Abdominal Sarcoidosis May Mimic Peritoneal Carcinomatosis

Sarcoidosis is a multisystem inflammatory disorder of unknown etiology. It shows a great variety of clinical presentation, organ involvement, and disease progression. Lungs and lymphoid system are the most common sites involved with a frequency of 90% and 30%, respectively. Extrapulmonary involvement of sarcoidosis is reported in 30% of patients and abdomen is the most frequent site. Furthermore, peritoneal involvement is extremely rare in sarcoidosis. The case presented here described peritoneal manifestations of sarcoidosis without involvement of lungs. A 78-year-old woman possessing signs of malignancy on blood test and abdominal magnetic resonance imaging underwent laparatomy with a suspicion of ovarian malignancy. The macroscopic interpretation during surgery was peritoneal carcinomatosis. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, peritoneal biopsies, total omentectomy, and appendectomy were performed. Final histopathological result revealed the diagnosis of sarcoidosis. Clinicians must keep in mind that peritoneal sarcoidosis can mimic intra-abdominal malignancies.

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Localized Retroperitoneal Lymphangioleiomyomatosis Mimicking Malignancy

Archives of Pathology & Laboratory Medicine ◽

10.5858/2003-127-879-lrlmm ◽

2003 ◽

Vol 127 (7) ◽

pp. 879-882 ◽

Cited By ~ 1

Author(s):

Vilkesh R. Jaiswal ◽

Julie Baird ◽

Jason Fleming ◽

David Scott Miller ◽

Suash Sharma ◽

...

Keyword(s):

Lymph Nodes ◽

Smooth Muscle Actin ◽

Total Abdominal Hysterectomy ◽

Pulmonary Involvement ◽

Abdominal Hysterectomy ◽

Reproductive Period ◽

Unknown Etiology ◽

Muscle Actin ◽

Resonance Imaging ◽

Hmb 45

Abstract Lymphangioleiomyomatosis (lymphangiomyomatosis [LAM]), a rare disease of unknown etiology that is seen only in women usually in the reproductive period, generally presents with features of pulmonary involvement. Extrapulmonary involvement, such as angiomyolipomas and retroperitoneal adenopathy, can occur in up to 75% of cases. It is very rare, however, for patients to present with features of extrapulmonary LAM. We present an unusual, localized case of LAM presenting with neurologic symptoms related to a retroperitoneal mass in a 51-year-old woman. Magnetic resonance imaging showed that the mass involved retroperitoneal lymph nodes, and a clinical diagnosis of atypical sarcoma (possibly from a uterine primary) was made. The mass was resected, and a total abdominal hysterectomy was performed. On pathologic examination, the mass showed classic histologic features of LAM with spread along lymphatic channels in the lymph nodes. Intralymphatic projections simulated lymphatic metastasis; however, the cytologic features were benign. Immunostains revealed the tumor to be positive for smooth muscle actin and desmin, but negative for HMB-45. The uterus was unremarkable, except for a subserosal leiomyoma. Although intratumoral variability for HMB-45 has recently been described, to the best of our knowledge, this is the first documented case of HMB-45–negative, histologically classic LAM. Because of the presence of several atypical features in this case, such as age, location, compressive neurologic presentation, radiologic impression of atypical sarcoma, and HMB-45 negativity, we feel that this case may represent a distinct, as yet uncharacterized variant of LAM.

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A rare case of primary rectal choriocarcinoma and review of the literature

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155219875510 ◽

2019 ◽

Vol 26 (4) ◽

pp. 989-994 ◽

Cited By ~ 2

Author(s):

Tugba A Telli ◽

Nazim C Demircan ◽

Ozkan Alan ◽

Tugba B Tuylu ◽

Rukiye Arikan ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Poor Prognosis ◽

Rare Case ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Resonance Imaging ◽

Abdominal Magnetic Resonance Imaging ◽

Response To Chemotherapy ◽

Β Hcg

Introduction Primary choriocarcinoma of the colon is an extremely rare neoplasm which has a poor prognosis. Only 18 cases have been previously reported in English medical literature. Here we present a case of primary rectal choriocarcinoma with a good response to chemotherapy and review the literature on this uncommon tumor. Case report A 36-year-old woman presented with abdominal pain and vaginal bleeding. Abdominal magnetic resonance imaging revealed 6.9 × 5.3 × 6.4 cm hypervascular mass posterior to uterus very close to rectum. Beta-human chorionic gonadotropin (β-hCG) level was markedly elevated. Low anterior resection of the rectum with lymph node dissection and total abdominal hysterectomy with bilateral salpingo-oophorectomy were performed. Pathologic diagnosis was reported as colonic choriocarcinoma with a focal component of adenocarcinoma. Post-operative magnetic resonance imaging detected multiple metastatic lesions throughout the liver. The patient was treated with systemic chemotherapy using bleomycin, etoposide and cisplatin (BEP protocol). After three cycles, β-hCG level decreased to normal and magnetic resonance imaging showed regression of liver metastasis. However, the patient died of respiratory failure due to bleomycin toxicity and pneumonia accompanied by rapid disease progression. Discussion This is an extremely rare case of primary rectal choriocarcinoma. Due to poor prognosis of the disease, it seems very important to start prompt treatment to improve patient’s survival.

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Iatrogenic Endometriosis and Intrauterine Adhesions after Myomectomy

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1424 ◽

2016 ◽

Vol 8 (3) ◽

pp. 236-238

Author(s):

Farheen Yousuf

Keyword(s):

South Asian ◽

Uterine Cavity ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Resonance Imaging ◽

Intrauterine Adhesions ◽

Ovarian Endometrioma ◽

Imaging Results ◽

Endometrial Cavity ◽

Cut Surface

ABSTRACT Aims To report a case of iatrogenic endometrioses as a result of improper closure of endometrial cavity during myomectomy. Case Report A 30-year-old para 1 has been self-referred to our institution for medical care. A fibroid protruding the endometrial canal was removed 8 months prior to this hospital admission. In less than a month after initial myomectomy, she began experiencing severe pelvic pain more accentuated during menstruation. The pain became progressively worse. The magnetic resonance imaging results are suggestive of ovarian endometrioma. She underwent total abdominal hysterectomy and bilateral salpingo-oophrectomy. Cut surface of uterine cavity shows obliteration of endometrial canal with hourglass constriction. Conclusion Closure of endometrium during myomectomy should be carefully done; keeping an account on patency of endometrial canal is essential to prevent iatrogenic endometriosis. How to cite this article Yousuf F. Iatrogenic Endometriosis and Intrauterine Adhesions after Myomectomy. J South Asian Feder Obst Gynae 2016;8(3):236-238.

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A Case Report of Primary Ovarian Mucinous Adenocarcinoma treated at Dr. Akbar Niazi Teaching Hospital, Bara Kahu, Islamabad

Journal of Rawalpindi Medical College ◽

10.37939/jrmc.v24i4.1348 ◽

2020 ◽

Vol 24 (4) ◽

pp. 430-433

Author(s):

Jahan Ara Saeed

Keyword(s):

Abdominal Distension ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Uneventful Recovery ◽

Ovarian Mass ◽

Resonance Imaging ◽

Risk Of Malignancy ◽

Risk Of Malignancy Index ◽

History Of ◽

Stage 1

Introduction: This is a case of a patient who had a history of grossly increasing abdominal distension for 6 months. The patient had no symptoms except pressure symptoms with a regular menstrual cycle. She initially was investigated as a case of abdominal distension and indigestion. With increasing size, the discomfort was the main symptom. She attended our Gynaecology Outpatient department and was diagnosed as a case of Large Ovarian mass. The first investigation performed was Pelvic ultrasound and Tumour markers and a Risk of malignancy index were calculated. Her Magnetic resonance imaging with contrast showed a large well encapsulated ovarian mass with no ascites and no metastasis. After getting all the investigations and discussion with the patient a Staging Laparotomy with Total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed, The ureters were stented before laparotomy to avoid damage to the ureters during surgery. She was diagnosed as Stage 1-A at the time of surgery and had an uneventful recovery. Her histopathology report showed a unilateral Mucinous cystadenocarcinoma with negative peritoneal wash and omentum histopathology.

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Uterine torsion in non-gravid women: A case report and review of cases reported in the last 20 years

SAGE Open Medical Case Reports ◽

10.1177/2050313x211066649 ◽

2021 ◽

Vol 9 ◽

pp. 2050313X2110666

Author(s):

Harunobu Matsumoto ◽

Yoko Aoyagi ◽

Taisuke Morita ◽

Kaei Nasu

Keyword(s):

Surgical Intervention ◽

Lower Abdominal Pain ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Uterine Leiomyomas ◽

Emergency Laparotomy ◽

Resonance Imaging ◽

Uterine Torsion ◽

Life Threatening ◽

Tomography Scan

Uterine torsion is defined as a rotation of >45° around the long axis of the uterus. Uterine torsion is an uncommon event but is even rarer in non-gravid women, with only 25 cases reported in the last 20 years. Here, we report a case of uterine torsion associated with multiple pedunculated subserosal uterine leiomyomas in an 83-year-old woman. She presented at the hospital with lower abdominal pain, and a computed tomography scan revealed multiple uterine leiomyomas with calcifications. Subsequent magnetic resonance imaging raised suspicion for torsion of pedunculated subserosal uterine leiomyomas. Emergency laparotomy was performed, and the patient was diagnosed with uterine torsion with multiple pedunculated subserosal uterine leiomyomas. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. The patient’s postoperative course was uneventful. Although difficult to diagnose due to its rarity, uterine torsion can be life-threatening and may cause infertility. Therefore, early diagnosis with imaging and surgical intervention are crucial to avoid serious complications.

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A Case of Giant Uterine Lipoleiomyoma Simulating Malignancy

Case Reports in Obstetrics and Gynecology ◽

10.1155/2015/926961 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4

Author(s):

Erbil Karaman ◽

Numan Çim ◽

Gülay Bulut ◽

Gülhan Elçi ◽

Esra Andıç ◽

...

Keyword(s):

Abdominal Cavity ◽

Correct Diagnosis ◽

Total Abdominal Hysterectomy ◽

Fatty Degeneration ◽

Abdominal Hysterectomy ◽

Primary Diagnosis ◽

Uterine Sarcoma ◽

Fatty Tissue ◽

Ovarian Malignancy ◽

Abdominal Magnetic Resonance Imaging

Introduction. Uterine leiomyoma is the most common benign pathology in women and lipoleiomyoma is an extremely rare and specific type of leiomyoma. Here, we report an unusual case of giant pedunculated subserous lipoleiomyoma misdiagnosed preoperatively as leiomyosarcoma.Case. A 45-year-old woman admitted to our gynecology outpatient clinic for complaints of abdominal distention, tiredness, and pelvic pain for the last 6 months. Sonography and abdominal magnetic resonance imaging (MRI) showed a giant semisolid mass that filled whole abdominal cavity from pelvis to subdiaphragmatic area. A primary diagnosis of uterine sarcoma or ovarian malignancy was made. On operation, total abdominal hysterectomy with a pedunculated mass of size 30 × 23 × 12 cm and weighing 5.4 kg and bilateral salpingo-oophorectomy were performed. The histopathology revealed a lipoleiomyoma with extensive cystic and fatty degeneration without any malignancy.Discussion. The diagnosis of leiomyoma is done usually with pelvic ultrasound but sometimes it is difficult to reach a correct diagnosis especially in cases of giant and pedunculated lipoleiomyoma that included fatty tissue which may mimick malignancy.Conclusion. Subserous pedunculated giant lipoleiomyoma should be kept in mind in the differential diagnosis of leiomyosarcoma or ovarian malignancy.

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Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome with remarkably elevated serum IgG4

European Journal of Inflammation ◽

10.1177/1721727x17708940 ◽

2017 ◽

Vol 15 (2) ◽

pp. 131-135 ◽

Cited By ~ 2

Author(s):

Chen Li ◽

Yihan Cao ◽

Wenrui Xu ◽

Wen Zhang

Keyword(s):

Bone Marrow Edema ◽

Elevated Serum ◽

Anterior Chest Wall ◽

Sapho Syndrome ◽

Unknown Etiology ◽

Inflammatory Disorder ◽

Resonance Imaging ◽

Abnormal Immune Response ◽

Serum Igg4 ◽

Magnetic Resonance Imaging Mri

Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare inflammatory disorder with unknown etiology, while the evidence of the association between IgG4 and inflammatory disorders is accumulating. We present the first report of a patient with SAPHO syndrome with remarkably elevated serum IgG4. The clinical features of this 45-year-old male patient included pain of the anterior chest wall and right elbow, bone marrow edema in the ulna suggested by magnetic resonance imaging (MRI), the “bull’s head” sign on the bone scintigraphy, and remarkably increased IgG4 and interleukin-6. This report may indicate a spectrum of diseases with serum IgG4 elevation broader than previously reported. Moreover, it also provides information on the underlying abnormal immune response in SAPHO syndrome.

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Magnetic Resonance Imaging and Flexible Hysterofiberscopic Findings of a Uterine Adenofibroma: Case Report and Literature Review

Case Reports in Obstetrics and Gynecology ◽

10.1155/2018/9685683 ◽

2018 ◽

Vol 2018 ◽

pp. 1-8

Author(s):

Hideki Watanabe ◽

Naoya Harada ◽

Ichiro Nobuhara ◽

Noriko Haruta ◽

Yumi Higashiura ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Resonance Imaging ◽

Perfusion Fluid ◽

Asymptomatic Woman ◽

Contrast Enhanced ◽

Weighted Magnetic Resonance Imaging ◽

Magnetic Resonance Imaging Mri

To our knowledge, highly detailed findings of flexible hysterofiberscopy in patients with adenofibroma have not been described. A 75-year-old nulliparous asymptomatic woman presented with a uterine polyp, which exhibited punctate heterogeneous hyperintensity or islands of isointense-to-hypointense signals on T2-weighted magnetic resonance imaging (MRI), hypointense signals on T1-weighted images (T1WI), and a little enhancement on contrast-enhanced T1WI. Flexible hysterofiberscopy revealed a red-pink polyp with a white-yellow, cobblestone-like surface easily deformed by perfusion fluid. The tumor was diagnosed histologically as an adenofibroma. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. The tumor in the uterus was necrotic macroscopically and histologically, and a residual adenofibroma could not be confirmed. At present, two years after surgery, the patient remains healthy. MRI and hysterofiberscopy can reveal the histological features of uterine adenofibromas and be useful for their diagnosis.

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Subarachnoid Block in a Patient with Ebstein’s Anomaly Posted for Total Abdominal Hysterectomy

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/47470.14548 ◽

2021 ◽

Author(s):

Jayshri Desai ◽

Jayati Bhabutmal Jain ◽

Venkata Suryanarayana Gopavajhula

Keyword(s):

General Anaesthesia ◽

Septal Defect ◽

Clinical Presentation ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Abnormal Development ◽

Ebstein’S Anomaly ◽

Successful Management ◽

Subarachnoid Block ◽

Ebstein's Anomaly

Ebstein’s anomaly is considered to be one of the rare congenital heart conditions which occur due to abnormal development of tricuspid valve and atrialisation of right ventricle and could be associated with either Atrial Septal Defect (ASD) or Patent foramen ovale through which shunting occurs. It might be associated with other cardiac malformations and rhythm disturbances. In such a patient, clinical presentation varies from congestive cardiac failure in childhood to incidental diagnosis in adulthood. If such a patient comes for surgery, it will be a challenging job for anaesthesiologist. Various cases have been reported of successful management either under general anaesthesia or epidural anaesthesia. In order to avoid complications of general anaesthesia, in a case report of 40-year-old female to provide some knowledge and information on the use of subarachnoid block in the case of Ebstein’s Anomaly posted for total abdominal hysterectomy.

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