Introduction: Unruptured intracranial aneurysms (UIAs) can induce psychological stress, leading to anxiety, depression, and impaired quality of life (QoL). Most studies on this topic are limited by small sample sizes, cross-sectional designs, and a focus on treated rather than untreated cases, leaving a gap in the literature. We aimed to conduct a systematic review and meta-analysis to evaluate mental health and QoL outcomes in patients with untreated UIAs. Methods: A systematic search was conducted up to 30 November 2024 using PubMed, Scopus, and Cochrane Central for studies comparing patients with untreated UIAs to a control group. The outcomes of interest included anxiety, depression, and QoL. Statistical analysis was performed using RevMan 5.1.7 and R 4.3.1. Heterogeneity was assessed using I² statistics and the Cochrane Q test. Risk ratios (RR) and standardized mean differences (SMD) were computed using a frequentist random-effects model. Results: We included five studies with 417,152 patients, of whom 85,668 (20.53%) had untreated UIAs. In the pooled analysis, patients with untreated UIAs had significantly higher anxiety levels (SMD 0.66; 95% CI [0.16; 1.17]; p = 0.01; I² = 76%) and lower QoL (SMD −0.82; 95% CI [−1.12; −0.53]; p = 0.01; I² = 56%) compared to the control group However, no statistically significant differences were found in depression (RR 0.94; 95% CI [0.52; 1.72]; p = 0.84; I² = 88%) between groups. Conclusions: This meta-analysis indicates a potential association between untreated UIAs and increased anxiety levels and reduced QoL. Regarding depression, no significant differences were observed between groups.

Background and Clinical Significance: Brenner tumors are rare epithelial tumors that can occur in both males and females. They consist of ovarian transition cells surrounded by dense fibrous tissue and can be classified as benign, borderline, or malignant. While most commonly found in the ovary, extraovarian Brenner tumors (EOBTs) have been reported in the uterus, vagina, broad ligament, and omentum. Case Presentation: A 71-year-old postmenopausal woman presented with a polypous formation on the upper third of the posterior vaginal wall, which was found at a routine health check. Macroscopically, the lesion appeared as a solid, polypoid mass with a yellowish-gray cut surface, measuring approximately 25 × 20 mm. Histological examination revealed a polypoid formation covered by stratified squamous epithelium, with a dense fibrous stroma (Van Gieson [VG]+) and tubular structures lined by clear epithelial cells. Parenchymal cells showed low proliferative activity, with Ki-67 expression in less than 5% of cells, also Cytokeratin (CK) 7/+/p63:/+/ CK AE1/AE3: /+/ Estrogen Receptor (ER): /+/ and Progesterone Receptor (PR)/−/; CK20/-/; p53/−/, Wilms’ Tumor (WT)-1/−/; Prostate-Specific Acid Phosphatase (PSAP)/−/. The final diagnosis was an extraovarian Brenner tumor. The patient was monitored for two months post-excision, with no signs of recurrence. Conclusions: EOBTs are extremely rarely seen and vaginal involvement is far less common. Due to their rarity, these tumors may be confused with other benign or malignant vaginal lesions. In order to differentiate EOBTs from other neoplasms, histological analysis is crucial due to their characteristic transitional-type epithelium and large fibrous stroma. Further studies are required to understand the origin and clinical behavior of EOBTs. Long-term monitoring should be performed to look for any recurrence or malignant change, even though benign Brenner tumors usually have a good prognosis. Awareness of EOBTs and their possible locations is essential for accurate diagnosis and appropriate management.

Background and Clinical Significance: Mesonephric adenocarcinoma (MA) of the uterine cervix is an exceptionally uncommon and aggressive cancer that arises from remnants of the mesonephric duct. It was first classified by the World Health Organization (WHO) in the 2020 WHO Classification of Female Genital Tumors as a type of cervical adenocarcinoma, also referred to as Gartner’s duct carcinoma. Due to its rarity, both detection and treatment pose significant challenges, and there is little information on its clinical manifestations and prognosis. Mesonephric hyperplasia (MH) in the uterine cervix is an uncommon condition that is often misdiagnosed as adenocarcinoma. Case Presentation: We present the case of a 49-year-old, asymptomatic, perimenopausal woman diagnosed with cervical mesonephric adenocarcinoma following a routine Pap smear, performed by Papanicolaou test, with a III A-B result; however, a cone biopsy revealed stage IB1 mesonephric adenocarcinoma. The patient underwent a radical hysterectomy type C (Querleu–Morrow 2017 classification). The final pathology confirmed stage IB2 of the cancer (2018 classification) according to The International Federation of Gynecology and Obstetrics (FIGO), with previous evidence of mesonephric hyperplasia from a trial abrasion performed three years earlier. Conclusions: This case highlights the challenges in recognizing and managing mesonephric hyperplasia and adenocarcinoma of the cervix. Given the uncommon nature of this cancer, clinicians should consider it when treating patients with ambiguous cervical pathology and mesonephric hyperplasia. Optimizing patient outcomes relies on early detection, accurate staging, and radical surgical treatment.

Background: Vulvar leiomyosarcoma (VLMS) is a rare and aggressive soft tissue malignancy arising from smooth muscle cells, comprising less than 3% of vulvar cancers. Its clinical resemblance to benign vulvar lesions often leads to delayed diagnosis. Despite surgical resection and adjuvant therapy, VLMS is associated with high recurrence rates and a poor prognosis, and due to its rarity, there is no standardized management or surveillance protocol. Case Report: We present a case of high-grade VLMS in a postmenopausal woman, initially diagnosed in 2020 and managed with surgical excision and adjuvant radiotherapy. The primary tumor was a 10 cm solid, lobulated mass involving the mons pubis, with histology confirming high-grade leiomyosarcoma based on marked cellular atypia, high mitotic activity, and smooth muscle differentiation. Immunohistochemistry was positive for SMA, vimentin, and CD34, and negative for S100 and MyoD1. Five years later, the patient developed a local recurrence with an enlarged inguinal lymph node. She underwent complete tumor resection and bilateral inguinal lymphadenectomy. Histology of the recurrent lesion mirrored the initial findings, with no lymph node metastases. This case highlights the aggressive nature and potential for late recurrence in vulvar leiomyosarcoma, underscoring the importance of long-term surveillance. Conclusions: High-grade VLMS is a rare malignancy with a high recurrence risk. This case highlights the importance of early diagnosis, radical surgical treatment, and long-term surveillance. Although recurrence occurred five years after the initial treatment, timely surgical intervention led to a favorable postoperative course. Multidisciplinary management and individualized follow-up strategies remain key to improving outcomes in these rare gynecologic sarcomas.

Background and Objectives: To summarize current evidence regarding the pathophysiology, clinical management, and maternal and neonatal outcomes associated with pregnancy in women with myasthenia gravis (MG). Materials and Methods: This structured narrative review was based on literature searches conducted in major biomedical databases, including PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library. Eligible publications included observational studies, cohort studies, case series, and clinically relevant case reports addressing MG management during pregnancy and postpartum. Due to heterogeneity in study design, patient populations, interventions, and reported outcomes, findings were synthesized narratively rather than quantitatively. Results: The available evidence suggests that pregnancy outcomes in women with MG are generally favorable when multidisciplinary monitoring and individualized treatment strategies are applied. Disease exacerbations may occur during pregnancy or the postpartum period, particularly in women with generalized MG or respiratory involvement. Observational evidence indicates that prior thymectomy may be associated with reduced rates of MG exacerbation and transient neonatal myasthenia gravis (TNMG), although available data remain limited. Careful selection of pharmacological therapy, prenatal monitoring, anesthetic management, and postpartum surveillance is essential to optimize maternal and neonatal outcomes. Conclusions: Myasthenia gravis is generally compatible with successful pregnancy outcomes; however, affected women may require closer monitoring because of the potential risk of disease exacerbation, myasthenic crisis, and neonatal complications. Management should be individualized and supported by multidisciplinary collaboration involving neurologists, obstetricians, anesthesiologists, and neonatologists.

Background: Genitourinary syndrome of menopause (GSM) is common among breast cancer survivors, particularly during endocrine therapy, and vaginal laser therapy has been proposed as a nonhormonal option; CO₂ and Er:YAG devices differ technically and their effects should not be assumed equivalent. Objective: To assess the efficacy, durability, and safety of vaginal laser therapy for GSM in breast cancer survivors, treating CO₂ and Er:YAG separately. Methods: Five databases and trial registries were searched from inception to 22 August 2026. Risk of bias was assessed with RoB 2, ROBINS-I, and the JBI cohort checklist; certainty with GRADE; and findings were synthesized narratively because of heterogeneity. Results: Thirty-five evidence reports represented 28 study families (19 CO₂, six Er:YAG alone, one Er:YAG plus Nd:YAG versus Er:YAG, two other systems). Only two CO₂ trials used sham controls, and neither showed a reproducible laser-specific benefit for dyspareunia or overall sexual function; one favored CO₂ for daily dryness and selected objective measures but not intercourse dryness or dyspareunia. Active-comparator trials showed no consistent laser advantage, and uncontrolled cohorts reported short-term gains that attenuated with follow-up. No serious treatment-related adverse event was reported in the included studies; however, the evidence was insufficient to assess uncommon or delayed harms. Certainty was low to very low for sham-controlled CO₂ effects and very low for Er:YAG versus hyaluronic acid; no study compared the modalities directly. Conclusions: Available evidence does not establish a consistent laser-specific benefit on the main patient-reported outcomes. CO₂ has the larger evidence base, but this does not demonstrate greater efficacy; Er:YAG data rely mainly on active-comparator or uncontrolled studies. No direct CO₂-versus-Er:YAG comparison is available, and neither modality superiority nor equivalence can be inferred. Durability and safety beyond the short term remain uncertain.