scholarly journals A case of broad ligament leiomyoma presenting as an ovarian mass

2017 ◽  
Vol 6 (6) ◽  
pp. 2635
Author(s):  
Rajesh Kumari ◽  
Vandana Vaishya ◽  
Vidushi Kulshrestha ◽  
Jai Bhagwan Sharma ◽  
Alka Kriplani
Keyword(s):  
Histopathological Examination ◽  
Abdominal Cavity ◽  
Broad Ligament ◽  
Lower Abdominal Pain ◽  
Abdominal Distension ◽  
Ovarian Tumour ◽  
Ca 125 ◽  
Cystic Degeneration ◽  
Limited Mobility ◽  
Computer Tomography Scan

The broad ligament is the commonest extra uterine site for the occurrence of leiomyoma but with a very low incidence rate. It poses both clinical and radiological challenge in differentiating from an ovarian tumour. A 25-year-old unmarried female presented with history of lower abdominal pain associated with rapidly increasing abdominal distension for last 3 months. General physical examination was unremarkable. Examination of the abdomen revealed a firm, non-tender mass, with limited mobility arising from the pelvis corresponding to a uterine size of 32 weeks. Ultrasonography of abdomen revealed a 20×17×11cm right adnexal multi-loculated cyst. Contrast enhanced computer tomography scan of abdomen and pelvis showed a 12×17×17 cm well defined cystic lesion arising from the pelvis and ascending in to the abdominal cavity. The lesion also showed internal septa and peripheral rim enhancement. Right ovary was not seen separately. Tumor markers including CA-125 (22.4 IU/ ml), CEA (1.83/ml), CA-19.9 (22U/ml), Beta HCG (1.20IU/ ml), LDH (1.17IU/ml), and alpha feto-protein (0.8 ng/ml) were within normal limit. Laparotomy revealed a cystic mass arising from the right broad ligament. Histopathological examination revealed a broad ligament leiomyoma with extensive cystic degeneration. Broad ligament leiomyoma is uncommon tumour of pelvis and its differentiation from ovarian masses may be challenging for the clinicians. 

scholarly journals ADENEXAL CYSTS

2011 ◽  
Vol 18 (01) ◽  
pp. 32-40
Author(s):  
TEHREEN RIAZ ◽  
SARWAT JABEEN ◽  
WASEEM TALIB ◽  
Nabeela Shami
Keyword(s):  
Demographic Data ◽  
Lower Abdominal Pain ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Ovarian Tumour ◽  
Risk Of Malignancy ◽  
Histopathologic Evaluation ◽  
Operative Findings

Objectives: (1) To evaluate the risk of malignancy in surgically removed ovarian cysts that was before the operation neither simple nor complex. (2) To determine the relationship of age with type of ovarian tumour. (3) To categorize the management of these cases according to the intra-operative findings. (4) To analyze the occurrence of various histopathological types of tumour. Date Source: Medline Study Design: Single centered prospective descriptive study of 150 cases. Place and Duration of Study: Department of Obstetrics and Gynaecology at Shaikh Zayed Hospital Lahore from 1st July 2005 to,31st December 2006. Subject and method: 150 patients presented with adnexal cysts on preoperative ultrasonography, peroperative findings and histopathology reports. These patients were followed up in OPD. Results: Showed the distribution of non-neoplastic and neoplastic tumours which were 84% and 16% respectively. The occurrence of malignancy increased with advancing age especially after 45 years Common presentations were lower abdominal pain (53%) followed by menstrual disturbances (30%), abdominopelvic mass, abdominal distension and infertility. Risk of malignancy also increased with parity. 73% masses were unilateral, 84% benign masses were unilocular whilst 85% malignant masses were echogenic and the complex cysts with papillary projection and multiloculations showed 3-6 times higher risk of malignancy. Most patients were managed by exploratory laparotomy. Cystectomy and total abdominal hysterectomy were the commonest procedures performed. Regarding histopathologic evaluation 40% patients had tumours, 2.66% borderline malignancy and 13.3% malignant. 44% had non-neoplastic lesions. Serous and endometriotic cysts were the commonest benign histopathologic types and among malignant ones, epithelial ovarian tumours were the leading variants. Conclusions: Preoperative characterization of adnexal masses using sonographic and demographic data may have considerable potential in determining risk of malignancy and may be advantageous in terms of counseling patients for management.

scholarly journals Broad Ligament Fibroid Mimicking as Ovarian Tumor on Ultrasonography and Computed Tomography Scan

2013 ◽  
Vol 3 ◽  
pp. 8 ◽  
Author(s):  
Dayananda Kumar Rajanna ◽  
Vaibhav Pandey ◽  
Sujit Janardhan ◽  
Sujatha N Datti
Keyword(s):  
Adnexal Mass ◽  
Histopathological Examination ◽  
Broad Ligament ◽  
Ovarian Neoplasm ◽  
Cystic Degeneration ◽  
Resonance Imaging ◽  
Computed Tomography Scan ◽  
Computed Tomographic ◽  
Contrast Enhanced ◽  
Tomography Scan

Giant fibroids are known to arise from the uterus, and very rarely from the broad ligament. Large fibroids often undergo hyaline, cystic, and at times, red degeneration. In the present case, cystic degeneration with intervening septations in an adnexal mass raised the suspicion of ovarian neoplasm as the ovaries were not seen as separate from the lesion. The ultrasonographic and contrast-enhanced computed tomographic findings of this case were characteristic of ovarian neoplasm. The differential diagnosis included rare possibility of giant fibroid with cystic degeneration. The diagnosis was confirmed on histopathological examination. The patient underwent excision of the broad ligament fibroid, hysterectomy, and bilateral salpingo-oophorectomy. Magnetic resonance imaging has a role in the diagnosis of such lesions.

scholarly journals Leiomyoma of Broad Ligament Mimicking Ovarian Malignancy– Report of a Unique Case

2015 ◽  
Vol 12 (3) ◽  
pp. 219-221
Author(s):  
D Mallick ◽  
M Saha ◽  
S Chakrabarti ◽  
J Chakraborty
Keyword(s):  
Histopathological Examination ◽  
Broad Ligament ◽  
Cystic Mass ◽  
Reproductive Age ◽  
Ca 125 ◽  
Resected Specimen ◽  
Benign Tumors ◽  
Ovarian Malignancy ◽  
Unique Case ◽  
The Right

Tumors of the broad ligament are uncommon. Leiomyoma, which is the commonest female genital neoplasm, is also the most common solid tumor of the broad ligament. Leiomyomas affect 30% of all women of reproductive age but the incidence of broad-ligament leiomyoma is <1%. These benign tumors are usually asymptomatic. A case is being described where a 52 year old presented with gradual abdominal swelling which was clinically and radiologically diagnosed as ovarian malignancy. On abdominal and bimanual palpation a soft cystic mass was noted in the right pelvic region. CA 125 was mildly raised. CEA, CA 19.9 levels were within normal limit. The radiological diagnosis was ovarian cyst with possibility of malignant changes. Staging laparotomy and histopathological examination of the resected specimen revealed a right sided broad ligament leiomyoma with cystic changes. The degenerative changes in the leiomyoma lead to the clinical and radiological diagnostic confusion. Thus, though uncommon, broad ligament leiomyoma should be considered during evaluation of adnexal masses for optimal patient management. The above description of leiomyoma in the broad ligament is a highly unique case and thus deserves appropriate attention.Kathmandu University Medical Journal Vol.12(3) 2014; 219-221

scholarly journals Giant angioleiomyoma of uterus masquerading as ovarian tumour: a case report

2019 ◽  
Vol 9 (1) ◽  
pp. 437
Author(s):  
Purnima Bhandari ◽  
Anil C. Humane ◽  
Vaishali S. Deshmukh
Keyword(s):  
Case Report ◽  
Unusual Case ◽  
Histopathological Examination ◽  
Broad Ligament ◽  
Exploratory Laparotomy ◽  
Ovarian Tumour ◽  
Benign Tumour ◽  
Diagnosis And Management ◽  
Rare Benign Tumour

Angioleiomyoma is a rare benign tumour of uterus. We are presenting an unusual case of 45-year-old female with 11 kg giant angioleiomyoma of uterus which was masquerading as ovarian tumour on imaging. Exploratory laparotomy was done which was suggestive of huge lobulated mass arising from the uterus. Hysterectomy with bilateral salpingo-oophorectomy was done. Histopathological examination of specimen was suggestive of uterine subserosal and broad ligament angioleiomyoma of cavernous type. This case is being reported because of its rarity and challenges in diagnosis and management.

scholarly journals Giant solid mesenchymal hamartoma of the liver in a neonate: case report

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Moaied A. Hassan
Keyword(s):  
Histopathological Examination ◽  
Abdominal Cavity ◽  
Surgical Excision ◽  
Abdominal Distension ◽  
Mesenchymal Hamartoma ◽  
Complete Excision ◽  
Inferior Aspect ◽  
Benign Liver Tumor ◽  
Right Lobe ◽  
The Right

Abstract Background Mesenchymal hamartoma is the second most common benign liver tumor in children, with 20% of the cases diagnosed during the neonatal period. The exact etiology in still unclear, and most investigators believe that it is a developmental anomaly rather than a true neoplasm. The presentation of these tumors is highly variable depending on the lesion’s size, ranging from small asymptomatic lesions to very large tumors with life threatening complications. Radical surgical excision, whenever possible, is the gold standard for treating these lesions to avoid the problems of local recurrence and possible malignant transformation. We present the rare occurrence of an entirely solid, giant hepatic mesenchymal hamartoma in a 3-week-old male newborn and discuss the mode of presentation, as well as the diagnostic and therapeutic approach. Case presentation A 3-week-old male newborn was referred to our institution with huge abdominal distension and respiratory distress. Imaging studies confirmed the presence of a very large solid intraabdominal mass occupying the majority of the abdominal cavity and abutting the inferior aspect of the right lobe of the liver, but did not reveal the diagnosis. At laparotomy, a huge solid mass was found attached to the right lobe of the liver. Complete excision was done, and histopathological examination confirmed the diagnosis of mesenchymal hamartoma. Conclusion Although rare, mesenchymal hamartoma of the liver can present as a neonatal surgical emergency. Emergency intervention is required in symptomatic patients. Radical surgical intervention is possible and is the treatment of choice to relieve the patient’s symptoms and avoid future complications.

scholarly journals Hyperreactio luteinalis: benign disorder masquerading as an ovarian malignancy

2018 ◽  
Vol 6 (5) ◽  
pp. 1815
Author(s):  
Kaur P. P. ◽  
Ashima . ◽  
Isaacs R. ◽  
Goyal S.
Keyword(s):  
Histopathological Examination ◽  
Costal Cartilage ◽  
Lower Abdominal Pain ◽  
Ca 125 ◽  
Ovarian Malignancy ◽  
Bilateral Oophorectomy ◽  
Maternal Complications ◽  
Pouch Of Douglas ◽  
The Masses ◽  
Ovarian Masses

Hyperreactio luteinalis (HL) refers to pregnancy related moderate to marked enlargement of the ovaries due to multiple benign theca lutein cysts. It is caused due to elevated Human chorionic gonadotropins leading to maternal complications such as preeclampsia and preterm delivery may result. We report case of a 24 years old lady, G3P1A1L1 with spontaneous twin pregnancy at 13 weeks + 4 days gestation presented with chief complaint of lower abdominal pain on exertion for 5 days. Ultrasonography (USG) showed a large left ovarian mass in Pouch of Douglas pushing uterus up and extending into the left side of midline upto costal cartilage. It showed multiple thick septations with vascularity pointing towards malignancy. CA-125 was elevated to 193U/ml. Laparotomy was undertaken. Intraoperatively, bilateral huge, congested, bosselated, multicystic ovarian masses were present which replaced normal ovaries and appeared malignant. Bilateral oophorectomy was done. Specimens received for histopathological examination comprised of two large multilobulated, dark brown, ovarian masses with intact glistening capsule. Serial sections through both the masses showed thin walled, multiloculated cysts with smooth inner lining, filled with thin clear to hemorrhagic fluid. On microscopic examination diagnosis of Hyperreactio luteinalis, bilateral ovarian masses were made. HL can be misinterpreted on USG or laparotomy as ovarian malignancy resulting in unnecessary surgical intervention.

A prospective observational study on the effectiveness of risk of malignancy index score (RMI 3) in a tertiary care centre in Eastern India

2020 ◽  
Vol 11 (5) ◽  
pp. 54-60
Author(s):  
Apurba Mandal ◽  
Shibram Chattopadhyay ◽  
Sushanta Mondal ◽  
Arunava Biswas
Keyword(s):  
Ovarian Cancer ◽  
Adnexal Mass ◽  
Malignant Tumors ◽  
Histopathological Examination ◽  
Tertiary Care ◽  
Ca 125 ◽  
Tertiary Care Centre ◽  
Gynecology And Obstetrics ◽  
Risk Of Malignancy ◽  
Malignant Lesions

Background: Adnexal mass is a common presentation in today’s gynecological practice. The incidence of ovarian cancer is increasing day by day and diagnosis is often difficult to be made pre operatively with inadequate surgical exploration is a regular occurrence. Aims and Objectives: To assess and validate the importance of RMI-3 score as pre-operative diagnostic tool of differentiating benign from malignant adnexal mass for starting first line therapy of ovarian cancer and to find out the incidences of ovarian malignancy among study population. Material and Methods: The study was conducted in the Department of Gynecology and Obstetrics on (n=115) patients attending GOPD and indoor with adnexal mass fulfilling the inclusion and exclusion criteria using purposive sampling technique. All the selected cases underwent ultrasonography and serum CA- 125 level estimation necessary for calculating RMI score. A score of >200 was taken as suggestive of malignancy and confirmatory diagnosis was performed by histopathological examination obtained from staging laparotomy of adnexal mass. The individual scores were then correlated with final outcomes with statistical analyses. Results: The study revealed benign ovarian tumors are more under 50 years (78.46%) and patients with normal BMI are diagnosed with maximum of malignancy (n = 28). History of tubal ligation carried less risk of malignancy (p<0.0001). Histologically malignant tumors found mostly in 71.4% postmenopausal group whereas 94.1% benign pathology were present in perimenopausal group and there is no association found between parity and histopathology (p=0.058). Bilateral (p=0.013), multilocular (p=0.000) tumors with solid areas (p<0.0001) and thick papillary projections (p<0.0001) had statistically significant association with malignant lesions. RMI score (>200) had more efficacy than serum CA-125 level (>46) in differentiating malignant lesions from benign one in terms of specificity (96% vs 83.87%) and positive predictive value (95% vs 79.17%). Conclusions: RMI-3 score is a simple, reliable and effective tool in differentiating benign from malignant adnexal masses thereby help in quick referral and management of cases with increase chances of survival of the patients.

scholarly journals Pyosalpinx due to Cronobacter sakazakii in an elderly woman

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Satoshi Ohira ◽  
Eri Ikeda ◽  
Kyosuke Kamijo ◽  
Tomokuni Nagai ◽  
Koji Tsunemi ◽  
...  
Keyword(s):  
Abdominal Cavity ◽  
Lower Abdominal Pain ◽  
The Elderly ◽  
Pathological Examination ◽  
Milk Formula ◽  
Adult Women ◽  
Cronobacter Sakazakii ◽  
Left Edge ◽  
Powdered Milk ◽  
First Case

Abstract Background Cronobacter sakazakii (C. sakazakii) is a bacterium known to cause severe neonatal infections in premature infants with the consumption of contaminated powdered milk formula. Adult infections are rare, and there have been no reports of pyosalpinx due to C. sakazakii to date. Case presentation We report a case of left pyosalpinx due to C. sakazakii in a sexually inactive postmenopausal woman. A 70-year-old woman presented to our hospital with left lower abdominal pain and fever. Abdominal computed tomography disclosed a cystic mass continuous with the left edge of the uterus. Urgent laparotomy revealed a ruptured left pyosalpinx with pus-like content. Left salpingo-oophorectomy, resection of the right tube, and washing of the abdominal cavity with saline were performed. Pathological examination of the left adnexa showed tubal tissue with acute inflammation and inflammatory exudate, which were compatible with pyosalpinx, and pus culture yielded C. sakazakii. Conclusions This is the first case report of pyosalpinx due to C. sakazakii. Cronobacter sakazakii infections in adult women might occur in the elderly, whose immunity has weakened. Further accumulation of cases of C. sakazakii infection is needed to clarify the etiology and behavior of C. sakazakii in adults.

A case of a lacerated dermoid ovarian cyst

1937 ◽  
Vol 33 (5) ◽  
pp. 626-628
Author(s):  
N. S. Sokolova
Keyword(s):  
General Practitioner ◽  
Blood Circulation ◽  
Abdominal Cavity ◽  
Broad Ligament ◽  
Ovarian Cysts ◽  
Long Time ◽  
Circulatory Disorders ◽  
Immediate Surgery ◽  
Turn Over ◽  
Reverse Development

Ovarian cysts are quite common among gynecological patients. Surgically available for small hospitals, they are undoubtedly of interest to the general practitioner. Often unnoticed for a long time, ovarian cysts nevertheless always pose for a woman a threat of either cancerous degeneration, or the possibility of twisting, with all its consequences: subsequent fusion with surrounding organs, hemorrhages into the tumor, suppurations, ruptures, peritonitis and lacing. The reason for such detachments is, in essence, still unclear. Franz, Slavyansky believe that the pedicle of the tumor often makes a 90 turn over the upper edge of the broad ligament. With greater twisting, the blood circulation of the tumor is disrupted until it stops completely. With a slow malnutrition of the tumor, the latter first stagnates and then shrinks. Its walls undergo reverse development, and the cyst, thus, can heal itself. With rapid twisting and severe circulatory disorders in the cyst, we have a clinical picture of an "acute abdomen", which requires immediate surgery. Sometimes the cyst leg, twisted with thrombosed vessels, from lack of nutrition, atrophies, becomes thinner and interrupted. The tumor is detached, made either completely free in the abdominal cavity, or feeds through adhesions with the surrounding organs.

Hypercalcaemia due to ovarian small cell carcinoma of the hypercalcaemic type

2021 ◽  
Vol 14 (7) ◽  
pp. e243571
Author(s):  
Annalisa Montebello ◽  
Mark Gruppetta
Keyword(s):  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Incidental Finding ◽  
Lower Abdominal Pain ◽  
Ovarian Tumour ◽  
Small Cell ◽  
Pelvic Radiotherapy ◽  
Wide Range ◽  
History Of ◽  
Parathyroid Hormone Related Peptide

A 37-year-old woman presented with a few days’ history of lower abdominal pain and an incidental finding of hypercalcaemia. A thorough workup ensued, and the cause was found to be an exceptionally rare ovarian tumour—ovarian small cell carcinoma of the hypercalcaemic type. Acute treatment of hypercalcaemia consisted of aggressive intravenous fluids and bisphosphonates. She underwent surgery to remove the tumour and is currently receiving systemic platinum/etoposide chemotherapy combination to be followed by pelvic radiotherapy. This case highlights the wide range of differential diagnosis for hypercalcaemia and the importance of a stepwise and thorough approach during investigations. We discuss the pathophysiology of malignancy-related hypercalcaemia, focusing especially on parathyroid hormone-related peptide-associated hypercalcaemia.

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