scholarly journals Retroperitoneum parasitic leiomyoma: Dilemmatic diagnostic

2021 ◽  
Vol 29 (2) ◽  
pp. 72
Author(s):  
Setyo Teguh Waluyo ◽  
Hariadi Yuseran ◽  
Ferry Armanza ◽  
Yuvens Richardo Wibowo
Keyword(s):  
Broad Ligament ◽  
Lower Abdomen ◽  
Rare Type ◽  
Pelvic Peritoneum ◽  
Pouch Of Douglas

HIGHLIGHTS1. Parasitic leimyoma was found in a 38 year-old woman with complaint of mass in lower abdomen and already done biopsy by laparotomy 4 months before.2. During operation, the tumor was detached from the uterus, located retroperitoneally as high as L4 – S1 vertebrae.3. The tumor had been confirmed intraoperatively and proven histopathologically as parasitic leimyoma.4. Retroperitoneal parasitic leiomyoma is of a rare type and it needs multidisciplinary examination and approaches to increase the quality of its management.ABSTRACTObjectives: To describe a retroperitoneum parasitic leiomyoma case: a dilemma in diagnosis and operation finding.Case Report: A 38 year-old woman with 3 children visited Ulin Hospital, Banjarmasin, Indonesia, with complaint of mass in lower abdomen and about 4 months before, she underwent biopsy by laparotomy which revealed leiomyoma. Parasitic leiomyoma is a rare type of leiomyoma with predilection area in broad ligament, pelvic peritoneum, pouch of douglas, and omentum. During operation, the tumor was detached from the uterus and located retroperitoneally as high as L4–S1. It had been confirmed intraoperatively and proven histopathologically as a leiomyoma.Conclusion: Retroperitoneal parasitic leiomyoma may cause a dilemma in the diagnosis. Multidiscipline examination and approaches may increase the quality of management. 

scholarly journals Prolonged Survival of a Patient with Advanced-Stage Combined Hepatocellular-Cholangiocarcinoma

2020 ◽  
Vol 14 (3) ◽  
pp. 658-667
Author(s):  
Sven H. Loosen ◽  
Nadine T. Gaisa ◽  
Maximilian Schmeding ◽  
Christoph Heining ◽  
Sebastian Uhrig ◽  
...  
Keyword(s):  
Targeted Therapy ◽  
Primary Liver Cancer ◽  
Advanced Stage ◽  
Rare Type ◽  
Treatment Protocols ◽  
Genetic Landscape ◽  
Standardized Treatment ◽  
Genomic Studies ◽  
Combined Hepatocellular Cholangiocarcinoma

Combined hepatocellular-cholangiocarcinoma (cHCC/CCA) represents a rare type of primary liver cancer with a very limited prognosis. Although just recently genomic studies have contributed to a better understanding of the disease’s genetic landscape, therapeutic options, especially for advanced-stage patients, are limited and often experimental, as no standardized treatment protocols have been established to date. Here, we report the case of a 38-year-old male patient who was diagnosed with extensive intrahepatic cHCC/CCA in an otherwise healthy liver without signs of chronic liver disease. An interdisciplinary stepwise therapeutic approach including locoregional liver-targeted therapy, systemic chemotherapy, liver transplantation, surgical pulmonary metastasis resection, and next-generation sequencing-based targeted therapy led to a prolonged overall survival beyond 5 years with an excellent quality of life. This case report comprises several provocative treatment decisions that are extensively discussed in light of the existing literature on this rare but highly aggressive malignancy.

scholarly journals True broad ligament fibroid mimicking ovarian mass in a postmenopausal woman

2019 ◽  
Vol 8 (7) ◽  
pp. 2910
Author(s):  
Lata Singh ◽  
Taru Gupta ◽  
Snigdha Kumari ◽  
Sangeeta Gupta
Keyword(s):  
Broad Ligament ◽  
Total Abdominal Hysterectomy ◽  
Large Mass ◽  
Abdominal Hysterectomy ◽  
Gravid Uterus ◽  
Ovarian Mass ◽  
Lower Abdomen ◽  
Diagnostic Dilemma ◽  
Co Morbidity ◽  
Smooth Muscle Tumors

Fibroids are benign smooth muscle tumors. Large fibroids are known to arise from the uterus, but occasionally from the broad ligament.  Here, we report a case of true broad ligament fibroid which is rare and difficult to diagnose in a 57 year old postmenopausal women with a large mass of 24 weeks size gravid uterus. Patient presented with pain lower abdomen and mass in abdomen with no other co-morbidity. This broad ligament fibroid was mimicking as ovarian tumor on ultrasonography and MRI as left ovary was not visualised separately, thus leading to diagnostic dilemma of ovarian malignancy. Mass resection with total abdominal hysterectomy and bilateral salpingo-oopherectomy was performed. No local or distant metastasis observed, and Histopathology showed true broad ligament fibroid of left side weighing 3.57 kilograms.

scholarly journals A rare case of unicornuate uterus with non communicating rudimentary horn containing functional endometrium

2018 ◽  
Vol 7 (12) ◽  
pp. 5182
Author(s):  
Priyanka Priyanka ◽  
Harbhajan Shergill ◽  
Romi Bansal ◽  
Mohini Aggarwal
Keyword(s):  
Severe Pain ◽  
Rare Case ◽  
Lower Abdomen ◽  
Rare Type ◽  
Mullerian Anomalies ◽  
Rudimentary Horn ◽  
Müllerian Anomalies ◽  
Unicornuate Uterus ◽  
Chief Complaints ◽  
Multiple Episodes

Unicornuate uterus with rudimentary horn is a rare type of anomaly. The incidence is approximately 1/100,000. Mullerian anomalies are associated with many obstetrical and gynecological complications. Non-communicating and functional rudimentary horn can cause severe pain in abdomen due to accumulation of the blood causing its distension. Authors report a case of 25 years old patient with unicornuate uterus with non-communicating rudimentary horn containing functional endometrium presenting with chief complaints of severe pain in lower abdomen associated with multiple episodes of vomiting.

scholarly journals Dietary Habit is Associated With Dysmenorrhea Among Adolescent

2020 ◽  
Vol 9 (2) ◽  
pp. 1359-1369
Author(s):  
Neti Sundari ◽  
Dian Nur Adkhana Sari ◽  
Endar Timiyatun ◽  
Viantika Kusumasari
Keyword(s):  
Negative Impact ◽  
Sampling Technique ◽  
Female Adolescent ◽  
Dietary Habit ◽  
Lower Abdomen ◽  
Chi Square ◽  
High Incidence ◽  
Testing Data ◽  
Chi Square Analysis

Dysmenorrhea is pain during menstruation which is felt in the lower abdomen and back. The high incidence of dysmenorrhea in adolescents still does not get enough concern, even though it can cause a person to become weak, pale, reduce concentration, disturb daily activities,  having a negative impact on quality of life. One of the factors that can cause dysmenorrhea is poor dietary habit. This study aims to analyze the correlation between dietary habit and dysmenorrhea in female adolescents. This type of research is quantitative, the number of samples are 262 respondents  and the sampling technique was accidental sampling. Testing data using the Chi Square analysis test.  From the results of the Chi Square analysis test, it was found that the value of p = 0.005 with a correlation value of 0.011, the study showed that there is a correlation between dietary habit with dysmenorrhea in female adolescent.

scholarly journals The combination of Tislelizumab and apatinib obtained complete remission for alpha-fetoprotein-producing gastric cancer with microsatellite stability: case report

2021 ◽  
Author(s):  
Jinyu Xiang ◽  
CongCong Wang ◽  
Wenjing Gong ◽  
Aina Liu ◽  
Ping Sun
Keyword(s):  
Gastric Cancer ◽  
Complete Remission ◽  
Combined Treatment ◽  
Progression Free Survival ◽  
Rare Type ◽  
Continuous Application ◽  
Substantial Progress ◽  
Microsatellite Stability ◽  
One Year

Abstract BackgroundAlpha‑fetoprotein (AFP)‑producing gastric cancer (AFPGC) is a rare type of gastric cancer with high metastasis rate and poor prognosis. Despite substantial progress in the treatment of many solid tumors, there are no reports of the safety and effectiveness of immune checkpoint inhibitor (ICI) in combination with anti-angiogenesis in AFPGC patients with microsatellite stability (MSS).Case presentationThis is a case of a 69-year-old man who was diagnosed with metastatic AFPGC. After the progression of resistance to chemotherapy, Tislelizumab combined with apatinib was attempted, although the patient was microsatellite stable. With 3 cycles of combination therapy, a partial remission (PR, shrunk by 56%) was obtained, and the quality of life improved significantly. Surprisingly, after more than one year of continuous application of the above treatment regimen, both the primary and metastatic tumors in this patient eventually disappeared, which achieved complete remission (CR) without surgery. Following the combined treatment, the patient had a progression-free survival of more than 16 months and now is still in continue to benefit. ConclusionsThis is the first report that we are aware of on the effective treatment of AFPGC with Tislelizumab in combination with Apatinib. This provides a highly effective and tolerable therapeutic strategy for microsatellite-stabilized AFPGC.

DOZ047.05: The flip side of the coin

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
C de Vos ◽  
W de Vos ◽  
D Sidler
Keyword(s):  
Quality Of Life ◽  
Esophageal Atresia ◽  
Support System ◽  
Emotional Support ◽  
Personal Experience ◽  
Treatment Plan ◽  
Family Practitioner ◽  
Rare Type ◽  
The Family

Abstract Background Being two medical doctors (family practitioner and pediatric surgeon) with a son born with a rare type of esophageal atresia we felt the need to explore the nonmedical side of this disease. Aim The aim of this study was to emphasize the role of emotional support for parents with children born with all types of esophageal atresia and to realize the importance of the nonsurgical side—the flip side of the coin, to explore the need for support not only for the patient but also the family. Literature Review and Personal Experience The epidemiology, surgical management, and biological outcome of esophageal atresia with/without trachea-esophageal fistula are well known. The softer, more humane side of this condition, the flipside of the coin, being the cause of PTSD children with OA (mothers > fathers).2 Severe anxiety also seems to be present in some of these parents. A meta-analysis done in 2013 concluded that psychological morbidity associated with esophageal atresia has important implications for clinical practise3; namely, if psychological support is being offered to parents during the neonatal period and continues as part of the long-term follow-up for both parents and the patients, the overall outcome is improved and the biopsychosocial morbidity of the parents decreases. Personal experience has taught us that a good support system is a critical part of a child's clinical treatment plan. Parents need good emotional support in order to be there for their child when he or she needs them. Conclusion Surgeons look at diseases from a technical point of view. They ask how they can surgically fix the problem and improve the patient's quality of life. They often forget the other side that parents need emotional support, someone to be there for them and to listen to their experience in hospital and at home. The family as another patient needs to be treated and included in the overall treatment plan if the intention is to improve the quality of life for both the patients and their families. There is a need to develop a multidisciplinary support system in South Africa to aid patients born with OA and their caring families. This includes the entire family and is not limited to the mothers but also includes fathers and other siblings often overlooked.

scholarly journals Term Broad Ligament Pregnancy with a Healthy Newborn

2019 ◽  
Vol 31 (1) ◽  
pp. 60-63
Author(s):  
Md Akbar Hossain ◽  
Farida Begum ◽  
Sultana Jahan ◽  
Israt Sharmin ◽  
Nazifatur Raihana
Keyword(s):  
Ectopic Pregnancy ◽  
Broad Ligament ◽  
Lower Abdominal Pain ◽  
Abdominal Pregnancy ◽  
Intrauterine Pregnancy ◽  
College Hospital ◽  
Rare Type ◽  
Healthy Newborn ◽  
Life Threatening ◽  
Life Threatening Complication

Introduction: Broad ligament pregnancy also known as inter ligamentous pregnancy is a rare type of ectopic pregnancy. It is one type of secondary abdominal pregnancy. Although ultrasonography is usually helpful in making the diagnosis but it is mostly established during laparotomy. Very few successful live births have been reported in this condition, where such pregnancies reached term and with live birth of a baby. Case Report: A case of 30 year old 2nd gravida of 38 weeks gestation with lower abdominal pain for 20 hours was admitted into Sher-E-Bangla Medical College Hospital, Barishal; Bangladesh. She was suggested for caesarean section as the ultrasonogram revealed transverse lie with complete placenta praevia. Intraoperative diagnosis of right sided broad ligament pregnancy was made and an incision was given on the anterior leaf of the broad ligament and a male live fetus was extracted. Post operative period was uneventful. Both mother and baby were discharged on seventh postoperative day in good health condition. Discussion: Broad ligament pregnancy usually results from rupture of tubal pregnancy through the tubal serosa and the mesosalpinx, with secondary implantation of trophoblast between the leaves of broad ligament. Incidence of broad ligament pregnancy is reported as 1 in 300 ectopic pregnancies. The prognosis is poor with the risk of dying from an abdominal pregnancy is 7.7 times higher than from other forms of ectopic pregnancy and often results from a delay in diagnosis. Trans-vaginal rather than transabdominal ultrasonography is superior in the evaluation of ectopic pregnancy. If there is no intrauterine pregnancy on ultrasonography and the ectopic sac is beside the lower part of the uterus a strong suspicion of broad ligament ectopic should be considered. Very rarely such pregnancy may reach up to term. Bleeding from placental implantation site is the most life-threatening complication during laparotomy. Conclusion: Abdominal pregnancy with resultant healthy newborn is very rare. High level of suspicion, careful clinical and ultrasound examinations are the routine means of diagnosis. Bleeding is the single most important life-threatening complication for the mother. Early diagnosis and proper management are vital in order to decrease maternal morbidity. Medicine Today 2019 Vol.31(1): 60-63

scholarly journals Broad Ligament Pregnancy: A Rare Case Repor

2020 ◽  
Vol 28 (1) ◽  
pp. 123-125
Author(s):  
Maruf Siddiqui ◽  
Nusrat Ghafoor ◽  
Fahmida Naznine ◽  
Rusmila Shamim Abdullah ◽  
T A Chowdhury
Keyword(s):  
Ovulation Induction ◽  
Rare Case ◽  
Transvaginal Ultrasound ◽  
Broad Ligament ◽  
Rare Type ◽  
Medical College

Broad ligament pregnancy is a rare obstetric condition. Its diagnosis is quite difficult and management is challenging. Here we report a case of a 26 years old primi gravida conceived following laparoscopy and ovulation induction. Diagnosis of the broad ligament pregnancy was done by a transvaginal ultrasound at her 9 weeks and was proceded with laparoscopy followed by laparotomy. A right broad ligament pregnancy was found and the sac with fetus was removed. Laparoscopy was converted into a laparotomy as there was an uncontrollable bleeding from the broad ligament. Here we present a case of this extreme rare type of broad ligament pregnancy. J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 123-125

Fallopian tube carcinoma: Energy lost in diagnosing without the total benefit of chemotherapy

1970 ◽  
Vol 2 (1) ◽  
pp. 63-66
Author(s):  
Neelam Pradhan ◽  
Sita Ghimire ◽  
Kesang D Bist ◽  
Reeta Manandhar
Keyword(s):  
Fallopian Tube ◽  
Adnexal Mass ◽  
Broad Ligament ◽  
Pap Test ◽  
Tumour Markers ◽  
Fallopian Tube Carcinoma ◽  
Lower Abdomen ◽  
Advanced Malignancy ◽  
Post Menopausal ◽  
Made In

A post menopausal lady presented with vague symptoms of swelling in lower abdomen giving an impression of left adnexal mass clinically, with detection of similar finding on USG and CT scan, and an additional feature suggestive of liver metastases. On laparotomy this looked like a fallopian tube carcinoma and it was confirmed histologically, which showed infiltration of both the ovaries, left broad ligament, and cervix. FNAC of lymph node depicted metastatic adenocarcinoma, although the tumour markers and Pap test were negative. Patient's refusal to undergo chemotherapy turned down all the efforts made in making the diagnosis of this advanced malignancy. Key words: Adnexal mass, fallopian tube carcinoma, tumour markers   doi:10.3126/njog.v2i1.1481 N. J. Obstet. Gynaecol Vol. 2, No. 1, p. 63 - 66 May -June 2007

scholarly journals Cervicovaginal cellular angiofibroma

2020 ◽  
Vol 13 (7) ◽  
pp. e235241
Author(s):  
Sarah Van Mulders ◽  
Ellen Faes ◽  
Glenn Broeckx ◽  
Yves Jacquemyn
Keyword(s):  
Histopathological Examination ◽  
Surgical Excision ◽  
Large Mass ◽  
Malignant Neoplasms ◽  
Middle Aged ◽  
Rare Type ◽  
Cellular Angiofibroma ◽  
First Case ◽  
Pouch Of Douglas ◽  
Mesenchymal Tumours

Cellular angiofibroma is a rare type of benign mesenchymal tumour that arises mostly in middle-aged women. It needs to be distinguished from other neoplasms and has a predilection for the vulvovaginal region. To our knowledge, this is the first case of a cervical cellular angiofibroma. A 34-year-old nulligravid woman was referred with a large mass bulging in the fornix posterior. Ultrasound scanning and MRI showed a large solid mass projecting in the pouch of Douglas. Laparoscopic surgical excision was performed. Histopathological examination showed a well-demarcated, unencapsulated tumour, consisting of short fascicles of spindle cells in-between thick-walled medium-sized vessels. On immunohistochemistry, there was strong reactivity with antibodies against CD34 and oestrogen receptor. Angiofibromas are benign mesenchymal tumours mostly occurring in middle-aged women. They can cause abnormal swelling and uterine bleeding and need to be distinguished from other (malignant) neoplasms.

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