scholarly journals Misdiagnosis of a Giant Uterine Leiomyosarcoma: Clinic and Image Challenges

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Jila Agah ◽  
Sedighe Karimzadeh ◽  
Fateme Moharrer Ahmadi
Keyword(s):  
Abdominal Distension ◽  
Gastrointestinal Disorder ◽  
Cystic Mass ◽  
Pathology Report ◽  
Uterine Leiomyosarcoma ◽  
Peripheral Tissues ◽  
Chief Complaints ◽  
Magnetic Resonance Imaging Mri ◽  
Diagnostic Modalities ◽  
Serous Cyst Adenoma

A 41-year-old woman (G3P2L2Ab1) was referred to gynecology clinic with chief complaints of abdominal distension and localized abdominal wall pruritus for three months. She was misdiagnosed with gastrointestinal disorder and ultimately had undergone imaging. Ultrasonography and computed tomography (CT) scan disclosed a huge solid-cystic mass originating from the ovary. On clinical examination the patient had no pain or tenderness and no gynecologic complaints. Laboratory tests showed normal tumor markers and hemoglobin at 8 g/dl. Laparotomy was carried out as diagnosis of ovarian serous cyst adenoma, but a huge tumor with attachment to uterus and ovaries and extension to pelvic floor, peripheral tissues of ureter, and upper abdomen was found. Hysterectomy with bilateral salpingooophorectomy was done. Pathology report demonstrated uterine leiomyosarcoma measuring 40 centimeters and weighing 10 kilograms. In conclusion, as pelvic masses even in a large size may present unspecific symptoms misdiagnosis may occur which lead to overgrowth, local invasion, or other complications. So, it is rather to suggest ultrasonography in patients with persistent abdominal or pelvic symptoms and if needed, more exact diagnostic modalities like magnetic resonance imaging (MRI) could be offered to avoid misdiagnosis and mismanagement.

scholarly journals Large intra-abdominal dermoid cyst presenting as small bowel volvulus

2017 ◽  
Vol 4 (9) ◽  
pp. 3188 ◽  
Author(s):  
Suneed Kumar ◽  
Gurudutt Varty
Keyword(s):  
Small Bowel ◽  
Dermoid Cyst ◽  
Surgical Intervention ◽  
Abdominal Distension ◽  
Cystic Mass ◽  
Lower Abdomen ◽  
Small Bowel Volvulus ◽  
Abdominal Emergencies ◽  
Acute Small Bowel Obstruction ◽  
Uncommon Location

Intestinal obstruction is one of the commonest abdominal emergencies requiring surgical intervention. Among its numerous causes, volvulus of the small and large bowel plays a less common aetiological role. This is a rare case of a large intra-abdominal dermoid cyst causing small bowel volvulus and presenting as obstruction. 46-year-old male presented with four-day history suggestive of acute small bowel obstruction, with gross abdominal distension on examination. With minimal investigations, he was explored to reveal a large 10×8 cm sized cystic mass in lower abdomen, with two vascular pedicles causing twisting of small bowel and resultant obstruction. Surgical intervention included unwinding of viable bowel, dividing pedicles and excision of the mass. The cyst was found to contain pultaceous material with hair and solid components. Patient tolerated the procedure well and was asymptomatic on discharge and subsequent follow-ups. This case illustrates an uncommon cause of a common presentation; an uncommon location of a relatively common cystic swelling; and the diagnostic surprise that was encountered during the management, thereby reiterating the need for keen observation and clinical acumen while dealing with such cases.

scholarly journals Diagnostic Dilemma of a Rare, Giant Retroperitoneal Schwannoma: A Case Report and Review of Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Mahendra Singh ◽  
Lovekesh Kumar ◽  
Rajkumar Chejara ◽  
Om Prakash Prasad ◽  
Yuvraj Kolhe ◽  
...  
Keyword(s):  
Low Frequency ◽  
Surgical Excision ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Postoperative Recovery ◽  
Cystic Mass ◽  
Imaging Features ◽  
Diagnostic Dilemma ◽  
Complete Surgical Excision ◽  
Retroperitoneal Schwannoma

Schwannoma is a benign tumour of peripheral nerve sheath. It usually arises from head, neck, and trunk. Retroperitoneal schwannoma is a rare entity, accounting for only 0.3–3% of total schwannomas. Majority of retroperitoneal schwannomas reported in literature have a diameter of 5 to 15 cm. Preoperative diagnosis is difficult due to low frequency, nonspecific clinical course, and nonspecific imaging features. Histology usually provides definitive diagnosis. Schwannomas are solitary, well-circumscribed, and noninvasive, so complete surgical excision provides good result. We report a case of a 23-year-old male, who presented with progressive abdominal distension and intermittent episodes of intestinal obstruction. CECT was suggestive of huge solid-cystic mass in abdominopelvic region. Image guided percutaneous aspiration revealed around 1 litre of frank pus and FNAC was suggestive of abscess. Exploratory laparotomy revealed a large 32 × 28 × 26 cm mass with solid and cystic components containing 1 litre of pus. Histological features of tumour were suggestive of benign schwannoma and immunohistochemistry for S-100 was positive. Postoperative recovery was uneventful. We report this case of a retroperitoneal schwannoma because of giant size, rare location, unusual presentation, and diagnostic dilemma.

scholarly journals Clinical manifestations and imaging features of white matter demyelination in older patients

2020 ◽  
Vol 48 (11) ◽  
pp. 030006052096680
Author(s):  
Jian Li ◽  
Yi-Ming Zhao
Keyword(s):  
White Matter ◽  
Clinical Diagnosis ◽  
Older Patients ◽  
Demyelinating Disease ◽  
Clinical Manifestations ◽  
Imaging Features ◽  
Significant Difference ◽  
Clinical Diagnoses ◽  
Chief Complaints ◽  
Magnetic Resonance Imaging Mri

Objective To investigate the clinical manifestations and imaging features of older patients with white matter demyelination diagnosed by magnetic resonance imaging (MRI). Methods Ninety-six patients with leukoaraiosis diagnosed by MRI were divided by their clinical diagnoses into a demyelinating group (40 cases) and a non-demyelinating group (56 cases). The imaging and clinical features of the patients in the two groups were analyzed. Results Compared with the non-demyelinating group, there were significantly more women in the demyelinating group than men. There was no significant difference in age between the two groups. Of the 37 cases who had an imaging report of “white matter demyelination and multiple sclerosis,” 36 cases had a clinical diagnosis in accordance with white matter demyelination (97.3%). Of the 59 cases who had an imaging report of “white matter demyelination”, only four cases had a clinical diagnosis in accordance with demyelination (6.8%). Conclusion In older patients with headaches, vertigo, other head symptoms, and unilateral numbness as the chief complaints, a clinical diagnosis of demyelinating disease is very unlikely when the imaging report states white matter demyelination only.

Cystic hygroma of the parotid gland

1993 ◽  
Vol 107 (9) ◽  
pp. 855-857 ◽  
Author(s):  
S. Goshen ◽  
D. Ophir Kfar-Saba
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Parotid Gland ◽  
Cystic Hygroma ◽  
Cystic Mass ◽  
Resonance Imaging ◽  
Congenital Neoplasm ◽  
Magnetic Resonance Imaging Mri ◽  
Cystic Masses ◽  
Relationship Of

AbstractCystic hygroma of the parotid gland is an uncommon benign congenital neoplasm that presents as an asymptomatic soft fluctuant mass. Cervical ultrasonography, computerized tomography (CT) and magnetic resonance imaging (MRI) are used to assess the size and extent of the lesion and to assist in planning the surgical approach. Ultrasonography may demonstrate a multilocular cystic mass containing septa of variable thicknesses. Extension of the mass into deeper structures is more accurately assessed by CT or MRI. A CT scan may show thin-walled cystic masses filled with material of density close to that of water. The use of contrast medium can demonstrate the relationship of the lesion to the surrounding structures. Magnetic resonance imaging is superior to CT in defining the nature and extent of the lesion.

Technology Assessment in Different Nations and Lessons from a Cross-Sectional Survey of Magnetic Resonance Imaging (MRI) Diffusion

1985 ◽  
Vol 1 (3) ◽  
pp. 515-536 ◽  
Author(s):  
Paul F. Gross
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cost Effectiveness ◽  
Magnetic Resonance ◽  
Medical Technology ◽  
Resonance Imaging ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Magnetic Resonance Imaging Mri ◽  
Diagnostic Modalities ◽  
Made In

Magnetic resonance imaging (MRI) is a rapidly evolving medical technology which has become widely diffused before comprehensive assessment of its safety, efficacy, cost-effectiveness, and relative cost-effectiveness compared with diagnostic modalities that it seems most likely to replace could be made. In early 1982 there were fewer than ten units worldwide. In August 1984, there were about 150 units and the figure will be closer to 300 by the end of 1985.

scholarly journals Synchronization of Synovial Chondromatosis and Mycobacterium intracellurae Infection in Olecranon Bursitis: A Case Report

2019 ◽  
Vol 22 (1) ◽  
pp. 46-49
Author(s):  
Dong Hyun Kim ◽  
Seunggi Min ◽  
Hyun Joo Lee ◽  
Hee-June Kim ◽  
Hoseok Lee ◽  
...  
Keyword(s):  
Past History ◽  
Mycobacterial Infection ◽  
Synovial Chondromatosis ◽  
Cystic Mass ◽  
Resonance Imaging ◽  
Olecranon Bursitis ◽  
Rice Bodies ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Mri Characteristics

A 73-year-old woman presented with a recurrent cystic mass around her left olecranon. She had a history of 8 steroid injections due to elbow pain beginning 3 years ago and twice had undergone aspiration of olecranon bursitis that developed two months prior to presentation. She had been taking medications for hypertension and diabetes with no pertinent past history. On magnetic resonance imaging (MRI), there were multiple nodules in the olecranon bursa, which were isointense to muscle on T1-weighted images and hyperintense to muscle on T2-weighted images. Our initial diagnosis was synovial chondromatosis. On bursoscopy, masses of gray-white colored nodules were observed in the bursa. Finally, synovial chondromatosis and non-tuberculous mycobacterial infection were concurrently diagnosed. In conclusion, uncalcified synovial chondromatosis and rice bodies can have similar visual and MRI characteristics; therefore, we suggest that clinicians should be aware of the possibility of other infections in cases of this type.

scholarly journals Isolated Fallopian Tubal Torsion Complicated by a Large Hydrosalpinx in a Perimenopausal Woman

2021 ◽  
Author(s):  
Masanori Kanemura ◽  
Atsushi Yoshida ◽  
Akihiko Toji ◽  
Yumi Murayama ◽  
Emi Iwai
Keyword(s):  
Laparoscopic Surgery ◽  
Fallopian Tube ◽  
Acute Abdominal Pain ◽  
Abdominal Cavity ◽  
Ovarian Tumour ◽  
Cystic Mass ◽  
Lower Abdomen ◽  
Acute Pelvic Pain ◽  
Magnetic Resonance Imaging Mri ◽  
Left Fallopian Tube

Adnexal torsion frequently causes acute pelvic pain in women. Ovarian tumour torsion is common; twisting and torsion of a fallopian tube are rare. This report presents a rare case of fallopian tubal torsion requiring the management of a large hydrosalpinx with laparoscopic surgery. A 48-year-old woman reported with acute abdominal pain and lower abdomen tenderness. Transvaginal ultrasonography and Magnetic Resonance Imaging (MRI) showed a cystic mass on the anterior uterine surface. Emergency surgery was performed for a suspected torsion of the left ovarian cyst. In the abdominal cavity, the left fallopian tube was enlarged (neonatal head size), dark purple coloured, and exhibited a 180° torsion; the left ovary was normal. Laparoscopic left salpingectomy was performed and the postoperative course was uneventful. Surgical pathology revealed hydrosalpinx with torsion. As diagnosing isolated fallopian tube torsion before surgery is difficult, laparoscopic surgery is useful in diagnosing and treating isolated tubal torsion.

scholarly journals Novel Method in Performing PTH Washout for Localizing Parathyroid Adenoma: Case Report & an Institute Experience in Qatar

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A265-A266
Author(s):  
Obada Khalil Mohammad Salameh ◽  
Wajiha Gul ◽  
Noora Al-Thani ◽  
Zaina Abdelhalim Alamer ◽  
Tarik A Elhadd ◽  
...  
Keyword(s):  
Surgical Removal ◽  
Pathology Report ◽  
Post Surgery ◽  
Control Tube ◽  
Benign Adenoma ◽  
Sestamibi Scan ◽  
Novel Method ◽  
Diagnostic Modalities ◽  
Operative Findings ◽  
Parathyroid Lesion

Abstract Introduction: Primary hyperparathyroidism (PHPT) is a common cause of hypercalcemia and mostly caused by benign solitary benign adenoma (80 to 85 %). Definite treatment is the surgical removal. The most commonly used diagnostic modalities are Sestamibi scan and neck ultrasound (US) which can be inconclusive in some cases. Parathyroid hormone (PTH) washout obtained with ultrasound guided FNA may be useful to accurately localize the adenoma. In our study we describe a novel method for PTH washout. Methods: First, blood samples are drawn from the patient’s peripheral vein and placed in two yellow top tubes (3 ml of blood in each tube). 1 ml of normal saline (NS) will be add to Tube # 1 (Control tube). The suspected parathyroid lesion aspirate is obtained via US guided FNA. It is washed in 1 ml of NS and added to tube #2 (PTH washout tube). Both tubes are sent to our local laboratory for PTH assay. The ratio of PTH in PTH washout tube to control tube (PTH W/C ratio) is calculated and considered positive if more than 2. Results: Total 16 patients (12 females and 4 males) underwent the PTH washout procedure. All patients had PHPT. Out of 16 patients, 13 had inconclusive Sestamibi scan while 3 patients didn’t have the scan due to pregnancy. PTH W/C ratio was positive in 13 patients (ruled in) and negative (ruled out) in 3 patients. All patients underwent parathyroid surgery. The operative findings and pathology report were consistent with PTH W/C ratio findings. i.e. parathyroid hypercellularity was found in all the 13 patients ruled in by PTH W/C ratio. Post-surgery, biochemical parameters normalized in all. Conclusion: PTH washout is an important tool in localizing parathyroid lesion in PHPT when Sestamibi scan cannot be done or if it is inconclusive. PTH W/C ratio can be performed with our novel method to accurately localize the PTH lesion and improve surgical outcome.

scholarly journals Recurrent Cerebral Astroblastoma with Aggressive Histology: An Uncommon Case

2017 ◽  
Vol 07 (02) ◽  
pp. 150-154
Author(s):  
Sumit Bansal ◽  
Susama Patra ◽  
Pritinanda Mishra ◽  
Ashok Mahapatra
Keyword(s):  
Postoperative Radiotherapy ◽  
Mass Effect ◽  
Cystic Mass ◽  
Cell Of Origin ◽  
Histopathologic Diagnosis ◽  
Adults And Children ◽  
Aggressive Histology ◽  
Uncommon Case ◽  
Magnetic Resonance Imaging Mri ◽  
Lost To Follow Up

AbstractAstroblastomas are uncommon tumors of uncertain histogenesis. Recently tanycyte is postulated to be the cell of origin. These occur predominantly in the cerebral hemisphere of young adults and children. Astroblastoma constitutes approximately 0.45 to 2.8% of all neuroglial tumors. We are reporting a case of 28-year-old woman who presented with headache and double vision. Magnetic resonance imaging (MRI) of the brain revealed well-demarcated, ring-enhancing solid cystic mass in right temporoparietal lobe with significant mass effect. The patient underwent gross total resection of the lesion through right temporoparietal craniotomy. The histopathologic diagnosis was suggestive of astroblastoma. She was advised for postoperative radiotherapy, but she lost to follow-up and again presented 1 year later with recurrent tumor in the same location along with another lesion in infratentorial location. She was reoperated and gross total excision of supra- and infratentorial tumor was done. She also received radiotherapy. We are reporting this uncommon case of astroblastoma and also reviewing the existing literature.

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