scholarly journals Multicystic Benign Cystic Mesothelioma Presenting as a Pelvic Mass

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Mazdak Momeni ◽  
Elena Pereira ◽  
Gennadiy Grigoryan ◽  
Konstantin Zakashansky
Keyword(s):  
Preoperative Evaluation ◽  
Pelvic Mass ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Cystic Lymphangioma ◽  
Ca 125 ◽  
Pathologic Evaluation ◽  
Pelvic Peritoneum ◽  
Cystic Mesothelioma

Background.Benign cystic mesothelioma (BCM) is a rare tumor that arises from the abdominal peritoneum with a predilection to the pelvic peritoneum. For this reason, it can often mimic gynecologic malignancies.Case.A 47-year-old perimenopausal female presented reporting several weeks of abdominal distention associated with abdominal tenderness and constipation. Computed tomography revealed a 24 cm multiloculated pelvic mass, and tumor markers were notable for an elevated CA-125. The patient was taken to the operating room for an exploratory laparotomy, total abdominal hysterectomy, bilateral salpingoophorectomy, and removal of pelvic mass. Final pathologic evaluation revealed a benign cystic mesothelioma.Conclusion.Classically these tumors present as large multicystic masses with thin-walled septations and on preoperative evaluation BCM can mimic many different disease entities including ovarian malignancies and cystic lymphangioma. Often diagnosis can only be made at time of surgery.

Meigs syndrome presenting with severely elevated CA-125 level

2021 ◽  
Vol 14 (3) ◽  
pp. e238931
Author(s):  
Alicia Palmieri ◽  
Karim ElSahwi ◽  
Verda Hicks
Keyword(s):  
Pleural Effusion ◽  
Ovarian Carcinoma ◽  
Pelvic Mass ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Ca 125 ◽  
Cancer Antigen 125 ◽  
Laboratory Findings ◽  
Pathological Evaluation

A 64-year-old woman referred to Gynaecological Oncology secondary to the finding of pelvic mass and ascites. Imaging showed multiple pelvic masses, with the largest mass measuring 20 cm in diameter, as well as bilateral pleural effusions and abdominal ascites, suspicious for ovarian carcinoma. Laboratory findings included elevated cancer antigen 125 (CA-125) of 2124 units/mL. The patient underwent an exploratory laparotomy, total abdominal hysterectomy and bilateral salpingo-oophorectomy for pathological evaluation. Postoperatively, the patient had resolution of ascites and pleural effusion. Surgical pathology revealed a 26 cm right ovarian fibroma, confirming the diagnosis of Meigs syndrome. Despite the high suspicion for ovarian carcinoma in patients presenting with elevated CA-125 level, pelvic mass, ascites and pleural effusion, the diagnosis of Meigs syndrome cannot be excluded without pathological evaluation of mass.

scholarly journals Borderline Clear Cell Adenofibroma of the Ovary

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Pilaiwan Kleebkaow ◽  
Apiwat Aue-aungkul ◽  
Amornrat Temtanakitpaisan ◽  
Chumnan Kietpeerakool
Keyword(s):  
Clear Cell ◽  
Pelvic Mass ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Ca 125 ◽  
Stromal Invasion ◽  
Post Operation ◽  
Clear Cytoplasm ◽  
Gross Examination ◽  
Clear Cell Adenofibroma

Borderline clear cell tumors are extremely rare, and few cases have been reported in the literature. Herein, we present a case of borderline clear cell adenofibroma of the ovary in a 58-year-old woman who presented with a pelvic mass and constipation. Physical examination revealed a 10 cm solid midline pelvic mass. Computed tomography showed an 8 cm heterogeneous enhancing mass attached to the left posterolateral wall of the uterus. The patient’s serum CA 125 levels were slightly elevated (80.9 U/ml). The patient was given a total abdominal hysterectomy with bilateral salpingooophorectomy. On gross examination, it was found that the left ovarian tumor was an 8.0 × 7.5 × 8.0 cm solid multilobulated mass containing tiny cysts. Histologically, the tumor was composed of small glands in dense fibrous and myxoid stroma. The glands were lined with cuboidal cells with clear cytoplasm and mild to moderate nuclear atypia. No stromal invasion was observed. The pathological diagnosis was borderline clear cell adenofibroma of the left ovary. There was no reoccurrence 36 months post operation.

scholarly journals High grade endometrial stromal sarcoma: a clinician dilemma

2021 ◽  
Vol 9 (8) ◽  
pp. 2493
Author(s):  
Poojan Dogra ◽  
Shuchi Sharma ◽  
Reena Sharma ◽  
Suraj Bhardwaj
Keyword(s):  
Tumor Cells ◽  
Pelvic Mass ◽  
Endometrial Stromal Sarcoma ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Anterior Wall ◽  
Pelvic Lymphadenectomy ◽  
Stromal Sarcoma ◽  
Endometrial Thickening

Uterine sarcomas are relatively rare tumors of mesodermal origin. ESS occurs primarily in perimenopausal women in 4th and 5th decade of their life; about one third occurs in postmenopausal women. Here in we describe a case of 44 years old patient presented with one month history of foul smelling discharge per vagina and a pelvic mass. Ultrasound and MRI gave possibility of a large anterior wall and fundal fibroid with degeneration versus neoplastic endometrial thickening. The patient underwent exploratory laparotomy with total abdominal hysterectomy with bilateral salpingoophorectomy with pelvic lymphadenectomy. Histopathology showed tumor cells with round to oval nuclei with high mitotic activity, blood vessel proliferation between the tumor cells and extensive lymphovascular invasion. The pathological diagnosis was HG-ESS stage IB. The patient was referred to radiotherapy department for adjuvant therapy. HG-ESS is a rare clinical entity and considered as important differential diagnosis.

scholarly journals Laparoscopic Vessel Endometriosis Resection Surgery: A Case Report and Review of Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Shadi Rezai ◽  
Richard A. Giovane ◽  
Tiffanie Mann ◽  
Ninad M. Patil ◽  
Elise Bardawil ◽  
...  
Keyword(s):  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Pathology Report ◽  
Review Of Literature ◽  
Pelvic Peritoneum ◽  
Patient Reported ◽  
History Of ◽  
Large Vessels

Background. Endometriosis usually occurs in the pelvis and often involves the ovaries, the uterosacral and broad ligaments, and the pelvic peritoneum. In rare instances, it can occur in the vasculature of the pelvis. Patients with endometriosis present with abnormal pain, menstrual cycle disruption and infertility. Management of endometriosis is usually surgical with excision of the tissue via laparoscopic means. Case. A 42-year-old Gravida 5, Para 2-0-3-2 patient with a 22 year history of endometriosis, who had had multiple laparoscopic endometriosis resections, total abdominal hysterectomy, and an exploratory laparotomy with bilateral salpingo-oophorectomy, presented with left pelvic pain when standing, dyspareunia, and a 3.7 cm cyst on ultrasound. The patient underwent laparoscopic vessel endometriosis resection and excision of endometriotic nodules from external iliac vessels. Final pathology report showed evidence of old endometriosis in all locations. On interval follow-up, the patient reported sustained relief from pain. Conclusion. Complete resection of endometriosis from large vessels can be successfully achieved laparoscopically by a well-experienced surgeon with delicate, proper techniques.

scholarly journals ADENEXAL CYSTS

2011 ◽  
Vol 18 (01) ◽  
pp. 32-40
Author(s):  
TEHREEN RIAZ ◽  
SARWAT JABEEN ◽  
WASEEM TALIB ◽  
Nabeela Shami
Keyword(s):  
Demographic Data ◽  
Lower Abdominal Pain ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Ovarian Tumour ◽  
Risk Of Malignancy ◽  
Histopathologic Evaluation ◽  
Operative Findings

Objectives: (1) To evaluate the risk of malignancy in surgically removed ovarian cysts that was before the operation neither simple nor complex. (2) To determine the relationship of age with type of ovarian tumour. (3) To categorize the management of these cases according to the intra-operative findings. (4) To analyze the occurrence of various histopathological types of tumour. Date Source: Medline Study Design: Single centered prospective descriptive study of 150 cases. Place and Duration of Study: Department of Obstetrics and Gynaecology at Shaikh Zayed Hospital Lahore from 1st July 2005 to,31st December 2006. Subject and method: 150 patients presented with adnexal cysts on preoperative ultrasonography, peroperative findings and histopathology reports. These patients were followed up in OPD. Results: Showed the distribution of non-neoplastic and neoplastic tumours which were 84% and 16% respectively. The occurrence of malignancy increased with advancing age especially after 45 years Common presentations were lower abdominal pain (53%) followed by menstrual disturbances (30%), abdominopelvic mass, abdominal distension and infertility. Risk of malignancy also increased with parity. 73% masses were unilateral, 84% benign masses were unilocular whilst 85% malignant masses were echogenic and the complex cysts with papillary projection and multiloculations showed 3-6 times higher risk of malignancy. Most patients were managed by exploratory laparotomy. Cystectomy and total abdominal hysterectomy were the commonest procedures performed. Regarding histopathologic evaluation 40% patients had tumours, 2.66% borderline malignancy and 13.3% malignant. 44% had non-neoplastic lesions. Serous and endometriotic cysts were the commonest benign histopathologic types and among malignant ones, epithelial ovarian tumours were the leading variants. Conclusions: Preoperative characterization of adnexal masses using sonographic and demographic data may have considerable potential in determining risk of malignancy and may be advantageous in terms of counseling patients for management.

scholarly journals MUCINOUS CYSTADENOCARCINOMA

2018 ◽  
Vol 16 (2) ◽  
pp. 59
Author(s):  
Sadia Anwar ◽  
Nasim Saba
Keyword(s):  
Abdominal Mass ◽  
Exploratory Laparotomy ◽  
Abdominal Hysterectomy ◽  
Genetic Mutation ◽  
Cystic Mass ◽  
Mucinous Cystadenocarcinoma ◽  
Ca 125 ◽  
Invasive Adenocarcinoma ◽  
Epithelial Tumor ◽  
Glandular Cells

A 55 years old lady presented to Gynecology outpatient of MMM Teaching Hospital, D.I.Khan in January 2018 with history of abdominal mass. Her abdominal hysterectomy was done one year back. On examination a huge cystic mass reaching up to the xiphisternum and occupying the whole abdomen was palpable. Her ultrasound revealed a mass arising from pelvis, most likely ovarian in nature. Her CA-125 level was 29.62 IU/ml (in normal range). Exploratory laparotomy revealed a huge cystic mass which was excised. Histopathology reported mucinous cystadenocarcinoma of the ovary. Chemotherapy was then done. There was no recurrence by the end of nine months follow-up as evaluated by ultrasonography. Mucinous cystadenocarcinoma is an invasive adenocarcinoma composed of malignant glandular cells containing intracytoplasmic mucin. It is relatively common in middle-aged women. Genetic mutation such as KRAS gene have been reported. It is a rapidly growing epithelial tumor usually presenting as a single solid mass. Treatment involves surgery and chemotherapy. The prognosis depends upon the stage of tumor.

scholarly journals The Imaging and Pathological Features of Metastatic Leiomyosarcoma in the Gallbladder

Rare Tumors ◽  
2016 ◽  
Vol 8 (4) ◽  
pp. 179-181 ◽  
Author(s):  
Yi Guo ◽  
Eleanor Chen ◽  
Darin J. Davidson ◽  
Venu G. Pillarisetty ◽  
Robin L. Jones ◽  
...  
Keyword(s):  
Metastatic Disease ◽  
Uterine Fibroids ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Metastatic Lesion ◽  
Uterine Leiomyosarcoma ◽  
High Grade ◽  
Initial Management ◽  
Pelvic Radiation

Uterine leiomyosarcoma is a rare and aggressive malignancy with poor overall prognosis. There have been few reports of metastatic leiomyosarcoma in the gallbladder. We report a case of a 41-year-old female who underwent total abdominal hysterectomy due to presumed uterine fibroids. The postoperative pathology revealed high-grade pleomorphic leiomyosarcoma, with involvement of the uterine serosal surface. She subsequently underwent exploratory laparotomy, followed by pelvic radiation and chemotherapy. Since initial management she has developed metastatic disease and has been under treatment and surveillance for 11 years. She has undergone multiple surgical procedures and numerous lines of systemic therapy for metastatic leiomyosarcoma, including cholecystectomy for a metastatic lesion in the gallbladder. There have been no previous reports of metastatic leiomyosarcoma in the gallbladder. Despite extensive metastatic disease this patient has had prolonged survival with multi-modality management.

scholarly journals Degenerated fibroid: a diagnostic dilemma

2020 ◽  
Vol 9 (4) ◽  
pp. 1766
Author(s):  
Nayanika Gaur ◽  
Manish Jha
Keyword(s):  
Histopathological Examination ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Cystic Degeneration ◽  
Ovarian Malignancy ◽  
Imaging Studies ◽  
Diagnostic Dilemma ◽  
Fibroid Uterus ◽  
Wide Range

Leiomyoma is one of the most commonly encountered benign gynaecological neoplasms. With a wide range of symptoms, sometimes even asymptomatic, these tumors are easy to diagnose and treat, unless there are degenerative changes, which makes them difficult to diagnose and differentiating them from other serious conditions including malignancy, thereby, complicating their management also. Here, the case present to you a case of 48-year-old women with symptoms and clinical examination suggesting fibroid uterus but imaging studies inconclusive to differentiate fibroid uterus with ovarian malignancy, thus, creating a diagnostic dilemma. Ultimately, patient underwent exploratory laparotomy, keeping possibility of ovarian malignancy. Histopathological examination of the specimen of total abdominal hysterectomy with bilateral salpingo-oopherectomy concluded extensive cystic degeneration of leiomyoma and no evidence of malignancy.

scholarly journals EP.TH.717Triple tumour: A myriad of serial incidental findings in a patient presenting with Gallstone pancreatitis

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Cameron Boyle ◽  
Katherine Lowe ◽  
Ahmed Dhaif ◽  
Adeeb Hassan ◽  
Kawan Shalli ◽  
...  
Keyword(s):  
Epigastric Pain ◽  
Pelvic Mass ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Small Bowel Resection ◽  
Gallstone Pancreatitis ◽  
Endometrioid Adenocarcinoma ◽  
Ovarian Adenocarcinoma ◽  
Desirable Outcome ◽  
Benign Ovarian Tumours

Abstract Aim To present a rare incidental synchronous triple tumours - colonic adenocarcinoma, endometroid ovarian adenocarcinoma and benign Brenner tumour in a patient admitted with acute gallstone pancreatitis. Methods A 75-year-old female presented with epigastric pain. Blood-tests and USS abdomen confirmed gallstones and pancreatitis. She was treated conservatively. USS also showed incidental pelvic mass which was further characterised by CT and MR scans. These scans confirmed heterogeneous lobulated mass in the left adnexa. CT scan also picked-up incidental mass in transverse colon, which was confirmed as cancer by colonoscopy. She was offered therapeutic resection after discussion in Colorectal and Gynaecology MDT. Intra-operatively, transverse colonic tumour was invading into the proximal ileum. Laprascopic surgery concluded with extended right hemicolectomy, small bowel resection-anastomosis, omentectomy, total abdominal hysterectomy and bilateral salpingo-oophorectomy. Results The patient had gradual recovery without any complications. Histopathology showed T4N2 poorly differentiated adenocarcinoma of colonic mass, FIGO grade 1 stage 1c endometrioid adenocarcinoma of left ovary and benign brenner tumour of right ovary. Post-operative MDT did not offer adjuvant-therapy due to slow recovery and fraility. So far, two-years of follow-up did not show any recurrence. Conclusion This report adds to the limited literature of triple synchronous tumours, including rare Brenner accounting for 5% of benign ovarian tumours and endometrioid ovarian tumour with an incidence of 4 -7%. Multi-disciplinary approach and combined surgery can achieve a desirable outcome in such complex cases. It is crucial to identify the primary status of the tumours as it will guide the adjuvant treatment.

scholarly journals A rare association of uterine leiomyoma with mesenteric vein thrombosis and bowel gangrene: case report

2021 ◽  
Vol 10 (4) ◽  
pp. 1721
Author(s):  
Rajneesh Rawat ◽  
Manik Gedam ◽  
Jyoti Baghel ◽  
Shalini Baghel
Keyword(s):  
Uterine Fibroid ◽  
Uterine Fibroids ◽  
Exploratory Laparotomy ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Mesenteric Vein Thrombosis ◽  
Mesenteric Vein ◽  
Vein Thrombosis ◽  
Jejunoileal Anastomosis ◽  
Bowel Gangrene

Uterine fibroids are the most common benign pelvic tumors in women. There are many complications reported with fibroids. However, mesenteric vein thrombosis and small bowel gangrene caused by a uterine fibroid are rare. This manuscript reports a rare case of 40 year female with a large uterine fibroid associated with mesenteric vein thrombosis and bowel ischemia. She underwent exploratory laparotomy in which resection of gangrenous bowel including jejunum and ileum was done along with left sided jejunostomy and right sided ileostomy. Total abdominal hysterectomy with bilateral salpingooophorectomy was done followed by jejunoileal anastomosis 6 weeks later. Hence, in patients presenting with acute abdomen and uterine fibroids, bowel gangrene must be included in the differential diagnosis.

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