old girl presented with abdominal distention and mild cyclical abdominal pain since 3 months ago. There was an abdominal distention, and huge firm mass was palpated from pelvis to epigastric region. Abdominal ultrasonography revealed normal uterus and large multiloculated adnexal mass with multiple fine septations. Laparotomy was performed, and the ovarian mucinous borderline tumor was reported in frozen section biopsy. Exploration of other abdominopelvic organs revealed no other pathological signs. The final pathological report showed the right ovarian mucinous borderline tumor. Although the mucinous ovarian borderline tumor is a rare condition in adolescent age, pelvic mass, especially with solid or nodular component, must arise this diagnosis, and exploratory laparotomy with comprehensive surgical staging with regard to fertility preservation is warranted.