scholarly journals Giant Fibrothecoma of the Ovary in a Young Patient a Case Report

Author(s):  
Martínez Rodas O ◽  

Fibrothecomas are benign ovarian stromal tumors, they are rare tumors of gonadal stromal cell origin that represent 3-4% of all ovarian tumors. It commonly occurs in post-menopausal women. The clinical presentation is often nonspecific, whereas patients more frequently present with a pelvic mass, metrorrhagia, and pelvic pain. We present a 35-year-old patient, nulli-pregnant, with no personal or family pathological history, who attended a medical consultation for presenting progressive abdominal distention of 6 months of evolution in addition to abdominal pain in the last 2 months type colic which increased during her menstrual periods concomitantly alteration in your defecatory habits. Abdominal ultrasound was performed, finding a solid intrapelvic mass of approximately 14x10x10 cm in diameter of probable left ovarian origin, free fluid in the Douglas space, compression and displacement of intestinal loops and bladder. The patient underwent surgery and an exploratory laparotomy was performed, finding a pelvic tumor adhered to the tube and left ovary, in addition to ascites fluid in the abdominal cavity, complete resection of the tumor, ovary and left salpingue was performed.

2019 ◽  
Vol XXIV (142) ◽  
pp. 72-82
Author(s):  
Sayonara da Luz Ferro ◽  
Fernanda Jönck ◽  
Marta Cristina T. Heckler ◽  
Ewerton Cardoso ◽  
Mateus Rychescki ◽  
...  

Intestinal lymphoma is the second most common form of lymphoma in dogs. It is characterized by the presence of neoplastic lymphocytes in the gastrointestinal tract or mesenteric lymph nodes. The chief clinical signs are vomiting, diarrhea, anorexia and weight loss. The diagnosis is made through fine needle aspiration and cytology, or by tissue biopsy and histopathology, and chemotherapy is the treatment of choice. We report a case of intestinal lymphoma in a five years old Boxer, presented with history of hematochezia and lethargy of 7 days duration, and 20 days of anorexia and persistent weight loss. Abdominal ultrasonography revealed free fluid in the abdominal cavity, and an intestinal mass. Exploratory laparotomy was performed and a tissue biopsy was performed. Histopathology confirmed the diagnosis of intestinal lymphoma, but the patient died during the surgical procedure.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andrea L. Maricuto ◽  
Viledy L. Velásquez ◽  
Jacinto Pineda ◽  
David M. Flora-Noda ◽  
Isaac Rodríguez ◽  
...  

Abstract Background Amoebiasis is a parasitic disease caused by Entamoeba histolytica, which affects people living in low- and middle-income countries and has intestinal and extraintestinal manifestations. To date, knowledge on coronavirus disease 2019 (COVID-19) coinfection with enteric parasites is limited, and E. histolytica coinfection has not been previously described. Here we present the case of a patient with COVID-19 who, during hospitalisation, presented a clinical picture consistent with an amoebic liver abscess (ALA). Case presentation A 54-year-old man, admitted as a suspected case of COVID-19, presented to our hospital with dyspnoea, malaise, fever and hypoxaemia. A nasopharyngeal swab was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by reverse-transcription polymerase chain reaction. After 7 days, he developed diarrhoea, choluria and dysentery. An abdominal ultrasound showed a lesion compatible with a liver abscess; stool examination revealed E. histolytica trophozoites, and additional serology for E. histolytica was positive. After 12 days of treatment with metronidazole, ceftazidime and nitazoxanide, the patient reported acute abdominal pain, and an ultrasound examination revealed free liquid in the abdominal cavity. An emergency exploratory laparotomy was performed, finding 3000 mL of a thick fluid described as “anchovy paste”. Computed tomography scan revealed a second abscess. He ended up receiving 21 days of antibiotic treatment and was discharged with satisfactory improvement. Conclusion Here we present, to the best of our knowledge, the first report of ALA and COVID-19 co-presenting. Based on their pathophysiological similarities, coinfection with SARS-CoV-2 and E. histolytica could change the patient’s clinical course; however, larger studies are needed to fully understand the interaction between these pathogens.


Author(s):  
Monalisa Mahajan

Genital tuberculosis tends to be an indolent infection and the disease may not manifest for year after initial seeding. The most common presentation reported in general population are pelvic pain, postmenopausal bleeding, ascites, abdominal mass, ovarian mass. The diagnosis is made by histopathological examination. Surgery is indicated as presence of abdominal pelvic mass with severe pain. Preoperative diagnosis of genital tuberculosis is often difficult because of confusion with ovarian malignancy. A 60 years old women present with weight loss, palpable abdominal mass with ascites, prominent bilateral ovaries and increase level of CA125. Pelvic malignancy was initially suspected but a diagnosis of tuberculosis was made following postoperative peritoneal wash biopsy. Patient managed with surgical laparotomy under a provisional diagnosis of ovarian malignancy but the final diagnosis was genital tuberculosis followed by anti tubercular regimen. Genital tuberculosis with high level of CA125 mimicking ovarian carcinoma. 


2018 ◽  
Vol XXIII (132) ◽  
pp. 56-64
Author(s):  
Sayonara da Luz Ferro ◽  
Ewerton Cardoso ◽  
Fernanda Jönck ◽  
Marta Cristina Thomas Heckler ◽  
Bruna Warmlin ◽  
...  

Hemangioma is a benign, noninvasive and non-metastatic neoplasm originating from endothelial cells of the blood vessels. The involvement of the urinary vesicle with neoplasias occurs in less than 0.5% of dogs. The main clinical signs are hematuria, dysuria, pollakiuria, incontinence and urinary obstruction. The diagnosis is based on imaging tests and is confirmed by histopathological examination. The treatment of choice is surgical resection with safety margins. This paper reports the case of a twelve-year-old Poodle with a history of abdominal pain, which was attended at the Florianópolis Veterinary Hospital. Abdominal ultrasound showed the presence of free fluid. During exploratory laparotomy, the urinary vesicle was observed to be ruptured, presenting a thickened wall and small areas of necrosis. A sample was sent for histopathological analysis and the diagnosis was of benign vascular neoplasia compatible with hemangioma.


2020 ◽  
Vol 185 (11-12) ◽  
pp. 2171-2172
Author(s):  
Laurie Bezjian Wallace ◽  
Patrick Wallace ◽  
Joel Herness

ABSTRACT We report a case of acute urinary retention in an adolescent female secondary to hematocolpos. A 13-year-old female presented to the emergency department with acute urinary retention and suprapubic abdominal pain for 24 hours. She denied menstruation or sexual history. Bedside bladder ultrasound scan revealed 1.2 L of retained urine and a Foley catheter was placed. A formal renal ultrasound detected a debris-filled structure in the abdomino-pelvic cavity. Follow-up computed tomography of the abdomen and pelvis revealed an 8.5 cm × 9.3 cm × 12.1 cm mass-like structure in the pelvis. No formal pelvic exam was completed and the patient was taken to the operating room for exploratory laparotomy due to concern for large pelvic mass versus tubo-ovarian abscess. However, upon entering the abdominal cavity, no mass was found. At that point, an external genital exam was performed, revealing an imperforate hymen. Hymenotomy resulted in the evacuation of 2.5 L of clotted blood from the vagina and uterus. Hematocolpos resulting in acute urinary retention is exceedingly rare; however, it is an important differential diagnosis that can be ruled in or out by physical exam findings. Although it may be uncomfortable for adolescent patients and physicians, external genital exams should be conducted in young females with acute urinary retention and amenorrhea to evaluate for imperforate hymen. This can ensure appropriate treatment and avoidance of unnecessary invasive procedures.


2020 ◽  
Vol 48 ◽  
Author(s):  
Fabiana Cardoso Gomes ◽  
John Willer Carvalho Anunciação ◽  
Paula Elisa Brandão Guedes ◽  
Renata Santiago Alberto Carlos

Background: Intestinal obstruction by a foreign body is a common occurrence in domestic animals, needing the attention of veterinarians and owners, given that a serious complication of this condition is intestinal rupture, with consequent peritonitis. Perforating objects are the ones most often associated with rupture, but any object that obstructs the intestinal tract, if not removed properly, can lead to intestinal rupture, generating a poor prognosis. This article reports a case of intestinal rupture caused by a non-perforating foreign body in a dog. Case: A 1-year-old Chow-Chow dog was taken by its owner to the Portal Pet private clinic, with a history of foreign body ingestion and emesis. The owner reported that he took the animal to veterinary care in another establishment on the day he noticed vomiting, with no other abnormality being detected. An injectable medication was administered, but the owner did not know what it was, and the dog was discharged. After 15 days, the owner sought care at the clinic initially mentioned, due to the persistence of emesis, in addition to the onset of diarrhea and apparent apathy. On physical examination, the dog was apathetic, with pale mucosa and pain on abdominal palpation. A firm structure was felt, located in the epigastric region, compatible with a foreign body. The dog was referred for hospitalization and an abdominal ultrasound was requested, in addition to blood samples for hematological and serum biochemical tests (urea, creatinine, alanine aminotransferase, and alkaline phosphatase). Serology for parvovirus was also performed. The blood count revealed leukopenia (4,800 thousand/mm3) and biochemical analysis showed an increase in alkaline phosphatase (895.5 U/l). The results for parvovirus were negative. Ultrasonography confirmed the presence of a foreign body. The animal was referred for exploratory laparotomy, in which the foreign body was found in the abdominal cavity as a result of intestinal rupture, and peritonitis was observed. The foreign body was removed, the abdominal cavity washed, intestinal raffia made, and an abdominal drain inserted. The foreign body was identified as a silicone makeup sponge. Three days later, the drain was removed. The patient had good post-surgical clinical evolution and was discharged. The prescription given was as follows: omeprazole 1 mg/kg (VO, every 24 h in the morning, for 2 weeks); dipyrone25 mg/kg (VO, TID, for 4 days); cephalexin 25 mg/kg (VO, BID, for 10 days); mineral vitamin supplement based on probiotics and prebiotics 1 tablet/10 kg (VO, every 24 h, for 10 days); vermifuge based on milbemycin oxime and praziquantel 5-25 mg (VO, in a single dose, with repetition after 15 days); enrofloxacin 50 mg 10 mg/kg (VO, every 24 h, for 7 days); immunoglobulinbased on blood plasma, vitamins and minerals 1 tablet/10 kg (VO, BID, until new recommendations); and metronidazole 40 mg/mL oral solution at a dose of 25 mg/kg (VO, BID, for 7 days). As topical treatment, an antiseptic spraybased on laurel, diethylene glycol ether, sodium sulfate, and povidine iodinewas prescribed for surgical wound cleansing, until the suture removal, and the use of a surgical collar was requested. A reassessment was scheduled after 10 days, during which the suture was removed. At this point the dog had fully recovered.Discussion: Intestinal obstruction by a foreign body is a common cause of veterinary emergencies. As observed in the reported case, rupture of the intestinal wall and peritonitis can result. Although the prognosis of the affected animals is guarded, diagnosis prior to the worsening of septicemia as well as immediate surgical intervention were essential for recovery.      


2020 ◽  
Author(s):  
Kung-Chuan Cheng ◽  
Ko-Chao Lee ◽  
Hong-Hwa Chen ◽  
YC Ou

Abstract Background Account for less than 1% of all gastrointestinal tumors, primary appendiceal malignancies are rare and their diagnoses are usually made after exploratory laparotomy. Most of them present with nonspecific symptoms, such as abdominal pain, abdominal fullness and huge pelvic mass, mimicking advanced stage ovarian cancer.Case Presentation We described two menopausal women who were referred to our institution under the impression of advanced stage of primary ovarian cancer. However, both patients were eventually found to have primary appendiceal adenocarcinoma with ovarian metastasis at laparotomy. Initial symptoms, intraoperative finding, pathology finding, and postoperative clinical courses were recorded.Conclusions Comparing with primary ovarian tumor, ovarian metastasis is relatively rare. The clinical picture can be misleading and the differential diagnoses of primary appendiceal cancer should be considered when preoperative workup is planned.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Anna Kajdy ◽  
Katarzyna Muzyka-Placzyńska ◽  
Dagmara Filipecka-Tyczka ◽  
Jan Modzelewski ◽  
Marek Stańczyk ◽  
...  

Abstract Background Heterotopic pregnancy (HP) is a rare condition when at least two pregnancies are present simultaneously at different implantation sites and only one located in the uterine cavity. The majority of cases are diagnosed in the first trimester. Case presentation We present a unique case of HP diagnosed at 26 weeks of spontaneous pregnancy in a patient without any relevant risk factors. We performed an extensive review of HP cases from MEDLINE (PUBMED) published in English between 2005-2019 to prove this case's uniqueness. A 24-year-old woman presented because of threatened preterm birth. Despite treatment, pain aggravated, without progression of labor. An emergency ultrasound exam revealed free fluid in the abdominal cavity. Suspicion of active bleeding prompted the medical team to perform an exploratory laparotomy. The surgery team found a ruptured heterotopic pregnancy. This was an unexpected cause of nontraumatic hemoperitoneum at such advanced gestational age. The postoperative period was uneventful, and the intrauterine pregnancy continued to term. The final review included 86 out of 124 records. A total number of 509 cases were identified, but not all of them had complete data. The maximum reported gestational age at the time of diagnosis was 16 weeks of pregnancy, while our case became symptomatic and was diagnosed at 26 weeks of pregnancy. Conclusions Regardless of pregnancy age, HP can be a cause of hemoperitoneum, and it should be included in the differential diagnosis of acute abdomen in the second trimester.


2016 ◽  
Vol 44 (1) ◽  
pp. 5
Author(s):  
Thalita Priscila Peres Seabra Da Cruz ◽  
Samara Rosolem Lima ◽  
David Ronald Parra Travagin ◽  
Caroline Argenta Pescador ◽  
Roberto Lopes De Souza

Background: The uterine horn agenesis or aplasia is a rare anomaly consisting of absence or incomplete development of the paramesonephric ducts that origin the uterine horns. This change occurs during fetal formation and may occur concomitantly to agenesis of the ovary and/or ipsilateral kidney. The extra-uterine pregnancy consists of fetal growth outside the uterine cavity and can occur as a tubal or abdominal pregnancy. We report here the case of a 7-years-old mix breed dog, attended at the Veterinary Hospital of the Federal University of Mato Grosso, with accidental diagnosis of agenesis of uterine horn and ovaries and ectopic fetal mummifcation.Case: A 7-years-old mix breed dog, not spayed, was attended at the Veterinary Hospital of the Federal University of Mato Grosso (HOVET-UFMT), complaining of mucous bloody vaginal discharge. The patient had regular estrus and was multiparous. There was no mating history in the last estrus neither trauma over the past months. In previous pregnancies the patientpresented eutocic labors. On physical examination the dog showed apathy although it was alert, pale mucous membranes, presence of perivulvar blackish secretion and discreet abdominal enlargement. As preoperative exams, a complete blood count, liver and renal function (serum creatinine and alanine aminotransferase) were performed. It has also performedthe abdominal ultrasound examination, which revealed the presence of uterus flled with hypoechoic luminal content and a thickened and irregular wall. The patient was referred to therapeutic ovariohysterectomy (OHE). After anesthesia and antisepsis, the access to the abdominal cavity was made, where there was a mummifed fetus with approximately 15.5 cmfrom neck to tail set, equivalent to 57 days of gestation. After removal of the papyraceus fetus, the uterus was found and then, when exposed, there was only the left uterine horn flled by content and ovarie, both were removed. After inspection, the synthesis of the abdominal cavity was carried out as the routine. During the postoperative period, the patient had no complications or other clinical signs similar to those observed in the initial presentation. Antibiotic (enrofloxacin 5 mg/kg every 12h), analgesic (dipyrone 20 mg/kg every 8 h) and non-steroidal anti-inflammatory (meloxicam 0.2 mg/kg every 24 h) were prescribed. The fetus and uterus were sent to the Veterinary Pathology UFMT Laboratory (PVL-HOVET).The fetus was covered by omentum and fat. After the initial incision, there was a hard fbrous capsule surrounding the mummifed fetus. There were no recent signs of rupture or scarring resulting from previous trauma in the uterus. Its size was 15x4.8x2.8 cm and it was flled out with mucus bloody brownish secretion (pyometra). Microscopically, had purulent inflammatory infltrate, diffuse and severe in mucosa and submucosa associated with cell debris and moderate hyperplasia glands containing microabscesses inside.Discussion: Reports of extra-uterine fetal mummifcation in dogs and cats are scarce. Even being reported infrequently in dogs if congenital uterine and ovarian abnormalities are found during surgery, a detailed inspection of the abdominal cavity should be performed in order to rule out the possible presence of the ipsilateral ovary. Even with the lack of specifc clinical signs, fetal ectopy can be diagnosed through a detailed clinical examination and image exams. Exploratory laparotomy can be used as a diagnostic and therapeutic tool, since the treatment is the excision of ectopic tissue and OHE in cases of uterine rupture.Keywords: aplasia, fetus, mummifcation, unicornuate uterus.


2020 ◽  
Author(s):  
Kung-Chuan Cheng ◽  
Ko-Chao Lee ◽  
Hong-Hwa Chen ◽  
YC Ou

Abstract BackgroundAlthough Primary appendiceal malignancies are rare accounting for less than 1% of all gastrointestinal tumors, the incidence of ovarian metastasis in appendiceal adenocarcinoma is encountered in 16.7 to 37% of all ovarian malignancy. The diagnosis is usually made after an exploratory laparotomy. Most of these tumors present with nonspecific symptoms, such as abdominal pain, abdominal fullness and huge pelvic mass, mimicking advanced stage ovarian cancer.Case PresentationWe described two menopausal women who were referred to our institution under the diagnostic impression of advanced stage of primary ovarian cancer. However, both patients were eventually found to have primary appendiceal adenocarcinoma with ovarian metastasis at laparotomy. Initial symptoms, intraoperative finding, pathology finding, and postoperative clinical courses were documented.ConclusionsComparing with primary ovarian tumor, ovarian metastasis is relatively rare. The clinical presentation can be misleading and the differential diagnoses of primary appendiceal cancer should be considered when preoperative workup is planned.


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