scholarly journals Bilateral huge fimbrial cysts with torsion of right fallopian tube

2012 ◽  
Vol 10 (2) ◽  
pp. 153-154 ◽  
Author(s):  
P Rijal ◽  
H Pokharel ◽  
S Chhetri ◽  
T Pradhan ◽  
A Agrawal

A case of bilateral fimbrial cyst with torsion of right side is presented, occurring in a 32 year old female. She presented in outpatient department with pain abdomen and feeling of mass in lower abdomen since six months. Initial assessment of ovarian cyst was made. Ultrasound showed cystic structures in left adnexa and complex cyst in right adnexa. Laprotomy was performed and bilateral fimbrial cysts in fallopian tubes were identified with torsion on right side which was subsequently confirmed on histopathology. Although huge fimbrial cysts with torsion of fallopian tube is rare, it should be considered in differential diagnosis of abdominal mass with pain in females.DOI: http://dx.doi.org/10.3126/hren.v10i2.6588 Health Renaissance 2012; Vol 10 (No.2); 153-154 

Author(s):  
Sonal Bhuyar ◽  
Bhavana Sontakke ◽  
Neha Dharmale

Fibroid/Leiomyoma is the most common benign tumor of the uterus, arising from uterine smooth muscle. Atypical leiomyomas are rare forms of Myoma (fibroid uterus), of which recurrent atypical leiomyoma post hysterectomy is rarer and its converting in leiomyosarcoma arising from vault is rarest.  Here we report an unusual case of a 76yrs female, with leiomyosarcoma in an atypical leiomyoma arising from vault post-hysterectomy. A 76-year-old P3L3 patient presented with pain and distension of abdomen, post hysterectomy done 4 years back for chronic inversion and cervical fibroid polyp she was diagnosed as atypical leiomyoma. Laparotomy was done with a provisional diagnosis of leiomyosarcoma. Though Rarest (0.13-0.26%), a differential diagnosis of neoplastic changes should be kept in mind in patients with atypical leiomyoma, in patients presenting with any mass/pain abdomen, irrespective of any gynaecological complaints. This case shows that though it is unexpected after hysterectomy, leiomyosarcoma has to be considered in a case of abdominal mass. Atypical leiomyoma develops approximately in one to five cases out of 1,000 women with fibroid and it getting converted in leiomyosarcoma is rarest. Hence, diagnosis of leiomyosarcoma should always be kept in mind though the patient is hysterectomised.


2018 ◽  
Author(s):  
Cian Murphy

UNSTRUCTURED DemDx is a differential diagnosis app for students and junior doctors. Starting with a patient’s presenting complaint the app goes through a step-by-process through history, examination and investigation findings to an increasingly refined differential diagnosis list until a single most likely diagnosis is reached. The aim of this project was to assess the accuracy of DemDx in an Emergency Department (ED) setting. Anonymised clinical records for 100 patients were retrospectively obtained from the ED in Beth Israel, Boston, USA. This contained the differential diagnoses from the clerking doctor, who performed the initial assessment (D1). The discharge diagnosis was used as the gold standard diagnosis (D2). D1 agreed with D2 in 74.44% of cases while DemDx agreed with D2 in 85.56% of cases (p=0.0003716). When the first, and thus most likely, differential was taken from D1 and DemDx, they agreed with D2 in 20 and 18.8% of cases, respectively (p=0.1428). This demonstration of the clinical accuracy of the app highlights how it can be a useful medical student education tool.


2020 ◽  
Vol 12 (04) ◽  
pp. 276-280
Author(s):  
Devesh Sharma ◽  
Anjali Vinocha

Abstract Objectives It is not clearly known whether some benign (simple) ovarian cysts can convert into cancerous cysts. Size of cyst and wall abnormalities do predict the potentiality of malignancy. Not many studies have been done to explore the malignant potential of large-sized (> 5 cm) unilocular ovarian cysts without wall abnormalities. This study evaluated the correlation between ultrasonographic size of benign ovarian cysts and carbohydrate antigen 125 (CA-125) levels. Methodology Sixty (60) premenopausal women were recruited for the study preoperatively, based on transvaginal ultrasound (TVUS) findings present in the case record sheet received along with the CA-125 sample in the biochemistry laboratories. Those cases with elevated CA-125 levels were selected, where patients had unilocular ovarian cysts without wall abnormalities. CA-125 was done using ECLIA methodology (Cobas e411, Germany). Statistical correlation was calculated between the ovarian cyst size and CA-125 levels using Spearman’s Rho coefficient. Results Mean age group of subjects were 29.7 ± 7.3 years and mean value of CA-125 (normal < 35 IU/mL) was found to be increased: 118.0 ± 147.1 IU/mL so was the mean diameter of cysts (cut off ≤ 5 cm): 48.6 ± 59.8 cm. No correlation was found between CA-125 levels and volume of ovarian cyst (r = 0.005, p = 0.680) for all subjects. Conclusions The lack of correlation between size of ovarian cysts and CA-125 levels provides a hint that the ovarian cyst epithelium does not directly express CA-125 and it may come from sites like the fallopian tube. Thus, raised level of CA-125 in benign ovarian cyst should be followed-up more closely, demanding assessment of fallopian tubes for early diagnosis of ovarian cancer. Also, algorithms can be explored to include size of ovarian cyst and CA 125 levels to predict ovarian cancer.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Sara L. Schaefer ◽  
Amy L. Strong ◽  
Sheena Bahroloomi ◽  
Jichang Han ◽  
Michella K. Whisman ◽  
...  

Abstract Background Lipoleiomyoma is a rare, benign variant of the commonplace uterine leiomyoma. Unlike leiomyoma, these tumors are composed of smooth muscle cells admixed with mature adipose tissue. While rare, they are most frequently identified in the uterus, but even more infrequently have been described in extrauterine locations. Case presentation We describe a case report of a 45-year-old woman with a history of in vitro fertilization pregnancy presenting 6 years later with abdominal distention and weight loss found to have a 30-cm intra-abdominal lipoleiomyoma. While cross-sectional imaging can narrow the differential diagnosis, histopathological analysis with stains positive for smooth muscle actin, desmin, and estrogen receptor, but negative for HMB-45 confirms the diagnosis of lipoleiomyoma. The large encapsulated tumor was resected en bloc. The patients post-operative course was uneventful and her symptoms resolved. Conclusions Lipoleiomyoma should be considered on the differential diagnosis in a woman with a large intra-abdominal mass. While considered benign, resection should be considered if the mass is symptomatic, and the diagnosis is unclear or there is a concern for malignancy.


2018 ◽  
Vol 13 (3) ◽  
pp. 63-65
Author(s):  
Amarnath Thakur ◽  
Ganesh Dangal ◽  
Aruna Karki ◽  
Hema Kumari Pradhan ◽  
Ranjana Shrestha ◽  
...  

Mucinous cystadenoma arises from the totipotent surface epithelium of the ovary. Its association with Brenner tumor suggests its origin as mucinous metaplasia of the epithelioid cells. The chance of malignancy is 5–10 percent. Patients usually present with abruptly increasing abdominal mass. Cystectomy is the management of choice in these cases. It was managed by laparoscopy.


PEDIATRICS ◽  
1984 ◽  
Vol 73 (2) ◽  
pp. 206-215
Author(s):  
J. Fred Johnson ◽  
Lawrence H. Robinson

Neonatal abdominal plain films were prospectively analyzed over a 41-month period in order to generate a differential diagnosis for focal bowel distension during the first 6 weeks of life. A total of 31 examples of locally distended bowel were collected. The study discredits the concept that asymmetrically distended bowel in the newborn is usually caused by necrotizing enterocolitis (only 9/31 cases) and indicates that distended bowel in the lower abdomen or left upper quadrant is often caused by air trapping in normal but redundant rectosigmoid (11 cases) or in distal transverse colon (three cases). Five other pathologic conditions not normally specified in differential diagnoses of focally distended bowel included inguinal hernia (three cases), small bowel atresia (two cases), midgut volvulus (one case), Hirschsprung's disease (one case), and small left colon (one case). The study emphasizes the value of sequential supine and prone filming for distinguishing normal from pathologic dilated loops of bowel.


Author(s):  
И.А. Баландина ◽  
А.М. Некрасова ◽  
А.А. Баландин

Работа основана на морфологическом исследовании ампул маточных труб 130 рожавших женщин молодого и старческого возраста. Применены макрометрический, гистологический, иммуногистохимический и микрометрический методы исследования. Выявлены закономерности возрастной морфологической изменчивости ампулы маточной трубы, проявляющиеся в уменьшении параметров их длины, а также наружных диаметров в середине ампулы и в местах перехода перешейка в ампулу и ампулы в воронку от молодого возраста к старческому возрасту. Гистоархитектоника ампул маточных труб у женщин в старческом возрасте характеризуется уплощением эпителия слизистой оболочки, образующей обилие близлежащих утолщенных складок, формирующих неравномерное сужение просвета ампулы. Определяется истончение мышечной оболочки с разрастанием вместо нее соединительной ткани и скоплением адипоцитов в подсерозной основе. В старческом возрасте отмечается более выраженная экспрессия виментина, прослеживающаяся не только в эндотелии и субэндотелиальном слое кровеносных сосудов, включая капилляры, но и в отдельных фибробластах. Установлено, что особенности микрометрических характеристик ампул маточных труб заключаются в уменьшении внутреннего периметра эпителиальной выстилки и площади просвета, наряду с увеличением площади их стенки при срединном сечении, в старческом возрасте в сравнении с молодым. The work is based on a morphological study of ampoules of the fallopian tubes of 130 young and senile women who gave birth. Macrometric, histological, immunohistochemical and micrometric methods of investigation were applied. The regularities of age-related morphological variability of the fallopian tube ampoule are revealed, which are manifested in a decrease in the parameters of their length, as well as external diameters in the middle of the ampoule and at the places of transition of the isthmus into the ampoule and ampoule into the funnel from young age to old age. Histoarchitectonics of ampoules of the fallopian tubes in women in old age is characterized by flattening of the epithelium of the mucous membrane, which forms an abundance of nearby thickened folds that form an uneven narrowing of the lumen of the ampoule. The thinning of the muscle membrane is determined with the growth of connective tissue instead of it and the accumulation of adipocytes in the subserose base. In old age, there is a more pronounced expression of vimentin, which can be traced not only in the endothelium and subendothelial layer of blood vessels, including capillaries, but also in individual fibroblasts. It was found that the features of the micrometric characteristics of the fallopian tube ampoules consist in a decrease in the inner perimeter of the epithelial lining and the lumen area, along with an increase in the area of their wall at the median cross-section in old age compared with young age.


1970 ◽  
Vol 37 (2) ◽  
pp. 66-67
Author(s):  
Hasina Afroz ◽  
Rabeya Akhter ◽  
Shahela Jesmin

Haemoperitoneum secondary to ruptured corpus luteum is a rare complication for women of reproductive life. The differential diagnosis of hemoperitoneum includes various types of acute abdomen that usually associated with acute lower abdominal pain and swelling lower abdomen. The differential diagnosis includes ruptured ectopic pregnancy, ruptured chocolate cyst, twisted ovarian tumor, pelvic inflammatory disease and pelvic peritonitis. Ruptured hemorrhagic corpus luteum is an uncommon cause of acute abdomem. Its occurrence is unknown but is likely quite frequent and without symptoms. Most cases are self limiting; enquire only observation with abdominal pain relieved with analgesics. Some need laparoscopy or laparotomy to achieve homeostasis if the patient is haemodynamically unstable. Key word: Haemoperitoneum, Appendicitis, Ruptured Corpus luteum.   DOI: 10.3329/bmj.v37i2.3596 Bangladesh Medical Journal 37(2) 2008 66-67


2018 ◽  
Vol 46 ◽  
pp. 5
Author(s):  
Jia-San Zheng ◽  
Zheng Wang ◽  
Jia-Ren Zhang ◽  
Shuang Qiu ◽  
Ren-Yue Wei ◽  
...  

Background: Ectopic pregnancy mainly refers to tubal pregnancy and abdominal pregnancy. Tubal pregnancy presents as an implanted embryo that develops in the fallopian tubes, and is relatively common in humans. In animals, tubal pregnancy occurs primarily in primates, for example monkeys. The probability of a tubal pregnancy in non-primate animals is extremely low. Abdominal pregnancy is a type of ectopic pregnancy that occurs outside of the uterus, fallopian tube, ovary, and ligament(broad ligament, ovarian ligament, suspensory ligament).This paper describes two cases of ectopic pregnancy in cats.Cases: Cat 1. The presenting sign was a significant increase in abdominal circumference. The age and immune and sterilization status of the cat were unknown. On palpation, a 4 cm, rough, oval-shaped, hard mass was found in the posterior abdomen. Radiographic examination showed three high-density images in the posterior abdomen. The fetus was significantlycalcified and some feces was evident in the colon. The condition was preliminarily diagnosed as ectopic pregnancy. Cat 2. The owner of a 2-year-old British shorthair cat visited us because of a hard lump in the cat’s abdomen. The cat had a normal diet and was drinking normally. Routine immunization and insect repulsion had been implemented. The cat had naturally delivered five healthy kittens two months previous. Radiographs showed an oval-shaped mass with a clear edge in the middle abdominal cavity. Other examinations were normal. The case was preliminarily diagnosed as ectopic pregnancy, and the pregnancy was surgically terminated. The ectopic pregnancies were surgically terminated. During surgery, the structures of the uterus and ovary of cat 1 were found to be intact and the organs were in a normal physiological position.Cat 1 was diagnosed with primary abdominal pregnancy. In cat 2, the uterus left side was small and the fallopian tube on the same side was both enlarged and longer than normal. Immature fetuses were found in the gestational sac. Thus, cat 2 was diagnosed with tubal ectopic pregnancy based on the presenting pathology.Discussion: Cats with ectopic pregnancies generally show no obvious clinical symptoms. The ectopic fetus can remain within the body for several months or even years. Occasionally, necrotic ectopic tissues or mechanical stimulation of the ectopic fetus can lead to a systemic inflammatory response, loss of appetite, and apathy. The two cats in our reportshowed no significant clinical symptoms. To our knowledge, there have been no previous reports of the development of an ectopic fetus to maturity, within the abdominal cavity of felines, because the placenta of cats cannot support the growth and development of the fetus outside of the uterus. Secondary abdominal ectopic pregnancy, lacking any signs of uterine rupture is likely associated with the strong regenerative ability of uterine muscles. A damaged uterus or fallopian tube can quickly recover and rarely leaves scar tissue. In the present report, cat 1 showed no apparent scar tissue, nor signs of a ruptured ovary or fallopian tubes. It was diagnosed with primary ectopic abdominal pregnancy, which could arise from the descent of the fertilized egg from the fallopian tube into the abdominal cavity. There was an abnormal protrusion in left of the fallopian tubes in cat 2, to which the gestational sac was directly connected. Based on pathological examination of the uterus, fallopian tubes, and gestational sac, the cat was diagnosed with a tubal pregnancy. Placental tissues and signs of fetal calcification were observed in both the fallopian tube and gestational sac.Keywords: tubal pregnancy, abdominal pregnancy, feline, ectopic fetus, fallopian tube, gestational sac.


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