Ultrasound features of polypoid endometriosis: a case report and a short review of Literature

2021 ◽  
pp. 228402652110530
Author(s):  
Matteo Mancarella ◽  
Luca Giuseppe Sgro ◽  
Luca Fuso ◽  
Paola Campisi ◽  
Nicoletta Biglia ◽  
...  
Keyword(s):  
Ultrasound Examination ◽  
Transvaginal Ultrasound ◽  
Pelvic Mass ◽  
Recurrent Abdominal Pain ◽  
Short Review ◽  
Pathological Examination ◽  
Surgical Removal ◽  
Histopathological Diagnosis ◽  
Histological Architecture ◽  
Polypoid Endometriosis

Introduction: Polypoid endometriosis is a rare variant of endometriosis characterized by histological features resembling an endometrial polyp. Lesions frequently affect the ovaries presenting as adnexal masses which may mimic malignancy, with an extremely complex differential diagnosis due to the poor evidence reported in Literature. Case description: In this report, we describe the case of a 43 years old woman referred to pelvic transvaginal ultrasound examination for recurrent abdominal pain, in whom sonography revealed a pelvic mass with features highly suspicious for ovarian carcinoma. Surgical removal allowed histopathological diagnosis of polypoid endometriosis, with no signs of malignancy. At ultrasound examination, the lesion appeared as a multilocular-solid mass, with low-level echogenicity of cystic content, multiple papillary projections, and solid areas with high vascularization and apparent infiltration of the uterus. At retrospective review of the sonographic images after pathological examination, some features mirroring the histological architecture of polypoid endometriosis could be identified in the solid components of the mass: these included the hyperechoic appearance, the rounded outline of the intracystic projections, and the vascularization pattern with a single central vessel with branching. Conclusions: To date, this is the first work providing a detailed ultrasonographic description of polypoid endometriosis using shared terms and definitions and relating these findings with available evidence about radiologic and histopathologic features. The report shows how this condition could strongly mimick ovarian malignancy, though several sonographic features can be identified reflecting the histopathological patterns of those lesions.

scholarly journals Clinical study on 7 cases of polypoid endometriosis. PEM: a mimic of malignancy, the symptoms of adenomyosis, endometrial polyps and infertility can assist in diagnosis

2021 ◽  
Author(s):  
Xiaohua Zheng ◽  
Ying Xu ◽  
xianjing chen ◽  
Qibing Zheng ◽  
Rong Zhao ◽  
...  
Keyword(s):  
Age Of Onset ◽  
Malignant Tumors ◽  
Clinical Manifestations ◽  
Pelvic Mass ◽  
Abnormal Uterine Bleeding ◽  
Diagnostic Methods ◽  
Pathological Examination ◽  
Rare Type ◽  
Endometrial Polyps ◽  
Polypoid Endometriosis

Abstract Objective: polypoid endometriosis (PEM) is a rare type of endometriosis (EMs), which is easy to be misdiagnosed. The purpose of this paper is to investigate the clinical features and diagnostic methods of PEM. Methods:The clinical data of 7 patients with PEM who were treated at Fujian Provincial Maternity and Children’s Hospital in China within July 2017 to December 2020 period were retrospectively analyzed, and their clinical characteristics, diagnosis, treatment and prognosis were summarized. Results: The age of onset was 31-41 (38.00 ± 1.72) years. There were 5 cases with adenomyosis, 4 cases with endometrial polyps and infertility. The clinical manifestations were diverse. Most of them were pelvic mass, compression symptoms and signs, dysmenorrhea and abnormal uterine bleeding, and three of them were similar to malignant tumors. The gross pathological features were cysts, endogenous or exogenous polypoid masses, which were all composed of endometrioid glands and stromal components, but more diverse than ordinary em. All the 7 patients were confirmed by operation and pathology. Conclusion: PEM is often complicated with adenomyosis, endometrial polyps and infertility. Pathological examination is the gold standard for diagnosis. Imaging examination is easy to be misdiagnosed. Abnormal increase of CA125 can assist in diagnosis.

scholarly journals Autoamputation of the Appendix in a Chronic Adnexal Abscess

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
C. Michele Markey ◽  
Lauren E. Vestal
Keyword(s):  
Gastrointestinal Disease ◽  
Pelvic Mass ◽  
Vermiform Appendix ◽  
Pelvic Abscess ◽  
Definitive Diagnosis ◽  
Pathological Examination ◽  
Preoperative Imaging ◽  
Surgical Removal ◽  
Pathological Review ◽  
The Right

Autoamputation of the appendix has rarely been described in the literature. We present a case of a pelvic mass, thought to be a dermoid cyst based on preoperative imaging. After surgical removal and pathological examination, the mass was found to be a chronic pelvic abscess containing the right adnexa as well as an autoamputated vermiform appendix. Differentiating between gynecologic and gastrointestinal disease preoperatively can be difficult and often a definitive diagnosis cannot be made until surgical exploration and pathological review. However, to our knowledge, this is the first described case of a chronic pelvic abscess containing an autoamputated vermiform appendix.

scholarly journals Coronary Heart Disease and an Incidental Parathyroid Carcinoma

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
M. Stoll ◽  
C. A. Nebiker ◽  
L. Remonda ◽  
R. Grobholz
Keyword(s):  
Parathyroid Carcinoma ◽  
Elevated Serum ◽  
En Bloc Resection ◽  
Pathological Examination ◽  
Surgical Removal ◽  
Histopathological Diagnosis ◽  
En Bloc ◽  
Large Tumor ◽  
Adjacent Structures ◽  
The Right

A 71-year-old woman was admitted with angina pectoris. During hospitalization she developed a myocardial infarction (NSTEMI). Laboratory results revealed a mild elevated troponin and an elevated calcium level (3.35 mmol/l). Subsequently, there was a decreased phosphate (0.36 mmol/l [normal 0.81-1.62 mmol/l]) as well as 16-fold elevated serum level of parathyroid hormone (PTH, 1156 ng/l [normal 10-73 ng/l]), indicating a primary hyperparathyroidism. Sonographically a thyroidal node was detected, not clearly demarcated (TIRADS 5). FNA showed a monomorphic, partial follicular cell population with an immunohistochemical positivity for PTH. Magnetic resonance imaging (MRI) showed a 5 cm large tumor at the right caudal pole of the thyroid with compression of the dorsolateral trachea without infiltration. Surgical removal with en bloc resection of the right hemithyroid with parathyroidectomy was performed. Postoperatively the PTH level dropped to 12.1 ng/l. Pathological examination revealed a 5 cm tumor with infiltration of the thyroid and a perineural invasion. The diagnosis of a presymptomatic parathyroid carcinoma could be established. The affirmative histopathological diagnosis of a parathyroid carcinoma can be challenging and is limited to tumors with evidence of invasive growth in adjacent structures such as the thyroid and/or soft tissue, perineural spaces, angioinvasion of capsular and/or extracapsular vessels, and/or documented metastases.

scholarly journals Benign Cystic Peritoneal Mesothelioma Revealed by Small Bowel Obstruction

2016 ◽  
Vol 2016 ◽  
pp. 1-3 ◽  
Author(s):  
Kaimba Bray Madoué ◽  
Moifo Boniface ◽  
Edzimbi Annick Laure ◽  
Herve Pierre
Keyword(s):  
Small Bowel ◽  
Small Bowel Obstruction ◽  
Bowel Obstruction ◽  
Abdominal Mass ◽  
Pelvic Mass ◽  
Peritoneal Mesothelioma ◽  
Reproductive Age ◽  
Pathological Examination ◽  
Surgical Removal ◽  
Cystic Mesothelioma

Benign cystic peritoneal mesothelioma is a rare tumor which frequently occurs in women of reproductive age. Abdominal pain associated with pelvic or abdominal mass is the common clinical presentation. We report the case of a 22-year-old woman with a pathological proved benign cystic mesothelioma of the peritoneum revealed by a small bowel obstruction and a painful left-sided pelvic mass with signs of psoitis. Contrast enhanced abdominal CT-scan demonstrated a large pelvic cystic mass with mass effect on rectosigmoid and pelvic organs. The patient underwent surgical removal of the tumor. Pathological examination revealed the diagnosis of benign cystic mesothelioma of the peritoneum. The outcome was excellent with a 12-month recoil.

A case of diagnosis of a giant fetal cervical teratoma

2018 ◽  
Author(s):  
S.V. Idimesheva, E.G. Bazhenova, V.A. Vedernikov
Keyword(s):  
Magnetic Resonance Imaging ◽  
Ultrasound Examination ◽  
Mature Teratoma ◽  
Tumor Resection ◽  
Histopathological Diagnosis ◽  
Resonance Imaging ◽  
Cervical Tumor ◽  
Third Trimester ◽  
The Third ◽  
Cervical Teratoma

А case of ultrasound diagnosis of the giant fetal cervical tumor in the third trimester of gestation is presented. The diagnosis of a cervical teratoma was supposed by ultrasound examination and magnetic resonance imaging. The tumor resection was successfully performed at 6 days of life. Histopathological diagnosis was mature teratoma.

scholarly journals Diagnosis, treatment, and misdiagnosis analysis of 28 cases of central nervous system echinococcosis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Guojia Du ◽  
Yandong Li ◽  
Pan Wu ◽  
Xin Wang ◽  
Riqing Su ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Clinical Features ◽  
Multiple Organ ◽  
Pathological Examination ◽  
Surgical Removal ◽  
Surgical Treatments

Abstract Background To explore central nervous system (CNS) involvement in this disease, from the perspectives of diagnosis, treatment, and misdiagnosis Methods Twenty-eight patients with CNS echinococcosis were included in this retrospective study, including 18 males (64.3%) and 10 (35.7%) females. The average age of all the patients were 23.5 years (ranged 4–60 years). Twenty-three (23) patients (82.1%) received the first surgical resection in our hospital. Five (5) patients (17.9%) gave up surgical treatment for multiple-organ hydatidosis and previous surgery history at other hospitals, and albendazole was applied for a long-term (3–6 months) adjunct therapy for the 5 patients. The average follow-up time was 8 years. Results For the 28 patients, 23 cases received surgical treatments, and the diagnosis was confirmed by pathological examinations. The diagnosis of 4 cases of brain echinococcosis and 2 cases of spinal cord echinococcosis could not be confirmed, resulting in a misdiagnosis rate of 21.4% (6/28). For the pathological examination, a total of 17 cases were infected with Echinococcus granulosus (including 2 cases of spinal cord echinococcosis), and 6 cases were infected with Echinococcus alveolaris. Conclusion The diagnosis should be specifically considered in endemic regions. The clinical features of CNS hydatidosis were intracranial space-occupying lesions. For the treatment, the surgical removal of cysts should be necessary. In addition, the adjuvant therapy with drug and intraoperative prophylaxis is also suggested. The misdiagnosis may have resulted from atypical clinical features and radiographic manifestations, as well as the accuracy of hydatid immunologic test.

scholarly journals A rare case of cavernous hemangioma accompanied with diffuse hepatic hemangiomatosis

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Takuji Ota ◽  
Toshiya Kamiyama ◽  
Takuya Kato ◽  
Takayuki Hanamoto ◽  
Kunihiro Hirose ◽  
...  
Keyword(s):  
Oral Contraceptives ◽  
Cavernous Hemangioma ◽  
Contraceptive Use ◽  
Careful Examination ◽  
Pathological Examination ◽  
Surgical Removal ◽  
Adjacent Area ◽  
Oral Contraceptive Use ◽  
History Of ◽  
Magnetic Resonance Imaging Mri

Abstract Background Hepatic cavernous hemangioma (CH) is the most common hepatic benign tumor. Most cases are solitary, asymptomatic, and found incidentally. In symptomatic cases with rapidly growing tumors and coagulopathy, surgical treatment is considered. In rare cases, diffuse hepatic hemangiomatosis (DHH) is reported as a comorbidity. The etiology of DHH is unknown. Case presentation A 29-year-old female patient had a history of endometriosis treated with oral contraceptives. Hepatic CH was incidentally detected in the segment IVa of the liver according to the Couinaud classification. Follow-up computed tomography (CT) and ultrasound sonography showed the growth of the lesion and formation of multiple new lesions near the first. Enhanced CT and magnetic resonance imaging (MRI) revealed that the new lesions were different from CH. Although oral contraceptives were stopped, all lesions grew in size. Malignancy and possibility of rupture of these tumors were considered due to the clinical course, and we opted for surgical removal of the tumors. Left liver lobectomy and cholecystectomy were performed. Surgical findings were small red spot spreading and a mass in segment IV of the liver. Pathological examination revealed a circumscribed sponge-like tumor with diffuse irregular extension to the adjacent area. Both of the lesions consisted of blood-filled dilated vascular spaces lined by flat endothelium without atypia. The diagnosis was hepatic CH with DHH. The patient was discharged on postoperative day 12 uneventfully. Conclusion We report the successful resection of CH with DHH. The case findings suggest a relationship between oral contraceptive use and enlargement of CH and DHH. Although DHH has been poorly understood, a few previously published cases reported DHH occurrence in patients using oral contraceptives. In such cases, the decision to perform surgical resection should be made after careful examination.

Variation in Cervical Length over Time during a Single Transvaginal Ultrasound Examination

2018 ◽  
Vol 36 (08) ◽  
pp. 781-784
Author(s):  
Katherine A. Connolly ◽  
Luciana Vieira ◽  
Elizabeth M. Yoselevsky ◽  
Stephanie Pan ◽  
Joanne L. Stone
Keyword(s):  
Correlation Coefficient ◽  
Intraclass Correlation Coefficient ◽  
Ultrasound Examination ◽  
Transvaginal Ultrasound ◽  
Intraclass Correlation ◽  
Cervical Length ◽  
Linear Mixed Effect Model ◽  
Mixed Effect ◽  
Time Points ◽  
Significant Difference

Objective To quantify the degree of change in cervical length (CL) over a 3-minute transvaginal ultrasound. Study Design We conducted a prospective observational study of nulliparous patients who underwent routine transvaginal CL screening at the time of their second-trimester ultrasound. We recorded CL at four time points (0, 1, 2, 3 minutes) and compared these values to determine the minute-to-minute change within a single patient. Results A total of 771 patients were included. The mean gestational age was 20.8 weeks (±0.84). We used a linear mixed effect model to assess if each minute during the ultrasound is associated with a change in CL. The intraclass correlation coefficient between minute 0 to minute 3 was 0.82 (95% confidence interval: 0.80, 0.84). This indicates that there is a relatively high within-patient correlation in CL during their ultrasound. Additionally, we stratified patients based on their starting CL; the intraclass correlation coefficient remained high for all groups. We additionally compared CL at each minute. Although there is a statistically significant difference between several time points, the actual difference is small and not clinically meaningful. Conclusion The variation in CL over a 3-minute transvaginal ultrasound examination is not clinically significant. It may be reasonable to conduct this examination over a shorter period.

scholarly journals Giant jejunal gasto-intestinal stromal tumor: A rare cause of abdominal mass in an elderly female

2021 ◽  
Vol 1 (2) ◽  
pp. 65-67
Author(s):  
AC Diallo ◽  
A Ndong ◽  
I Niang ◽  
MB Ba ◽  
JA Thiam ◽  
...  
Keyword(s):  
Abdominal Mass ◽  
Pelvic Mass ◽  
Final Diagnosis ◽  
Progressive Increase ◽  
Stromal Tumor ◽  
Biological Assessment ◽  
Pathological Examination ◽  
Tissue Mass ◽  
Surgical Specimen ◽  
One Year

OBJECTIVE: We report the case of a patient presenting an abdominal mass whose final diagnosis is a gastrointestinal stromal tumor (GIST). CLINICAL OBSERVATION: It was a 61-year-old patient with no pathological history received for a progressive increase in the volume of the abdomen evolving for one year and painless. On examination, the patient was in good general condition, with normal patterns. There was an abdomino-pelvic mass of about 20 cm long axis, mobile. The rest of the exam was unremarkable. The biological assessment was normal. Abdominopelvic computed tomography revealed a tissue mass with necrosis. During the surgical exploration, a mass developed on the mesenteric border 45 cm from the Treitz angle was noted. It is not associated with ascites or peritoneal carcinoma. Bowel resection removing the mass was performed followed by end-to-end anastomosis. Pathological examination of the surgical specimen diagnosed GIST. The postoperative course at three months was excellent both clinically and radiologically. CONCLUSION: The case that we report underlines the possible jejunal localization of GIST and the clinical presentation may be usual. It also shows the difficulty of obtaining a preoperative diagnosis and the central role of surgery in management.

scholarly journals DIAGNOSTIC PROBLEMS ACCOMPANYING BRANHYOGENIC CANCER – A CLINICAL CASE

2020 ◽  
Vol 73 (3) ◽  
pp. 614-618
Author(s):  
Uliana D. Matolych ◽  
Svetlana V. Ushtan ◽  
Victoria V. Pankevych ◽  
Kateryna V. Horytska
Keyword(s):  
Head And Neck ◽  
Morphological Analysis ◽  
Clinical Case ◽  
Ultrasound Examination ◽  
Transitional Cell ◽  
Final Diagnosis ◽  
Surgical Removal ◽  
Invasive Squamous Cell Carcinoma ◽  
Bronchial Cancer ◽  
Neck Vessels

Tumours and tumorous lesions of head and neck account for 10% of all oncological pathologies. Branhyogenic cancer is found in 4.5% of patients with lateral cysts in the neck. The article highlights the results of research the clinical case of branhyogenic cancer, provide its clinical and morphological analysis. The aim of our work was to study the clinical case of bronchial cancer, providing clinical and pathomorphological analysis. Examination and treatment was conducted in accordance with the clinical protocol using the diagnostic criteria necessary for management of patients diagnosed with tumours and tumorous lesions in a particular clinical case. We applied ultrasound examination of the locus, angiography of head and neck vessels with tomohexol and with 3D reconstruction, histological examination of surgical specimens (macroscopy and microscopy). On the basis of clinical investigaton, ultrasound examination, angiography clinical diagnosis was formulated – lateral cyst on the left side of the neck. A radical surgical removal of the mass was conducted. Histopathological conclusion: there is a proliferation of cystic transitional cell epithelium with the locus of invasive squamous cell carcinoma in the cystic wall that suggests malignant transformation of bronchogenic cyst. Final diagnosis: branhyogenic cancer. Thorough examination and analysis of a clinical case demonstrates that the development of branhyogenic cancer, is histo-genetically associated with lateral cysts in the neck. Complexity of diagnosing and high percentage of malignancy induces to more early discovery and removal of lateral cysts in the neck .

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