title: Decidual cast in a girl receiving depot medroxyprogesterone acetate--a case report.
abstract: BACKGROUND
  The passage of tissue per vaginam in a young girl raises several diagnostic considerations that include aborted pregnancy, benign polyp, rhabdomyosarcoma, and rarely decidual cast.
  
  
  METHODS
  A 9-yr-old girl who was receiving depot medroxy-progesterone acetate to suppress menstruation passed tissue per vaginam. Pathological examination of the tissue showed a decidual cast with no chorionic villi, while a serum hCG test was also negative.
  
  
  CONCLUSIONS
  Decidual cast formation is a rare side effect of progestogen use and should be considered in the differential diagnosis of passage of tissue per vaginam.
authors.affiliation: Departments of Pathology, Pediatrics, and Gynecological Surgery, Children's Mercy Hospital, Kansas City, Missouri 64108, USA. vsingh@cmh.edu
authors.forename: Vivekanand
authors.initials: V
authors.lastname: Singh
authors.forename: Nasreen
authors.initials: N
authors.lastname: Talib
authors.forename: Julie
authors.initials: J
authors.lastname: Strickland
mesh_terms: D002648:Child; D003271:Contraceptive Agents, Female / Q000009:adverse effects*; D003656:Decidua / Q000473:pathology*; D003692:Delayed-Action Preparations / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008607:Intellectual Disability; D017258:Medroxyprogesterone Acetate / Q000009:adverse effects*; D011629:Puberty, Precocious / Q000188:drug therapy; D019522:Vaginal Discharge
chemical_list: D003271:Contraceptive Agents, Female; D003692:Delayed-Action Preparations; D017258:Medroxyprogesterone Acetate