Mucinous Ovarian Tumors With Anaplastic Mural Nodules: Case Report

Ovarian mucinous cystic tumors may be associated with various types of mural nodules, which can be classified as benign or malignant (anaplastic carcinoma, sarcoma, carcinosarcoma). However, anaplastic malignant nodules have rarely been reported. Here, we present a case of a 35-year-old woman who presented with abdominal discomfort. Ultrasonography showed a large cystic mass in the pelvic and abdominal cavities measuring 337 × 242 mm. Abdominal computed tomography revealed upper anterior and posterior uterine pelvic cystic lesions based on multiple nodule partition walls and classes. During hospitalization, the patient underwent exploratory laparotomy, which revealed a poorly differentiated ovarian malignant tumor, and subsequent surgical excision was performed. The pathological analysis of the surgical samples of the right ovary revealed a mucinous ovarian tumor, while the mural nodules were classified as anaplastic carcinoma. After surgery, the patient started receiving chemotherapy. Unfortunately, the patient died 6 months later. Mucinous tumor occurring with an anaplastic carcinoma is rare, and the current diagnostic methods are not sufficient in providing an early and accurate diagnosis. Most patients are already in the advanced stage upon diagnosis and combined with poorly differentiated pathological features, the prognosis is extremely poor. Clinicians need to improve the clinical evaluation before surgery and conduct preoperative preparation and communication to improve the prognosis of patients as much as possible.

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Diagnostic Dilemma of a Rare, Giant Retroperitoneal Schwannoma: A Case Report and Review of Literature

Case Reports in Oncological Medicine ◽

10.1155/2014/628538 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Mahendra Singh ◽

Lovekesh Kumar ◽

Rajkumar Chejara ◽

Om Prakash Prasad ◽

Yuvraj Kolhe ◽

...

Keyword(s):

Low Frequency ◽

Surgical Excision ◽

Abdominal Distension ◽

Exploratory Laparotomy ◽

Postoperative Recovery ◽

Cystic Mass ◽

Imaging Features ◽

Diagnostic Dilemma ◽

Complete Surgical Excision ◽

Retroperitoneal Schwannoma

Schwannoma is a benign tumour of peripheral nerve sheath. It usually arises from head, neck, and trunk. Retroperitoneal schwannoma is a rare entity, accounting for only 0.3–3% of total schwannomas. Majority of retroperitoneal schwannomas reported in literature have a diameter of 5 to 15 cm. Preoperative diagnosis is difficult due to low frequency, nonspecific clinical course, and nonspecific imaging features. Histology usually provides definitive diagnosis. Schwannomas are solitary, well-circumscribed, and noninvasive, so complete surgical excision provides good result. We report a case of a 23-year-old male, who presented with progressive abdominal distension and intermittent episodes of intestinal obstruction. CECT was suggestive of huge solid-cystic mass in abdominopelvic region. Image guided percutaneous aspiration revealed around 1 litre of frank pus and FNAC was suggestive of abscess. Exploratory laparotomy revealed a large 32 × 28 × 26 cm mass with solid and cystic components containing 1 litre of pus. Histological features of tumour were suggestive of benign schwannoma and immunohistochemistry for S-100 was positive. Postoperative recovery was uneventful. We report this case of a retroperitoneal schwannoma because of giant size, rare location, unusual presentation, and diagnostic dilemma.

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Pathologically confirmed brain metastases from primary uterine cervical tumors: two cases and a literature review

World Journal of Surgical Oncology ◽

10.1186/s12957-019-1720-7 ◽

2019 ◽

Vol 17 (1) ◽

Cited By ~ 1

Author(s):

Yalan Bi ◽

Lei Li

Keyword(s):

Cervical Cancer ◽

Brain Metastasis ◽

Literature Review ◽

Parietal Lobe ◽

Neuroendocrine Differentiation ◽

Occipital Lobe ◽

Surgical Excision ◽

Intracranial Metastasis ◽

Poorly Differentiated ◽

The Right

Abstract Background Pathologically confirmed brain metastasis from primary cervical cancer is extremely rare. Herein, we report two cases of intracranial metastasis from cervical cancer that were histopathologically confirmed after surgical excision. In addition, we conducted a literature review to characterize the clinical manifestation, pathogenesis, and treatment of these patients. Case summary Among the 1800 patients with primary cervical cancer who received therapy at our center from 2010 to 2018, two patients (0.1%) had definite histopathological evidence of brain metastasis. A 46-year-old female who had a history of poorly differentiated stage IIB cervical cancer with neuroendocrine differentiation presented with a solitary mass in the right occipital lobe 26 months after the initial diagnosis. She underwent surgery and chemotherapy but died of disease progression 9 months later. Another 55-year-old female diagnosed with poorly differentiated stage IVB cervical squamous cancer presented with a solitary mass in the right frontal lobe 16 months after simple hysterectomy. Twelve months later, multiple lesions were observed in the bilateral frontal-parietal lobe. The lesions were treated by surgery and stereotactic radiosurgery. The patient died of multiple organ failure 14 months later. Conclusion The pathogenesis and best management of brain metastasis from cervical cancer are not clear. Highly invasive subtypes or advanced cancer stages may be the key clinicopathological factors of brain metastasis. Surgical treatment is warranted in patients with a good health status and without metastasis to other sites.

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Rare finding of a large cell poorly differentiated neuroendocrine tumor in the colon

International Surgery Journal ◽

10.18203/2349-2902.isj20202418 ◽

2020 ◽

Vol 7 (6) ◽

pp. 1999

Author(s):

Stephanie A. Luster ◽

Daniel K. Kakish ◽

Manroop Gill ◽

Narendra Kumthekar

Keyword(s):

Neuroendocrine Tumor ◽

Bowel Obstruction ◽

Exploratory Laparotomy ◽

Large Cell ◽

Ascending Colon ◽

Liver Mass ◽

Poorly Differentiated ◽

Right Lobe ◽

Rare Malignancy ◽

The Right

A 43 year old female presented to the emergency department for nausea, vomiting and abdominal pain secondary to a bowel obstruction subsequently revealed to be a poorly differentiated large cell neuroendocrine tumor of the colon. After a CT scan showed a mass in the ascending colon with possible metastasis to the right lobe of the liver, an exploratory laparotomy was performed. A hemicolectomy was performed with biopsy of the liver mass. Pathology was consistent with large cell neuroendocrine tumor in all specimens including the liver biopsy, ascending colon, and transverse colon. Although large cell neuroendocrine tumors of the colon are a rare malignancy, they are an important consideration in the workup of multiple colonic masses with metastases, especially in patients presenting with bowel obstruction. The literature on poorly differentiated large cell neuroendocrine cancer and treatment is reviewed. Poorly differentiated large cell neuroendocrine tumor is a rare pathology but should be included in the differential diagnosis in patients presenting with a colon mass and bowel obstruction.

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Huge Retroperitoneal Dermoid: A Presentation

The Surgery Journal ◽

10.1055/s-0039-1697630 ◽

2019 ◽

Vol 05 (04) ◽

pp. e142-e145

Author(s):

Tanweerul Huda ◽

Mahendra Pratap Singh

Keyword(s):

Histopathological Examination ◽

Cystic Teratoma ◽

Exploratory Laparotomy ◽

Cystic Mass ◽

Contrast Enhanced ◽

Chief Complaints ◽

Region Contrast ◽

The Right ◽

Enhanced Computed Tomography ◽

Upper Abdomen

AbstractTeratoma can be defined as a true neoplasm that contains tissues that either are foreign to the primary site of origin or are histologically diverse and represent more than one of the embryonic germ layers. A 20-year-old female patient presented with chief complaints of swelling in the right upper abdomen since childhood and back pain for the past 4 years. Per abdomen, examination revealed a lump of around 15 cm in size in the right hypochondrial region extending to the epigastric region. Contrast-enhanced computed tomography abdomen revealed a 14.3 × 14.1 × 17.4 cm well-defined heterogeneously hypoattenuating nonenhancing complex cystic mass with focal areas of calcifications and fat attenuation in retroperitoneum. The patient was taken up for exploratory laparotomy and a tumor was found in the retroperitoneum, retrocavally and was excised with due care. Histopathological examination features were suggestive of mature cystic teratoma. The postoperative stay was uneventful.

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A rare case of retroperitoneal teratoma with obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome

BMJ Case Reports ◽

10.1136/bcr-2021-243302 ◽

2021 ◽

Vol 14 (5) ◽

pp. e243302

Author(s):

Kazuki Mitani ◽

Elena Yukie Uebayashi ◽

Hisanori Fujino ◽

Shinichi Sumimoto

Keyword(s):

Good Condition ◽

Surgical Excision ◽

Abdominal Distension ◽

Cystic Mass ◽

Renal Anomaly ◽

Complete Surgical Excision ◽

Ohvira Syndrome ◽

Obstructed Hemivagina ◽

The Right

A 9-month-old girl presented with progressive abdominal distension. Imaging revealed a huge cystic mass in the left retroperitoneum with solid components. The right kidney was absent and hydrometrocolpos was found. Tumour drainage and complete surgical excision were performed. A bulge in the right side of the uterus, suggestive of a uterine anomaly, was seen on laparoscopic observation. Pathology was consistent with teratoma with a small portion of immature neural tissue. The patient was discharged in good condition and was advised regular follow-up.

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A Case Giving Proof of Pathogenesis of Abdominoscrotal Hydrocele: A Case Report

Soonchunhyang Medical Science ◽

10.15746/sms.21.022 ◽

2021 ◽

Vol 27 (2) ◽

pp. 91-94

Author(s):

Hee Jo Yang ◽

Myoung Won Son ◽

Doo Sang Kim

Keyword(s):

Abdominal Cavity ◽

Surgical Excision ◽

Cystic Mass ◽

Palpable Mass ◽

Lower Quadrant ◽

Uncommon Condition ◽

Abdominoscrotal Hydrocele ◽

The Right ◽

Right Lower Quadrant

An abdominoscrotal hydrocele (ASH) is an uncommon condition characterized by cystic mass that occupies the scrotum and abdomen. The characteristic aspect is the presence of two hydrocele sacs in the abdominal cavity and the scrotum, and compression of one side causes enlargement of the other side, thereby connecting the two sacs. There are several hypotheses regarding the occurrence of ASH. However, the evidence of the hypotheses is lacking. The patient was a 52-year-old male. During observation of the right inguinoscrotal hydrocele, the patient complained of a palpable mass lesion on the right lower quadrant of the abdomen. Physical examination revealed ASH that occurred with the growth of the inguinoscrotal hydrocele. This was further confirmed by sequential imaging test thereby proposing the verification of cephalad extension of hydrocele. The surgical excision was recommended and inguinal exploration was performed under general anesthesia. No evidence of relapse was observed during the 2-year follow-up period after surgery. The present case proves the cephalad extension of hydrocele among other hypotheses on the etiology of ASH.

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CASE REPORT: ENDOMETRIAL STROMAL SARCOMA AND LIPOSARCOMA IN AN AFRICAN HEDGEHOG (Atelerix albiventris)

Taiwan Veterinary Journal ◽

10.1142/s1682648515720117 ◽

2016 ◽

Vol 42 (03) ◽

pp. 181-186 ◽

Cited By ~ 3

Author(s):

Fang-Yi Tsai ◽

Hui-Ming Chang ◽

Hao-Kai Chang ◽

Ju-Pai Kao ◽

Jiunn-Wang Liao

Keyword(s):

Smooth Muscle Actin ◽

Abdominal Mass ◽

Endometrial Stromal Sarcoma ◽

Surgical Excision ◽

Exploratory Laparotomy ◽

Species Interaction ◽

Neoplastic Cells ◽

Stromal Sarcoma ◽

Subcutaneous Mass ◽

The Right

A 2-year-7-month-old female intact African hedgehog was presented with a subcutaneous mass around the right side of the neck as well as an intra-abdominal mass found during palpation. Surgical excision and exploratory laparotomy were performed. A uterine mass was identified during laparotomy and ovariohysterectomy was performed. The botryoid mass measured [Formula: see text][Formula: see text]cm and was located in the right uterine horn. It had a meat-like texture and was yellow-white and dark red in color. The removed subcutaneous mass measured [Formula: see text][Formula: see text]cm. The mass was well-encapsulated and had a yellow-white homogeneous texture on the cut surface. Histologically, the myometrium was invaded by neoplastic cells and the tissue boundaries were not obvious. Neoplastic cells were arranged in a whirling or intersecting pattern, with strong angiogenesis present. Vacuolated nuclei were round and oval to cigar shaped, with one to multiple nucleoli present. Immunohistochemistry revealed a positive reaction for CD10, but a negative reaction for smooth muscle actin (SMA) and desmin in the uterine neoplastic cells. Histologically, well-differentiated adipocytes with sheets of undifferentiated polygonal neoplastic cells, which were characterized by vacuolated nuclei with prominent multiple nucleoli, were found in the subcutaneous mass. Neoplastic cells of the subcutaneous mass were positively stained with antibodies of MDM2 and estrogen receptor (ER), but failed to give a positive result for vimentin because the cross-species interaction was insufficient. The definitive diagnosis was endometrial stromal sarcoma and liposarcoma in an African hedgehog.

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Mucinous Tumor of the Gallbladder With a Separate Nodule of Anaplastic Carcinoma

Archives of Pathology & Laboratory Medicine ◽

10.5858/1999-123-1280-mtotgw ◽

1999 ◽

Vol 123 (12) ◽

pp. 1280-1284

Author(s):

Tsutomu Mizuno ◽

Tadaaki Eimoto ◽

Toyohiro Tada ◽

Hisashi Tateyama ◽

Hiroshi Inagaki ◽

...

Keyword(s):

Preoperative Diagnosis ◽

Epithelial Membrane Antigen ◽

Immunohistochemical Study ◽

Anaplastic Carcinoma ◽

Mucinous Tumor ◽

First Report ◽

Cystic Tumors ◽

Old Japanese ◽

Atypical Cells ◽

Mural Nodules

Abstract A case of mucinous tumor of the gallbladder with a separate nodule of anaplastic carcinoma is reported. The patient was an 83-year-old Japanese man who underwent cholecystectomy under the preoperative diagnosis of a mucus-producing gallbladder tumor. A mucinous tumor was found in the neck and distal body of the gallbladder, associated with a separate nodule in the fundus. The latter nodule was initially diagnosed as a benign xanthogranulomatous lesion. However, the immunohistochemical study revealed that the atypical cells in the superficial part of the nodule were positive for cytokeratin and epithelial membrane antigen, confirming the diagnosis of anaplastic carcinoma. Although the occurrence of mural nodules in mucinous cystic tumors of the ovary and pancreas is well reported, to our knowledge, this is the first report on the occurrence of a mucinous tumor with a nodule of anaplastic carcinoma in the gallbladder.

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Laporan Kasus Ureterocele dengan Double Collecting Sistem Bilateral

Jurnal Integrasi Kesehatan & Sains ◽

10.29313/jiks.v2i2.6259 ◽

2020 ◽

Vol 2 (2) ◽

Author(s):

Suci Syamsiah Ramdhini ◽

Freedy L.P. Tambunan ◽

Ristaniah D. Soetikno

Keyword(s):

Complicated Urinary Tract Infection ◽

External Genitalia ◽

Surgical Excision ◽

Cystic Mass ◽

Duplex System ◽

System A ◽

First Child ◽

History Of ◽

The Right ◽

Collecting System

Ureterocele adalah kelainan kongenital pada ureter terminal. Ureterocele berupa massa kistik yang berdilatasi pada segmen ureter intravesikal dapat berkaitan baik dengan ureter tunggal maupun dupleks. Kelainan kongenital berupa obstruksi pada meatus dan timbulnya ureterocele merupakan efek hiperplasia akibat obstruksi ini. Ureter dupleks dapat terjadi pada 75% pasien ureterocele, sementara single ureter hanya 20%. Insidensi ureterocele sebesar 1:4.000 anak dan 4–7 kali lebih sering pada perempuan. Kami melaporkan kasus seorang bayi perempuan berusia lima bulan yang dibawa ke Rumah Sakit Hasan Sadikin tanggal 27 Maret 2019 dengan keluhan utama massa yang tampak menonjol dan hilang timbul pada lubang tempat keluar urine disertai nyeri dan mengedan saat buang air kecil dan demam dalam waktu satu bulan terakhir. Pasien merupakan anak pertama, lahir dari ibu P1A0 riwayat kehamilan cukup bulan. Pada pemeriksaan fisis genitalia eksterna, tampak benjolan berwarna putih dan lunak yang hilang timbul di daerah meatus uretra eksterna. Hasil pemeriksaan BNO-IVP, USG dan CT urologi tampak duplikasi sistem pelvokalises ginjal bilateral dan gambaran berbentuk kantung di daerah vesika urinaria menyokong ureterocele. Berdasar atas hasil anamnesis, pemeriksaan fisis dan pemeriksaan penunjang, pasien didiagnosis ureterocele dekstra, double collecting system bilateral, infeksi saluran kemih komplikata, dan bakteremia. Penatalaksanaan berupa pembedahan eksisi ureterocele dekstra dan reimplantasi ureter. Pencitraan radiologi memiliki peranan penting dalam menegakkan diagnosis ureterocele secara dini untuk menghindari komplikasi dan morbiditas, serta menentukan penatalaksanaan yang tepat. URETEROCELE WITH BILATERAL DOUBLE COLLECTING SYSTEM: A CASE REPORTUreterocele is a congenital abnormality in the terminal ureter. Ureterocele is dilated cystic mass in the intravesical ureteral segment may be associated with a single or duplex system. Duplex ureters occur in 75% of ureterocele patients, while single ureters are only 20%. The incidence of ureterocele is 1: 4,000 children and 4–7 times more common in girls than boys. We are reporting a five month female infant with an intermittent protruding mass from urethra, accompanied by dysuria and fever in the past one month. The baby was the first child, born by P1A0 mother with a history of term pregnancy. External genitalia examination showed protuding soft white lump in the external urethral meatus. The results of BNO-IVP, ultrasound and CT urology revealed duplications of the bilateral renal pelvocalises system and the appearance of sacs inside bladder sugesting an ureterocele. Based on history, physical and medical examination, the patient was diagnosed as right ureterocele, bilateral double collecting system, complicated urinary tract infection and bacteremia, the management was surgical excision of the right uroterocele and ureter reimplantation. Radiological imaging has a important role in obtaining an early diagnosis of ureterocele, to avoid complications and morbidity and determine an appropriate management.

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Clinical and Complementary Diagnosis of Sinus Neoplasia in Horses

Acta Scientiae Veterinariae ◽

10.22456/1679-9216.112304 ◽

2021 ◽

Vol 49 ◽

Author(s):

Tatiana Yumi Mizucina Akutagawa ◽

Ricardo De Francisco Strefezzi ◽

Carla Bargi Belli ◽

Raquel Yvonne Arantes Baccarin ◽

Luis Cláudio Lopes Correia Da Silva ◽

...

Keyword(s):

Early Diagnosis ◽

Oral Cavity ◽

Clinical Signs ◽

Surgical Excision ◽

Anaplastic Carcinoma ◽

Clinical Aspects ◽

Ossifying Fibroma ◽

Complementary Methods ◽

Poorly Differentiated Carcinoma ◽

Poorly Differentiated

Background: Sinus neoplasms are reported as low frequency in horses. Its clinical characteristics are often nonspecific, depend on complementary methods for diagnosis, and when diagnosed, generally they are already advanced, limiting therapeutic possibilities. The objective of this case series was to detail clinical aspects and complementary exams for sinus neoplasms for early diagnosis, comparing them with the literature.Cases: Four horses were treated at the College of Veterinary Medicine and Animal Science of the University of São Paulo, with different clinical signs and previous diagnoses, which when evaluated by respiratory endoscopy, radiography, oral cavity evaluation and histopathological exams, revealed the diagnosis of anaplastic carcinoma, poorly differentiated carcinoma, ossifying fibroma and lymphoma. Previous diagnosis, based mainly on clinical signs, were sinusitis secondary to apical infection, ethmoidal hematoma, sinus cyst and sinusitis secondary to periapical disease. The cases of anaplastic carcinoma (case 1) and lymphoma (case 4) presented with an advanced degree of the disease with involvement and destruction of paranasal structures and adjacent tissues, in addition to a poor general condition, which made surgical treatment impossible and led to euthanasia. In these cases, previous treatment was made to apical infection and periodontal disease with secondary sinusitis, but negative evolution led to suspicion of neoplasia, confirmed by histopathological exam of incisional biopsy of the mass in oral cavity. Benign ossifying fibroma (case 3) presented with progressive respiratory difficulty due to occlusion of the lumen of some nasal meatus and radiographic signs of invasion and deformation of the adjacent bones, it was submitted for surgical excision and there was no recurrence until hospital discharge. The poorly differentiated carcinoma (case 2) was a multilobulate neoformation in the ethmoidal region, similar to ethmoid hematoma in endoscopic and radiographic evaluation, it was submitted for excision and two sessions of electrochemotherapy with bleomycin, associated with administration of piroxicam, which obtained a good result until the period of 1 year after discharge.Discussion: It was found that many characteristics are common with these types of neoplasms, and the clinical signs, such as nasal secretions, airway obstruction, increased facial volume, severe alterations in oral cavity, although unspecific, suggest the differential diagnosis for neoplasms. It is important to differentiate from other diseases noting the evolution and growth of these tumors, like in cases 1 and 4, especially the growth to internal tissues, using complementary methods described here, like endoscopic and radiographic examination. Late identification or even manipulation of neoplasms, without proper diagnosis, leads to a few prognoses regarding life. When it is possible to perform surgical excision, complementary methods are important to guide the procedure, and definitive diagnosis is made through histopathologic exam and some need immunohistochemistry analysis. Cases 2 and 3 had surgical access, were submitted to excision and treatment with good results, both with close monitoring in first months and prolonged quality of life. These results highlight the importance of complementary methods for early diagnosis, correct intervention and monitoring of evolution.Keywords: sinus neoplasia, paranasal sinus, tumor, head, horses.

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