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 A Case Report of Primary Ovarian Mucinous Adenocarcinoma treated at Dr. Akbar Niazi Teaching Hospital, Bara Kahu, Islamabad

2020 ◽  
Vol 24 (4) ◽  
pp. 430-433
Author(s):  
Jahan Ara Saeed
Keyword(s):  
Abdominal Distension ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Uneventful Recovery ◽  
Ovarian Mass ◽  
Resonance Imaging ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index ◽  
History Of ◽  
Stage 1

Introduction: This is a case of a patient who had a history of grossly increasing abdominal distension for 6 months. The patient had no symptoms except pressure symptoms with a regular menstrual cycle. She initially was investigated as a case of abdominal distension and indigestion. With increasing size, the discomfort was the main symptom. She attended our Gynaecology Outpatient department and was diagnosed as a case of Large Ovarian mass. The first investigation performed was Pelvic ultrasound and Tumour markers and a Risk of malignancy index were calculated. Her Magnetic resonance imaging with contrast showed a large well encapsulated ovarian mass with no ascites and no metastasis. After getting all the investigations and discussion with the patient a Staging Laparotomy with Total abdominal hysterectomy and bilateral salpingo-oophorectomy was performed, The ureters were stented before laparotomy to avoid damage to the ureters during surgery. She was diagnosed as Stage 1-A at the time of surgery and had an uneventful recovery. Her histopathology report showed a unilateral Mucinous cystadenocarcinoma with negative peritoneal wash and omentum histopathology.

scholarly journals Rare Presentation of Chorioadenoma Destruens as Acute Haemoperitoneum Mimicking Ruptured Ectopic Pregnancy

2015 ◽  
Vol 12 (4) ◽  
pp. 288-291 ◽  
Author(s):  
M Sinha ◽  
R Kaur ◽  
R Gupta ◽  
R Rani ◽  
A Aggarwal
Keyword(s):  
Ectopic Pregnancy ◽  
Lower Abdominal Pain ◽  
Myometrial Invasion ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Acute Onset ◽  
Rare Presentation ◽  
Placental Site ◽  
Invasive Mole

Gestational trophoblastic neoplasms (GTN) are proliferative degenerative disorders of placental elements and include complete or partial mole (90%), invasivemole (5-8%), choriocarcinoma (1-2%) and placental site tumor (1-2%). Chorioadenoma destruens is a trophoblastic tumor, characterized by myometrial invasion through direct extension or via venous channels. We present a case of invasive mole eroding uterus and uterine vasculature, causing sudden rupture of uterus with massive haemoperitoneum mimicking ectopic pregnancy. A 20 year old G1P0 at 6 weeks gestation presented in Casualty of Kasturba Hospital complaining of severe acute onset lower abdominal pain for one hour. Clinical examination revealed shock. Sonography suggested ectopic pregnancy and immediate exploratory laparotomy was decided. On laparotomy, 2000cc of haemoperitoneum was noted. Grape like vesicles protruding through fundal perforation with profuse active bleeding was seen. Bleeding persisted despite evacuation. Step wise uterine devascularisation failed to achieve haemostasis. Total abdominal hysterectomy was performed as a life saving measure.Kathmandu University Medical Journal Vol.12(4) 2014; 288-291

scholarly journals The Imaging and Pathological Features of Metastatic Leiomyosarcoma in the Gallbladder

Rare Tumors ◽  
2016 ◽  
Vol 8 (4) ◽  
pp. 179-181 ◽  
Author(s):  
Yi Guo ◽  
Eleanor Chen ◽  
Darin J. Davidson ◽  
Venu G. Pillarisetty ◽  
Robin L. Jones ◽  
...  
Keyword(s):  
Metastatic Disease ◽  
Uterine Fibroids ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Metastatic Lesion ◽  
Uterine Leiomyosarcoma ◽  
High Grade ◽  
Initial Management ◽  
Pelvic Radiation

Uterine leiomyosarcoma is a rare and aggressive malignancy with poor overall prognosis. There have been few reports of metastatic leiomyosarcoma in the gallbladder. We report a case of a 41-year-old female who underwent total abdominal hysterectomy due to presumed uterine fibroids. The postoperative pathology revealed high-grade pleomorphic leiomyosarcoma, with involvement of the uterine serosal surface. She subsequently underwent exploratory laparotomy, followed by pelvic radiation and chemotherapy. Since initial management she has developed metastatic disease and has been under treatment and surveillance for 11 years. She has undergone multiple surgical procedures and numerous lines of systemic therapy for metastatic leiomyosarcoma, including cholecystectomy for a metastatic lesion in the gallbladder. There have been no previous reports of metastatic leiomyosarcoma in the gallbladder. Despite extensive metastatic disease this patient has had prolonged survival with multi-modality management.

scholarly journals Degenerated fibroid: a diagnostic dilemma

2020 ◽  
Vol 9 (4) ◽  
pp. 1766
Author(s):  
Nayanika Gaur ◽  
Manish Jha
Keyword(s):  
Histopathological Examination ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Cystic Degeneration ◽  
Ovarian Malignancy ◽  
Imaging Studies ◽  
Diagnostic Dilemma ◽  
Fibroid Uterus ◽  
Wide Range

Leiomyoma is one of the most commonly encountered benign gynaecological neoplasms. With a wide range of symptoms, sometimes even asymptomatic, these tumors are easy to diagnose and treat, unless there are degenerative changes, which makes them difficult to diagnose and differentiating them from other serious conditions including malignancy, thereby, complicating their management also. Here, the case present to you a case of 48-year-old women with symptoms and clinical examination suggesting fibroid uterus but imaging studies inconclusive to differentiate fibroid uterus with ovarian malignancy, thus, creating a diagnostic dilemma. Ultimately, patient underwent exploratory laparotomy, keeping possibility of ovarian malignancy. Histopathological examination of the specimen of total abdominal hysterectomy with bilateral salpingo-oopherectomy concluded extensive cystic degeneration of leiomyoma and no evidence of malignancy.

scholarly journals A Novel Case of Fibroids after Menopause

2018 ◽  
Vol 2018 ◽  
pp. 1-2
Author(s):  
Jade Edwards ◽  
Hamza Katali
Keyword(s):  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Younger Women ◽  
Benign Pathology ◽  
Leiomyomatosis Peritonealis Disseminata ◽  
Long Term Follow Up ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index

Fibroids are a condition commonly seen as part of routine gynaecological practice and generally present with menorrhagia, infertility, or pressure symptoms depending on their exact location. We report the case of a postmenopausal 57-year-old lady presenting with left-sided pain and frequency with a complex 15 cm mass mid pelvis and an adjacent additional 7 cm cyst but a risk of malignancy index suggesting benign pathology. She underwent total abdominal hysterectomy (TAH) and right-sided salpingo-oophrectomy (RSO) on recommendation of the multidisciplinary team (MDT) and histology confirmed leiomyomatosis peritonealis disseminata. This rare but important condition is often confused with peritoneal carcinomatosis on imaging. The mainstay of treatment involves lesion and omental excision followed by removal of hormonal stimuli although this approach must be personalised as many younger women may wish to retain their uteri. Long-term follow-up is essential due to the potential for malignant transformation.

scholarly journals Subacute uterine inversion following an induced abortion in a teenage girl: a case report

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Asiphas Owaraganise ◽  
Leevan Tibaijuka ◽  
Joseph Ngonzi
Keyword(s):  
Rare Complication ◽  
Hypovolemic Shock ◽  
Lower Abdominal Pain ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Unsafe Abortion ◽  
Axillary Temperature ◽  
Uterine Inversion ◽  
History Of ◽  
Failed Surgery

Abstract Background Subacute uterine inversion is a very rare complication of mid-trimester termination of pregnancy that should be considered in a situation where unsafe abortion occurs. Case presentation We present a case of subacute uterine inversion complicated by hypovolemic shock following an unsafe abortion in a 17-year-old nulliparous unmarried girl. She presented with a history of collapse, mass protruding per vagina that followed Valsalva, and persistent lower abdominal pain but not vaginal bleeding. This followed her second attempt to secretly induce an abortion at 18 weeks amenorrhea. On examination, she was agitated, severely pale, cold on palpation, with an axillary temperature of 35.8 °C, a tachycardia of 143 beats per minute and unrecordable low blood pressure. The abdomen was soft and non-tender with no palpable masses; the uterine fundus was absent at its expected periumbilical position and cupping was felt instead. A fleshy mass with gangrenous patches protruding in the introitus was palpated with no cervical lip felt around it. We made a clinical diagnosis of subacute uterine inversion complicated with hypovolemic shock and initiated urgent resuscitation with crystalloid and blood transfusion. Non-operative reversal of the inversion failed. Surgery was done to correct the inversion followed by total abdominal hysterectomy due to uterine gangrene. Conclusion Our case highlights an unusual presentation of subacute uterine inversion following unsafe abortion. This case was managed successfully but resulted in significant and permanent morbidity.

scholarly journals A rare association of uterine leiomyoma with mesenteric vein thrombosis and bowel gangrene: case report

2021 ◽  
Vol 10 (4) ◽  
pp. 1721
Author(s):  
Rajneesh Rawat ◽  
Manik Gedam ◽  
Jyoti Baghel ◽  
Shalini Baghel
Keyword(s):  
Uterine Fibroid ◽  
Uterine Fibroids ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Mesenteric Vein Thrombosis ◽  
Mesenteric Vein ◽  
Vein Thrombosis ◽  
Jejunoileal Anastomosis ◽  
Bowel Gangrene

Uterine fibroids are the most common benign pelvic tumors in women. There are many complications reported with fibroids. However, mesenteric vein thrombosis and small bowel gangrene caused by a uterine fibroid are rare. This manuscript reports a rare case of 40 year female with a large uterine fibroid associated with mesenteric vein thrombosis and bowel ischemia. She underwent exploratory laparotomy in which resection of gangrenous bowel including jejunum and ileum was done along with left sided jejunostomy and right sided ileostomy. Total abdominal hysterectomy with bilateral salpingooophorectomy was done followed by jejunoileal anastomosis 6 weeks later. Hence, in patients presenting with acute abdomen and uterine fibroids, bowel gangrene must be included in the differential diagnosis.

scholarly journals Breast ovarian cancer syndrome

2021 ◽  
Vol 8 (8) ◽  
pp. 2454
Author(s):  
Abhirup H. R. ◽  
Priyanka Kenchetty ◽  
Aishwarya K. Chidananda
Keyword(s):  
Ovarian Cancer ◽  
Early Stage ◽  
Radical Mastectomy ◽  
Abdominal Distension ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Care Patient ◽  
Human Beings ◽  
Cancer Syndrome ◽  
Brca1 And Brca2

BRCA1 and BRCA2, known as breast and ovarian cancer predisposition genes, were discovered in the 1990s. As part of a normal genetic structure, these genes are intrinsic to all human beings, but they are mutated in some individuals increasing the risk for breast and ovarian cancers development. BRCA1 is not only expressed in endocrine tissues but is also detected in other cells such as the neuroepithelial cells in the early stage of cell development. Like BRCA1, BRCA2 is also expressed in a wide variety of tissues and is observed with higher rates in the breast and thymus and with lower rates in the lung, ovary and spleen. We presented to you a case of 40 year old female admitted in surgical ward with lump in the left breast since 2 months with ipsilateral discrete axillary lymphadenopathy. Bilateral sono-mammography showed BIRADS V lesion in left breasts with satellite nodules. Ultrasonography of abdomen and pelvis showed large left adnexal solid mass lesion and right sided ovarian cyst with retrocaval, preaortic lymphadenopathy. Patient underwent a diagnostic laparoscopy which was converted to a laparotomy. Total abdominal hysterectomy with bilateral salphingo-oophorectomy was done. For the breast lump, patient underwent left sided modified radical mastectomy. Gene testing for revealed BRCA1 positivity. Chemotherapy was given to cover both breast and ovarian carcinoma. Patient came back with abdominal distension after 9 months and was offered palliative care. Patient succumbed for disease after 1 year after diagnosis. We reviewed the literature for the same.

scholarly journals Post Caesarean Vesicouterine Fistula Causing Menouria

2013 ◽  
Vol 25 (1) ◽  
pp. 46-48
Author(s):  
R Sultana ◽  
N Haque
Keyword(s):  
Fistulous Tract ◽  
Bladder Wall ◽  
Rare Event ◽  
Lower Abdominal Pain ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
The Body ◽  
Vesicouterine Fistula ◽  
Fibroid Uterus ◽  
Urogenital Fistula

Vesicouterine fistula is an uncommon urogenital fistula. The incidence is on the rise because of increasing incidence of Caesarean sections. Cyclical Haematuria or Menouria is an important clinical feature of this fistula which may or may not be associated with urinary incontinence depending on the location of the fistulous tract. We present a case report of Post caesarean section Vesicouterine fistula following 2 Caesarean sections. This was successfully managed by laparotomy with repair of fistulous tract in bladder wall and Total Abdominal Hysterectomy for multiple Fibroid uterus done. Menouria is a rare event in Gynecology and one should always keep this possibility in mind when there is cyclical haematuria. A 42 year old Bangladeshi woman was hospitalized with complaints of menorrhagia, lower abdominal pain for last 8 years, cyclical hematuria for last 20 years. She was mildly anemic, haemodynamically stable and regularly menstruating women. The primary Ultrasound scans suggested multiple fibroid with cystic ovary in left side. Cystoscopy was done and findings are a fistulous opening in the bladder measuring around 7mm in size. It was supratrigonal in position. The patient had no history of Endometriosis, Pelvic irradiation therapy, Inflammatory disease, Trauma or Malignancy. Initially there was dilemma in her diagnosis and the patient was diagnosed as a case of bladder Endometriosis besides fibroid uterus. So surgery was planned and Total Abdominal Hysterectomy & bilateral salphingo-oophorectomy done. There was a fistula about 3cm × 2cm in the lower part of the body of uterus connecting with the base of Bladder. Fistula repaired after dissection, patient follow up done and catheter removed after 14 days without any complications. Vesicouterine fistula can be prevented if care is taken to separate the bladder from the uterus during repeat Caesarean sections. DOI: http://dx.doi.org/10.3329/medtoday.v25i1.16072 Medicine Today 2013 Vol.25(1): 46-48

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. 

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