Siriraj Medical Journal

38-41

Authors: Chairat Leelaphattanadit, M.D., Saifon Chawanpaiboon, M.D., Siripong Sawasdimongkol, M.D.

Objective: To determine the prevalence of ovarian cancer, staging, presenting symptoms, gestational age of diagnoses, screening and diagnostic methods and pregnancy outcomes during pregnancy at Siriraj Hospital over a 13-year period (1998-2010). Methods: Medical records of pregnant women diagnosed with ovarian cancer at Siriraj Hospital from 1998 to 2010 were reviewed. Results: During the 13-year period, 1998-2010, eight cases of pregnant women with ovarian cancer were detected. Six cases of ovarian cancer stage I and 2 cases of ovarian cancer stage II were recorded. All of the patients presented with the symptom of abdominal mass. Two cases presented with abdominal pain. Ultrasonography was performed in all cases to confirm the diagnosis. Two patients with stage II ovarian cancer which was diagnosed in early pregnancy, subsequently had abortions. Five cases from 6 cases of those patients with stage I ovarian cancer underwent caesarean delivery while one case had a normal vaginal delivery. Conclusion: Regarding to this 13-year review, the prevalence of ovarian cancer in pregnancy was low. The management of pregnant patients with ovarian cancer depended on the gestational age and the staging of malignancy.

47-51

Authors: Kullathorn Thephamongkhol, M.D., M.Sc., Kanyanee Laebua, M.D., Pittaya Dankulchai, M.D., Janjira Petsuksiri, M.D., Chumpot Kakanaporn, M.Sc., Lalida Tuntipumiamorn, M.Sc., Porntip Iampongpaiboon, M.Sc., Yaowalak Chansilpa, M.D.,Pittayapoom Pattaranutraporn, M.D.

Objective: Setup verification is the critical part to make sure of the accuracy for Intensity-modulated radiotherapy in nasopharyngeal cancer patients. This pilot study was designed to answer whether and how much the kV-CBCT in addition to 2DkV is more accurate than 2DkV alone in terms of verification parameters. Methods: Images acquisition: Offline images were displayed in the matched position between reference images. 2D and 3D matches: The bony matches were done by using the location of the tumor in the nasopharyngeal and upper neck regions. The distances displaced from the isocenter were recorded in x-y-z directions. Analysis: The distance of the isocenter shift in each direction (X, Y, Z) were presented as point estimations. The alignment between the two methods was assessed with Pearson’s and Spearman’s correlation. The 3 mm difference within 90% is considered as an acceptable range of non-inferiority of 2DkV, compared with CBCT. Results: 11 nasopharyngeal cancer patients were included into this study. The correlation between 2DkV and kV-CBCT were 0.46, 0.11 and 0.16 for Superior-inferior (SI), Anterior-posterior (AP) and Left-right (LR) directions, respectively. The central value for the kV-CBCT; SI, AP and LR directional shift were 0.07, 0.06 and 0.03 cm, respectively, whereas the central value for 2DkV; SI, AP and LR directional shift were 0.05, 0.07 and 0.04 cm. For the difference shift < 3 mm, the results > 90% were within acceptable value: 100% and 96.96% for SI and LR directions whereas the AP direction was 87.87%. Conclusion: Compared with kV-CBCT by using our criteria, 2DkV images are accurate enough for treatment verification in nasopharyngeal cancer patients.

58-59

Authors: Prapat Wanitpongpan, M.D., Kusol Russameecharoen, M.D., Tuenjai Chuangsuwanich, M.D.,Buraya Phattanachindakun, M.D.

A rare mirror syndrome (Ballantyne syndrome) was seen in a woman who carried a hydropic fetus caused by fetal atrio-ventricular septal defect (AVSD). Diagnosis was made with confidence after ruling out cardiogenic pulmonary edema and preeclampsia. Placental pathology demonstrated multifocal villous edema and accelerated maturation of trophoblasts which may support the earlier reports about potential etiologic roles of the placenta to trigger the disease.

64-67

Authors: Sopon Iamsirithaworn, M.D., Ph.D., Pasakorn Akarasewi, M.D., Thitipong Yingyong, M.D., Suthanun Suthachana, M.Sc.,Chakrarat Pittayawonganon, M.D., M.P.H., Kumnuan Ungchusak, M.D., M.P.H.

No abstract available.