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Showing 4 results for Farazestanian
Choriocarcinoma after caesarian section: case report
Zohreh Yousefi , Laya Shirinzadeh , Marjaneh Farazestanian , Amir Hossein Jafarian , Roya Jalali,
Volume 74, Issue 11 (February 2017)
Abstract

Background: The most common symptom of patients with gestational trophoblastic neoplasia is abnormal vaginal bleeding. Despite repeated visits of patients with postpartum choriocarcinoma and abnormal postpartum hemorrhage, delayed diagnosis leads to advanced disease with widespread metastasis. Therefore, occurrence of choriocarcinoma with variable patterns in different diagnosis of late onset postpartum hemorrhage should be considered. Early diagnosis of choriocarcinoma after term pregnancy is important that resulted in decrease of maternal morbidity. Therefor late onset postpartum hemorrhage should have an awareness. The aim of this study was to report a case of choriocarcinoma after caesarian section.

Case Presentation: A 33-years-old woman one month after antecedent caesarian section in her second pregnancy admitted with abnormal vaginal bleeding. Based on raised titer concentration of β-hCG was 187000 u, with clinical suspicious of choriocarcinoma she was referred to oncology department of Ghaem Hospital, Mashhad University of Medical Sciences, Iran, in 2016. Vaginal exam revealed an enlarged uterus about 10 weeks of pregnancy. Transvaginal sonography showed an intracavitary heterogeneous mass with irregular surface in fundus without myometrium invasion. Extra pelvic metastasis excluded via vaginal exam, pulmonary X-ray and, ultrasonography and computed tomography scan. Due to early stage of gestational trophoblastic neoplasia and diagnosis of this condition, single agent chemotherapy (methotrexate) was recommended, but because of unresponsive disease, subsequently, she was treated with combination chemotherapy (etoposide, methotrexate, and actinomycin, followed by cyclophosphamide and vincristine) that led to remarkable response. After three courses of therapy, normal level of β-hCG was observed and now the patient is free of disease and under-serial follow-up visit for choriocarcinoma.

Conclusion: Diagnosis of choriocarcinoma should be considered in any postpartum woman with abnormal vaginal bleeding.

Local injection of anesthetic agent in surgical incision in post-operation pain control: a review article
Masoomeh Tabari , Marjaneh Farazestanian, Helena Azimi, Maryam Esmaeilpour, Malihe Hasanzadeh Mofrad ,
Volume 79, Issue 9 (December 2021)
Abstract
Today surgery is supposed as the cure for many diseases and the fear of post-operation pain burdens stress over the patients. Postoperative pain can, especially if severe, complicate the patient's condition and may lead to chronic postoperative pain. post-operation pain control is effective in the recovery process, hospitalization period and patients’ satisfaction. Insufficient post-operation pain control increases complications and care costs. Local analgesia is one of the components of multimodal postoperative. analgesic protocol to control pain. Local analgesia technique is a simple, accessible and feasible method for various surgeries. The opioid analgesics to control post-operation pain are associated with some complications such as opium addiction, nausea and vomiting, late return of bowel function and social costs. This review study aims. to review previous studies on the effect of injection of analgesic agents in the surgical incision in post-operation pain control. This is a Narrative review study. to related scientific documentaries a search was conducted in Persian and English using the keywords of local injection of the incision site, wound infiltration with analgesic agents and post-operation pain control in Google scholar, PubMed and Scopus database during the years 2000 to 2020. The obtained articles included systematic reviews, Meta-analyses and randomized clinical trials (RCT). We reviewed studies that had utilized single-dose injection of analgesic agents in surgical incisions at the end of surgery to control post-operation pain. A total of ten studies were reviewed. There were 4 studies in the field of laparoscopic gynecological and non-gynecological surgeries, three studies in the field of laparotomy and three review studies. injection of analgesic agents in the surgical incision to control post-operation pain is easily available and does not necessitate any special skill. On the other hand, it is a safe method without further complications and does not increase the duration of surgery. Regardless of the differences in various studies and the kind of analgesic agents, a general reduction in pain severity and consumption of opioid and non-opioid analgesic agents were observed using the injection of analgesic agents in surgical site incision.

Bartholin gland cancer in a young woman: a case report
Ali Taghizadeh, Leila Pourali , Amirhosein Jafarian , Farokh Seilanian Toosi , Ghazal Ghasemi, Marjaneh Farazestanian, Mitra Enzebati,
Volume 79, Issue 11 (February 2022)
Abstract
                                                                        
 
 
 
 
 
 
 
Background: With 6,020 new cases and 1,150 deaths annually in the United States, vulvar cancer is uncommon, resulting in age-adjusted incidence rates of 2.8 and 1.7 per 100,000 in white and black women, respectively. Vulvar cancer represents about 4% to 6% of malignancies of the female genital tract and 0.6% of all cancers in women. Vulvar cancer predominantly affects postmenopausal women, and it is the most common anogenital cancer in women with more than 70 years of age. HPV infection is associated with a significant number of vulvar cancers. Bartholin Gland carcinoma is a rare form of vulvar malignancy that accounts for less than 5% of all vulvar cancers and 0.001% of all genital cancers. The aim of this study was to report a rare case of Bartholin's cancer in a young patient.
Case Report: The patient was a 37-year-old woman p2l2 (history of two pregnancy and two delivery) who had complains of severe pain in perineal area and was referred to the gynecology emergency clinic, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran, in June 2020. In past medical history she had no previous history of medical illnesses or surgical interventions. She had swelling and pain in perineal area since one year ago. Bartholin Gland abscess was diagnosed and she received some oral antibiotics, but did not improve. On the last examination under anesthesia, a firm mass of about 3 cm was palpated in the third distal part of posterior vagina which was at the site of Bartholin Gland and was necrotic. The pathologic report of the mass biopsy confirmed the diagnosis of squamous cell carcinoma. The patient was underwent chemo radiation therapy. At a follow up visit about 5 month later she was cured completely and there was not any symptom of recurrence or metastasis.
Conclusion: In dealing with any patient with diagnosis of Bartholin Gland abscess, in the case of resistance to medical treatment, further evaluation and biopsy of the mass should be considered to rule out Bartholin's gland cancer.
 

 

Aggressive angiomyxoma of the vulva: a case report
Malihe Hasanzadeh, Marjaneh Farazestanian, Afrooz Azad, Parnian Malakuti, Maryam Esmaeilpour,
Volume 80, Issue 4 (July 2022)
Abstract
Background: Aggressive angiomyxoma is a rare mesenchymal tumor with extensive local invasion. It often presents with a lump in the perineal area and pelvic. Since it often does not involve adjacent organs such as the urethra and anus, does not cause obstructive symptoms. Its incidence is 6 times higher in women than men. This tumor grows slowly and has a slight tendency to metastasize. However, the rate of local recurrence is high. MRI is the most widely used diagnostic method. Ultrasound and CT scan are also used for diagnosis. Due to the rarity of this tumor, it is difficult to diagnose before surgery and pathology assessment. Due to the penetrating nature of the tumor and the lack of a clear capsule, incomplete surgical resection is common. Local recurrence is common even after complete mass resection. Therefore, patients need a long follow-up. The main treatment is surgery but non-surgical interventions such as hormonal therapy, radiotherapy, arterial embolization, etc. have been associated with variable success rates.
Case Presentation: A 54-year-old female patient presented with a vulvar mass in February 2021. The patient mentioned that the mass had existed for ten years and had increased in size in the last two years. After discussion on the tumor board, she underwent surgery. The pathology of the mass was reported to be aggressive angiomyxoma. The patient was treated with a GNRH agonist after surgery. The patient is currently under follow-up and has not had a recurrence so far (March 2020).
Conclusion: Aggressive angiomyxoma is a rare mesenchymal tumor. It has extensive local invasion and a high recurrence rate, but distant metastasis is rare. Estrogen receptors or Progesterone receptors are commonly positive in aggressive angiomyxoma. The best treatment for aggressive angiomyxoma remains unknown. Extensive local resection of the tumor has been reported as an important therapeutic measure. In cases of mass recurrence, reoperation and hormone therapy have been effective. It is important for gynecologists to consider this tumor as a differential diagnosis when dealing with vulvar masses.

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