scholarly journals A case of postmenopausal bleeding with an unusual finding

2020 ◽  
Vol 9 (2) ◽  
pp. 835
Author(s):  
Samar Rudra ◽  
Manasi Mukund Thakur
Keyword(s):  
Endometrial Thickness ◽  
Postoperative Recovery ◽  
Cystic Mass ◽  
Endometrial Biopsy ◽  
Granulosa Cell Tumour ◽  
Postmenopausal Bleeding ◽  
Imaging Studies ◽  
Provisional Diagnosis ◽  
Uneventful Postoperative Recovery ◽  
Mri Study

Authors report the case of a 55-year-old patient who presented with postmenopausal bleeding. On clinical evaluation uterus was 12 weeks size with a left sided adnexal cystic mass of 8 × 6 cm size. Further imaging studies revealed uterus size of 11.5 × 6.7 × 6.3 cm, left ovarian mass of size 8.4 × 6.7 × 6 cm and endometrial thickness of 17 mm on ultrasonography. She underwent endometrial biopsy to exclude endometrial cancer. The report of which came to be endometrial hyperplasia without atypia. Further MRI study confirmed the findings of USG of a complex cystic lesion of left adnexa 75 × 57 × 60 mm. Tumor marker for ovarian tumors were sent and inhibin B was found to be markedly raised. A provisional diagnosis of GCT (Granulosa cell tumour) was made and staging laparotomy was done. The uterus was found to be 12 × 8 cm size and a left sided ovarian cyst of 8-9 cm size with smooth wall and intact capsule was found. Patient had an uneventful postoperative recovery.

scholarly journals Clear Cell Carcinoma of the Endometrium in a Patient Presenting with Postmenopausal Bleeding but Negative Endometrial Biopsy

2021 ◽  
pp. 1768-1772
Author(s):  
Swechchha Silwal ◽  
Sumeet Kumar Yadav ◽  
Benedict Amalraj ◽  
Mohamed Mandeel ◽  
Geetha Krishnamoorthy
Keyword(s):  
Endometrial Cancer ◽  
Cell Carcinoma ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Endometrial Biopsy ◽  
Postmenopausal Bleeding ◽  
Gynecological Malignancy ◽  
The Usa

Endometrial carcinoma is the most common gynecological malignancy in the USA with approximately 66,570 cases and 12,940 deaths in 2020. Clear cell carcinoma (CCC) of the endometrium is an estrogen-independent type II endometrial cancer which accounts for <5% of endometrial cancer. When diagnosed roughly, 45% of patients have extrauterine metastases. Current American College of Obstetrics and Gynecology guidelines recommend transvaginal ultrasound for postmenopausal bleeding and a biopsy for those with endometrial thickness >5 mm. However, we present a case of a postmenopausal woman with a history of fibroid where endometrial biopsy has failed to make diagnosis twice. Hence, further testing should be performed in patients with unexplained postmenopausal bleeding including vaginal hysterectomy with lymph node dissection.

Hysteroscopy in the diagnosis of postmenopausal bleeding

2007 ◽  
Vol 13 (3) ◽  
pp. 132-134 ◽  
Author(s):  
Bramara Guruwadayarhalli ◽  
Siân E Jones ◽  
Vyjayanthi Srinivasan
Keyword(s):  
Gold Standard ◽  
Hospital Admissions ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Endometrial Biopsy ◽  
Postmenopausal Bleeding ◽  
First Line ◽  
Endometrial Cavity ◽  
Outpatient Hysteroscopy ◽  
Transvaginal Ultrasound Scan

Postmenopausal bleeding (PMB) accounts for 5% of gynaecology referrals. Investigations should exclude malignancy and pre-malignancy, and diagnose the benign conditions that need treatment. The three modalities that are most commonly used are transvaginal ultrasound scan (TVS), endometrial biopsy (EB) and hysteroscopy. Most authors agree that the first-line investigation should be TVS, followed by endometrial assessment (EB or hysteroscopy) if the endometrial thickness is >4 mm. When scanning demonstrates the possibility of pathology, outpatient hysteroscopy and biopsy are the gold standard for investigating the endometrial cavity. Focal pathology can be removed during the hysteroscopy, thereby reducing hospital admissions and costs.

scholarly journals Xanthomatous Hypophysitis Mimicking a Pituitary Adenoma: Case Report and Review of the Literature

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Laura Aste ◽  
Mattia Bellinzona ◽  
Veronica Meleddu ◽  
Graziella Farci ◽  
Cristina Manieli ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Gland ◽  
Diabetes Insipidus ◽  
Correct Diagnosis ◽  
Pituitary Tumors ◽  
Inflammatory Lesion ◽  
Postoperative Recovery ◽  
Cystic Mass ◽  
Uneventful Postoperative Recovery ◽  
High Level

Background. Hypophysitis is an inflammatory disease of the pituitary gland that may mimic pituitary tumors clinically and radiologically.Case Description. We report a case of a xanthomatous hypophysitis initially diagnosed as pituitary adenoma. A 31-year-old woman presented with headache, diabetes insipidus, and amenorrhea. A head CT scan showed no intrasellar changes, while an MRI scan showed a sellar cystic mass. An endocrinological work up revealed mild hypocortisolism and diabetes insipidus (DI). Transsphenoidal surgery was performed. The intraoperative histological examination suggested a pituitary adenoma. The removed tissue showed central necrosis surrounded by accumulation of foamy cells and xanthomatous epithelioid cells. The patient made an uneventful postoperative recovery, Nevertheless, DI persisted and the adenohypophysis hypofunction did not recover.Conclusion. We describe an unusual inflammatory lesion of the pituitary gland mimicking an adenoma. A high level of clinical suspicion of inflammatory disorders is necessary for correct diagnosis and optimal management.

A Clinico-pathological Study of Transvaginal Endometrial Thickness Measurement in Asymptomatic Postmenopausal Patients and Patients with Postmenopausal Bleeding

2019 ◽  
pp. 1
Author(s):  
Ayse Filiz Gokmen Karasu ◽  
Seda Ates ◽  
Tugba Gurbuz ◽  
Nurhan Sahin ◽  
Taha Takmaz ◽  
...  
Keyword(s):  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Thickness Measurement ◽  
University Hospital ◽  
Postmenopausal Bleeding ◽  
Pathological Study ◽  
Endometrial Polyps ◽  
Endometrial Sampling ◽  
Proliferative Endometrium

<p><strong>Objective:</strong> We aimed to determine the frequency of endometrial pathologies of patients who presented to our outpatient clinic with postmenopausal bleeding (PMB) and asymptomatic menopausal patients with a finding of thickened endometrium on transvaginal ultrasonography.</p><p><strong>Study Design:</strong> This study was performed at Bezmialem University Hospital. Women who presented to our clinic from January 2015 to January 2017 were analyzed. Patients were divided to two groups. All patients underwent transvaginal ultrasound with a 7.5 MHz probe. Endometrial sampling was performed by either blind D&amp;C (dilatation &amp; curettage) or pipelle sampling. We excluded patient specimens that were obtained by hysteroscopy.</p><p><strong>Results:</strong> Electronic records of a total of 368 patients in menopause were inspected. Out of these patients; 287 (78%) underwent endometrium sampling indicated by bleeding. Eighty-one patients (22%) were asymptomatic; however, a thickened endometrium echo on TVUSG examination (≥ 5 mm) was suspected. The median age was 57 (42-85). In both groups the two leading causes of endometrial pathology was; endometrial polyps followed by proliferative endometrium. The frequency of endometrial cancer was 9.4 % for the PMB group and 1.2 % in the asymptomatic patient group</p><p><strong>Conclusion:</strong> Evaluation of PMB as soon as possible is essential for diagnosing endometrial pathologies. Role of endometrial thickness is decisive in detecting patients at high risk for malignancy especially with comorbid conditions. Histopathological evaluation is mandatory for ruling out malignancy.</p>

Value of endometrial thickness assessed by transvaginal ultrasound for the prediction of endometrial cancer in patients with postmenopausal bleeding

2017 ◽  
Vol 296 (2) ◽  
pp. 319-326 ◽  
Author(s):  
Amelie Schramm ◽  
Florian Ebner ◽  
Emanuel Bauer ◽  
Wolfgang Janni ◽  
Ulrike Friebe-Hoffmann ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Endometrial Thickness ◽  
Transvaginal Ultrasound ◽  
Postmenopausal Bleeding

SECRETORY CARCINOMA OF ENDOMETRIUM: A MORPHOLOGICAL MIMICKER POSING DIAGNOSTIC DILEMMA - A RARE CASE

2021 ◽  
pp. 32-33
Author(s):  
Dharani V C ◽  
Manjunath H K ◽  
Bhargavi Mohan ◽  
Varaprasad B M ◽  
Thej M J
Keyword(s):  
Endometrial Thickness ◽  
Good Prognosis ◽  
Endometrial Biopsy ◽  
Pathological Examination ◽  
Secretory Carcinoma ◽  
Diagnostic Dilemma ◽  
Immunohistochemical Markers ◽  
Obese Female ◽  
Well Differentiated ◽  
Post Menopausal

BACKGROUND: Secretory carcinoma of the endometrium, a rare subtype of endometrioid carcinoma morphologically resembles the early secretory phase of endometrium and is almost always well differentiated and carries excellent prognosis. Very few cases of secretory carcinoma have been reported in the literature till date. Case presentation:A 58 yr old obese female presented with post-menopausal bleeding. Ultrasound revealed increased endometrial thickness and endometrial biopsy showed hyperplasia without atypia in secretory transformation. Pathological examination of the hysterectomy specimen revealed features of secretory carcinoma of the endometrium as an incidental nding. CONCLUSION: Secretory carcinoma, a rare subtype of well differentiated endometrial carcinoma carries very good prognosis and morphologically mimics various pathological conditions of endometrium. Hence, this needs to be carefully evaluated morphologically in addition with immunohistochemical markers to arrive at an accurate diagnosis.

Mixed Epithelial and Stromal Tumors of the Kidney: An Overview

2009 ◽  
Vol 133 (9) ◽  
pp. 1483-1486 ◽  
Author(s):  
Sambit K. Mohanty ◽  
Anil V. Parwani
Keyword(s):  
Progesterone Receptor ◽  
Growth Pattern ◽  
Current Knowledge ◽  
Cystic Mass ◽  
Stromal Tumor ◽  
Renal Neoplasms ◽  
Imaging Studies ◽  
Stromal Tumors ◽  
Ovarian Stroma ◽  
Estrogen And Progesterone Receptor

Abstract Mixed epithelial and stromal tumor of the kidney is a recently recognized distinct neoplasm that should be distinguished from other renal neoplasms. These tumors are relatively rare with a female preponderance. Imaging studies are not diagnostic but reveal a solid or solid and cystic mass in most cases. Histopathologically, these tumors reveal biphasic growth pattern comprising mesenchymal and epithelial elements with characteristic estrogen and progesterone receptor immunoreactive mesenchyme reminiscent of ovarian stroma. Malignant transformation, recurrence, and metastasis are rare; however, recently a few cases of malignant mixed epithelial and stromal tumors have been reported in the literature. Recently a case with translocation t(1;19) has been described. This article provides a brief overview of the current knowledge of mixed epithelial and stromal tumor of the kidney.

scholarly journals Diagnostic Dilemma of a Rare, Giant Retroperitoneal Schwannoma: A Case Report and Review of Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Mahendra Singh ◽  
Lovekesh Kumar ◽  
Rajkumar Chejara ◽  
Om Prakash Prasad ◽  
Yuvraj Kolhe ◽  
...  
Keyword(s):  
Low Frequency ◽  
Surgical Excision ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Postoperative Recovery ◽  
Cystic Mass ◽  
Imaging Features ◽  
Diagnostic Dilemma ◽  
Complete Surgical Excision ◽  
Retroperitoneal Schwannoma

Schwannoma is a benign tumour of peripheral nerve sheath. It usually arises from head, neck, and trunk. Retroperitoneal schwannoma is a rare entity, accounting for only 0.3–3% of total schwannomas. Majority of retroperitoneal schwannomas reported in literature have a diameter of 5 to 15 cm. Preoperative diagnosis is difficult due to low frequency, nonspecific clinical course, and nonspecific imaging features. Histology usually provides definitive diagnosis. Schwannomas are solitary, well-circumscribed, and noninvasive, so complete surgical excision provides good result. We report a case of a 23-year-old male, who presented with progressive abdominal distension and intermittent episodes of intestinal obstruction. CECT was suggestive of huge solid-cystic mass in abdominopelvic region. Image guided percutaneous aspiration revealed around 1 litre of frank pus and FNAC was suggestive of abscess. Exploratory laparotomy revealed a large 32 × 28 × 26 cm mass with solid and cystic components containing 1 litre of pus. Histological features of tumour were suggestive of benign schwannoma and immunohistochemistry for S-100 was positive. Postoperative recovery was uneventful. We report this case of a retroperitoneal schwannoma because of giant size, rare location, unusual presentation, and diagnostic dilemma.

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