scholarly journals Giant tuberculous pseudocarcinomatous hyperplasia of fallopian tube mimicking ovarian neoplasm - A challenging diagnosis

2017 ◽  
Vol 4 (2) ◽  
pp. 39
Author(s):  
Richa Sharma ◽  
Vishnu Bhartiya

Pseudocarcinomatous hyperplasia of the fallopian tubes is an incidental histopathological finding or it causes slight enlargement of tubes. We are reporting a case where 38 years old woman reported with lump abdomen (corresponding to 28 weeks gravid uterus) and hypomenorrhea, was diagnosed as ovarian neoplasm after extensive work up that included tumor markers and CT scan. Staging laprotomy was undertaken, but intraoperatively it revealed massive enlargement of both the tubes. Frozen section and histopathological examination showed tuberculous pseudocarcinomatous hyperplasia of fallopian tubes. Bilateral salpingectomy was done. We are reporting this case because of its rarity, where massive enlargement of both the tubes was due to tuberculous Pseudocarcinomatous hyperplasia that mimicked ovarian neoplasm on clinical examination and on radioimaging techniques.

Author(s):  
Arpita De ◽  
Reva Tripathi

To report the successful conservative surgical management of Ovarian mucinous cystadenoma with silent torsion in a 24 years old pregnant woman in a tertiary care center in Delhi. An antenatal woman came for a routine visit to the OPD of the hospital at 13 weeks gestation. She had a vague, mild pain in lower abdomen since the last four weeks. A cystic mass was discovered during an abdominal examination. Further on sonography, a multisepatated cystic mass was seen, likely to be mucinous cystadenoma. Routine tumor markers came out to be negative. A laparotomy was planned at 15 weeks. On laparotomy a 20 × 15 cm multiloculated cyst with one and half turns of torsion was found. Detorsion, cystectomy of the intact cyst followed by ovarian reconstruction was done after due consent. On histopathological examination the cyst was found to be Benign mucinous cystadenoma. The pregnancy continued without any adverse effects. The woman delivered vaginally at 38 weeks without any feto-maternal complications. She was able to conceive again spontaneously at 18 months post-delivery. After 16 weeks of gestation in the second pregnancy she went to her home town and no further follow-up was possible. This case emphasizes the importance of a thorough examination in all pregnant woman to rule out any adnexal mass separate from the gravid uterus. Big ovarian masses in pregnancy, if not diagnosed can cause growth retardation, preterm deliveries, acute abdomen due to infection, rupture or torsion. Sonography, MRI and tumor markers can facilitate diagnosis before surgery. Torsion and rupture of mucinous cystadenoma need prompt surgery. Wherever possible conservative surgery (detorsion and cystectomy) should be done especially in young women.


Author(s):  
Maanasa Palani ◽  
Volga Harikrishnan

Introduction: The Fallopian tubes are a pair of narrow tubular structures connecting the ovary and the uterus. It is usually the site of fertilization and plays a very important role in the fusion of the sperm and ovary and helps in movement of the fertilized zygote to the uterus. Even though being an organ of very small size the importance of the variety of lesions occurring in the fallopian tubes is often not considered. Biopsies of the fallopian tubes are taken to show the different lesions found in the tubes. Aim: The main aim of the study is to study the spectrum of lesions occurring in the fallopian tubes and correlation of these findings with its clinical parameters. Study Design: This is a retrospective descriptive study Place and Duration of Study: Department of Pathology, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Thandalam, Chennai between June 2019- December 2019. Methodology: A retrospective study of all the fallopian tube specimens sent for routine histopathological analysis over a period of 6 months was carried out. The different pathological lesions were observed from the relevant clinical data and the correlation with its clinical parameters was done. Results: A sample size of 77 specimens was collected among which the commonest age group which was found to have the highest number of lesions was between 26-30 years. This was found to be in correlation to the reproductive age group of women. The most common form of pathological lesion observed was ectopic pregnancy (about 46% of total pathological lesions), followed by Paratubal cysts (23%), Hydrosalpinx (15%) and Hematosalpinx (8%). Cystadenoma was the only benign tumor observed in this study and constituted 8% of the total pathological lesions. Conclusion: This study shows the importance of histopathological examination of all fallopian tube specimens with or without abnormal findings.


2021 ◽  
Author(s):  
Salvatore Paiella ◽  
Luca Landoni ◽  
Sarah Tebaldi ◽  
Michele Zuffante ◽  
Matteo Salgarello ◽  
...  

Introduction:The combined use of 68Gallium [68GA]-DOTA-peptides and 18Fluorine-fluoro-2-deoxyglucose [18F-FDG] PET/TC scans in the work-up of pancreatic neuroendocrine tumors (PanNETs) is controversial. This study aimed at assessing both tracers’ capability to identify tumors and to assess its association with pathological predictors of recurrence. Methods:Prospectively collected, preoperative, dual-tracer PET/CT scan data of G1-G2, non-metastatic, PanNETs that underwent surgery between January 2013 and October 2019 were retrospectively analyzed. Results:The final cohort consisted of 124 cases. There was an approximately equal distribution of males and females(50.8%/49.2%), and G1 and G2 tumors(49.2%/50.8%). The disease was detected in 122(98.4%) and 64(51.6%) cases by 68Ga-DOTATOC and by 18F-FDG PET/CT scans, respectively, with a combined sensitivity of 99.2%. 18F-FDG-positive examinations found G2 tumors more often than G1 (59.4% versus 40.6%;p = 0.036), and 18F-FDG-positive PanNETs were larger than negative ones (median tumor size 32 mm, IQR 21 versus 26 mm, IQR 20;p = 0.019). The median Ki67 for 18F-FDG-positive and -negative examinations was 3(IQR 4) and 2(IQR 4), respectively, (p = 0.029). At least one pathologic predictor of recurrence was present in 74.6% of 18F-FDG-positive cases (versus 56.7%;p = 0.039), whereas this was not found when dichotomizing the PanNETs by their dimensions (≤/> 20 mm). None of the two tracers predicted nodal metastasis. ROC curve analysis showed that 18F-FDG uptake higher than 4.2 had a sensitivity of 49.2%, and specificity of 73.3% for differentiating G1 from G2 (AUC=0.624, p=0.009). Conclusion: The complementary adoption of 68Ga-DOTATOC and 18F-FDG tracers may be valuable in the diagnostic work-up of PanNETs despite not being a game-changer for the management of PanNETs ≤ 20 mm.


2021 ◽  
Vol 11 (1) ◽  
pp. 1898-1901
Author(s):  
Moushami Singh ◽  
Raghu Ram Bhandary ◽  
Jitendra Pariyar ◽  
Swechha Maskey ◽  
Hari Prasad Dhakal

Struma ovarii, also known as goiter of the ovary is a rare disease.1 Considering the rarity of this tumor and constrained literature in Nepal’s context, we hereby present a case of a 46-year-old female, asymptomatic, with normal blood parameters who presented with an abdominal mass. She was suspected of malignant ovarian mass on an ultrasonogram. Intraoperative frozen section examination revealed a benign tumor suggestive of dermal tumor versus struma ovarii. Postoperatively, histopathological examination was performed to assess the percentage of thyroid tissue and a diagnosis of benign struma ovarii was made which was confirmed by thyroglobulin positivity on immunohistochemistry. No features of immature teratoma and malignancy were identified.


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.


2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Mustafa Erkan Sari ◽  
Ozhan Ozdemir ◽  
Pinar Kadirogullari ◽  
Funda Arpaci Ertugrul ◽  
Cemal Resat Atalay

Background. Mature cystic teratomas of the fallopian tube are extremely rare and only 54 cases have been reported in the literature. In this paper, we report a mature cystic teratoma of the fallopian tube in a postmenopausal woman and we report the review of literature of tubal cystic teratomas.Case. A 62-year-old, gravida 4 postmenopausal woman presented with pain in the right lower abdominal region for a long time. An 88 × 72 × 95 mm heterogeneous mass which contained calcifications and lipoid components was detected in the right adnexal region by transvaginal ultrasonogram (TV-USG). Serum tumour markers, namely, CA125, CA15-3, and CA19-9, were within normal range. A laparotomy revealed a 9 × 10 cm cystic mass within the fimbrial region in the right fallopian tube, and right salpingoopherectomy was performed consequently. Microscopic examination revealed squamous epithelium with sebaceous glands and hair follicles, and pseudostratified ciliated respiratory epithelium with cartilage and mucous glands. Because the frozen section resulted in a benign dermoid cyst, no further operative procedure was performed. The postoperative follow-up was uneventful and the patient was discharged on the second postoperative day.Conclusion. In cases of undetermined pelvic or abdominal masses, a teratoma of the fallopian tube should be considered.


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.


Author(s):  
Kirty Nahar ◽  
Usha Bohra ◽  
Vivek Arya

Androgenic alopecia is a patterned hair loss occurring due to systemic androgens and genetic factors. It is the most common cause of hair loss in both genders. The appearance of this condition is the cause of significant stress and psychological problems, making appropriate management important. A 68-year-old postmenopausal female presented with complaints of increased hair loss from scalp, excessive hair growth at undesired sites and hirsutism not corrected with medications. On thorough investigations, CT scan whole abdomen and endocrinological workup, a clinical diagnosis of alopecia and hirsutism due to hyperandrogenemia secondary to ovarian tumor made. Abdominal hysterectomy with B/L salpingo-oophorectomy was done. Histopathological examination revealed an encapsulated tumor in right ovary-sex cord stromal tumor consistent with Leydig cell tumor in right ovary, no evidence of malignancy. Left ovary was normal. Patient showed significant regression of clinical signs and symptoms on follow up after 1 month. All women with severe hirsutism or androgenic alopecia needs further work up to locate the source of androgen over production.


2015 ◽  
Vol 1 (1) ◽  
pp. 31-40
Author(s):  
Rino Rusdiono ◽  
Arif Faisal

Odontogenic tumor is a lesion originated from epithelium, ectomesenchymal, or mesenchymal component which still retain part of dental-forming element.A female 20 years old had complaint a mass in the oral cavity and obtructed nasal. Physical examination showed a mass on molar region of the left axillary bone. Diagnostic imaging by using OPG was suspected ameloblastoma, while CT scan concluded as a dentigerous cyst in left maxillary bone. Both of the lesions were cystic  abnormalities, that sometimes very difcult to di?erentiate due to their similarity. Pathological fndings was clear cell odontogenic tumor or clear cell odontogenic carcinoma of tissue mass after resection had been conducted. This case report is proposed because there is a discordance from imaging examination in both OPG and CT Scan with the fnal histopathological examination. CCOC di?erential diagnosis will be outlined here so we can understand the feature of CCOC better in imaging examination to prevent misdiagnosis which can infere further treatment.


2013 ◽  
Vol 3 ◽  
pp. 8 ◽  
Author(s):  
Dayananda Kumar Rajanna ◽  
Vaibhav Pandey ◽  
Sujit Janardhan ◽  
Sujatha N Datti

Giant fibroids are known to arise from the uterus, and very rarely from the broad ligament. Large fibroids often undergo hyaline, cystic, and at times, red degeneration. In the present case, cystic degeneration with intervening septations in an adnexal mass raised the suspicion of ovarian neoplasm as the ovaries were not seen as separate from the lesion. The ultrasonographic and contrast-enhanced computed tomographic findings of this case were characteristic of ovarian neoplasm. The differential diagnosis included rare possibility of giant fibroid with cystic degeneration. The diagnosis was confirmed on histopathological examination. The patient underwent excision of the broad ligament fibroid, hysterectomy, and bilateral salpingo-oophorectomy. Magnetic resonance imaging has a role in the diagnosis of such lesions.


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