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CURRENT ISSUEGAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE

A Journal on Internal Medicine and Pharmacology


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Gazzetta Medica Italiana Archivio per le Scienze Mediche 2002 April;161(2):83-5

 CLINICAL CASES

Cranio-per­i­to­neal ­shunt and ­ascites due to a prob­able par­a­crine ­activity of cere­bro­spinal ­fluid on the ­ovaries

Cobellis L., Ambrosio D., Pecori E., De Lucia E., Stradella L., Cobellis G.

Facoltà di Medicina e Chirurgia, Dipartimento di Ostetricia e Ginecologia, Seconda Università degli Studi di Napoli, Napoli

In ­this ­study a prob­able par­a­crine ­activity of the cere­bro­spinal ­fluid on ­ovaries is hypoth­e­sized in deter­mining an evi­dent ­ascites. A ­severe ­case of ­ascites ­appeared in a ­patient ­after 3 ­years of posi­tioning a ­cranio-per­i­to­neal ­shunt for tri­ven­tric­ular hydro­cephaly and arach­noid ret­ro­cer­e­bellar ­cyst; the ­tumor ­markers (­Alfer Fet­o­pro­tein, CEA, CA 125, CA 19-9) ­were ­very ­high. The ­patient under­went a lap­a­rotomy for sus­pected ­ovaric neo­plasia not con­firmed by a his­to­path­o­logic intra­op­er­a­tive ­impromptu exam­ina­tion. ­Even if the clin­ical, his­to­path­o­logic and par­tially the hor­monal pic­tures ­were ­very sim­ilar to ­those of ­ovaric hyper­stim­u­la­tion syn­drome (­OHSS), a hys­ter­ec­tomy was car­ried out ­with bilat­eral annex­ec­tomy due to the ­uterus con­di­tion and ­because the syn­drome was con­nected to ­serious irre­ver­sible func­tional dis­or­ders of the ­ovaries. The ­ascitic syn­drome ­regressed ­after exci­sion of the ­ovaries and ­tumor ­markers ­returned to ­normal ­values. It is hypoth­e­sized ­that the ­ascites ­could be con­nected ­with the hyper­pro­duc­tion of FSH and prob­ably to a par­a­crine ­activity the cere­bro­spinal ­fluid on ­ovaries ­which ­could ave ­involved the ­system of the ­ovaric homeo­stasis reg­u­la­tion.

language: Italian


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