Ectopic pregnancy (EP) refers to blastocyst implantation outside the uterine endometrium. EP is major cause of maternal morbidity and mortality. Treatment options include surgery, medical therapy with methotrexate, or expectant management. Methotrexate is the primary regimen used in cases of early, unruptured ectopic pregnancies. Most side effects of methotrexate are minor, including nausea, vomiting, abdominal discomfort, and photosensitive skin reaction. Serious side effects, including bone marrow suppression, and pulmonary fibrosis, are invariably observed when methotrexate is administered in high doses with frequent dosing intervals, in chemotherapeutic protocols for malignancy. These side effects are uncommon with the doses used to treat ectopic pregnancies. Since cases of methotrexate-induced pancreatitis are rare, we report a case of pancreatitis in a patient with EP treated with methotrexate and expect to consider pancreatitis as a side effect of methotrexate in a patient with upper abdominal pain undergoing methotrexate chemotherapy.

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• Methotrexate
  
  Reactions Weekly.2023; 1972(1): 212.     CrossRef

Listeriosis is an infectious disease caused by Listeria monocytogenes. It’s rare in healthy adults, it could be fatal in pregnant women. Listeriosis in pregnant women causes fever and flu-like symptoms, but could lead to fatal consequences. However, because there are few cases of listeriosis reported in Korea, the symptoms are ambiguous and the standard diagnostic tool has yet to be determined, making accurate diagnosis difficult. We present a case of a 35-year-old pregnant woman who had fever and headache. Initially, we didn’t find the cause of fever. However, after delivery, L. monocytogenes was detected in the neonatal gastric aspirate culture, blood cultures. The placenta and amniotic membrane showed acute suppurative inflammation and chorioamnionitis. The mother recovered after antibiotic treatment and delivery, but in the case of the newborn baby, the patient died despite treatment. We report a case of listeriosis in a pregnant woman and a neonate with literature review.

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• Whole-genome sequencing of Listeria monocytogenes isolated from the first listeriosis foodborne outbreak in South Korea
  Seung Hun Lee, Sangmi Lee, Sang Hun Park, Ok Kyung Koo
  Frontiers in Microbiology.2023;[Epub]     CrossRef

A 66-year-old postmenopausal woman received routine gynecologic check-up. Transvaginal ultrasonography and abdominal and pelvic computed tomography showed about 5-cm cystic mass in uterus with solid component and the patient had thin endometrium and the serum level of CA 125 was normal. We performed a total hysterectomy and bilateral salpingo-oophorectomy and found tumor which had brownish cystic fluid and about 2 cm sized and colored in light yellowish, polypoid protruding solid mass, located within the myometrial wall. Histopathological examination of frozen section revealed malignancy. The tumor was confined within the myometrium and its histologic type was clear cell adenocarcinoma. Finally we identified that the myometrial mass was clear cell adenocarcinoma originated from adenomyosis pathologically. The malignant transformation of adenomyosis is very rare. When we find a cystic change with solid component in adenomyosis patients, clear cell adenocarcinoma should be suspected as a differential diagnosis and magnetic resonance imaging should be considered for further evaluation.