scholarly journals Two cases of sporadic intra-abdominal desmoid tumor with a very unusual onset

2020 ◽  
Author(s):  
Hiroshi Kuwabara ◽  
Sou Katayanagi ◽  
Itsuki Koganezawa ◽  
Masashi Nakagawa ◽  
Kenji Katsumata ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Soft Tissue Tumors ◽  
Sudden Onset ◽  
Clinical Findings ◽  
Definitive Diagnosis ◽  
Ileocecal Resection ◽  
Desmoid Tumors ◽  
Mesenchymal Tumors ◽  
Causative Gene ◽  
Abdominal Ultrasonography

Abstract BackgroundIntra-abdominal desmoid tumors are rare soft tissue tumors that arise mainly in the mesentery and pelvis. Causes include mutations in the APC gene, which is the causative gene of familial adenomatous polyposis (FAP), estrogen-associated changes after childbirth, and mechanical factors, such as history of abdominal surgery. However, there are cases of intra-abdominal desmoid tumors that develop in the absence of such causes, although they are rare, and diagnosis is often difficult from clinical findings. We encountered 2 cases of patients with sporadic intra-abdominal desmoid tumors with a very unusual onset.Case presentationThe first patient was a 51-year-old man. He presented to the clinic with sudden onset of abdominal pain, and was referred to our department because of a giant tumor detected on abdominal ultrasonography. Imaging diagnosis displayed a 19-cm tumor with internal tumoral hemorrhage, but no definitive diagnosis was made. Resection of the tumor was performed for diagnostic and therapeutic purposes. The second patient was a 41-year-old man. Right hydronephrosis was detected on abdominal ultrasonography at a medical check-up. We diagnosed invasion of the primary mesenteric tumor into the right ureter by diagnostic imaging, and performed ileocecal resection with partial right ureteral resection for a definitive diagnosis and therapeutic purposes. The tumors of both patients had developed from the ileal mesentery. Although the tumors were substantially different in their macroscopic morphology and progression pattern, they showed similar pathological characteristics, i.e., they consisted of bundles of collagen fibrils of spindle-shaped fibroblasts with low cell atypia, and were diagnosed to be desmoid tumors by positive immunohistochemical staining for β-catenin. Both patients had no susceptibility factors for desmoid tumors.ConclusionsTo our knowledge, there have been very few reports to date of sporadic intra-abdominal desmoid tumors that were diagnosed owing to acute abdominal pain caused by tumoral hemorrhage or asymptomatic ureteral obstruction. Intra-abdominal desmoid tumors can cause various symptoms depending on the location of their occurrence and their progression pattern and are often difficult to differentiate from other mesenchymal tumors on imaging findings. Diagnosis therefore requires experience and knowledge that is not bound by preconceptions.

scholarly journals Sporadic intra-abdominal desmoid tumor with a very unusual onset: two case reports

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Hiroshi Kuwabara ◽  
Sou Katayanagi ◽  
Itsuki Koganezawa ◽  
Masashi Nakagawa ◽  
Kenji Katsumata ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Case Reports ◽  
Obstructive Uropathy ◽  
Tumor Resection ◽  
Sudden Onset ◽  
Definitive Diagnosis ◽  
Ileocecal Resection ◽  
Desmoid Tumors ◽  
Imaging Findings ◽  
Abdominal Ultrasonography

Abstract Background Intra-abdominal desmoid tumors are rare soft tissue tumors that arise mainly in the mesentery and pelvis. Their etiology may include genetic mutations, estrogen-associated changes after childbirth, and mechanical factors such as a history of abdominal surgery. However, there are cases of intra-abdominal desmoid tumors that develop in the absence of such causes. Since they are rare, diagnosis is often difficult based on clinical findings. We encountered two cases of patients with sporadic intra-abdominal desmoid tumors with a very unusual onset and contrasting features. Case presentation The first patient was a 51-year-old asian man who presented with sudden onset of abdominal pain. He was referred to our department because of a giant tumor detected on abdominal ultrasonography. Imaging revealed a 19-cm tumor with internal tumoral hemorrhage; however, no definitive diagnosis was made. Tumor resection was performed for diagnostic and therapeutic purposes. The second patient was a 41-year-old asian man, and right hydronephrosis was detected on abdominal ultrasonography during a periodic medical checkup. We diagnosed invasion of the primary mesenteric tumor into the right ureter using diagnostic imaging and performed ileocecal resection with partial right ureteral resection for a definitive diagnosis and therapeutic purposes. Although the tumors of both patients had developed from the ileal mesentery, the tumors were substantially different from each other based on their imaging findings, macroscopic morphology, and progression pattern. Meanwhile, they showed similar pathological characteristics. Both consisted of bundles of collagen fibrils of spindle-shaped fibroblasts with low cell atypia. Moreover, they were diagnosed as desmoid tumors using positive immunohistochemical staining for β-catenin. Conclusions Neither patient had susceptibility factors for desmoid tumors, and to our knowledge, there have been very few reports to date of intra-abdominal desmoid tumors that were diagnosed because of acute abdominal pain caused by tumoral hemorrhage or asymptomatic obstructive uropathy. Furthermore, it is clinically interesting that the two patients showed contrasting progression patterns and imaging findings. Intra-abdominal desmoid tumors are rare and may present with various symptoms and findings similar to those observed in our patients. Diagnosis therefore requires experience and knowledge that is not bound by preconceptions.

scholarly journals Y Shaped Colonic Duplication Mimicking Intestinal Volvulus: A Case Report and Review of Literature

2021 ◽  
Author(s):  
Volkan Sarper Erikçi
Keyword(s):  
Abdominal Pain ◽  
Hospital Admissions ◽  
Surgical Intervention ◽  
Relevant Literature ◽  
Clinical Findings ◽  
Definitive Diagnosis ◽  
Chronic Abdominal Pain ◽  
Review Of Literature ◽  
Colonic Duplication ◽  
Intestinal Volvulus

Enteric duplications are rare congenital anomalies found anywhere from mouth to anus. Colonic duplications constitute about 13% of all enteric duplications. In this report a 6-year-old boy with chronic abdominal pain for a duration of last 2 years requiring intermittent hospital admissions was diagnosed as colonic duplication mimicking intestinal volvulus. Clinical findings are nonspecific and definitive diagnosis can only be made during surgical intervention and surgical treatment is advocated for all duplications. The topic is discussed under the light of relevant literature with a brief a brief literature review.

scholarly journals Results of Abdominopelvic CT Scan in patient with abdominal pain

2019 ◽  
Vol 7 (2) ◽  
pp. 1
Author(s):  
Mahboub Pouraghaei ◽  
Mohammad Hossein Somi ◽  
Payman Moharramzadeh ◽  
Samad Shams Vahdati ◽  
Mahsa Ghanbari
Keyword(s):  
Abdominal Pain ◽  
Physical Examination ◽  
Ct Scan ◽  
Decisive Role ◽  
Abdominal Ultrasound ◽  
Clinical Findings ◽  
Ct Scans ◽  
Abdominal Ultrasonography ◽  
Imaging Device ◽  
Plain Abdominal Radiography

Background: CT scan is an imaging device that is widely available and is very sensitive to different causes of abdominal pain. The aim of this study was to evaluate the CT scan results role of patients with abdominal pain in diagnosis and future decisions on patient and comparison with patient’s history and physical examination. Methods: In this descriptive analytical study, 215 patients admitted to the emergency room at Imam Reza Teaching Hospital with non-traumatic abdominal pain were studied over the years regarding the comparison of CT findings with the history, physical examination, plain radiography and ultrasound. Demographic characteristics, patient history, symptoms at the first visit, clinical findings, laboratory tests, imaging findings, diagnosis and treatment of all patients were collected. Results: CT scan to confirm the diagnosis or screening patients with abdominal pain has been helpful. The results of 215 CT scan 28.40% was normal, most frequently diagnosis in CT scans was related to pancreatitis 24% and least diagnostic of CT scans related to ileus. Of 215 patients, plain abdominal radiography was requested in 78 patients (36.3%) that the air-fluid level was reported in 18 cases (23.7%). Of 215 patients, abdominal ultrasonography was performed in 117 patients (54.4%) that the most recognizable diagnosis was cholelitiasis in 22 cases (18.8%) an abdominal ultrasound result was normal in 98 cases (83.7%). Finally of the 215 patients, 116 patients (77.2%) admitted and 49 patients (22.7%) were discharged. Of 166 patients, 51 patients (30.72%) were transferred directly from the emergency department to the operating room. Conclusion: CT scan play a decisive role in the decision to hospitalize patients and request in right place expedite the handling patients. Our study suggests the balance between the amount of requested CT in patients with non-traumatic abdominal pain and hospitalization rate.

scholarly journals Corrective surgery using a gridiron incision for abdominal pain caused by a folded ovary in the third trimester of pregnancy

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199774
Author(s):  
A Mi Kim ◽  
Jong Woon Kim ◽  
Yoon Ha Kim ◽  
Tae Young Kim ◽  
Hyun Kyung Ryu ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Laparoscopic Surgery ◽  
Tender Point ◽  
Sudden Onset ◽  
Third Trimester ◽  
Normal Appendix ◽  
Abdominal Ultrasonography ◽  
Lower Quadrant ◽  
The Third ◽  
The Right

Introduction Sonography and magnetic resonance imaging (MRI) may be helpful to obtain an accurate diagnosis of acute abdominal pain in pregnancy. Adnexal torsion presenting in the first or second trimester can be confirmed and treated through laparoscopic surgery; however laparoscopic surgery in the third trimester can be difficult owing to the large uterus, and a gridiron incision can be useful. Case Report/Case presentation An 18-year-old gravida 1, para 0 (G1P0) woman at 30 + 4 weeks of gestation presented with sudden-onset cyclic pain in the right lower quadrant. Abdominal ultrasonography showed a normal appendix, and MRI showed a normal appendix and normal ovaries. The patient’s prominent tender point was marked and compared with the MR images, which confirmed the mark as the position of the right ovary. Laparotomy was performed through a gridiron incision, and a folded right ovary was identified. The ovary was unfolded, and TachoSil® and Surgicel® were used to maintain the unfolded position. The patient’s pain resolved, and her postoperative course was uneventful. She delivered a healthy, 2540-g male baby at 35 weeks’ gestation. Discussion/Conclusions A gridiron incision was useful to treat a folded ovary in the third trimester and to evaluate the adnexa and minimize uterine manipulation.

scholarly journals Coexistence of common gallstones and sinusoidal obstruction syndrome: Case report and review of the literature

2021 ◽  
Vol 5 (2) ◽  
pp. 020-022
Author(s):  
Karahan Furkan ◽  
Acar Nihan ◽  
Avcı Arzu ◽  
Dilek Osman Nuri
Keyword(s):  
Abdominal Pain ◽  
Liver Function ◽  
Histopathological Examination ◽  
Liver Function Tests ◽  
Clinical Findings ◽  
Definitive Diagnosis ◽  
Sinusoidal Obstruction Syndrome ◽  
Function Tests ◽  
Biliary Diversion ◽  
Long Time

Purpose: The sinusoidal obstruction syndrome (SOS) of the liver is an obliterative vasculitis that involves the terminal branches of the hepatic venules and sinusoids. When it is not treated, it will be a serious risk of mortality. Here, we aim to present our patient who has been associated with recurrent cholangitis attacks due to cholelithiasis and choledocholithiasis and is associated with sinusoidal obstruction syndrome with the literature. Description of the case: A 30 years old male patient had complaints of abdominal pain and nausea for a long time. The patient had a history of choledocholithiasis and cholangitis attacks. Although ERCP was performed and a stent was placed in the biliary tract, his jaundice did not disappear. Liver function tests were high. Tumor markers were negative. Methods: We could not make a definitive diagnosis with imaging methods and biopsy and we planned surgery. We performed segmental liver resection and biliary diversion in the surgery. Histopathological examination of the resected liver tissue was compatible with SOS. Conclusion: Many studies have been done on the etiology of SOS and different causes have been revealed. Accompanied with clinical findings, a definitive diagnosis is made with the exclusion of the presumptions considered. Surgery can be performed for both diagnostic and therapeutic purposes. If patients with elevated liver function tests and bilirubin have long-term abdominal pain, SOS should be bear in mind.

Diagnostic Value of Electron Microscopy in Soft Tissue Tumors

1970 ◽  
Vol 28 ◽  
pp. 220-221
Author(s):  
Gerald Fine ◽  
Azorides R. Morales
Keyword(s):  
Cardiac Myxoma ◽  
Osteogenic Sarcoma ◽  
Diagnostic Value ◽  
Soft Tissue Tumors ◽  
Amelanotic Melanoma ◽  
Growth Patterns ◽  
Light Microscopic Level ◽  
Mesenchymal Tumors ◽  
Good Agreement

For years the separation of carcinoma and sarcoma and the subclassification of sarcomas has been based on the appearance of the tumor cells and their microscopic growth pattern and information derived from certain histochemical and special stains. Although this method of study has produced good agreement among pathologists in the separation of carcinoma from sarcoma, it has given less uniform results in the subclassification of sarcomas. There remain examples of neoplasms of different histogenesis, the classification of which is questionable because of similar cytologic and growth patterns at the light microscopic level; i.e. amelanotic melanoma versus carcinoma and occasionally sarcoma, sarcomas with an epithelial pattern of growth simulating carcinoma, histologically similar mesenchymal tumors of different histogenesis (histiocytoma versus rhabdomyosarcoma, lytic osteogenic sarcoma versus rhabdomyosarcoma), and myxomatous mesenchymal tumors of diverse histogenesis (myxoid rhabdo and liposarcomas, cardiac myxoma, myxoid neurofibroma, etc.)

scholarly journals Sudden-Onset Abdominal Pain in a 76-Year-Old Woman With Graft-vs-Host Disease

CHEST Journal ◽  
2019 ◽  
Vol 156 (4) ◽  
pp. e77-e79 ◽  
Author(s):  
Vishal J. Tolia ◽  
Danielle N. O’Hara ◽  
Kazi I. Ullah ◽  
Sahar Ahmad
Keyword(s):  
Abdominal Pain ◽  
Sudden Onset ◽  
Host Disease ◽  
Graft Vs Host Disease

scholarly journals Neuralgic amyotrophy: an underrecognized entity

2021 ◽  
Vol 49 (4) ◽  
pp. 030006052110065
Author(s):  
Tae Uk Kim ◽  
Min Cheol Chang
Keyword(s):  
Clinical Practice ◽  
Magnetic Resonance ◽  
Clinical Manifestations ◽  
Clinical History ◽  
Cervical Radiculopathy ◽  
Sudden Onset ◽  
Clinical Findings ◽  
Magnetic Resonance Neurography ◽  
Essential Information ◽  
Neuralgic Amyotrophy

Neuralgic amyotrophy (NA) is markedly underdiagnosed in clinical practice, and its actual incidence rate is about 1 per 1000 per year. In the current article, we provide an overview of essential information about NA, including the etiology, clinical manifestations, diagnostic investigations, differential diagnosis, treatment, and prognosis. The causes of NA are multifactorial and include immunological, mechanical, or genetic factors. Typical clinical findings are a sudden onset of pain in the shoulder region, followed by patchy flaccid paralysis of muscles in the shoulder and/or arm. A diagnosis of NA is based on a patient’s clinical history and physical examination. Gadolinium-enhanced magnetic resonance imaging and high-resolution magnetic resonance neurography are useful for confirming the diagnosis and choosing the appropriate treatment. However, before a diagnosis of NA is confirmed, other disorders with similar symptoms, such as cervical radiculopathy or rotator cuff tear, need to be ruled out. The prognosis of NA depends on the degree of axonal damage. In conclusion, many patients with motor weakness and pain are encountered in clinical practice, and some of these patients will exhibit NA. It is important that clinicians understand the key features of this disorder to avoid misdiagnosis.

scholarly journals Cannabinoid Hyperemesis Syndrome: A Case Report of an Underdiagnosed Condition

2020 ◽  
pp. 1-5
Author(s):  
João Machado Nogueira ◽  
Inês Fonseca ◽  
Marco Duarte
Keyword(s):  
Emergency Department ◽  
Abdominal Pain ◽  
Diagnostic Tests ◽  
Clinical Symptoms ◽  
Definitive Diagnosis ◽  
Hot Water ◽  
Illustrative Case ◽  
Raising Awareness ◽  
Detailed Medical History ◽  
Cannabinoid Hyperemesis Syndrome

Cannabinoid hyperemesis syndrome (CHS) is characterized by episodic bursts of nausea, vomiting and abdominal pain, affecting chronic cannabis users. The clinical picture mimics an acute abdomen, usually leading to multiple assessments in the emergency department. Several complementary diagnostic examinations are performed with non-specific results, making differential diagnosis puzzling. We present a case of a 42-year-old man, who has been admitted multiple times to the emergency department in the last 3 months for abdominal pain, nausea and vomiting, without triggering factors and improving only with hot water baths. He was evaluated by different specialties, the various complementary diagnostic tests performed showed no significant results, and no definitive diagnosis was obtained. Treatment resulted only in a partial and transient resolution of symptoms. A more detailed medical history revealed cannabis use for more than 5 years, with a recent increase in the amount consumed. After psychoeducation, explaining the risks associated with consumption and its relationship with the clinical symptoms, which resulted in complete suspension of cannabis, there have been no new symptomatic episodes since then. We present an illustrative case of a poorly reported clinical entity despite having a probable significant prevalence, raising awareness in order that clinicians identify and properly manage these cases.

scholarly journals FOXO1 gene involvement in a non-rhabdomyosarcomatous neoplasm

2021 ◽  
Author(s):  
Simon Haefliger ◽  
Muriel Genevay ◽  
Michel Bihl ◽  
Romina Marone ◽  
Daniel Baumhoer ◽  
...  
Keyword(s):  
Transcription Factors ◽  
Soft Tissue ◽  
Genetic Heterogeneity ◽  
Gene Fusion ◽  
Fusion Gene ◽  
Soft Tissue Tumors ◽  
Gene Fusions ◽  
Mesenchymal Tumors ◽  
Myoepithelial Differentiation ◽  
Foxo1 Gene

AbstractMyoepithelial neoplasms of soft tissue are rare tumors with clinical, morphological, immunohistochemical, and genetic heterogeneity. The morphological spectrum of these tumors is broad, and the diagnosis often requires immunostaining to confirm myoepithelial differentiation. Rarely, tumors show a morphology that is typical for myoepithelial neoplasms, while the immunophenotype fails to confirm myoepithelial differentiation. For such lesions, the term “myoepithelioma-like” tumor was introduced. Recently, two cases of myoepithelioma-like tumors of the hands and one case of the foot were described with previously never reported OGT-FOXO gene fusions. Here, we report a 50-year-old woman, with a myoepithelial-like tumor localized in the soft tissue of the forearm and carrying a OGT-FOXO1 fusion gene. Our findings extend the spectrum of mesenchymal tumors involving members of the FOXO family of transcription factors and point to the existence of a family of soft tissue tumors that carry the gene fusion of the OGT-FOXO family.

Sign in / Sign up

Export Citation Format

Share Document