scholarly journals Perioperative Management of a Giant Ovarian Tumour in an Adolescence with Severe Scoliosis and Unilateral Diaphragmatic Dysfunction: A Case Report

2021 ◽  
Vol 9 (1) ◽  
pp. 50-57
Author(s):  
Gezy Wita Giwangkancana ◽  
Andi Kurniadi ◽  
Yunita Susanto Putri ◽  
Euis Maryani
Keyword(s):  
Case Report ◽  
Ovarian Tumor ◽  
Perioperative Management ◽  
Abdominal Mass ◽  
Preoperative Assessment ◽  
Ventilator Weaning ◽  
Diaphragmatic Dysfunction ◽  
Severe Scoliosis ◽  
Severe Stage ◽  
Operative Care

Though giant ovarian tumor are rare but due to the limitations in oncology surgery during the COVID-19 pandemic, many oncology patients are presented with a more severe stage and giant ovarian tumors may be more commonly seen during this period. The aim of this case report study was to describe the perioperative management of an adolescent patient with a giant ovarian tumor, severe scoliosis, and unilateral diaphragm dysfunction. An 18-years-old girl weighing 28 kgBW came with a giant abdominal mass that extended to her thoracic and back areas. The patient had a history of severe scoliosis since childhood. She had signs of respiratory distress and was not comfortable lying down. Preoperatively, the surgeon used ultrasonography to guide cyst puncture using a thoracic tube and 6,500 cc of mucinous fluid was drained. Inhalational induction with preservation of spontaneous breathing was performed. Two massive masses filled the entire abdominal area, adhering to the peritoneum while pushing and tenting the diaphragm cranially and laterally to the right and bilateral salpingo-oophorectomy was conducted. Serial radiological examinations showed unilateral diaphragmatic dysfunction and a progressing ventilator associated pneumonia. Improving post-operative outcome of patients with giant intraabdominal masses must include preoperative assessment of potential peri-operative respiratory complications, preparation of intraoperative hemodynamic, and ventilatory disturbances with gentle weaning and multidisciplinary approach during the post-operative care to assess readiness of ventilator weaning.

scholarly journals Challenges for endocrine surgeons: management of a colossal normotensive pheochromocytoma

2018 ◽  
Vol 5 (7) ◽  
pp. 2672
Author(s):  
Zahir Hussain ◽  
Jabamalai Ferdinant ◽  
Senthilkumar M. S. ◽  
Kumaran M. P. ◽  
Saivishnupriya V.
Keyword(s):  
Case Report ◽  
Perioperative Management ◽  
Abdominal Mass ◽  
Unusual Presentation ◽  
Paroxysmal Hypertension

Although the presentation of pheochromocytoma is remarkably protean, it usually presents as sustained or paroxysmal hypertension with triad of headache, palpitation and diaphoresis. The Incidence of serendipitously discovered pheochromocytoma is approximately 4% to 8%. Perioperative management of such cases are not only controversial but also poses infallible challenges to the surgeon. This case report intends to highlight an unusual presentation of asymptomatic, normotensive pheochromocytoma as a huge abdominal mass and its management.

Cystic struma ovarii, a rare form of ovarian tumor – a case report, and review of the literature

2007 ◽  
Vol 148 (48) ◽  
pp. 2285-2287 ◽  
Author(s):  
Gabriella Östör ◽  
Ildikó Tóth ◽  
Zsuzsanna Hrubyné Tóth ◽  
Sándor Bazsa
Keyword(s):  
Case Report ◽  
Ovarian Tumor ◽  
Ca 125 ◽  
Struma Ovarii ◽  
Review Of The Literature ◽  
Rare Form

Az ovarialis strumák a petefészek-teratomák kevesebb mint 3%-át adják. Megjelenhet bennük a pajzsmirigy szinte minden betegsége, és előfordulhat malignitás is. A szerzők esetében egy 31 éves nő bal oldali petefészekcisztáját távolították el, amely az ovariumcarcinoma klinikai tüneteit mutatta, úgymint nagy hasi térfoglalás, ascites, emelkedett szérum-CA 125-szint. A szövettani diagnózis benignus struma ovarii volt. A posztoperatív pajzsmirigyműködés normális maradt.

The case of prenatal diagnosis of a germ cell tumor of the fetal ovary

2018 ◽  
Author(s):  
N.N. Bondarenko, E.Yu. Andreeva , N.B. Filippova
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumor ◽  
Ovarian Tumor ◽  
Ultrasound Examination ◽  
Abdominal Mass ◽  
Abdominal Cavity ◽  
Cell Tumor ◽  
Fetal Ovary ◽  
Entire Abdominal Cavity ◽  
Spontaneous Delivery

A case of prenatal ultrasound diagnosis of a rare congenital ovarian tumor is presented. By ultrasound examination at 36–37 weeks of gestation the intra-abdominal mass 66  47  74 mm occupying the entire abdominal cavity was discovered. At 38 weeks of pregnancy spontaneous delivery occurred with girl weight 2840 g. On the eighth day after birth the child has been successfully undergone surgery. Histological examination revealed congenital germ-cell tumor with structures of dysgerminoma and yolk sac tumor.

scholarly journals P3 A closed loop audit on pre-operative anaemia in major elective orthopaedic surger

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Chan Hee Koh ◽  
Nicolai Gruner-Hegge ◽  
Dancho Ignatov ◽  
Aneesul Shakir ◽  
Chan Hee Koh
Keyword(s):  
Closed Loop ◽  
Perioperative Management ◽  
Consensus Statement ◽  
Preoperative Assessment ◽  
Action Plans ◽  
International Consensus ◽  
Change In Practice ◽  
International Consensus Statement ◽  
Preoperative Anaemia

Abstract Introduction The international consensus statement on perioperative management of anaemia advises that patients with haemoglobin (Hb) <130 be treated before undergoing elective operations. The advantages include reduced risk of acute kidney injuries, infections and transfusions, and quicker recovery. Methods Data was collected prospectively from 127 consecutive patients undergoing elective arthroplasties at Hinchingbrooke hospital. Baseline compliance with the consensus statement was first assessed in May 2018, and the results presented at a clinical governance meeting. Departmental action plans included early identification of anaemia and treatment to Hb 130, delaying operations where necessary. We then reassessed compliance in May 2019. Results There was a statistically significant change in practice (p = 0.036). The proportion of patients undergoing arthroplasties despite Hb < 130 reduced from 38% to 21%. Those operated with Hb < 120 decreased from 14% to 0%. The proportion of preoperative anaemias that were appropriately investigated during preoperative assessment increased from 11% to 80% (p < 0.001). The increase in attempted treatment of preoperative anaemia prior to surgery however was not significant (7% vs 20%; p = 0.279). Discussion Implementation of departmental action plans resulted in substantial improvements to clinical practice. For those that underwent arthroplasties despite mild preoperative anaemia, it may have been felt that delays in improvement to quality of life for treatment may be unacceptable, or the causes (e.g. chronic disease) difficult to treat. Further action plans should involve even earlier identification of anaemia, involving primary care at the point of referral.

scholarly journals Large intraperitoneal lipoleiomyoma in a pre-menopausal woman: a case report

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Sara L. Schaefer ◽  
Amy L. Strong ◽  
Sheena Bahroloomi ◽  
Jichang Han ◽  
Michella K. Whisman ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Smooth Muscle ◽  
Case Report ◽  
Smooth Muscle Actin ◽  
Abdominal Mass ◽  
Histopathological Analysis ◽  
Menopausal Woman ◽  
En Bloc ◽  
Cross Sectional

Abstract Background Lipoleiomyoma is a rare, benign variant of the commonplace uterine leiomyoma. Unlike leiomyoma, these tumors are composed of smooth muscle cells admixed with mature adipose tissue. While rare, they are most frequently identified in the uterus, but even more infrequently have been described in extrauterine locations. Case presentation We describe a case report of a 45-year-old woman with a history of in vitro fertilization pregnancy presenting 6 years later with abdominal distention and weight loss found to have a 30-cm intra-abdominal lipoleiomyoma. While cross-sectional imaging can narrow the differential diagnosis, histopathological analysis with stains positive for smooth muscle actin, desmin, and estrogen receptor, but negative for HMB-45 confirms the diagnosis of lipoleiomyoma. The large encapsulated tumor was resected en bloc. The patients post-operative course was uneventful and her symptoms resolved. Conclusions Lipoleiomyoma should be considered on the differential diagnosis in a woman with a large intra-abdominal mass. While considered benign, resection should be considered if the mass is symptomatic, and the diagnosis is unclear or there is a concern for malignancy.

scholarly journals COVID‐19 complicating perioperative management of LVAD implantation: A case report and systematic review

2021 ◽  
Author(s):  
Deborah de Sá Pereira Belfort ◽  
Bruno Biselli ◽  
Mônica Samuel Ávila ◽  
Maria Tereza Sampaio de Sousa Lira ◽  
Filomena Regina Barbosa Gomes Galas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Perioperative Management

scholarly journals Multiple recurrence of granulosa cell tumor of the ovary: A case report and literature review

2016 ◽  
Author(s):  
Varkha Chandra ◽  
Sandhya Jain ◽  
Neerja Goel ◽  
Bindia Gupta ◽  
Shalini Rajaram
Keyword(s):  
Case Report ◽  
Granulosa Cell ◽  
Adnexal Mass ◽  
Malignant Tumors ◽  
Abdominal Mass ◽  
Pelvic Mass ◽  
Granulosa Cell Tumor ◽  
Cell Tumor ◽  
Surgical Staging ◽  
Granulosa Cell Tumors

Introduction: Granulosa cell tumors comprise approximately 5% of all ovarian malignancy and account for 70% of malignant sex cord stromal tumors. Granulosa cell tumors have been diagnosed from infancy, the peak incidence being perimenopausal age. The potential of malignancy of these tumors is low, recurrences are often late and found in 10-33% of cases. Case Report: A 32-year-old P1L1 presented with large abdominal mass for which she underwent staging laparotomy with debulking surgery. She was a known case of granulosa cell tumor in the past and had undergone three laparotomies, along with chemotherapy. At the age of 13 yrs, she was diagnosed with a stage IA granulosa cell tumor (GCT) of the ovary first time. She underwent surgical staging and removal of left sided adnexal mass, after which she was asymptomatic for 7 years. In 2003 she again presented with lump abdomen for which she underwent resection of adnexal mass, histopathology was consistent with recurrent GCT. After second surgery she also received two cycles of chemotherapy. Despite adjuvant chemotherapy, patient presented again after three years in 2006 with adnexal mass and was found to have a third recurrence. At that time, she received 6 cycles of chemotherapy and the mass regressed. Meanwhile she got married and had one child. After four year in 2010 she again presented with lump abdomen and she underwent surgical staging, total abdominal hysterectomy with right salphingo ophorectomy along with removal of mass. After five year in 2015 she again presented with lump abdomen; there was a large pelvic mass which was removed and patient referred for chemotherapy. Discussion: GCTS which a rare malignant tumors of ovary tend to be associated with late recurrences. Although most recurrences occurs within 10 years after initial diagnosis, there are occasional reports of recurrences after10 years. We experienced the rare case of a patient who relapsed multiple times over 20 years, despite surgical and targeted treatment. Conclusion: The long history of granulosa cell tumor highlights the importance of extended follow up of the patient.

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