scholarly journals Recurrent Leiomyomatosis Peritonealis Disseminata: Sonographic and Laparoscopic Correlation

2012 ◽  
Vol 6 (3) ◽  
pp. 327-332
Author(s):  
Ulrich Honemeyer ◽  
Lisa Montgomery ◽  
Kallie Appleton ◽  
Thomas G Tullius ◽  
Jason R Ross ◽  
...  
Keyword(s):  
Health Care Professionals ◽  
Obstet Gynecol ◽  
Spindle Cell ◽  
Treatment Options ◽  
Uterine Fibroids ◽  
Histological Evaluation ◽  
Laparoscopic Treatment ◽  
Leiomyomatosis Peritonealis Disseminata ◽  
History Of ◽  
Disseminated Peritoneal Leiomyomatosis

ABSTRACT We present a 39-year-old G0P0 with history of infertility treatment-caused ovarian hyperstimulation and uterine fibroids, who was found to have a rare pathological presentation. Peritoneal lesions were identified during laparoscopic treatment for this patient's fibroids. Histological evaluation of these lesions revealed leiomyomatosis peritonealis disseminata (LPD), also known as disseminated peritoneal leiomyomatosis. While LPD can often be confused for metastatic leiomyosarcoma due to the histological presence of fibroblasts, myofibroblasts, smooth muscle, collagen, and spindle cell appearance, cases of LPD are generally benign, and present no need for therapy in asymptomatic cases. We present a discussion based on the clinical and sonographic presentation of LPD, its pathophysiology, treatment options and prognosis. A question set has been designed to reinforce comprehension of this presentation and associated topics for health care professionals. How to cite this article Honemeyer U, Ross JR, Barnard JJ, Appleton K, Tullius TG Jr, Montgomery L, Plavsic SK. Recurrent Leiomyomatosis Peritonealis Disseminata: Sonographic and Laparoscopic Correlation. Donald School J Ultrasound Obstet Gynecol 2012;6(3):327-332.

scholarly journals Late-Onset Metastatic Malignant Spindle Cell Tumour Presenting with Massive Intra-Abdominal Haemorrhage

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Pamathy Gnanaselvam ◽  
Malintha Lahiru ◽  
Mariathas Priatharshan ◽  
Umesh Jayarajah ◽  
Kathirvetpillai Kopinath
Keyword(s):  
Spindle Cell ◽  
Late Onset ◽  
Cell Tumour ◽  
Histological Evaluation ◽  
Spindle Cell Sarcoma ◽  
Rare Tumour ◽  
Cell Sarcoma ◽  
Metastatic Deposit ◽  
History Of ◽  
Spindle Cell Tumour

Primary spindle cell sarcoma is a rare tumour. The presentation of acute intra-abdominal bleeding from a metastatic spindle cell tumour has not been previously reported. We report a case of a 40-year-old woman with a history of curative resection of the medial compartment of the right thigh for spindle cell sarcoma presenting with an acute onset abdominal pain and haemorrhagic shock after 5 uneventful years. Emergency exploratory laparotomy was conducted that revealed a retropancreatic mass which had ruptured along its inferior border. Histological evaluation revealed a metastatic deposit of the spindle cell sarcoma. In cases of spontaneous abdominal haemorrhage, it is important to consider the possibility of a ruptured metastatic deposit among the differentials especially in patients with a history of malignancies. Moreover, this is the first reported case of metastatic malignant spindle cell sarcoma presenting with intra-abdominal haemorrhage.

scholarly journals Extra-Uterine Fibroids

2020 ◽  
Author(s):  
Rakesh Kumar Gupta ◽  
Poonam Wasnik
Keyword(s):  
Histopathological Examination ◽  
Uterine Fibroids ◽  
Growth Patterns ◽  
Reproductive Age ◽  
Uterine Neoplasms ◽  
Cell Of Origin ◽  
Diagnostic Challenge ◽  
History Of ◽  
Disseminated Peritoneal Leiomyomatosis ◽  
Metastasizing Leiomyoma

Leiomyomas are the most common gynecologic and uterine neoplasms. Uterine leiomyomas present in approximately 25% of women during reproductive age. Extrauterine leiomyomas (EULs) are rarer and usually arise in the genitourinary tract, however, may arise at nearly any anatomic location and possess a great diagnostic challenge. Moreover, the EULs may also present with unusual growth patterns such as disseminated peritoneal leiomyomatosis, intravenous leiomyomatosis, benign metastasizing leiomyoma, parasitic leiomyoma, and retroperitoneal mass. However, the cell of origin from smooth muscle cells and histological benign characteristics is similar to their uterine counterpart. The presence of a synchronous uterine leiomyoma or history of previous hysterectomy is a considerable evidence for the diagnosis of these abnormally located and unusual growth pattern displaying EULs. Different imaging modalities like ultrasonography, computed tomography, and magnetic resonance imaging are helpful in the diagnosis of EULs, however, sometimes a histopathological examination is required for the confirmation.

scholarly journals Disseminated peritoneal leiomyomatosis: a case report and review of the literature

2021 ◽  
Vol 49 (8) ◽  
pp. 030006052110331
Author(s):  
Xu Liu ◽  
Yuchang Hu ◽  
Lu Chen ◽  
Quan Zhou
Keyword(s):  
Good Prognosis ◽  
Subsequent Pregnancy ◽  
Pathological Examination ◽  
Hormonal Stimulation ◽  
Abdominal Masses ◽  
Smooth Muscle Tumors ◽  
Leiomyomatosis Peritonealis Disseminata ◽  
History Of ◽  
Disseminated Peritoneal Leiomyomatosis

Disseminated peritoneal leiomyomatosis (DPL), also known as leiomyomatosis peritonealis disseminata, is a rare disease characterized by multiple benign smooth muscle tumors proliferating along the peritoneal surfaces. The cause of the disease is unclear, and possible factors include iatrogenic and hormonal stimulation. The patient was a 41-year-old Chinese woman with a history of laparoscopic myomectomy and subsequent pregnancy. Multiple abdominal masses were identified and required surgical intervention. The patient had no tenderness or other discomfort. The clinical and imaging diagnosis was gastrointestinal stromal tumor, but DPL was confirmed by postoperative pathological examination. The patient had a good prognosis, and no recurrence was observed during follow-up. Iatrogenic and hormonal stimulation leading to DPL is very rare, and we believe that multiple factors led to DPL in this case. Clinicians should be aware of such potential patients.

History of uterine fibroids reported by California women

2008 ◽  
Author(s):  
Zipora Weinbaum ◽  
Terri Throfinnson
Keyword(s):  
Uterine Fibroids ◽  
History Of

Safety of a Clozapine Trial Following Quetiapine-Induced Leukopenia: A Case Report

2019 ◽  
Vol 14 (1) ◽  
pp. 80-83 ◽  
Author(s):  
Asma H. Almaghrebi
Keyword(s):  
Treatment Options ◽  
Young Female ◽  
Similar Reaction ◽  
Careful Monitoring ◽  
Treatment Resistant ◽  
Blood Cell Count ◽  
Antipsychotic Medications ◽  
Case Presentation ◽  
Clozapine Treatment ◽  
History Of

Background: The clozapine-derivative quetiapine has been shown in some cases to cause leukopenia and neutropenia. Case Presentation: We reported on a case of a young female diagnosed with treatment-resistant schizophrenia. After failed trials of three antipsychotic medications and despite a history of quetiapineinduced leukopenia, clozapine treatment was introduced due to the severity of the patient’s symptoms, the limited effective treatment options, and a lack of guidelines on this issue. Result: Over a ten-week period of clozapine treatment at 700 mg per day, the patient developed agranulocytosis. Her white blood cell count sharply dropped to 1.6 &#215; 10<sup>9</sup> L, and her neutrophils decreased to 0.1 &#215; 10<sup>9</sup> L. There had been no similar reaction to her previous medications (carbamazepine, risperidone, and haloperidol). Conclusion: The safety of clozapine in a patient who has previously experienced leukopenia and neutropenia with quetiapine requires further investigation. Increased attention should be paid to such cases. Careful monitoring and slow titration are advisable.

scholarly journals Bloodstream infection with Acinetobacter baumanii in a Plasmodium falciparum positive infant: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Charity Wiafe Akenten ◽  
Kennedy Gyau Boahen ◽  
Kwadwo Sarfo Marfo ◽  
Nimako Sarpong ◽  
Denise Dekker ◽  
...  
Keyword(s):  
Case Report ◽  
Bacterial Infections ◽  
Treatment Options ◽  
Female Child ◽  
Correct Choice ◽  
Blood Cultures ◽  
Microbial Culture ◽  
Acinetobacter Baumanii ◽  
Inappropriate Use ◽  
History Of

Abstract Background The increasing incidence of multi-antibiotic-resistant bacterial infections, coupled with the risk of co-infections in malaria-endemic regions, complicates accurate diagnosis and prolongs hospitalization, thereby increasing the total cost of illness. Further, there are challenges in making the correct choice of antibiotic treatment and duration, precipitated by a lack of access to microbial culture facilities in many hospitals in Ghana. The aim of this case report is to highlight the need for blood cultures or alternative rapid tests to be performed routinely in malaria patients, to diagnose co-infections with bacteria, especially when symptoms persist after antimalarial treatment. Case presentation A 6-month old black female child presented to the Agogo Presbyterian Hospital with fever, diarrhea, and a 3-day history of cough. A rapid diagnostic test for malaria and Malaria microscopy was positive for P. falciparum with a parasitemia of 224 parasites/μl. The patient was treated with Intravenous Artesunate, parental antibiotics (cefuroxime and gentamicin) and oral dispersible zinc tablets in addition to intravenous fluids. Blood culture yielded Acinetobacter baumanii, which was resistant to all of the third-generation antibiotics included in the susceptibility test conducted, but sensitive to ciprofloxacin and gentamicin. After augmenting treatment with intravenous ciprofloxacin, all symptoms resolved. Conclusion Even though this study cannot confirm whether the bacterial infection was nosocomial or otherwise, the case highlights the necessity to test malaria patients for possible co-infections, especially when fever persists after parasites have been cleared from the bloodstream. Bacterial blood cultures and antimicrobial susceptibility testing should be routinely performed to guide treatment options for febril illnesses in Ghana in order to reduce inappropriate use of broad-spectrum antibiotics and limit the development of antimicrobial resistance.

scholarly journals Uterine serous carcinoma: key advances and novel treatment approaches

2021 ◽  
pp. ijgc-2021-002753
Author(s):  
J Stuart Ferriss ◽  
Britt K Erickson ◽  
Ie-Ming Shih ◽  
Amanda N Fader
Keyword(s):  
Endometrial Cancer ◽  
Black Women ◽  
Treatment Options ◽  
Molecular Genetic ◽  
Serous Carcinoma ◽  
Cancer Syndrome ◽  
Her2 Positive ◽  
Incidence And Mortality ◽  
History Of ◽  
Uterine Serous Carcinoma

The incidence and mortality rates from endometrial cancer continue to increase worldwide, while rates in most other cancers have either plateaued or declined considerably. Uterine serous carcinoma represents a fraction of all endometrial malignancies each year, yet this histology is responsible for nearly 40% of all endometrial cancer-related deaths. These deaths disproportionately affect black women, who have higher rates of advanced disease at diagnosis. Molecular genetic analyses reveal major alterations including TP53 mutation, PIK3CA mutation/amplification, ERBB2 amplification, CCNE1 amplification, FBXW7 mutation/deletion, PPP2R1A mutation, and somatic mutations involving homologous recombination genes. Clinical risk factors for uterine serous carcinoma include advancing age, a history of breast cancer, tamoxifen usage, and the hereditary breast–ovarian cancer syndrome. Surgery remains the cornerstone of treatment. Recent advances in our understanding of uterine serous carcinoma molecular drivers have led to development of targeted therapeutics that promise improved outcomes for patients. Overexpression or amplification of HER2 in uterine serous carcinoma carries a poor prognosis; yet this actionable target has led to the incorporation of several anti-HER2 therapies, including trastuzumab which, when added to conventional chemotherapy, is associated with improved survival for women with advanced and recurrent HER2-positive disease. The combination of pembrolizumab and lenvatinib is also a promising targeted treatment strategy for women with uterine serous carcinoma, with a recent phase II study suggesting a 50% response rate in women with recurrent disease. Several trials examining additional targeted agents are ongoing. Despite years of stalled progress, meaningful, tailored treatment options are emerging for patients with this uncommon and biologically aggressive endometrial cancer subtype.

scholarly journals History of the Military Nurse Corps and the 1918 Influenza Pandemic: Lessons for the 2019 Coronavirus Pandemic

2020 ◽  
Author(s):  
Laura A Talbot ◽  
E Jeffrey Metter ◽  
Heather King
Keyword(s):  
World War I ◽  
Patient Outcomes ◽  
Influenza Pandemic ◽  
Treatment Options ◽  
Primary Therapy ◽  
World War ◽  
Military Nursing ◽  
History Of ◽  
1918 Influenza ◽  
The Military

ABSTRACT During World War I, the 1918 influenza pandemic struck the fatigued combat troops serving on the Western Front. Medical treatment options were limited; thus, skilled military nursing care was the primary therapy and the best indicator of patient outcomes. This article examines the military nursing’s role in the care of the soldiers during the 1918 flu pandemic and compares this to the 2019 coronavirus pandemic.

scholarly journals Metastatic small cell carcinoma of the lung with prominent spindle cell morphology and hemangiopericytoma-like vascular pattern: A sarcoma mimicker

2020 ◽  
Vol 8 ◽  
pp. 2050313X2098117
Author(s):  
Esra Nsour ◽  
Ali Al Khader ◽  
Bushra Al-Tarawneh
Keyword(s):  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Spindle Cell ◽  
Small Cell ◽  
Nerve Sheath Tumor ◽  
Vascular Pattern ◽  
Nerve Sheath ◽  
History Of ◽  
Wall Mass ◽  
Aggressive Clinical Behavior

Small cell carcinoma is a malignant neuroendocrine tumor with aggressive clinical behavior. Histologically, the tumor is characterized by the proliferation of small, round, blue cells. Here, we present the case of a 50-year-old man with a 1-month history of enlarging chest wall mass. Microscopic examination of the lesion revealed a highly cellular neoplasm composed of closely packed, atypical spindle cells with scant cytoplasm, inconspicuous nucleoli, and brisk mitotic activity. The hemangiopericytoma-like vascular pattern was prominent. Areas showing a fibrosarcoma-like fascicular pattern were also observed. The tumor was immunohistochemically positive for TTF1, synaptophysin, and chromogranin, confirming small cell carcinoma. Further investigations revealed a lung origin and widespread metastases. The tumor in this case closely mimicked synovial sarcoma or malignant peripheral nerve sheath tumor. Small cell carcinoma demonstrates a hemangiopericytoma-like pattern that can mimic sarcoma histologically. This is a serious pitfall that can significantly affect the speed of diagnosis and management.

Episodic versus Chronic Dizziness: An Analysis of Predictive Factors

2021 ◽  
pp. 000348942110254
Author(s):  
Eric J. Formeister ◽  
Ricky Chae ◽  
Emily Wong ◽  
Whitney Chiao ◽  
Lauren Pasquesi ◽  
...  
Keyword(s):  
Multivariate Regression ◽  
Treatment Options ◽  
Depression And Anxiety ◽  
Imaging Studies ◽  
Comorbid Depression ◽  
Cross Sectional ◽  
Tertiary Center ◽  
Chronic Dizziness ◽  
Associated Symptoms ◽  
History Of

Objectives: To elucidate differences in demographic and clinical characteristics between patients with episodic and chronic dizziness. Methods: A cross-sectional, observational study of 217 adults referred for dizziness at 1 tertiary center was undertaken. Subjects were split into a chronic dizziness group (>15 dizzy days per month) and an episodic dizziness group (<15 dizzy days per month). Results: 217 adults (average age, 53.7 years; 56.7% female) participated. One-third (n = 74) met criteria for chronic dizziness. Dizziness handicap inventory (DHI) scores were significantly higher in those with chronic dizziness compared to those with episodic dizziness (53.9 vs 40.7; P < .001). Comorbid depression and anxiety were more prevalent in those with chronic dizziness (44.6% and 47.3% vs 37.8% and 35.7%, respectively; P > .05). Abnormal vestibular testing and abnormal imaging studies did not differ significantly between the 2 groups. Ménière’s disease and BPPV were significantly more common among those with episodic dizziness, while the prevalence of vestibular migraine did not differ according to chronicity of symptoms. A multivariate regression that included age, sex, DHI, history of anxiety and/or depression, associated symptoms, and dizziness triggers was able to account for 15% of the variance in the chronicity of dizziness (pseudo- R2 = 0.15; P < .001). Conclusions: Those who suffer from chronic dizziness have significantly higher DHI and high comorbid rates of depression and anxiety than those with episodic dizziness. Our findings show that factors other than diagnosis alone are important in the chronification of dizziness, an observation that could help improve on multimodal treatment options for this group of patients.

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