Ovarian epithelioid angiosarcoma complicating pregnancy: a case report and review of the literature

Epithelioid angiosarcoma is a rare and highly aggressive soft tissue angiosarcoma most commonly arising in the deep soft tissues. Given that abundant vascular cavities anastomose with each other, most angiosarcomas prone to metastasis recur quickly, and the overall prognosis is poor. We report a 25-year-old woman at 24 weeks’ gestation who presented with a 1-month history of abdominal distension. Ultrasonography suggested a mass in the right adnexa, and she underwent two operations owing to uncontrolled intraperitoneal bleeding with progressive anemia. The right ovarian tumor and right adnexa were removed successively. Biopsy yielded a diagnosis of primary epithelioid angiosarcoma with mature cystic teratoma. The patient died from uncontrolled progressive bleeding 1 week after the second operation. This case revealed that epithelial angiosarcoma is a highly malignant endothelial cell tumor. The results of surgery and chemoradiotherapy tend to be poor, and the recurrence rate is high. The purpose of this study is to raise clinical awareness of epithelial angiosarcoma and its adverse events and to provide new ideas for the treatment of these adverse events. Immunohistochemical staining of pathological specimens can facilitate diagnosis. Pregnancy with malignant tumors may lead to rapid disease progression, extensive lesions, and a poor prognosis.

Download Full-text

Resection of a colonic mass following trauma: a diagnostic dilemma

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa226 ◽

2020 ◽

Vol 2020 (7) ◽

Author(s):

Paul Burchard ◽

Alan A Thomay

Keyword(s):

Ct Scan ◽

Abdominal Distension ◽

Exploratory Laparotomy ◽

Symptomatic Improvement ◽

Diagnostic Dilemma ◽

Vehicle Accident ◽

Abdomen Ct ◽

History Of ◽

Mitotic Figures ◽

The Right

Abstract A 53-year-old Caucasian male presented with a 2-week history of abdominal distension, pain, nausea and lethargy. His symptoms began 1 day after an all-terrain vehicle accident during which he suffered blunt-force trauma to his mid-right abdomen. CT scan demonstrated abnormal thickening of the ascending colon and terminal ilium with surrounding inflammation within the retroperitoneum and colonic mesentery. Given his likely mechanism and symptomatic improvement, he was initially managed conservatively. However, he was readmitted with recurrence of symptoms, and a repeat CT scan demonstrated no interval improvement. An exploratory laparotomy was performed and a firm, fixed mass of the right-colon and colonic mesentery was found. Final histopathology of the mass revealed a diffuse lymphoid infiltrate with numerous mitotic figures and apoptotic cells. Immunohistochemical staining was positive for CD45, CD20, CD10, and BCL-6 and negative for CD3, TdT, and BCL-2, indicating a diagnosis of Burkitt lymphoma.

Download Full-text

Acute popliteal thrombus workup leads to discovery of primary peritoneal mesothelioma in the absence of any known asbestos exposure

BMJ Case Reports ◽

10.1136/bcr-2019-232812 ◽

2020 ◽

Vol 13 (2) ◽

pp. e232812

Author(s):

Syed Tausif Ahmed ◽

Matthew Barvo ◽

Nayana Kamath ◽

Richard Alweis

Keyword(s):

Emergency Department ◽

Asbestos Exposure ◽

Anticoagulation Therapy ◽

Abdominal Distension ◽

High Density ◽

Chemotherapy Treatment ◽

Lower Limb Pain ◽

History Of ◽

The Right ◽

Vague Abdominal Pain

A 75-year-old man presented to the emergency department with 1-day history of right lower limb pain and 3-month history of vague abdominal pain. In the emergency department a thrombus was discovered in the right popliteal artery. CT scan of the abdomen and pelvis revealed high-density material in the pelvis, multiple hypodensities on the liver, ascites with omental nodularity, and high-density material along the stomach wall. He underwent thrombectomy and was started on anticoagulation therapy. The core needle biopsy revealed primary omental mesothelioma. There was no history of any known asbestos exposure. He also had to undergo therapeutic paracentesis twice due to abdominal distension. Mesothelioma treatment of carboplatin and pemetrexed was started, and the patient is currently receiving this chemotherapy treatment regimen.

Download Full-text

A Case of Phosphoglyceride Crystal Deposition Disease in the Pelvic Soft Tissues Recurring after Initial Surgery

Case Reports in Obstetrics and Gynecology ◽

10.1155/2015/751582 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Yuki Yamada ◽

Kazuhiro Nishioka ◽

Hirotaka Kajihara ◽

Taketoshi Noguchi ◽

Katsuhiko Naruse ◽

...

Keyword(s):

Soft Tissues ◽

Malignant Tumors ◽

Exploratory Laparotomy ◽

Abdominal Ultrasound ◽

Crystal Deposition ◽

Crystal Deposition Disease ◽

Deposition Disease ◽

Initial Surgery ◽

Abdominal Masses ◽

History Of

Phosphoglyceride crystal deposition disease (PGDD) is a rare disease entity that is characterized by phosphoglyceride crystal deposition that stimulates the formation of masses in soft tissue scars or bones. We report a case of PGDD in the pelvic soft tissues that recurred after initial surgical treatment. A 50-year-old woman was referred to our hospital for the evaluation of pelvic masses that were observed on an abdominal ultrasound. Magnetic resonance imaging (MRI) revealed masses in the pelvic region, with the largest being 10 cm in diameter. The masses were diagnosed as ovarian malignant tumors, and an exploratory laparotomy was performed. Operative findings revealed them to be foreign body granulomas, and the patient was diagnosed with PGDD. The patient had a history of cesarean delivery at the age of 24 years. PGDD is extremely rare, but it should be considered in the differential diagnosis of abdominal masses in patients with a history of abdominal surgery.

Download Full-text

Primary leiomyoma of the ureter: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-021-02960-w ◽

2021 ◽

Vol 15 (1) ◽

Author(s):

Shingo Morinaga ◽

Shigeyuki Aoki ◽

Motoi Tobiume ◽

Genya Nishikawa ◽

Hiroyuki Muramatsu ◽

...

Keyword(s):

Malignant Tumors ◽

Histopathological Examination ◽

Urine Cytology ◽

Benign Tumors ◽

Case Presentation ◽

Old Japanese ◽

Retrograde Pyelogram ◽

History Of ◽

The Right ◽

Enhanced Computed Tomography

Abstract Background Only 14 cases of leiomyoma with ureteral origin have been reported previously. Such primary leiomyomas often present as hydronephrosis, making the diagnosis difficult. Radical nephroureterectomy is often performed because of the possible diagnosis of a malignant tumor. We report the 15th case of primary leiomyoma with a ureteral origin. Case presentation A 51-year-old Japanese man presented with a chief complaint of asymptomatic gross hematuria with a history of hypertension. Enhanced computed tomography showed a tumor at the upper part of the right ureter that appeared to be the cause of hydronephrosis and contracted kidney; no retroperitoneal lymphadenopathy and distal metastasis were observed. A well-defined 20-mm (diameter) defect was identified at the upper of the right ureter on retrograde pyelogram with no bladder cancer on cystoscopy. Urine cytology and right divided renal urine cytology findings were negative. Laparoscopic nephroureterectomy was performed, and the extracted tumor measured 20 × 13 mm. Histopathological examination revealed primary leiomyoma with no recurrence 16 months after the operation. Conclusions Preoperative examination with the latest available ureteroscopic technology can help preserve renal function in the case of benign tumors by enabling preoperative ureteroscopic biopsy or intraoperative rapid resection. Moreover, nephroureterectomy is recommended in the case of preoperative suspicion of ureteral malignant tumors.

Download Full-text

In memory of N.I. Pirogov

Kazan medical journal ◽

10.17816/kazmj48525 ◽

1911 ◽

Vol 11 (1-2) ◽

pp. 5-9

Author(s):

F. Ya. Chistovich

Keyword(s):

Scientific Knowledge ◽

Common Good ◽

Spiritual Power ◽

Human Culture ◽

The Common Good ◽

History Of ◽

New Ideas ◽

The Common ◽

The Right

The significance of individual peoples in the history of human culture is determined by the outcome of scientific inventions and ideological conquests, which they brought to the general progress. The spiritual power of the nation is composed of the efforts of individuals working for the common good by disseminating scientific knowledge and moral ideas. But new ideas are not born every day; they are created by the creativity of outstanding people, national generations, whose spiritual influence does not stop with death, but experiences the personality and bears fruit in the course of centuries and generations. All cultural peoples can proudly read on the pages of their history those immortal names that gave them the right to go in the first ranks along the path of progress. People's heroes are the guarantee of the vitality of the whole nation.

Download Full-text

A New Case of Spontaneous Regression of Inflammatory Hepatic Pseudotumor

Case Reports in Medicine ◽

10.1155/2011/139125 ◽

2011 ◽

Vol 2011 ◽

pp. 1-4 ◽

Cited By ~ 7

Author(s):

Hichem Jerraya ◽

Slim Jarboui ◽

Hassen Daghmoura ◽

Abdeljelil Zaouche

Keyword(s):

Malignant Tumors ◽

Previous History ◽

Percutaneous Biopsy ◽

Contrast Injection ◽

Function Test ◽

History Of ◽

Segment Viii ◽

Histological Confirmation ◽

The Right ◽

Normal Laboratory

Introduction. Inflammatory pseudo-tumors (IPT) of the liver are rare and difficult to diagnose, because mimicking malignant tumors.Aim. We report a case of IPT of the liver wich diagnosis was made on clinical, radiological and evolutif features.Observation. A 15-year-old man had a 4-month history of abdominal pain in the right upper quadrant with fever and cought. Two successives ultrasonographies revealed a hypoechoic lesion occuping the segment VIII with 8 cm of diametre. Physical examination was normal. Laboratory investigation showed normal blood counts, liver function test and tumoral markers. Another ultrasonography was interpretated as normal. Tomodensitometry had showon a 3-cm lesion wich enhanced later after contrast injection. A second tomodensitometry done one mounth later described a 2-cm sub capsular heaptic lesion.Discussion. On routine activiy, pre operative diagnosis of IPT of the liver is difficut, and rarely made with certitude because mimicking a malignant tumor. In our cae report here, the analysis of previous history, of clinical, biological and radiological presentation, had permittes us to pose the diagnosis of PTI of the liver and this despite the absence of histological confirmation by percutaneous biopsy.

Download Full-text

Liposomal doxorubicin-related palmar–plantar erythrodysesthesia (hand–foot syndrome): a case report

Journal of International Medical Research ◽

10.1177/0300060520974854 ◽

2020 ◽

Vol 48 (12) ◽

pp. 030006052097485

Author(s):

Chenxu Ni ◽

Juemin Fang ◽

Hong Qian ◽

Qing Xu ◽

Fuming Shen

Keyword(s):

Adverse Events ◽

Liposomal Doxorubicin ◽

Skin Toxicity ◽

Symptomatic Treatment ◽

Asian Woman ◽

Hand Foot Syndrome ◽

New Ideas ◽

Soles Of The Feet ◽

Hands And Feet ◽

Clinical Awareness

Hand–foot syndrome (HFS) is a skin toxicity that occurs in areas of compressed skin. HFS manifests mainly in insensitive palms and the soles of the feet or in erythematous areas on the extremities caused by chemotherapy, which may be related to the dosage. This paper reports a case of HFS caused by liposomal doxorubicin. A 64-year-old Asian woman presented with severe erythema, ulceration, pruritus, and edema-related pain in her back, hands, and feet after receiving four cycles of liposomal doxorubicin. Clinicians and a pharmacist analyzed and evaluated the patient’s adverse reactions. After symptomatic treatment and patient education, her HFS symptoms were significantly relieved. The purpose of this study was to raise clinical awareness regarding adverse events following liposomal doxorubicin injection, and to provide new ideas for the clinical treatment of these adverse events.

Download Full-text

Silent Hypertensive Crisis in an Adolescent: First Case Report of Pediatric Pheochromocytoma from Indonesia

Global Pediatric Health ◽

10.1177/2333794x211015484 ◽

2021 ◽

Vol 8 ◽

pp. 2333794X2110154

Author(s):

Cahyani Gita Ambarsari ◽

Eka Laksmi Hidayati ◽

Bambang Tridjaja ◽

Chaidir Arif Mochtar ◽

Haryanti Fauzia Wulandari ◽

...

Keyword(s):

Case Report ◽

Hypertensive Crisis ◽

Pediatric Nephrology ◽

Tumor Resection ◽

Secondary Hypertension ◽

Antihypertensive Medications ◽

First Case ◽

History Of ◽

The Right ◽

Clinical Awareness

Secondary hypertension in children, to the rare extent, can be caused by endocrine factors such as pheochromocytoma, an adrenal tumor that secretes catecholamine. Only a few cases have been reported in the past 3 decades. To the best of our knowledge, this is the first case report of pediatric pheochromocytoma from Indonesia. We reviewed a case of a 16-year-old Indonesian boy with history of silent hypertensive crisis who was referred from a remote area in an island to the pediatric nephrology clinic at Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Despite medications, his symptoms persisted for 14 months. At the pediatric nephrology clinic, pheochromocytoma was suspected due to symptoms of catecholamine secretion presented, which was palpitation, diaphoresis, and weight loss. However, as the urine catecholamine test was unavailable in Indonesia, the urine sample was sent to a laboratory outside the country. The elevated level of urine metanephrine, focal pathological uptake in the right adrenal mass seen on 131I-MIBG, and histopathology examination confirmed the suspicion of pheochromocytoma. Following the tumor resection, he has been living with normal blood pressure without antihypertensive medications. This case highlights that pheochromocytoma should always be included in the differential diagnoses of any atypical presentation of hypertension. In limited resources setting, high clinical awareness of pheochromocytoma is required to facilitate prompt referral. Suspicion of pheochromocytoma should be followed by measurement of urine metanephrine levels. Early diagnosis of pheochromocytoma would fasten the optimal cure, alleviate the symptoms of catecholamine release, and reverse hypertension.

Download Full-text

Solitary Fibrous Tumor of Nasal Cavity in Patient With Long-Standing History of Cocaine Inhalation

Archives of Pathology & Laboratory Medicine ◽

10.5858/2004-128-e1-sftonc ◽

2004 ◽

Vol 128 (1) ◽

pp. e1-e4 ◽

Cited By ~ 2

Author(s):

Suman S. Chauhan ◽

Jayshree Krishnan ◽

Denis K. Heffner

Keyword(s):

Nasal Cavity ◽

Solitary Fibrous Tumor ◽

Soft Tissues ◽

S100 Protein ◽

Large Mass ◽

Left Nasal Cavity ◽

Posterior Aspect ◽

History Of ◽

Fibrous Tumor ◽

The Right

Abstract We report a solitary fibrous tumor in the nasal cavity of a 48-year-old woman who presented with a history of bilateral nasal obstruction and long-standing cocaine inhalation. Physical examination revealed a large mass involving the right nasal cavity and extending into the posterior aspect of the left nasal cavity. The computed tomography scan showed opacification of airways. During surgery, the mass was found to involve the entire nasal cavity, with extension to the right maxillary sinus, posterior nasal airways, and left nasal cavity. The mass was completely excised. Pathologic examination revealed a polypoid mass 3.7 × 3.0 × 1.2 cm. This tumor was composed of spindle cells that were cytologically bland in a background of ropey and nodular collagen, giving a “patternless” pattern. Immunohistochemically, the neoplastic cells stained for CD34 and vimentin but not for S100 protein, keratin, desmin, HMB-45, and c-Kit. This immunohistochemical pattern confirmed the diagnosis of solitary fibrous tumor. Although solitary fibrous tumors are usually found in the pleura, they can occur in various other locations, such as the orbit, nasal cavity, paranasal sinuses, mediastinum, breast, vagina, meninges, and soft tissues. This case is of interest because the tumor occurred in a patient with prolonged cocaine inhalation. Such an association has not been previously described. The exact causal relationship between cocaine inhalation and the tumor is not known.

Download Full-text

Periorbital Cellulitis in Children

PEDIATRICS ◽

10.1542/peds.62.3.390 ◽

1978 ◽

Vol 62 (3) ◽

pp. 390-392 ◽

Cited By ~ 2

Author(s):

Roger M. Barkin ◽

James K. Todd ◽

Jules Amer

Keyword(s):

Pediatric Patients ◽

Soft Tissues ◽

Purulent Discharge ◽

Conjunctival Hyperemia ◽

Impaired Vision ◽

Orbital Involvement ◽

Bilateral Involvement ◽

History Of ◽

Local Tenderness ◽

The Right

Inflammation of periorbital tissues is common in pediatric patients, but little information regarding guidelines for treatment is available. The patient with periorbital cellulitis has erythema and swelling of the soft tissues of the eye. The condition is distinguished from more severe orbital involvement by the absence of ophthalmoplegia, proptosis, or impaired vision (Table I).1 This review was initiated to develop bacteriologic data for the treatment of periorbital cellulitis. PATIENT POPULATION Patients hospitalized at the Children's Hospital of Denver between December 1972 and June 1976 with the diagnosis of orbital or periorbital cellulitis were reviewed. Patients with periorbital cellulitis (lid swelling and erythema without ophthalmoplegia, proptosis, or impaired vision) were analyzed; clinical, bacteriologic, and roentgenographic data were obtained. A positive blood or cellulitis aspirate culture was required to prove a bacteriologic cause. Roentgenograms were interpreted by two pediatric radiologists. FINDINGS Seventy-one cases of periorbital cellulitis without orbital involvement were identified during the study period. Children ranged in age from 10 days to 18 years; 41 (58%) were 4 years of age or younger. The right periorbital tissues were involved in 39 patients (55%) and the left in 28 (39%); bilateral involvement was noted in four. A temperature greater than 37.8 C (100 F) was documented on the day of admission in 52 (73%) children; 34 (48%) had temperatures greater than 38.3 C (101 F). Although not a presenting complaint, 19 (27%) exhibited mild conjunctival hyperemia without purulent discharge. Clinical sinusitis manifested by a history of drainage, pain, or local tenderness was noted in ten (14%) patients.

Download Full-text