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Nagarsheth NP, Rahaman J, Cohen CJ, Gretz H, Nezhat F The incidence of port-site metastases in gynecologic cancers JSLS 2004;8:133 139 33 Huang KG, Wang CJ, Chang TC, et al Management of port-site metastasis after laparoscopic surgery for ovarian cancer Am J Obstet Gynecol 2003;189:16 21 34 Schilder JM, Thompson AM, DePriest PD, et al Outcome of reproductive age women with stage IA or IC invasive epithelial ovarian cancer treated with fertility-sparing therapy Gynecol Oncol 2002;87:1 7 35 Khoury-Collado F, Bombard AT Hereditary breast and ovarian cancer: what the primary care physician should know Obstet Gynecol Surv 2004;59:537 542 36 Benjamin I, Morgan MA, Rubin SC Occult bilateral involvement in stage I epithelial ovarian cancer Gynecol Oncol 1999;72:288 291 37 Zanetta G, Chiari S, Rota S, et al Conservative surgery for stage I ovarian carcinoma in women of childbearing age Br J Obstet Gynaecol 1997;104:1030 1035 38.

For instance, Carole is of the opinion that Maggie is morally wrong to treat her mother as she does (Carole also believes Maggie is morally wrong to treat herself as she does), while Maggie has no doubt that she is justi ed in her actions And not only are statements such as Maggie is a bad daughter value-laden, but far less overtly judgemental statements such as Maggie is overweight , Maggie eats unwholesome food and Maggie s house is a mess also have subjective content In the example, many of the value judgements will be reasonably clear to outside observers, though not so apparent to those directly involved Value judgements such as these do not occur only in the context of professional health work interventions, nor only between people who come from different class backgrounds.

Colombo N, Parma G, Lapresa MT, Maggi F, Piantanida P, Maggioni A Role of conservative surgery in ovarian cancer: the European experience Int J Gynecol Cancer 2005; 15(suppl):206 211 39 Sainz de la Cuesta R, Goff BA, Fuller AF, Jr, Nikrui N, Eichhorn JH, Rice LW Prognostic importance of.

On the contrary, value judgements are made in the great majority of human encounters, even those where people share the same values It is vital that health workers become more accomplished at recognising the varieties of values that come into play Much bad feeling, and many disputes over moral matters , come about simply because alternative values are not recognised as potentially plausible possibilities (though seen through the eyes of someone who conceives of the world differently) Each side tends to regard their own position and outlook as right, and that of the opposition wrong Yet if the values are spelled out and clari ed it becomes far easier to see the situation from other perspectives.

(Is Carole totally correct in her view Is Maggie truly mistaken isn t she happy Is she really morally wrong to act as she does What are her priorities Are they so unreasonable ) This way it becomes easier to gain a fuller picture of what is going on It becomes possible to take a different way of thinking seriously and to appreciate why another person values something you do not see Eleven in particular..

tumors presents several challenges for the pathologist, especially for the uncommon sex cord stromal tumors The pathologist s chief task is to segregate the true sex cord stromal tumors from other tumor types that show similar histopathologic features Special stains are often required to make this distinction Pathology reports from these tumors should include tumor type, tumor size, grade/differentiation (if applicable), and statement clarifying likely biological behavior for borderline and low-grade malignant neoplasms Almost 90% of ovarian sex cord stromal neoplasms fall into the broma/thecoma group and are clearly benign The diagnosis and management of the usual broma/thecoma is straightforward Predicting the biological behavior of the small subset of tumors in this group that shows increased mitotic activity is problematic Most cellular bromas showing increased mitotic activity ( 3 mitotic gures/10 high-power elds) without associated cytologic atypia demonstrate benign biological behavior.

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13 Tumors associated with marked adhesions show a higher risk of recurrence Tumors showing both increased mitotic rate and cytologic atypia are classi ed as brosarcoma Cellular bromatous tumors showing cytologic atypia and a low mitotic index fall into the uncertain malignant potential group, but these tumors are exceedingly rare The Sertoli Leydig cell tumors show tremendous variation in histologic appearance The tumors are classi ed into well, moderately, and poorly differentiated tumors based on the histologic pattern The main challenge for the pathologist in these cases is to exclude other tumors, especially carcinomas, mimicking a Sertoli Leydig cell tumor A classic example includes some endometrioid adenocarcinomas that form small tubules resembling a Sertoli Leydig cell tumor (Plate 111) Steroid cell tumors are rare tumors comprising 1% of all sex cord stromal neoplasms.