scholarly journals Rare cause of unexplained hypertension in an oligomenorrheic adolescent girl with adnexal mass: case report and review of literature

2021 ◽  
Vol 10 (10) ◽  
pp. 3995
Author(s):  
Ankita Sethi ◽  
Vidushi Kulshrestha ◽  
Seema Kaushal ◽  
Neerja Bhatla
Keyword(s):  
Frozen Section ◽  
Exploratory Laparotomy ◽  
Cystic Mass ◽  
Pelvic Lymphadenectomy ◽  
Cell Tumour ◽  
Ca 125 ◽  
Post Surgery ◽  
Not Otherwise Specified ◽  
Surgery Patient ◽  
Mass Case

A 17-year-old girl with oligomenorrhoea was detected to have hypertension and right adnexal solid-cystic mass, 6×8 cm on ultrasound. Hormone profile was normal, CA-125 was 132.5 U/mL, other tumour markers were in normal range; though RMI-4 and ROMA index suggested malignancy. Patient underwent exploratory laparotomy, peritoneal wash cytology, right salpingo-oophorectomy, pelvic lymphadenectomy and omental biopsy. Intraoperative frozen-section revealed ovarian steroid cell tumour. Later, steroid cell tumour-not otherwise specified (SCT-NOS) was confirmed on histopathology and immunohistochemistry. When followed three months post-surgery, patient had resumed 30-32 days menstrual-cycle, and she was normotensive without medications. This case is being reported to emphasize that imaging though not recommended for evaluation of PCOS in adolescence; and measuring blood-pressure which is often skipped in young women; proved crucial in this patient.

scholarly journals MUCINOUS CYSTADENOCARCINOMA

2018 ◽  
Vol 16 (2) ◽  
pp. 59
Author(s):  
Sadia Anwar ◽  
Nasim Saba
Keyword(s):  
Abdominal Mass ◽  
Exploratory Laparotomy ◽  
Abdominal Hysterectomy ◽  
Genetic Mutation ◽  
Cystic Mass ◽  
Mucinous Cystadenocarcinoma ◽  
Ca 125 ◽  
Invasive Adenocarcinoma ◽  
Epithelial Tumor ◽  
Glandular Cells

A 55 years old lady presented to Gynecology outpatient of MMM Teaching Hospital, D.I.Khan in January 2018 with history of abdominal mass. Her abdominal hysterectomy was done one year back. On examination a huge cystic mass reaching up to the xiphisternum and occupying the whole abdomen was palpable. Her ultrasound revealed a mass arising from pelvis, most likely ovarian in nature. Her CA-125 level was 29.62 IU/ml (in normal range). Exploratory laparotomy revealed a huge cystic mass which was excised. Histopathology reported mucinous cystadenocarcinoma of the ovary. Chemotherapy was then done. There was no recurrence by the end of nine months follow-up as evaluated by ultrasonography. Mucinous cystadenocarcinoma is an invasive adenocarcinoma composed of malignant glandular cells containing intracytoplasmic mucin. It is relatively common in middle-aged women. Genetic mutation such as KRAS gene have been reported. It is a rapidly growing epithelial tumor usually presenting as a single solid mass. Treatment involves surgery and chemotherapy. The prognosis depends upon the stage of tumor.

scholarly journals Duodenal Leiomyosarcoma Mimicking a Pancreatic Pseudocyst

HPB Surgery ◽  
1994 ◽  
Vol 8 (1) ◽  
pp. 49-52 ◽  
Author(s):  
C. Sperti ◽  
C. Pasquali ◽  
F. Di Prima ◽  
R. Baffa ◽  
S. Pedrazzoli
Keyword(s):  
Smooth Muscle ◽  
Pancreatic Pseudocyst ◽  
Frozen Section ◽  
Exploratory Laparotomy ◽  
Cystic Mass ◽  
Tumour Markers ◽  
Cyst Fluid ◽  
Radiological Findings ◽  
Smooth Muscle Tumour

A case of duodenal leiomyosarcoma presenting as a cystic mass is reported. Amylase, tumour markers levels in the cyst fluid and radiological findings suggested an inflammatory pancreatic pseudocyst. Exploratory laparotomy and frozen section examination showed a smooth muscle tumour of the duodenum. Pancreatoduodenectomy with pylorus-preser vation was performed and the patient remained symptom-free at 8 months follow-up.

scholarly journals A Case Presentation: Decidualized Endometrioma Mimicking Ovarian Cancer during Pregnancy

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Aybike Tazegül ◽  
Özlem Seçilmiş Kerimoğlu ◽  
Feyza Nur İncesu ◽  
Nasuh Utku Doğan ◽  
Setenay Arzu Yılmaz ◽  
...  
Keyword(s):  
Blood Flow ◽  
Differential Diagnosis ◽  
Frozen Section ◽  
Cystic Mass ◽  
Left Ovary ◽  
Arterial Blood Flow ◽  
Ca 125 ◽  
Case Presentation ◽  
Arterial Blood ◽  
Douglas Pouch

During pregnancy, masses that are larger than 5 cm and appearing in the Doppler ultrasonography as having increased blood flow, echoes of heterogeneous density, and containing solid components are suspicious for malignancy; however, differential diagnosis of decidualized endometriomas should also be considered. The patient was an 8 weeks pregnant primigravida. The ultrasonographic evaluation showed a cystic mass of size 65 × 57 mm in the left ovary that was well circumscribed, heterogeneous, with highly dense internal echo, and containing a solid component of size 8 × 14 mm. In the 12th week, the ultrasonographic examination revealed an increase in the size of the mass and increased arterial blood flow in the mass. The patient underwent surgery. It was observed that both ovaries were adherent in the Douglas pouch and that the left ovary contained an endometrioma of size 8cm. While the capsule was being peeled, lesions of soft density, with irregular surfaces, and with adhesion in the Douglas pouch were observed. The results of the frozen section revealed decidualized endometrioma and decidual structures. Even in pregnant women when adnexal masses are encountered and the ultrasonography, Doppler, MRI, and CA 125 level analysis still do not favor endometriosis, decidualized endometrioma should be considered in the differential diagnosis.

scholarly journals Case Hepatic Endometriosis: A Continuing Diagnostic Dilemma

HPB Surgery ◽  
2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
P. J. Goldsmith ◽  
N. Ahmad ◽  
D. Dasgupta ◽  
J. Campbell ◽  
J. A. Guthrie ◽  
...  
Keyword(s):  
Frozen Section ◽  
Liver Function Tests ◽  
Cystic Mass ◽  
Ca 125 ◽  
Liver Mass ◽  
Quadrant Pain ◽  
Diagnostic Dilemma ◽  
Cystic Liver ◽  
Time Of Operation ◽  
Ct And Mri

Background. Intraparenchymal endometriosis of liver is rare. It may present as liver tumour and the diagnosis is not usually established till after surgery. Case Outline. A 48-year-old postmenopausal woman presented with right upper quadrant pain and a cystic liver mass. Liver function tests and tumour markers (αFP, CEA, CA 19-9, and CA 125) were normal. Radiological imaging (USS, CT and MRI) suggested a thick walled cystic mass involving segments IV and VIII with complex intracystic septations. Frozen section at operation suggested a benign cystadenoma. The cyst was enucleated using a CUSA (Cavitron ultrasonic aspirator). The final histology confirmed endometriosis. Discussion. Eleven cases of hepatic endometrioma have been reported and only four in postmenopausal women. Preoperative diagnosis poses a challenge and so far none of the cases have been diagnosed preoperatively. Surgery remains the treatment of choice. Accurate diagnosis at time of operation may avoid extensive liver surgery and its associated morbidity.

scholarly journals Pseudomyxoma Peritonei Revisited: A Case Report

2018 ◽  
Vol 2 (2) ◽  
Keyword(s):  
Immunohistochemical Staining ◽  
Frozen Section ◽  
Exploratory Laparotomy ◽  
Ca 125 ◽  
Abdominal Girth ◽  
Negative Results ◽  
Histopathology Result ◽  
Disseminated Peritoneal Adenomucinosis ◽  
The Right ◽  
Lost To Follow Up

Bleeding after menopause raises suspicion of malignancy; more so, if combined with increased abdominal girth and constitutional symptoms. This is a case of a 74-year-old Gravida 10 Para 8 (8026) who presented with generalized abdominal pain, enlargement, bloatedness and vaginal bleeding. Ultrasound revealed a complex abdominopelvic mass, likely ovarian in origin. Tumor markers CA-125 and CA-199 were elevated. Endometrial curettage with frozen section revealed Leiomyosarcoma. It was followed by exploratory laparotomy revealing gelatinous material in the peritoneum with seeding of mucoid material into the omentum, ovary and appendix. Frozen section of the right ovary revealed Atypical Mucinous Proliferative Ovarian Tumor (APMOT). Final histopathology result of the endometrial curetting revealed adenomatoid tumor of the uterus. Immunohistochemical staining with desmin and caldesmon revealed negative results implicating the absence of leiomyosarcoma. Final histopathology results were consistent with Disseminated Peritoneal Adenomucinosis (DPAM). Immunohistochemical staining with CK20 was positive and CK7 was negative, consistent with metastases from a primary gastrointestinal tumor. Chemotherapy in the form of FOLFOX regimen was contemplated. However, the patient was lost to follow up.

Gliomatosis peritonei arising in setting of immature teratoma of ovary: a case report

2019 ◽  
Vol 8 (10) ◽  
pp. 4097
Author(s):  
Dhruba Prasad Paul ◽  
Kashish Garg ◽  
Ashis Kumar Rakshit
Keyword(s):  
Exploratory Laparotomy ◽  
Large Mass ◽  
Cystic Mass ◽  
Immature Teratoma ◽  
Ca 125 ◽  
Xiphoid Process ◽  
Grade 3 ◽  
Operative Recovery ◽  
Infracolic Omentectomy

A 14 years old girl presented to the gynecology OPD with pain abdomen and huge abdominal lump since 2 months. On clinical examination, a large mass of 20x15 cm size was found extended upto the xiphoid process. Serum studies showed rise of CA-125 up to 406.9U/mL and LDH up to 310U/L. USG shows right ovarian cyst of 14.8x14.1x12.8 cm with internal calcification. MRI revealed a well encapsulated mass of 21x19x17cm with solid and cystic mass and upward peritoneal extension. Exploratory laparotomy was performed with right sided salpingo- ophorectomy with infracolic omentectomy, as the omentum appeared granular. She had an uneventful post-operative recovery. Subsequently HPE showed immature teratoma NORRIS grade 3 with co-existent peritoneal gliomatosis (grade 0). She is under regular follow-up and decided to give six cycles of combination chemotherapy with BEP at regional cancer hospital.

scholarly journals Immature teratoma

2016 ◽  
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumor ◽  
Frozen Section ◽  
Mature Teratoma ◽  
Germ Cell Tumors ◽  
Pelvic Lymphadenectomy ◽  
Immature Teratoma ◽  
Cell Tumor ◽  
Ca 125 ◽  
Grade Iii

Introduction: Immature teratoma represents 3% of all teratomas, 1 % of all ovarian cancers and 20% of malignant ovarian germ cell tumors. It is found either in pure form or as a component of a mixed germ cell tumor. It occurs essentially during the first two decades of life. According to WHO, immature teratoma is defined as a teratoma containing a variable amount of immature embryonal type neuroectodermal tissue Case: We present here a report of 23 years old unmarried female who presented with complaint of abdominal pain since 1 month and her CT scan done outside, showed fibroid uterus. She had history of typhoid fever 1 month back for which USG was done which suggested large uterine fibroid. On examination she was hemodynamically stable. On abdominal examination a non-tender supra-pubic mass of 24 weeks size with firm consistency, irregular margin was felt. On investigation CA 125 was 64.90 IU/L, LD- 223, beta HCG- 1.14. On MRI a large abdomino-pelvic lesion, likely left adnexal lesion with multiple cystic areas, with hemorrhage, with ascites and enlarged retroperitoneal lymph nodes with omental infiltration suggestive of a possibility of malignant germ cell tumor. In view of large ovarian tumor, possibly malignant decision for staging laparotomy was taken. Intra-operatively a large irregular vascular solid mass of 20 x 20 cms with bosselated appearance with few cystic lesions over it was seen, arising from left ovary and was sent for frozen section which reported malignant mature teratoma with components of immature teratoma. She underwent laparotomy with left salpingo-oophorectomy with right ovarian biopsy, omentectomy, appendectomy with B/L pelvic lymphadenectomy. Histopathology was suggestive of grade III immature teratoma. In view of grade III immature teratoma, she received chemotherapy (BEP regimen) post-operatively and is currently under follow up. Conclusion: This case reflects the importance of early diagnosis in cases of pelvic masses in young females. Fertility preservation should be considered in young women with germ cell tumors. Patients with grade II or III tumors or a mere advanced stage disease should be treated with adjuvant chemotherapy (BEP) in addition to surgery.

scholarly journals A stable method for 4D CT-based CFD simulation in the right ventricle of a TGA patient

2020 ◽  
Vol 35 (5) ◽  
pp. 315-324
Author(s):  
Yuri Vassilevski ◽  
Alexander Danilov ◽  
Alexander Lozovskiy ◽  
Maxim Olshanskii ◽  
Victoria Salamatova ◽  
...  
Keyword(s):  
Right Ventricle ◽  
Cfd Simulation ◽  
Fluid Motion ◽  
4D Ct ◽  
Post Surgery ◽  
Surgery Patient ◽  
Time Dependent Domain ◽  
Flow Domain ◽  
The Right ◽  
Dependent Domain

AbstractThe paper discusses a stabilization of a finite element method for the equations of fluid motion in a time-dependent domain. After experimental convergence analysis, the method is applied to simulate a blood flow in the right ventricle of a post-surgery patient with the transposition of the great arteries disorder. The flow domain is reconstructed from a sequence of 4D CT images. The corresponding segmentation and triangulation algorithms are also addressed in brief.

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