Endometrioid adenocarcinoma of the rectovaginal septum with invasion of the rectum: a case report and review of literature

Abstract Background Malignant transformation of endometriosis in the rectovaginal septum is rare and usually misdiagnosed as a colorectal or gynecological tumor. We report a rare case of primary endometrioid adenocarcinoma of the rectovaginal septum with invasion of the rectum. Case presentation A 57-year-old overweight woman presented with vaginal bleeding and self-reported left lower abdominal pain during the previous 2 weeks. Preoperative imaging showed a large pelvic mass with invasion of the rectum, suggestive of a gynecologic malignancy. Multiple endoscopic biopsies and immunohistochemical analyses of specimens was performed. The patient received joint gynecological-surgical laparotomy, and there were no intra- or postoperative complications. The histopathological diagnosis was rectovaginal endometrioid adenocarcinoma with rectum infiltration. The patient received adjuvant chemotherapy and achieved good treatment response, with no early complications. At 12 months after surgery, there was no evidence of recurrence. Conclusions A high index of clinical suspicion is required for the diagnosis of endometrioid adenocarcinoma in the rectovaginal septum. Surgery combined with additional chemotherapy or radiotherapy seems to be a standard treatment, and hormonal therapy is optional. The efficacies of other therapies, including targeted medication and immunotherapy, are unknown.

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Two rare cases of ovarian collision tumor

10.21203/rs.3.rs-37752/v1 ◽

2020 ◽

Author(s):

yan tian ◽

xinshan cao ◽

mimi ma ◽

yunfu cui ◽

qingchao mu

Keyword(s):

Lower Abdominal Pain ◽

Cystic Teratoma ◽

Pelvic Mass ◽

Collision Tumor ◽

Serous Cystadenoma ◽

Biological Behavior ◽

Anatomical Site ◽

Normal Range ◽

Primary Tumors ◽

Case Presentation

Abstract Background: Collision tumor is a clinically rare disease, it is defined as two or more primary tumors from different tissues occurring at the same anatomical site. Ovarian collision tumor is more rare. Case presentation: A patient was hospitalized with a pelvic mass. The CA125 level was 53.46U per milli liter (normal range, 0 to 30u/ml). Another patient was hospitalized with lower abdominal pain and no apparent hormonal abnormalities. Ovarian lesions were found in both patients after examination, and postoperative pathology showed that both patients were ovarian collision tumors. Conclusion: Collision tumor composed of mature cystic teratoma, follicular membranous cell tumor and serous cystadenoma was first reported. The biological behavior of collision tumor is different due to its different components. Accurate diagnosis is of great significance to treatment.

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Retroperitoneal Solitary Fibrous Tumor: A “Patternless” Tumor

Case Reports in Oncological Medicine ◽

10.1155/2017/4634235 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4

Author(s):

D. Myoteri ◽

D. Dellaportas ◽

C. Nastos ◽

I. Gioti ◽

G. Gkiokas ◽

...

Keyword(s):

Solitary Fibrous Tumor ◽

Spindle Cell ◽

Pelvic Mass ◽

Histopathological Diagnosis ◽

Recurrence Rates ◽

Rare Type ◽

Case Presentation ◽

Spindle Cells ◽

Fibrous Tumor ◽

Mesenteric Excision

Introduction. Solitary fibrous tumor is a rare type of mesenchymal, spindle-cell tumor reported mostly in the pleura. Retroperitoneal occurrence is rare and histopathological diagnosis is challenging. Case Presentation. A 55-year-old woman with nonspecific abdominal pain was found to have a retroperitoneal/pelvic mass adjacent to the upper rectum. The patient underwent surgical resection in clear margins of this pelvic tumor, entering the total mesenteric excision surgical plane. Final histopathology revealed a solitary fibrous tumor and the case is presented herein. Discussion. Solitary fibrous tumor in the retroperitoneum is rarely found in the literature and to the best of our knowledge less than a hundred cases are described so far. Histopathological diagnosis is mostly based on a “patternless pattern” on microscopic examination, which is a storiform arrangement of spindle cells combined with a “hemangiopericytoma-like appearance” and increased vascularity of the lesion. Surgery is the mainstay of treatment and recurrence rates are generally low.

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Female Adnexal Tumor of Wolffian Origin Presenting as Paratubal / Broad Ligament Masses: A Case Report

International Journal of Cancer Management ◽

10.5812/ijcm.108336 ◽

2021 ◽

Vol 14 (10) ◽

Author(s):

Sedigheh Ghasemian Dizaj Mehr ◽

Setareh Akhavan ◽

Behnaz Jahanbin ◽

Sharzad Sheikhhasani ◽

Farzaneh Rashidi Fakari

Keyword(s):

Benign Tumor ◽

Frozen Section ◽

Broad Ligament ◽

Pelvic Mass ◽

Conservative Surgery ◽

Rare Type ◽

Case Presentation ◽

Adnexal Tumor ◽

Gynecological Tumor

Introduction: A female adnexal tumor of probable Wolffian origin (FATWO) is a rare type of gynecological tumor that is difficult to diagnose based on laboratory and radiologic studies. Although FATWO is considered a benign tumor, recurrence and metastasis have been reported. Currently, there is no best surgical and surveillance approach for FATWO. We presented two Wolffian tumors as paratubal / broad ligament masses. Case Presentation: This is a report of a 32-year-old woman with vaginal discharge and incidentally pelvic mass diagnosis who underwent conservative surgery with a frozen section based on the Wolffian duct tumor. Immunohistochemically, the results confirmed FATWO. The patient was free of recurrence 20 months after conservative surgery. Conclusions: Although FATWO has benign behavior, some types of this tumor have malignant features, and there is no clear recommendation regarding optimal treatment and surveillance of FATWO. Therefore, based on the literature, pathologists are recommended to utilize a wide array of immunohistochemical stainings to offer appropriate diagnosis and optimal surgery to patients. Moreover, patients should be followed up for a long-term period until we have enough knowledge in the field.

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Laparoscopic surgical management of a mature presacral teratoma: a case report

Surgical Case Reports ◽

10.1186/s40792-019-0702-x ◽

2019 ◽

Vol 5 (1) ◽

Cited By ~ 1

Author(s):

Liming Wang ◽

Yasumitsu Hirano ◽

Toshimasa Ishii ◽

Hiroka Kondo ◽

Kiyoka Hara ◽

...

Keyword(s):

Laparoscopic Resection ◽

Mature Teratoma ◽

Skin Incision ◽

Histopathological Diagnosis ◽

Tailgut Cyst ◽

Resonance Imaging ◽

Presumptive Diagnosis ◽

Case Presentation ◽

Contrast Enhanced ◽

Magnetic Resonance Imaging Mri

Abstract Background Mature presacral (retrorectal) teratoma is very rare. We report a case in which a mature retrorectal teratoma in an adult was successfully treated with laparoscopic surgery. Case presentation A 44-year-old woman was diagnosed with a presacral tumor during a physical examination. Endoscopic ultrasonography (EUS) revealed a multilocular cystic lesion; the lesion was on the left side of the posterior rectum and measured approximately 30 mm in diameter on both contrast-enhanced pelvic computed tomography (CT) and magnetic resonance imaging (MRI). The presumptive diagnosis was tailgut cyst. However, the histopathological diagnosis after laparoscopic resection was mature teratoma. It is still difficult to preoperatively diagnose mature retrorectal teratomas. Conclusions Laparoscopic resection of mature retrorectal teratomas is a feasible and promising method that is less invasive and can be adapted without extending the skin incision.

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Solitary fibrous tumor of the greater omentum: case report and review of literature

Surgical Case Reports ◽

10.1186/s40792-021-01176-w ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Karim M. Eltawil ◽

Carly Whalen ◽

Bryce Knapp

Keyword(s):

Solitary Fibrous Tumor ◽

Management Strategy ◽

Abdominal Mass ◽

Lower Abdominal Pain ◽

Greater Omentum ◽

Team Approach ◽

Review Of Literature ◽

Case Presentation ◽

Multidisciplinary Team Approach ◽

Fibrous Tumor

Abstract Background Solitary fibrous tumor (SFT) is a rare neoplasm of mesenchymal origin occurring most often in the visceral pleura, however, it has been described in almost every anatomic location of the human body. While most SFTs have a benign behavior, they can potentially be locally aggressive and demonstrate a malignant behavior. Case presentation A 63 year-old male patient presented with lower abdominal pain and nausea and was noted on CT to have a large, heterogeneous lower abdominal mass with no evidence of metastatic disease. A surgical resection was performed and the mass appeared to be connected to the greater omentum with a vascular pedicle. It was not invading any intra-abdominal or pelvic organs. Pathology revealed an SFT of omental origin. The mitotic count was less than 4 per 10 high-power fields and all pathologic characteristics did not meet the criteria for a malignant SFT. Conclusions We report an extremely rare case of SFT originating from the greater omentum. A multidisciplinary team approach was followed to plan the patient’s management strategy.

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Clinico-pathological profile of ovarian cysts in a tertiary care hospital

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20174456 ◽

2017 ◽

Vol 6 (10) ◽

pp. 4642 ◽

Cited By ~ 1

Author(s):

Sairem Mangolnganbi Chanu ◽

Biswajit Dey ◽

Vandana Raphael ◽

Subrat Panda ◽

Yookarin Khonglah

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Lower Abdominal Pain ◽

Cystic Teratoma ◽

Serous Cystadenoma ◽

Mature Cystic Teratoma ◽

Ovarian Cysts ◽

Histopathological Diagnosis ◽

Care Hospital ◽

North East

Background: Ovarian cystic neoplasms are common in gynaecological practice. These may pose diagnostic difficulty to the pathologists. This study was conducted to analyse the clinical and histological profile of ovarian cystic neoplasms.Methods: This is a retrospective study done from January 2016 to April 2017 in a tertiary care hospital in North East India. All the patients, who were clinically and radiologically diagnosed as ovarian cysts, which had histopathological confirmation were included in the study. Data including the age, parity, clinical symptoms, laterality and histopathological findings were analysed.Results: A total of 101 patients operated for ovarian cysts in the study period were analysed. The most common clinical presentation was lower abdominal pain. There were 11 (10.9%) malignant cases, 4 (4%) were intermediate grade and borderline in nature, and 85 (84.1%) cases were benign in nature. There was 1 (1%) case of metastasis to ovary. Mature cystic teratoma was most common (20.8%) histopathological diagnosis. The second most common cyst was serous cystadenoma (19.8%).Conclusion: Ovarian cysts are commonly encountered in gynaecological practice and equally encountered by the pathologists. Most commonly found ovarian cysts were mature cystic teratoma followed by serous cystadenoma.

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Large-extension osteosarcoma with involvement of multiple maxillofacial structures: a rare case report

Research Society and Development ◽

10.33448/rsd-v9i10.8461 ◽

2020 ◽

Vol 9 (10) ◽

pp. e1519108461

Author(s):

Rani Iani Costa Gonçalo ◽

Cristiane Kalinne Santos Medeiros ◽

Humberto Pereira Chaves Neto ◽

Janaina Lessa de Moraes dos Santos ◽

Adriano Rocha Germano ◽

...

Keyword(s):

Rare Case ◽

Correct Diagnosis ◽

Malignant Neoplasm ◽

Neck Region ◽

Primary Treatment ◽

Histopathological Diagnosis ◽

Anatomical Structures ◽

Case Presentation ◽

Head And Neck Region ◽

Rare Case Report

Background: Osteosarcoma is a malignant neoplasm that occurs most often in long bones, with the head and neck region being rarely affected, accounting for less than 1% of all cancers in this region. Objective: To report a rare case of a large-extension osteosarcoma with emphasis on its clinical and diagnostic aspects. Case presentation: A 43-year-old woman presenting an intraoral exophytic lesion with involvement of other maxillofacial structures, such as nostril, zygoma and orbit. Despite the initial clinical diagnosis of actinomycosis, an incisional biopsy confirmed the histopathological diagnosis of osteosarcoma, showing a wide morphological variety. Conclusion: This case highlights the importance of clinical and histopathological findings for the correct diagnosis of osteosarcoma. Moreover, it shows that, although surgical resection is the primary treatment for this neoplasia, depending on the extent of the tumor and its proximity to vital anatomical structures, the most appropriate conduct is not always feasible.

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A Case of Cholangiolocellular Carcinoma Preoperatively Diagnosed With Typical Imaging Findings

International Surgery ◽

10.9738/intsurg-d-18-00002.1 ◽

2019 ◽

Vol 103 (1-2) ◽

pp. 72-79

Author(s):

Yoshihiro Mochizuki ◽

Yuji Iimuro ◽

Osamu Suzuki ◽

Yoji Nagashima

Keyword(s):

Preoperative Diagnosis ◽

Imaging Finding ◽

Genomic Analysis ◽

Liver Neoplasm ◽

Preoperative Imaging ◽

Molecular Entity ◽

Imaging Findings ◽

Cholangiolocellular Carcinoma ◽

Case Presentation ◽

Contrast Enhanced

Introduction: Cholangiolocellular carcinoma (CoCC) is a rare primary liver neoplasm. A recent integrative genomic analysis has revealed that CoCC represents a distinct biliary-derived molecular entity. Several cases of CoCC have been reported so far, but accurate preoperative diagnosis was difficult in most cases. Case presentation: We report a case of 70-year-old woman with CoCC. Preoperative imaging findings revealed several typical signs of CoCC (i.e., thick early ring enhancement in the peripheral area of the tumor and its prolongation, vessel penetration through the tumor, no dilatation of the peripheral bile ducts, and dot-/band-like internal enhancement or a target appearance on contrast-enhanced magnetic resonance imaging). We strongly suspected CoCC from these preoperative imaging findings of the tumor and performed extended left hepatectomy. Pathologic diagnosis was CoCC, and the histologic findings such as peripheral highly cellular areas, central abundant hyalinized/edematous fibrotic stroma, and retained Glisson's sheath structures in the tumor, corresponded closely to each preoperative imaging finding. Immunohistochemical study revealed the tumor cells were positive for cytokeratin 7 and epithelial membrane antigen. The postoperative course was uneventful, and the patient is alive without recurrence for 15 months. The prognosis of CoCC is known to be better than that of cholangiocellular carcinoma, indicating the importance of preoperative differential diagnosis of these tumors. Conclusion: Even though preoperative diagnosis of CoCC is difficult because of its rarity, cautious investigation of preoperative typical imaging findings can possibly lead to accurate diagnosis of CoCC.

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Evaluation of female pelvic mass - correlation of clinical and histopathological findings in female patients attending at Birat Medical College and Teaching Hospital, Morang, Nepal

Birat Journal of Health Sciences ◽

10.3126/bjhs.v4i3.27038 ◽

2020 ◽

Vol 4 (3) ◽

pp. 845-849

Author(s):

Seema Kumari Mishra ◽

Roshan Pradhan ◽

Hanoon P Pokharel

Keyword(s):

Clinical Diagnosis ◽

Teaching Hospital ◽

Pelvic Mass ◽

Exploratory Laparotomy ◽

Cross Sectional Study ◽

Histopathological Diagnosis ◽

Female Pelvis ◽

Cross Sectional ◽

Medical College ◽

Pelvic Masses

Introduction: The female pelvis is a quite complex anatomical region consisting of uro-genital system as its main part and other structures like blood vessels, gastrointestinal tracts, lymphatics, nerves and a part of musculoskeletal system. Thus, the differential diagnosis of pelvic masses may be of gynecological or non gynecological origin. Gynecological pelvic masses are uterine, ovarian or adnexal masses which may be benign or malignant. Objective: The objective of this study was to evaluate the type of various gynecological pelvic masses and to correlate the preoperative diagnosis with histopathological diagnosis. Methodology: This was a hospital based cross sectional study conducted on 107 patients from September 2018 to September 2019 at Birat Medical College and Teaching Hospital (BMCTH) with presenting complian of lump in the abdomen. These patients underwent clinical examination, routine and specific investigations along with ultrasonographic evaluation and tumour markers to reach a preoperative clinical diagnosis. Patients were admitted and preanesthetic consultation was done. Patients were taken for therapeutic or diagnostic laparoscopy or exploratory laparotomy and diagnosis were confirmed with histopathological diagnosis. Results: Total 107 patients were enrolled in the study with age ranging from 21 to ≥70 years and among them majority (42.1%) were in the age group of 41-50 years. The most common presenting complain of patients were lower abdominopelvic pain (58.87%). The most common clinical diagnosis was leiomyoma in 39.25% patients followed by adenomyosis in 24.29% patients. The most common histopathological diagnosis was fibroid uterus seen in 42.05% patients. There were 2 (1.86%) patients of ovarian malignancies and 1 (0.93%) patient of uterine malignancy.

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Endometrial Cancer with Sarcoidosis in Regional Lymph Nodes: A Case Report

Case Reports in Oncology ◽

10.1159/000440800 ◽

2015 ◽

Vol 8 (3) ◽

pp. 409-415 ◽

Cited By ~ 2

Author(s):

Satoshi Tamauchi ◽

Yuji Shimomura ◽

Hiromi Hayakawa

Keyword(s):

Endometrial Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Pelvic Lymphadenectomy ◽

Preoperative Imaging ◽

Endometrioid Adenocarcinoma ◽

Regional Lymph Nodes ◽

Lymph Node Swelling ◽

Histological Confirmation ◽

Noncaseating Granulomas

Sarcoidosis is a chronic, multisystemic disease commonly affecting the lungs and lymphatic system and is characterized by the formation of noncaseating granulomas. Although several reports are available on cases developing both sarcoidosis and cancer metachronously, cases of simultaneous diagnosis of these diseases have rarely been reported. A 67-year-old woman diagnosed with endometrial cancer had developed systemic lymph node swelling, including bilateral hilar, paraaortic, and a few pelvic lymph nodes, as observed on preoperative imaging. During surgery, frozen sections of a paraaortic lymph node were examined, revealing noncaseating granulomas compatible with sarcoidosis. Next, modified radical hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy were performed. Postoperative pathological analysis revealed endometrioid adenocarcinoma of the uterus, and no metastasis but noncaseating granulomas were detected in the resected lymph nodes. Postoperatively, we identified cutaneous sarcoidosis and uveitis in the presence of a tuberculin-negative test. On the basis of these findings, we diagnosed the patients with endometrial cancer complicated by sarcoidosis. She underwent adjuvant chemotherapy, and at the 1-year follow-up, the lymph node swelling due to sarcoidosis was stable, and no recurrence of the cancer was observed. This turned out to be a case of early endometrial cancer mimicking advanced cancer by sarcoidosis. Histological confirmation and additional examination for sarcoidosis are necessary in cancer patients suspected of sarcoidosis.

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