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P968 Leiomyomatosis peritonealis disseminata: A case report
S686
Poster presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S413–S729
P968 Leiomyomatosis peritonealis disseminata: A case report M. Abe We hereby report the first case of Leiomyomatosis peritonealis disseminata (LPD) in Ireland. Worldwide, only about 100 cases have been described. This is a very rare histologically benign uterine smooth muscle tumour with variable malignant potential. Radiological features are virtually indistinguishable from extensive intra-abdominal malignant process with metastasis. As this condition has been described almost exlusively in women of reproductive age, estrogen (endogenous & exogenous) is implicated as key aetiological factor. This case report features a 29 year old nulliparous on estrogen containing oral contraceptive pills who presented with 22 week size pelvic mass. A CT giuded biopsy confimed diagnosis of LPD. She was succesfully treated with GnRH analogues with complete radiological resolution after 6 months. P969 Knowledge and perception of cancer of the cervix among women with invasive cervical cancer in Lagos, Nigeria M. Adegbesan, R. Anorlu. Lagos University Teaching Hospital Objective: To determine the knowledge and awareness of cervical cancer among women with invasive cervical cancer in Lagos, Nigeria. Materials and Methods: A structured form was used to obtained information on the awareness and knowledge of cervical cancer among women with cervical cancer who attended the Gynaecologic and the Radiation Oncology clinics of the Lagos University Teaching Hospital (LUTH) between 1st March 2008 and 28th February 2009. Results: There were 189 cases during the period. The median age was 54.1 ± 5.8 years. (Age range 27–80 years). Eighty (42.3%) of respondents had no formal education, while only 30 (15.9%) had tertiary education. While 186 (98.4%) of respondents were aware of breast cancer, only 3 (1.6%) were aware of cervical cancer. One hundred and eight (57.1%) presented with foul smelling vaginal discharge, 72 (38.1%) with postmenopausal bleeding, and 3 (1.6%) with intermenstrual bleeding. On what they thought was wrong with them when they first noticed the symptoms, 118 (62.4%) thought they were menstruating, 37 (19.6%) thought it was due to abstinence from sexual intercourse, 4 (2.1%) thought it was due to evil forces, while 31 (16.4%) had no idea. Conclusion: This study shows Nigerian women have little or no knowledge about cervical cancer. This perhaps accounts for the late presentation of the cancer. P970 Molar pregnancies in a Nigerian teaching hospital A. Eke1 , G. Eleje1 , J. Okonkwo1 , G. Udigwe2 , U. Ijeneme2 . 1 Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria, 2 Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria Objective: To determine the prevalence, risk factors, clinical presentation, diagnosis, treatment options and outcome of molar pregnancy in a Nigerian teaching hospital. Materials and Methods: A ten-year retrospective study of patients with molar pregnancy managed at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria, from 1st July 1999 to 30th June, 2008 was undertaken. Results: There were 34 cases of molar pregnancy out of a total delivery of 7,579, giving a prevalence of 0.4% (1 in 223 deliveries). Of the 1,612 gynecological admissions over the study period, molar pregnancy constituted 2.1%. The majority (45.2%) of the patients were between 21–30 years. Most of the patients
were nulliparous (29.0%). The most common presenting symptoms were abnormal vaginal bleeding (93.5%), large for gestational age (51.6%), abdominal pain (45.2%) and hyperemesis gravidarum (38.7%). Anemia was the commonest complication (96.8%). Almost all the patients (93.5%) had suction evacuation while only 6.5% had hysterectomy. Only 2 patients (6.5%) had post-evacuation chemotherapy while almost 65% of the patients had post treatment contraception. 20 patients (64.5%) had complete post treatment follow-up for at least 6 months. The case fatality rate was 9.7%. Conclusion: Molar pregnancy has remained an important cause of maternal morbidity and mortality in Nigeria. There is need for early detection and proper treatment of this condition. Adequate follow-up of the patients is mandatory. P971 Carcinoma of the ovary in a Nigerian tertiary hospital A. Eke1 , G. Eleje1 , U. Ijeneme1 , C. Ezeigwe2 . 1 Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria, 2 Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria Objective: This study was to determine the prevalence, risk factors, clinical presentation, treatment modalities and outcome of ovarian cancer in tertiary hospital in Nigeria. Materials and Methods: A 5-year retrospective study of patients with ovarian cancer managed in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria, between 1st January 2003 and 31st December 2007 was undertaken. Results: There were 29 cases of ovarian cancer out of 122 cases of gynecological malignancies and 1003 gynecological admissions respectively. Ovarian cancer constituted 23.8% of all gynecological malignancies, with a prevalence rate of 2.9%. More than 60% of the patients were above 50years and the majority (66.7%) were grandmultiparous. Abdominal swelling (47.8%) followed by abdominal pain (13.7) were the most common presenting symptoms. 2 patients (7.4%) had a family history of cancer. Late presentation, with stage III (76.9%) was commonest stage at presentation. The majority of the tumors (62.7%) were of epithelial origin. Serous cyst-adenocarcinoma predominated. The majority of the patients (88.9%) had cyto-reductive surgery as first line treatment while 92.3% of these patients had adjuvant chemotherapy. Two (7.6%) patients died intra-operatively, while 75.0% of the patients died within 6 months of therapy. Conclusion: Ovarian cancer is still a problem in Nigeria. Introduction of screening programmes for early detection and public enlightenment is advocated. P972 HPV-DNA persistence after treatment for cervical intraepithelial neoplasia D. Ljuca1 , B. Ahmetovic1 , E. Iljazovic2 , E. Hajder1 , S. Sabic3 , A. Hadzimehmedovic. 1 Ob/Gyn Clinic, University Clinical Centre Tuzla, 2 Department for Laboratory Diagnostics, University Clinical Centre Tuzla, 3 Ob/Gyn Department, General Hospital of Brcko District Objective: Cervical intraepithelial neoplasia (CIN) is a precursor in the development of invasive cancer of the uterine cervix. HPV is the major cause of CIN and cervical cancer. This study was undertaken to examine the HPV presence in patients after treatment of CIN. Methods: This retrospective-prospective study included 70 patients who underwent a biopsy because of abnormal PAP smear testing. 35 of them with CIN I and koilocytosis have been treated by medicaments, while patients with CIN II, III and koilocytosis have been treated by conization. After one year patients have undergone a PAP smear testing and HPV screening (Digene Hybride Capture II test). Results: HPV-DNA has been detected in 48.6% of patients after the conization, and in 65.7% of patients treated with medicaments.
Poster presentations / International Journal of Gynecology & Obstetrics 107S2 (2009) S413–S729
P968 Leiomyomatosis peritonealis disseminata: A case report M. Abe We hereby report the first case of Leiomyomatosis peritonealis disseminata (LPD) in Ireland. Worldwide, only about 100 cases have been described. This is a very rare histologically benign uterine smooth muscle tumour with variable malignant potential. Radiological features are virtually indistinguishable from extensive intra-abdominal malignant process with metastasis. As this condition has been described almost exlusively in women of reproductive age, estrogen (endogenous & exogenous) is implicated as key aetiological factor. This case report features a 29 year old nulliparous on estrogen containing oral contraceptive pills who presented with 22 week size pelvic mass. A CT giuded biopsy confimed diagnosis of LPD. She was succesfully treated with GnRH analogues with complete radiological resolution after 6 months. P969 Knowledge and perception of cancer of the cervix among women with invasive cervical cancer in Lagos, Nigeria M. Adegbesan, R. Anorlu. Lagos University Teaching Hospital Objective: To determine the knowledge and awareness of cervical cancer among women with invasive cervical cancer in Lagos, Nigeria. Materials and Methods: A structured form was used to obtained information on the awareness and knowledge of cervical cancer among women with cervical cancer who attended the Gynaecologic and the Radiation Oncology clinics of the Lagos University Teaching Hospital (LUTH) between 1st March 2008 and 28th February 2009. Results: There were 189 cases during the period. The median age was 54.1 ± 5.8 years. (Age range 27–80 years). Eighty (42.3%) of respondents had no formal education, while only 30 (15.9%) had tertiary education. While 186 (98.4%) of respondents were aware of breast cancer, only 3 (1.6%) were aware of cervical cancer. One hundred and eight (57.1%) presented with foul smelling vaginal discharge, 72 (38.1%) with postmenopausal bleeding, and 3 (1.6%) with intermenstrual bleeding. On what they thought was wrong with them when they first noticed the symptoms, 118 (62.4%) thought they were menstruating, 37 (19.6%) thought it was due to abstinence from sexual intercourse, 4 (2.1%) thought it was due to evil forces, while 31 (16.4%) had no idea. Conclusion: This study shows Nigerian women have little or no knowledge about cervical cancer. This perhaps accounts for the late presentation of the cancer. P970 Molar pregnancies in a Nigerian teaching hospital A. Eke1 , G. Eleje1 , J. Okonkwo1 , G. Udigwe2 , U. Ijeneme2 . 1 Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria, 2 Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria Objective: To determine the prevalence, risk factors, clinical presentation, diagnosis, treatment options and outcome of molar pregnancy in a Nigerian teaching hospital. Materials and Methods: A ten-year retrospective study of patients with molar pregnancy managed at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria, from 1st July 1999 to 30th June, 2008 was undertaken. Results: There were 34 cases of molar pregnancy out of a total delivery of 7,579, giving a prevalence of 0.4% (1 in 223 deliveries). Of the 1,612 gynecological admissions over the study period, molar pregnancy constituted 2.1%. The majority (45.2%) of the patients were between 21–30 years. Most of the patients
were nulliparous (29.0%). The most common presenting symptoms were abnormal vaginal bleeding (93.5%), large for gestational age (51.6%), abdominal pain (45.2%) and hyperemesis gravidarum (38.7%). Anemia was the commonest complication (96.8%). Almost all the patients (93.5%) had suction evacuation while only 6.5% had hysterectomy. Only 2 patients (6.5%) had post-evacuation chemotherapy while almost 65% of the patients had post treatment contraception. 20 patients (64.5%) had complete post treatment follow-up for at least 6 months. The case fatality rate was 9.7%. Conclusion: Molar pregnancy has remained an important cause of maternal morbidity and mortality in Nigeria. There is need for early detection and proper treatment of this condition. Adequate follow-up of the patients is mandatory. P971 Carcinoma of the ovary in a Nigerian tertiary hospital A. Eke1 , G. Eleje1 , U. Ijeneme1 , C. Ezeigwe2 . 1 Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria, 2 Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria Objective: This study was to determine the prevalence, risk factors, clinical presentation, treatment modalities and outcome of ovarian cancer in tertiary hospital in Nigeria. Materials and Methods: A 5-year retrospective study of patients with ovarian cancer managed in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria, between 1st January 2003 and 31st December 2007 was undertaken. Results: There were 29 cases of ovarian cancer out of 122 cases of gynecological malignancies and 1003 gynecological admissions respectively. Ovarian cancer constituted 23.8% of all gynecological malignancies, with a prevalence rate of 2.9%. More than 60% of the patients were above 50years and the majority (66.7%) were grandmultiparous. Abdominal swelling (47.8%) followed by abdominal pain (13.7) were the most common presenting symptoms. 2 patients (7.4%) had a family history of cancer. Late presentation, with stage III (76.9%) was commonest stage at presentation. The majority of the tumors (62.7%) were of epithelial origin. Serous cyst-adenocarcinoma predominated. The majority of the patients (88.9%) had cyto-reductive surgery as first line treatment while 92.3% of these patients had adjuvant chemotherapy. Two (7.6%) patients died intra-operatively, while 75.0% of the patients died within 6 months of therapy. Conclusion: Ovarian cancer is still a problem in Nigeria. Introduction of screening programmes for early detection and public enlightenment is advocated. P972 HPV-DNA persistence after treatment for cervical intraepithelial neoplasia D. Ljuca1 , B. Ahmetovic1 , E. Iljazovic2 , E. Hajder1 , S. Sabic3 , A. Hadzimehmedovic. 1 Ob/Gyn Clinic, University Clinical Centre Tuzla, 2 Department for Laboratory Diagnostics, University Clinical Centre Tuzla, 3 Ob/Gyn Department, General Hospital of Brcko District Objective: Cervical intraepithelial neoplasia (CIN) is a precursor in the development of invasive cancer of the uterine cervix. HPV is the major cause of CIN and cervical cancer. This study was undertaken to examine the HPV presence in patients after treatment of CIN. Methods: This retrospective-prospective study included 70 patients who underwent a biopsy because of abnormal PAP smear testing. 35 of them with CIN I and koilocytosis have been treated by medicaments, while patients with CIN II, III and koilocytosis have been treated by conization. After one year patients have undergone a PAP smear testing and HPV screening (Digene Hybride Capture II test). Results: HPV-DNA has been detected in 48.6% of patients after the conization, and in 65.7% of patients treated with medicaments.