exudates and Uterine-Neoplasms

Following its capture in March 2014, an adult female Sumatran rhinoceros frequently showed profuse vaginal bleeding. An ultrasonography suggested the presence of multiple reproductive lesions, including two uterine masses which were suspected to be leiomyomas. Soon after, an open pyometra was confirmed. Later in November 2019, the patient died and necropsy confirmed the presence of two uterine masses; one was located at the cervico-uterine junction and another in the uterine body, with pyometra, and cystic endometrial hyerplasia. Based on histological, special stains, and immunohistochemical examination, it was shown that one of the masses was composed of large, ovoid and polyhedral neoplastic mesenchymal cells with eosinophilic cytoplasm and a few binucleated cells surrounded by collagen fibres. It was tested positive for SMA and vimentin, while negative for desmin, cytokeratin AE1/AE3, EMA, CD34, and S100. The other mass was composed of mesenchymal cells undergoing myxoid degeneration as evidenced by the presence of glycosaminoglycan-rich matrix. It was tested positive for SMA, vimentin, partially positive for desmin, and negative for the other markers. With the aid of human medical nomenclature, these masses were diagnosed as epithelioid leiomyoma and myxoid leiomyoma, respectively. This report provides a clinical presentation, and histologic descriptions of the two variants of leiomyomas that have not been reported in veterinary medicine.

Topics: Animals; Borneo; Diagnosis, Differential; Fatal Outcome; Female; Leiomyoma; Malaysia; Perissodactyla; Uterine Neoplasms

Topics: Adult; Cohort Studies; Female; Humans; Laparoscopy; Leiomyoma; Malaysia; Retrospective Studies; Uterine Myomectomy; Uterine Neoplasms

Gestational trophoblastic disease is a common gynaecological problem in Malaysia. The incidence of molar pregnancy is 2.8 per 1000 deliveries, being more common amongst the Chinese. The preferred method of evacuation is suction curettage; complete evacuation of the uterus was not achieved at the first attempt in 25 per cent of cases. Partial moles in our centre comprised 30 per cent of all moles. This is potentially malignant and needs follow-up for a complete mole. In the management of an invasive mole, chemotherapy should not be withheld in the presence of metastases and failure of regression of hCG. The role of prophylactic hysterectomy and prophylactic chemotherapy in the management of molar pregnancy is discussed "Selective preventive chemotherapy" in patients at "risk" appears appropriate. Chemotherapy remains the main modality of treatment for gestational trophoblastic tumours (GTT). We categorised our patients into low, medium and high-risk groups; survivals were 100, 98, and 61.7 percent respectively. These patients when categorised according to FIGO staging had survivals of 100, 80, 78.6 and 68.2 per cent respectively for stages 1, 2, 3 and 4 respectively. The reasons for the poor survival in the 'high-risk' group are discussed. Colour doppler blood flow studies are now being carried out; its role needs further evaluation. Surgery and radiotherapy have only a limited role in the management of these cases.

Topics: Choriocarcinoma; Female; Humans; Hydatidiform Mole; Malaysia; Pregnancy; Trophoblastic Neoplasms; Uterine Neoplasms

A clinicohistological study of acute atherosis in molar pregnancy was undertaken. Maternal decidual vessels in currettage samples of 38 histologically confirmed complete hydatidiform moles were examined histologically for acute atherosis, recognised as fibrinoid necrosis of the smooth muscle wall with a perivascular mononuclear cell infiltrate, with or without lipophages. Acute atherosis was detected in eight of 38 cases, an incidence of 18.4%. All the patients were normotensive. The significance of acute atherosis in molar pregnancy remains to be clarified.

Topics: Acute Disease; Adult; Arteries; Arteriosclerosis; Decidua; Female; Humans; Hydatidiform Mole; Incidence; Malaysia; Muscle, Smooth, Vascular; Pregnancy; Pregnancy Complications, Neoplastic; Uterine Neoplasms

Sixty cases with uterine leiomyomata in pregnancy are presented. The incidence was 1 in 1033 deliveries. The median age of the patients was 33.4 years. The majority were primigravidae (60%). A significant number of patients gave a history of infertility (43%) and spontaneous abortions (25%). The commonest antenatal complication was malpresentation and in all these patients the myomata were larger than 6 cm. Typical features of red degeneration occurred in 10% of cases. The cesarean section rate was 73%, the commonest indication being obstructed labor. Severe hemorrhage was encountered at cesarean section in 10 patients, 3 of whom needed hysterectomy. There were no perinatal deaths.

Topics: Adult; Cesarean Section; Female; Humans; Hysterectomy; Incidence; Leiomyoma; Malaysia; Middle Aged; Pregnancy; Pregnancy Complications, Neoplastic; Uterine Hemorrhage; Uterine Neoplasms

The close epidemiological relationships between specific genital human papillomavirus (HPV) types and neoplasia of the cervix uteri have been extensively documented worldwide, including Singapore. Cervical cancer incidence rates in Singapore show variations between the major ethnic groups. To ascertain the corresponding HPV infection rates among the various races in Singapore, we analysed the cervical smears of 225 women by filter in situ DNA hybridization, and compared the data with a previous similar study. Fourteen (6.2%) individuals were HPV-positive, with HPV 16 and HPV 31 being the commonest types. No significant difference between HPV positivity rates in Chinese (5.0%) and in Malays (6.7%) was found, even though Chinese have a higher cervical cancer incidence than Malays. Furthermore, the cervical HPV carriage rate among women with normal cytology was 5.9%. In the light of reports of high genital HPV prevalence rates detected by DNA amplification, these data support the notion that HPV infection is commonly latent and requires the cooperation of other factors for cervical carcinogenesis.

Topics: Adult; Aged; China; Female; Genital Diseases, Female; Humans; India; Malaysia; Middle Aged; Papillomaviridae; Singapore; Tumor Virus Infections; Uterine Neoplasms

Topics: Choriocarcinoma; Female; Humans; Malaysia; Pregnancy; Uterine Neoplasms

Topics: Adolescent; Adult; Female; Humans; Hydatidiform Mole; Malaysia; Middle Aged; Pregnancy; Uterine Neoplasms

Topics: Adult; Choriocarcinoma; Female; Humans; Malaysia; Middle Aged; Pregnancy; Uterine Neoplasms

Topics: Aging; Allergy and Immunology; Asian People; Blood Group Antigens; Blood Protein Electrophoresis; Choriocarcinoma; Female; Fertility; Geography; Humans; Hydatidiform Mole; Incidence; Liver Function Tests; Malaysia; Nutritional Physiological Phenomena; Nutritional Sciences; Pregnancy; Sociology; Statistics as Topic; Trophoblastic Neoplasms; Uterine Neoplasms