Primary peritoneal mucinous cystadenocarcinoma mimicking possible recurrent ovarian mucinous cystadenoma: coincidental pathology or a spectrum of disease?

2021 ◽  
Vol 14 (7) ◽  
pp. e242478
Author(s):  
Claire Filippini ◽  
Sarah Smyth ◽  
Hooman Soleymani Majd ◽  
Catherine Johnson
Keyword(s):  
Magnetic Resonance ◽  
Young Patient ◽  
Management Strategies ◽  
Mucinous Cystadenoma ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Cystic Mass ◽  
Mucinous Cystadenocarcinoma ◽  
Surgical History ◽  
History Of ◽  
Well Differentiated

We present the case of a 32-year-old woman with a previous surgical history of benign mucinous cystadenoma resected in 2012 who underwent magnetic resonance cholangiopancreatography following her second pregnancy in 2020. This demonstrated a large cystic mass in the left subdiaphragmatic space. Histopathology confirmed a well-differentiated primary peritoneal mucinous cystadenocarcinoma displaying cells of a Mullerian origin. We subsequently discuss the aetiology of these conditions separately and explore the possibility of a connection between the two regarding origin or potential malignant transformation that may otherwise have occurred coincidentally in this young patient. We also acknowledge a paucity of evidence regarding subsequent management strategies.

scholarly journals Parenchymal mucinous cystadenoma of the kidney: a case report and literature review

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Mahmoudreza Kalantari ◽  
Shakiba Kalantari ◽  
Mahdi Mottaghi ◽  
Atena Aghaee ◽  
Salman Soltani ◽  
...  
Keyword(s):  
Renal Cyst ◽  
Left Kidney ◽  
Previous History ◽  
Mucinous Cystadenoma ◽  
Single Layer ◽  
Renal Cysts ◽  
Cystic Mass ◽  
Flank Pain ◽  
History Of

Abstract Background Mucinous cystadenoma (MC) of the kidney is exceedingly rare. We found 22 similar cases in the literature. These masses are underdiagnosed due to radiologic similarities with simple renal cysts. Case presentation A 66-year-old man with a previous history of hypertension and anxiety was referred to our tertiary clinic with left flank pain. Ultrasound revealed a 60 mm-sized, complex cystic mass with irregular septa in the lower pole of the left kidney (different from last year's sonographic findings of a simple benign cyst with delicate septa). CT scan showed the same results plus calcification. Due to suspected renal cell carcinoma, a radical nephrectomy was performed. Postoperative histopathologic examination revealed a cyst lined by a single layer of columnar mucin-producing cells with small foci of pseudo-stratification, consistent with the MC’s diagnosis. The first follow-up visit showed normal blood pressure without medication and no flank pain and anxiety after a month. Conclusion It is quite challenging to distinguish the primary MC of the kidney from a simple renal cyst based on clinical and imaging findings. The radiologic features of these entities overlap significantly. Thus, complex renal cyst and renal cysts with mural nodules should be followed closely to detect malignancy earlier.

scholarly journals 417 Initial Choice of Imaging Investigation for Patients Presenting with Acute Pancreatitis: Should MRCP Be First Line in Selected Patients?

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
L Yao ◽  
C Briggs ◽  
P Labib
Keyword(s):  
Acute Pancreatitis ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Abdominal Ultrasound ◽  
Liver Function Tests ◽  
First Line ◽  
Retrospective Audit ◽  
Surgical History ◽  
History Of ◽  
Line Imaging ◽  
Initial Choice

Abstract Introduction Current guidelines for acute pancreatitis advocate abdominal ultrasound (AUS) as the first-line imaging investigation to identify if gallstones are the cause of pancreatitis. However, many patients have a history of cholecystectomy or present with known gallstones and deranged liver function tests (LFTs). In these patients, magnetic resonance cholangiopancreatography (MRCP) is indicated due to its higher sensitivity and specificity for detecting choledocholithiasis. Method This retrospective audit reviewed all consecutive patients who presented to the surgical assessment unit with acute pancreatitis over one month. Their past surgical history, bloods and imaging were reviewed. Results Of the 30 patients, seventeen (57%) had no previous cholecystectomy or known gallstones, nine (30%) had previous cholecystectomy and eight (27%) had known gallstones, seven (88%) of which presented with deranged LFTs. Of the seventeen patients who should have had AUS first (n = 17), thirteen (76%) had AUS first, none had MRCP first and four (24%) had computerised tomography (CT) first. Of the patients in whom MRCP was indicated first-line (n = 13), seven (54%) had AUS first, none had MRCP first, four (31%) had CT first and two (15%) went straight to endoscopic retrograde cholangiopancreatography having had recent outpatient MRCPs. In the seven patients in whom MRCP was indicated but AUS was performed first, six (86%) underwent subsequent MRCP. Conclusions MRCP should be considered the first line imaging investigation for patients presenting with acute pancreatitis and a history of cholecystectomy or known gallstones with deranged LFTs, as AUS rarely prevents the need for subsequent MRCP.

Appendiceal Mucocele of Mucinous Cystadenocarcinoma with a Cutaneous Fistula

2002 ◽  
Vol 30 (4) ◽  
pp. 452-456 ◽  
Author(s):  
A Nakao ◽  
S Sato ◽  
A Nakashima ◽  
A Nabeyama ◽  
N Tanaka
Keyword(s):  
Iliac Fossa ◽  
Right Hemicolectomy ◽  
Cystic Mass ◽  
Japanese Woman ◽  
Mucinous Cystadenocarcinoma ◽  
Appendiceal Mucocele ◽  
Old Japanese ◽  
Well Differentiated ◽  
The Right ◽  
Skin Fistula

We report a novel case of cystadenocarcinoma forming an appendiceal mucocele with development of a skin fistula. The patient was a 75-year-old Japanese woman who originally presented with a skin ulcer on the right flank (inferior to the ribs and superior to the iliac bone) with mucus discharge. The serum concentration of carcinoembryonal antigen was elevated (57.4 ng/ml). Ultrasonography and computed tomography demonstrated a cystic mass with septations in the right iliac fossa. Fistulography from the skin ulceration showed a communication via the fistula to the caecum. A right hemicolectomy and enbloc resection of the skin fistula was performed. The histological findings revealed a well-differentiated mucinous cystadenocarcinoma of the appendix. The patient has been alive for 7 years following surgery without any sign of recurrence. This report is of interest as it demonstrates that tumour rupture to the extraperitoneal space could result in a good outcome by preventing the development of pseudomyxoma peritonei.

scholarly journals Hepatic mucinous cystadenoma of the left liver in a pacient with right hepatectomy for hepatic hydatid cyst

2021 ◽  
Vol 17 (1) ◽  
pp. 52-55
Author(s):  
Bogdan Mihnea Ciuntu
Keyword(s):  
Computer Tomography ◽  
Mucinous Cystadenoma ◽  
Benign Neoplasm ◽  
Hepatic Cyst ◽  
Malignant Degeneration ◽  
Low Grade ◽  
Right Hepatectomy ◽  
Biochemical Tests ◽  
Surgical History ◽  
History Of

Cystadenoma of the liver is a rare benign neoplasm with a intrahepatic ingrowth, with a representation of only 5 % of the hepatic cystic lesions The literature describes the malignant degeneration in average of 10 % of cases. Material and met|hod: We present the case of a 48 year old patient with personal surgical history of right hepatectomy for hepatic hidatic cyst, with a tumoral mass in the epigastric region accompanied by pain that appears spontaneous and by palpation . The abdominal-pelvic computer tomography performed carried out raised the suspicion of hepatic hidatid cyst. During surgery we identified the presence of a serous hepaticcyst inthe segment IV of the liver. The result of the anatomical pathological examinationhas reviled a cystic mucinous neoplasm with low-grade dysplasia (cystadenoma of the liver). Discussion The biochemical tests are in most cases normal, the alkaline phosphatase and Bilirubin can be modified in the case in which the mass creates compression on the biliary ducts. As regards the tumor markers CA 19-9, they can have the value slightly raised; The surgical intervention is the treatment proposed in the majority of cases, within the oncological limits of resection. In this case, the patient’s surgical antecedents (right hepatectomy) have made the resection in oncological limits impossible, the only option being the oncological dispensarisation and periodic biochemical and imaging monitoring . Results The clinical presentations of the hidatid hepatic cyst and hepatic cystadenoma may be similar as well as the imaging scans, such as ultrasonography, computer tomography, magnetic resonance, imaging may not establish a diagnosis of certainty.

scholarly journals The recurrence rate of ovarian endometrioma in women aged 40–49 years and impact of hormonal treatment after conservative surgery

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Nara Lee ◽  
Seunggi Min ◽  
Seyeon Won ◽  
Yeon Jean Cho ◽  
Miseon Kim ◽  
...  
Keyword(s):  
Risk Factor ◽  
Recurrence Rate ◽  
Hormonal Treatment ◽  
Conservative Surgery ◽  
Disease Recurrence ◽  
Cystic Mass ◽  
Time To Recurrence ◽  
Ovarian Endometrioma ◽  
Surgical History ◽  
History Of

Abstract The aim of this study was to evaluate the rate of and risk factors for recurrence ovarian endometrioma after conservative surgery in patients aged 40–49 years. This retrospective, single-center study included 408 women between January 2008 and November 2018. All patients underwent ovarian cyst enucleation, were pathologically diagnosed with ovarian endometrioma and were followed up for ≥ 6 months. Recurrence was defined as a cystic mass with diameter ≥ 2 cm detected by sonography. Recurrence rate after conservative surgery and risk factor of recurrence were analyzed. The median follow-up duration after surgery was 32.0 ± 25.9 months (range 6–125 months). Ovarian endometrioma recurred in 34 (8.3%) of included women and median time to recurrence was 22.4 ± 18.2 months. The cumulative recurrences rate at 12, 24, 36, and 60 months were 3.7%, 6.7%, 11.1%, and 16.7%, respectively. Recurrence was correlated with multilocular cysts (p = 0.038), previous surgical history of ovarian endometrioma (p = 0.006) and salpingectomy (p = 0.043), but not use or duration of post-operative medication. In multivariate analysis, large cyst size (> 5.5 cm) was only risk factor for recurrence in this age group. Post-operative medication did not reduce disease recurrence rate, and thus may be administered for endometriosis-associated pain rather than to prevent recurrence in patients aged 40–49 years.

scholarly journals Retroperitoneal Liposarcoma with Multilocular Cysts

2019 ◽  
Vol 13 (3) ◽  
pp. 514-520 ◽  
Author(s):  
Chika Komine ◽  
Minoru Fukuchi ◽  
Shinji Sakurai ◽  
Yuichi Tabe ◽  
Akihiko Sano ◽  
...  
Keyword(s):  
Signal Intensity ◽  
External Iliac Artery ◽  
Cystic Mass ◽  
Resonance Imaging ◽  
Solid Fat ◽  
Weighted Image ◽  
Intermediate Signal Intensity ◽  
Retroperitoneal Liposarcoma ◽  
History Of ◽  
Well Differentiated

In this study, we describe a 60-year-old man with a giant retroperitoneal liposarcoma with multilocular cysts. He was admitted to our hospital because of a 5-month history of abdominal distention. Abdominal computed tomography revealed a giant lobulated cystic mass occupying the retroperitoneal space that contained partially solid fat components. Magnetic resonance imaging indicated that this complex mass exhibited a low signal intensity on a T1-weighted image, whereas it exhibited a high and focally intermediate signal intensity on a T2-weighted image. This patient was diagnosed with a mucinous type of retroperitoneal sarcoma, which was then resected. During surgery, the tumor was isolated from the retroperitoneum and other organs, but the detachment was required only because of fixation around the left external iliac artery. The histological diagnosis was a well-differentiated liposarcoma with multilocular cysts that contained old bloody, serous, and mucinous fluids, which are a rare phenomenon in liposarcoma. This case indicates that retroperitoneal liposarcoma should also be considered as a differential diagnosis of retroperitoneal cystic mass.

Intraventricular astroblastoma

2008 ◽  
Vol 1 (2) ◽  
pp. 152-155 ◽  
Author(s):  
Luca Denaro ◽  
Marina Gardiman ◽  
Milena Calderone ◽  
Marta Rossetto ◽  
Pietro Ciccarino ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Relevant Literature ◽  
Radical Resection ◽  
Cystic Mass ◽  
Gross Total Resection ◽  
Total Resection ◽  
Initial Surgery ◽  
History Of ◽  
Well Differentiated ◽  
Brain Gliomas

✓Astroblastoma is a rare primary brain neoplasm that accounts for 0.45–2.8% of brain gliomas. Intraventricular localization is extremely rare. The authors report a case of well-differentiated completely intraventricular astroblastoma in a 6-year-old girl and review the relevant literature. Their patient presented with a 5-week history of progressive nausea and vomiting. Magnetic resonance (MR) imaging revealed a large, well-demarcated, solid-cystic mass in the left temporooccipital ventricular horn. Macroscopic radical resection of the tumor was performed via the superior temporal sulcus. The postoperative course was uneventful and no adjuvant therapy was administered after surgery. No recurrence was detected at 9-months follow-up. Gross-total resection has the greatest impact on patient survival. In differentiated tumors, recurrence is usually local, and adjuvant therapy is recommended after repeated resection for the treatment of recurrence. In patients harboring anaplastic astroblastoma, gross-total resection and adjuvant therapy after the initial surgery seems to be the best choice. It is important to distinguish astroblastoma from ependymoma in clinical practice because of the differences in therapeutic approaches.

Magnetic Resonance Imaging of Pseudo-impingement of Rotator Cuff with Strength Training

2019 ◽  
Vol 1 ◽  
pp. 2-6
Author(s):  
Asad Naqvi ◽  
Timothy Ariyanayagam ◽  
Mir Akber Ali ◽  
Akhila Rachakonda ◽  
Hema N. Choudur
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rotator Cuff ◽  
Strength Training ◽  
Radiology Department ◽  
Resonance Imaging ◽  
Subacromial Space ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Training Exercises

Objective: The objective of this study was to outline a novel unique concept of secondary impingement of the muscles, myotendons, and tendons of the rotator cuff from hypertrophy as a result of strength training exercises. Methods: In this retrospective observational study, 58 patients were referred for an magnetic resonance imaging (MRI) by the orthopedic surgeon to the radiology department over a period of 1½ years. All patients gave a history of strength training exercises and presented with clinical features of rotator cuff impingement. Results: We identified features of hypertrophy of rotator cuff muscles, myotendons, and tendons in 12 of these 58 patients. This was the only abnormality on MRI. The hypertrophy of rotator cuff muscles and tendon bulk completely filling the subacromial space to the point of overfilling and resulting in secondary compressive features. Conclusion: Rotator cuff impingement is a common phenomenon that can occur with various inlet and outlet pathological conditions. However, rotator cuff impingement may also result from muscle and tendon hypertrophy from strength training regimens. Hypertrophy of the rotator cuff can result in overfilling of the subacromial space, leading to secondary impingement, which we have termed as “pseudo-impingement.”

Hilar cholangiocarcinoma

2018 ◽  
Vol 1 (3) ◽  
pp. 28-30
Author(s):  
Tanita Suttichaimongkol
Keyword(s):  
Magnetic Resonance ◽  
Hilar Cholangiocarcinoma ◽  
Critical Role ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Resonance Imaging ◽  
Extrahepatic Cholangiocarcinoma ◽  
Case Presentation ◽  
Duct Epithelium ◽  
Bile Duct Epithelium ◽  
High Degree

Cholangiocarcinoma is a primary biliary tract tumor arising from the bile duct epithelium. Classically, these tumors have been categorized according to their anatomic location as intrahepatic and extrahepatic. Hilar cholangiocarcinoma is the most common type of extrahepatic cholangiocarcinoma. It is the most difficult cancer to diagnose and therefore carries a poor prognosis with a 5-year survivalrate of less than 10%. Diagnostic imaging, coupled with a high degree of clinical suspicion, play a critical role in timely diagnosis, staging, and evaluation for surgical resectability. The most common imagingmodalities used for diagnosis and staging of hilar cholangiocarcinoma include ultrasound (US), computed tomography (CT), magnetic resonance imaging/magnetic resonance cholangiopancreatography(MRI/MRCP). This article showed a case presentation and reviewed the imaging appearance of hilar cholangiocarcinoma.   Figure 1  Greyscale sonography at the level of hepatic hilum revealed an ill-defined hilar mass (asterisk)resulting in upstream dilatation of right (arrow) and left (arrow head) main intrahepatic duct.  

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