Extraovarian primary seromucinous cystadenoma masquerading as mesenteric cyst

2021 ◽  
Vol 14 (5) ◽  
pp. e240414
Author(s):  
Kishor R J ◽  
Bhuvaneshwari Harikrishnan ◽  
Naveen Alexander ◽  
Veena Bheeman
Keyword(s):  
Lower Abdominal Pain ◽  
Interesting Case ◽  
Mesenteric Cyst ◽  
Lumbar Region ◽  
Normal Limits ◽  
Mesenteric Border ◽  
Contrast Enhanced ◽  
Laparoscopic Excision ◽  
Abdominal Examination ◽  
The Right

We report an interesting case of extraovarian, primary seromucinous cystadenoma, which presented as a mesenteric cyst. A 31-year-old woman came with complaints of lower abdominal pain for 2 years, which is intermittent and aggravated during the menstrual cycle. On examination, her vitals were within normal limits; per abdominal examination revealed 7×7 cm mass in the right lumbar and right hypochondrium with well-defined margins. A Contrast-enhanced whole abdomen done showed a thin-walled of cyst of size 7×8×9 cm in the right lumbar region abutting and replacing the mesenteric border of ascending colon suggesting of mesenteric cyst. Patient underwent laparoscopic excision of mesenteric cyst. Histopathology revealed seromucinous cystadenoma without ovarian stroma.

scholarly journals Acute Abdomen due to Mutual Tangle of Two Small Paratubal Cysts

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Hiroharu Kobayashi ◽  
Shinichi Shibuya ◽  
Kentaro Iga ◽  
Keiichiro Kato ◽  
Airi Kato ◽  
...  
Keyword(s):  
Acute Abdomen ◽  
Histopathological Examination ◽  
Lower Abdominal Pain ◽  
Cystic Teratoma ◽  
Cystic Mass ◽  
Mature Cystic Teratoma ◽  
Contrast Enhanced ◽  
The Right ◽  
Enhanced Computed Tomography ◽  
Paratubal Cyst

A 30-year-old woman (gravida 0) visited our hospital with a complaint of right lower abdominal pain. Transvaginal ultrasonography revealed a 5-cm swollen right ovary, which was suspected to be a mature cystic teratoma. Pelvic examination revealed moderate pain. Contrast-enhanced computed tomography showed a 44-mm cystic mass containing fat and calcified material in the right pelvis. Since torsion was suspected, emergent laparoscopic surgery was performed. Intraoperative findings were a swollen right ovary without torsion or congestion. Two small pedunculated 1- and 2-cm diameter paratubal cysts that grew from almost the same place of the ampulla of the right fallopian tube were observed. The thin stalk of the 1-cm paratubal cyst was entangled around the stalk of the 2-cm paratubal cyst, with its head congested. Through a small abdominal laparoscopic incision, the tumor of the right ovary and the two paratubal cysts were excised. Histopathological examination revealed that the right ovarian tumor was a mature cystic teratoma, and the two paratubal cysts had no malignancy. This case showed that only a 2-cm tumor with congestion caused the acute abdomen.

scholarly journals Interesting case discussion of a lesion over the right abdominal wall

2019 ◽  
Vol 6 (2) ◽  
pp. 636
Author(s):  
Anand Ignatius Peter ◽  
Souvik Patra ◽  
Samreen Jaffar
Keyword(s):  
Pleural Effusion ◽  
Abdominal Wall ◽  
Malignant Lesion ◽  
Skin Surface ◽  
Liver Lesion ◽  
Interesting Case ◽  
Lumbar Region ◽  
Contrast Enhanced Ct ◽  
Surgical History ◽  
The Right

A diagnosis of hepatic actinomycosis is challenging and often overlooked because of its indiscernible nature and slow rate of progression. This is further complicated with absence of any specific clinical and radiologic manifestations. In this case, a 49 years old male, farmer, with no co-morbidities or significant past medical or surgical history, reported to the department of surgery, with complains of non-healing ulcer over right upper abdomen since five months. Examination of the ulcer led to a clinical suspicion of a malignant lesion. Sonogram of abdomen and pelvic region, which revealed heterogenous lesion with central necrosis in the right lumbar region of the abdominal wall with extension into the skin surface, a heterogenous lesion noted on the liver, and right pleural effusion with the suggestion to consider the possibility of primary skin/abdominal wall tumor with hepatic metastasis with right pleural effusion. Further investigation was performed using contrast enhanced CT scan which also favoured the diagnosis of a malignancy. However, biopsy of the skin lesion was negative for malignancy and it confirmed the diagnosis of Actinomycosis. This diagnosis was further confirmed with an ultrasound guided biopsy of the liver lesion. The patient was then started on appropriate treatment for the same and he recovered well.

scholarly journals Computed Tomography Appearance of the “Whirlpool Sign” in Ovarian Torsion

2021 ◽  
Vol 5 (4) ◽  
pp. 468-469
Author(s):  
Joshua Livingston ◽  
Savannah Gonzales ◽  
Mark Langdorf
Keyword(s):  
Computed Tomography ◽  
Lower Abdominal Pain ◽  
Cystic Mass ◽  
Ovarian Torsion ◽  
Venous Flow ◽  
Contrast Enhanced ◽  
Whirlpool Sign ◽  
Ovarian Pathology ◽  
The Right ◽  
Enhanced Computed Tomography

Case Presentation: A 28-year-old female presented to the emergency department complaining of right lower abdominal pain. A contrast-enhanced computed tomography (CT) was done, which showed a 15-centimeter right adnexal cyst with adjacent “whirlpool sign” concerning for right ovarian torsion. Transvaginal pelvic ultrasound (US) revealed a hemorrhagic cyst in the right adnexa, with duplex Doppler identifying arterial and venous flow in both ovaries. Laparoscopic surgery confirmed right ovarian torsion with an attached cystic mass, and a right salpingo-oophorectomy was performed given the mass was suspicious for malignancy. Discussion: Ultrasound is the test of choice for diagnosis of torsion due to its ability to evaluate anatomy and perfusion. When ovarian pathology is on the patient’s right, appendicitis is high in the differential diagnosis, and CT may be obtained first. Here we describe a case where CT first accurately diagnosed ovarian torsion by demonstrating the whirlpool sign, despite an US that showed arterial flow to the ovary. Future studies should determine whether CT alone is sufficient to diagnose or exclude ovarian torsion.

scholarly journals Laparoscopic Management of Unruptured Interstitial Ectopic Pregnancy

1970 ◽  
Vol 26 (3) ◽  
pp. 147-148
Author(s):  
Shamsun Nahar
Keyword(s):  
Ectopic Pregnancy ◽  
Iliac Fossa ◽  
Signs And Symptoms ◽  
Uterine Wall ◽  
Laparoscopic Excision ◽  
Operative Outcome ◽  
Anterolateral Wall ◽  
Abdominal Examination ◽  
Interstitial Ectopic Pregnancy ◽  
The Right

A 27 years old women para -1 had a complaint of dullache pain in right iliac fossa for 5 days with irregular spotting. Her previous menstrual cycle was normal but in last one month she had an irregular spotting. On examination she was normotensive. Hb% was 65%. there was no tenderness during per abdominal examination but tenderness during per vaginal examination on right side. Transvaginal ultrasonography (TUVS) detected a degenerative sub serous fibroid of 3.5 x 3 cm on the right fundoanterior side, both adnexae were normal, no fluid was present in cul-de-sac. Her pregnancy test was positive but signs and symptoms of pregnancy were absent. Operative plan was intervention by laparoscope. An unruptured interstitial ectopic pregnancy was found at the anterolateral wall of the fundus. Laparoscopic excision was done and the uterine wall sutured with 2/0 polyprolylin. Post operative outcome was good. DOI: 10.3329/jbcps.v26i3.4199 J Bangladesh Coll Phys Surg 2008; 26: 147-148

scholarly journals Non-Steroidal Anti-Inflammatory Drugs: A Rare Cause of Colonic Mass

2021 ◽  
pp. 395-399
Author(s):  
Ahmed Baiomi ◽  
Hafsa Abbas ◽  
Shehriyar Mehershahi ◽  
Myrta Daniel
Keyword(s):  
Lower Abdominal Pain ◽  
Interesting Case ◽  
Right Colon ◽  
Intravenous Contrast ◽  
Colonic Malignancy ◽  
History Of ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
The Right ◽  
Mucosal Thickening

NSAIDs (non-steroidal anti-inflammatory drugs) are one of the most used medications worldwide. Every day they are used by more than 30 million Americans. Here, we report a rare and interesting case of a 63-year-old woman with a history of NSAID use who presented to our emergency room with lower abdominal pain. Computed tomography (CT) scan of the abdomen with intravenous contrast revealed focal mucosal thickening in the cecum which was highly suspicious for colonic malignancy. She had a colonoscopy which showed two masses and ulcers in the right colon, pathology was negative for malignancy and showed inflammation consistent with NSAID colopathy.

scholarly journals Immature Teratoma after Three Laparoscopic Resections for Mature Cystic Teratomas

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Kazuhiro Nishioka ◽  
Naoto Furukawa ◽  
Taketoshi Noguchi ◽  
Hirotaka Kajihara ◽  
Kiyoshige Horie
Keyword(s):  
Ovarian Cyst ◽  
Lower Abdominal Pain ◽  
Immature Teratoma ◽  
High Signal ◽  
Multilocular Cyst ◽  
Contrast Enhanced ◽  
Associated Symptoms ◽  
Cyst Recurrence ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

We report a case in which an immature teratoma developed following three previous resections for mature cystic teratomas. The patient was a 26-year-old nulliparous woman with a regular menstrual cycle. Twelve years earlier, she had consulted a pediatrician for complaints of lower abdominal pain. Bilateral cystic teratomas were suspected and she underwent a left salpingo-oophorectomy and a right cystectomy laparoscopically, and bilateral mature cystic teratomas were diagnosed histologically. She underwent a right cystectomy twice afterwards and mature cystic teratomas were diagnosed. Three years after the third surgery, a regular checkup performed annually for ovarian cyst recurrence revealed a 9.3 cm ovarian cyst by ultrasonography without marker elevation or complaint of symptoms. Magnetic resonance imaging (MRI) showed a 10 cm multilocular cyst, including a part with heterogeneous medium and high-signal intensity on T2-weighted images, which revealed enhancement on dynamic contrast-enhanced MRI unlike the previous images. Ovarian tumors, including immature teratomas and malignancy, were considered. She had a strong wish to undergo laparoscopic surgery. She was diagnosed with an immature teratoma, grade 1 of the right ovary. Although the frequency of recurrence of immature teratomas after resection of mature cystic teratomas is very low, regular checkups are necessary because there may be no associated symptoms.

scholarly journals Pituitary apoplexy presenting as a peripheral rim enhancing parasellar mass lesion with dural enhancement along the tentorium

2017 ◽  
Vol 30 (6) ◽  
pp. 561-567 ◽  
Author(s):  
Laxminadh Sivaraju ◽  
Vinay S Hegde ◽  
Narayanam AS Kiran ◽  
Nandita Ghosal ◽  
Alangar S Hegde
Keyword(s):  
Pituitary Apoplexy ◽  
Sudden Onset ◽  
Interesting Case ◽  
Mass Lesion ◽  
Normal Limits ◽  
Rapid Enlargement ◽  
Life Threatening ◽  
Dural Enhancement ◽  
Dural Tail ◽  
The Right

Pituitary apoplexy is a potentially life-threatening clinical condition caused by rapid enlargement of a pituitary adenoma because of haemorrhage or infarction. The clinical features are typically acute in onset. We report an interesting case of 25-year-old man with complaints of sudden onset of headache and ophthalmoplegia in the right eye one month previously. He had ptosis and complete ophthalmoplegia in the right eye with visual acuity 6/24 and 6/12. Imaging showed a peripheral rim-enhancing mass lesion in the right parasellar and cavernous sinus with a dural tail. He underwent craniotomy and subtotal excision of the lesion. Histopathology was reported as pituitary apoplexy. Hormonal analysis was within normal limits. At two years of follow-up he had complete resolution of ophthalmoplegia and improvement in his vision. It is very uncommon to see pituitary apoplexy evolved in right parasellar region presenting as peripheral rim-enhancing mass lesion.

scholarly journals Airway Foreign Body Mimicking an Endobronchial Tumor Presenting with Pneumothorax in an Adult: A Case Report

Medicina ◽  
2021 ◽  
Vol 57 (1) ◽  
pp. 50
Author(s):  
Jun-Ho Ha ◽  
Byeong-Ho Jeong
Keyword(s):  
Computed Tomography ◽  
Foreign Body ◽  
Chest Tube ◽  
Biopsy Forceps ◽  
Chest Computed Tomography ◽  
Contrast Enhanced ◽  
Lobar Bronchus ◽  
Green Pea ◽  
Airway Foreign Body ◽  
The Right

Foreign body (FB) aspiration occurs less frequently in adults than in children. Among the complications related to FB aspiration, pneumothorax is rarely reported in adults. Although the majority of FB aspiration cases can be diagnosed easily and accurately by using radiographs and bronchoscopy, some patients are misdiagnosed with endobronchial tumors. We describe a case of airway FB that mimicked an endobronchial tumor presenting with pneumothorax in an adult. A 77-year-old man was referred to our hospital due to pneumothorax and atelectasis of the right upper lobe caused by an endobronchial nodule. A chest tube was immediately inserted to decompress the pneumothorax. Chest computed tomography with contrast revealed an endobronchial nodule that was seen as contrast-enhanced. Flexible bronchoscopy was performed to biopsy the nodule. The bronchoscopy showed a yellow spherical nodule in the right upper lobar bronchus. Rat tooth forceps were used, because the lesion was too slippery to grasp with ellipsoid cup biopsy forceps. The whole nodule was extracted and was confirmed to be a FB, which was determined to be a green pea vegetable. After the procedure, the chest tube was removed, and the patient was discharged without any complications. This case highlights the importance of suspecting a FB as a cause of pneumothorax and presents the possibility of misdiagnosing an aspirated FB as an endobronchial tumor and selecting the appropriate instrument for removing an endobronchial FB.

scholarly journals 1003 A Case of Tunnel-Vision in Upper Renal Tract Imaging: The Invisible Gorilla

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Swamad ◽  
M K Quraishi ◽  
S Ahmed
Keyword(s):  
Renal Mass ◽  
Left Kidney ◽  
Interesting Case ◽  
Ct Scans ◽  
Renal Ultrasound ◽  
Ultrasound Scan ◽  
Surgical Team ◽  
Tunnel Vision ◽  
Impact Patient Care ◽  
The Right

Abstract We present an interesting case of a 70-year-old female who presented with haematuria on the suspected cancer pathway. Renal ultrasound showed a vascular renal mass on her right kidney measuring 8x7cm with an unremarkable left kidney. She underwent a laparoscopic radical nephrectomy following confirmation of an 8cm renal mass in the right kidney on the contrasted staging CT scan with a repeat review at the multidisciplinary meeting. Post-operatively a subsequent review of the pre-operative CT and ultrasound scan, showed an incidental large left(contralateral) upper quadrant retroperitoneal fatty mass sized 15x10cm, displacing the stomach and spleen. Further investigation in the form of an MRI Abdomen excluded features of a liposarcoma, resulting in the diagnosis of a large retroperitoneal lipoma. This case highlights the significance of selective attention in imaging interpretation. We believe this to be a prime example of the level of meticulousness required as fat-rich tissues have low attenuation on CT-scans, which can be easily missed out. A cautious multi-clinician interpretation of scans should be performed to avoid missing potentially sinister pathology which would impact patient care dramatically. This case has led to more thorough review of future pre-operative imaging by the operating surgical team.

scholarly journals Cervical Sympathetic Trunk-Centered Inflammatory Myofibroblastic Tumor Complicated with Postoperative First Bite Syndrome

2021 ◽  
Author(s):  
Liu Yang ◽  
Wen Li
Keyword(s):  
Neck Region ◽  
Sympathetic Trunk ◽  
Cervical Sympathetic Trunk ◽  
First Line Therapy ◽  
Normal Limits ◽  
Serum Igg4 ◽  
Postoperative Serum ◽  
Cervical Sympathetic ◽  
The Right ◽  
First Bite Syndrome

AbstractInflammatory myofibroblastic tumors (IMTs) in the head and neck region are common, but those with sympathetic trunk involvement are extremely rare. Here we present a case of cervical sympathetic trunk-centered IMT which is also accompanied by ipsilateral carotid artery, internal jugular vein, and vagus nerve involvement. The patient initially complained of an episodic painful swelling on the right side of the neck and underwent surgery. Preoperative and postoperative serum IgG4 level during 3-year follow-up time is within normal limits. Immunohistochemical study of the tumor has also revealed negativity to IgG4. Postoperative first bite syndrome (FBS) was observed. Surgery seems to be first-line therapy in the patient with IgG4-negative IMT.

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