Medical treatment of ectopic pregnancy (EP) is based on the administration of methotrexate (MTX). It concerns ectopic pregnancy with β-hCG <10000 without cardiac activity and applies to women informed, without history of ectopic pregnancy and who understand the predictive signs of break. These women should always be monitored until β-hCG negativity. The risk of tubal break persists throughout the treatment with MTX. The authors report three cases of ectopic pregnancy treated medically and whose evolution has been marked by a break. They talk through these cases about the indications and limitations of medical treatment and the risks of tubal break under medical treatment.
Trastuzumab is the first target molecule designed for breast cancer treatment. In first-line metastatic, trastuzumab in combination with chemotherapy significantly improved survival of patients bearing HER2-positive breast cancer. In adjuvant trastuzumab was tested in several randomized trials. In contemporary literature, many strong arguments confirm the clear survival benefit of trastuzumab in adjuvant administered concomitantly with taxane-based chemotherapy and concomitant with radiation therapy, and for a period of one year.
Peripartum cardiomyopathy (PPCM) is a rare cardiac disorder of unknown origin associated with a high risk of mortality (50%). Echocardiography confirms the diagnosis by showing a left ventricular dilatation and a decreased ejection fraction. Up to date, the treatment remains symptomatic. The authors report the case of a woman of 36 years old who presented a peripartum cardiomyopathy.
The authors report the case of a 26 years old woman with a medical history of three late fetal loss (between 20 to 22 weeks) who benefit in her actual pregnancy a recue cervical cerclage at 20 weeks of gestation. It allowed the continuation of the pregnancy until 38 weeks after elective suture removal at 36SA. The patient give birth by natural delivery to a baby girl in good condition. Prophylactic cerclage was recommended to the patient in later pregnancies. Through this case and based on recent literature reviews, the authors discuss the indications, contraindications, technical aspects and prognosis of rescue cervical cerclage.
Carcinosarcomas are rare uterine cancers and carry poor prognosis. Although these tumours usually arise de novo, some cases developed under tamoxifen therapy have been reported. We report a case of uterine carcinosarcoma occurring in a postmenopausal patient benefiting from tamoxifen therapy as adjuvant treatment of breast cancer.
A case of a malignant mesothelioma of clitoral location is reported in a 52 year-old woman.The microscopic and immunohistochemical exam of biopsy conﬁrmed the diagnosis of malignant mesothelioma of the clitoris. The computed tomography scan of thoraco abdominal pelvic was normal. The patient underwent surgical treatment followed by radiotherapy and chemotherapy. Most malignant mesotheliomas are pleural location; they rarely occur within the peritoneum and their clitoral location is exceptional. Our objective about this particular case is to discuss the diagnostic problems of exceptional tumour of the clitoris and clinical and pathologic aspects.
The authors report a case of hydrops fetalis discovered incidentally during a morphological ultrasound performed at 23 weeks of gestation in a 31 years old primigravida woman. The etiology was an infection by parvovirus B19. What is special about our observation is firstly that fetal infection by parvovirus B19 in pregnancy is rare and responsible of fetal anemia. Besides, thanks to a multidisciplinary care including obstetricians, neonatologists, anesthetists and after two transfusions, our patient was conducted pregnancy up to 34 weeks of gestation and give birth by caesarean section of a newborn female.