scholarly journals Giant asymptomatic borderline ovarian tumor in a patient suffering from choledocholithiasis and cholangitis

2012 ◽  
Vol 59 (1) ◽  
pp. 111-114 ◽  
Author(s):  
Radmila Sparic ◽  
Sasa Kadija ◽  
Snezana Buzadzic ◽  
Ivana Likic

Borderline tumors account for about 15% of all ovarian epithelial tumors and are usually diagnosed only when they reach a significant size causing abdominal pain or distension. Clinical, sonographic and Doppler examinations, as well as tumor marker levels cannot detect this type of ovarian tumor with certainty. The definitive diagnosis can only be established by a histopathological examination. We present a case of a 58-year-old patient operated on at our clinic for asymptomatic borderline ovarian tumor. Prior to admission, the patient underwent a medical check-up at the surgery department, where she was diagnosed with choledocholithiasis, and, consequently, the need for urgent surgical treatment for calculosis was excluded. In the presented case the ovarian tumor was revealed owing to the occurrence of choledocholithiasis and cholangitis. The choledocholithiasis and cholangitis, which contributed to the accurate diagnosis of the tumor, were at the same time some of the possible reasons for misleading diagnosis and therapy complications in our patient?s case.

Author(s):  
Priyanka Anand ◽  
Namrata Nargotra

Ectopic pregnancy occurs in 2% of all pregnancies. Primary ovarian pregnancy is a rare entity and accounts for only 0.15-3% of all ectopic gestations. It usually ends with rupture before the end of first trimester. The diagnosis is often made intraoperatively and confirmed histopathologically. A 23 year old female presented with severe hypogastric abdominal pain with no history of amenorrhea. She underwent a laprotomy and a right sided salpingo-oopherectomy and the excised material was sent for histopathological examination. Chorionic villi were seen within the ovarian stroma suggesting the likely possibility of an ovarian pregnancy. Ovarian pregnancy is rare; although awareness of this condition is important for reducing its associated morbidity and mortality. This highlights the importance of histopathology for the accurate diagnosis of this condition.


Author(s):  
Dagmara Pietkiewicz ◽  
Agnieszka Horała ◽  
Szymon Plewa ◽  
Piotr Jasiński ◽  
Ewa Nowak-Markwitz ◽  
...  

This study presents the use of matrix-assisted laser desorption and ionization mass spectrometry imaging (MALDI-MSI) directly on the tissue of two ovarian tumors that often present a diagnostic challenge, a low-grade serous borderline ovarian tumor and ovarian fibrothecoma. Different spatial distribution of m/z values within the tissue samples was observed, and regiospecific peaks were identified. Among the 106 peaks in the borderline ovarian tumor five, regiospecific peaks (m/z: 2861.35; 2775.79; 3368.34; 3438.43; 4936.37) were selected using FlexImaging software. Subsequently, the distribution of those selected peaks was visualized on the fibrothecoma tissue section, which demonstrated the differences in the tissue homo-/heterogeneous structure of both tumors. The comparison with the histopathological staining of the ovarian borderline tumor tissue section, obtained during serial sectioning, showed a close correlation of the molecular map with the morphological and histopathological features of the tissue and allowed the identification of different tissue types within the sample. This study highlights the potential significance of MSI in enabling morphological characterization of ovarian tumors as well as correct diagnosis and further prognosis than thus far seen in the literature. Osteopontin, tropomyosin and orosomucoid are only a couple of the molecules investigated using MALDI-MSI in ovarian cancer research. This study, in line with the available literature, proves the potential of MALDI-MSI to overcome the current limitations of classic histopathological examination giving a more in-depth insight into the tissue structure and thus lead to the more accurate differential diagnosis of ovarian tumors, especially in the most challenging cases.


2021 ◽  
Vol 7 (3) ◽  
pp. 122
Author(s):  
Yuliza Yuliza ◽  
Alfian Nur Rosyid ◽  
Wiwin Is Effendi ◽  
Prastuti Asta Wulaningrum ◽  
Herley Windo Setiawan

Introduction: Gastrointestinal tuberculosis (GI TB) is quite rare with 3% incidence of all extrapulmonary involvement. Appendicular TB may occur in 0.1 - 3% of cases. Diagnosis is often difficult because the patient usually complains about chronic abdominal pain and fever. A definite diagnosis is based on histopathological examination of resected specimens from the appendectomy procedure.Case: We present a 37-year-old male patient admitted to the hospital with chronic abdominal pain, fever, nausea, and loss of body weight. The patient never had a persistent cough, hemoptysis, or night sweating. Physical examination showed pain and muscular rigidity in the right iliac area during palpation with Blumberg's sign and Rovsing's sign positive. Abdomen ultrasound imaging showed an appendicular abscess. The patient underwent appendectomy afterwards with histopathology result showing TB. The patient was treated with first category anti-tuberculosis drugs (ATD).Discussion: Diagnosis of appendicular TB is difficult due to unspecific clinical presentations. Appendicular TB patients often complain of signs and symptoms which are similar to acute appendicitis. These conditions can delay ATD treatment because the definitive diagnosis could be made after histopathological examination.Summary: Appendicular TB is a rare case of extrapulmonary TB. It can present as acute appendicitis. The definitive diagnosis is based on the histopathological examination. It is recommended to check the appendicectomy specimens histopathologically to exclude TB or other diseases. 


2021 ◽  
Vol 5 (2) ◽  
pp. 020-022
Author(s):  
Karahan Furkan ◽  
Acar Nihan ◽  
Avcı Arzu ◽  
Dilek Osman Nuri

Purpose: The sinusoidal obstruction syndrome (SOS) of the liver is an obliterative vasculitis that involves the terminal branches of the hepatic venules and sinusoids. When it is not treated, it will be a serious risk of mortality. Here, we aim to present our patient who has been associated with recurrent cholangitis attacks due to cholelithiasis and choledocholithiasis and is associated with sinusoidal obstruction syndrome with the literature. Description of the case: A 30 years old male patient had complaints of abdominal pain and nausea for a long time. The patient had a history of choledocholithiasis and cholangitis attacks. Although ERCP was performed and a stent was placed in the biliary tract, his jaundice did not disappear. Liver function tests were high. Tumor markers were negative. Methods: We could not make a definitive diagnosis with imaging methods and biopsy and we planned surgery. We performed segmental liver resection and biliary diversion in the surgery. Histopathological examination of the resected liver tissue was compatible with SOS. Conclusion: Many studies have been done on the etiology of SOS and different causes have been revealed. Accompanied with clinical findings, a definitive diagnosis is made with the exclusion of the presumptions considered. Surgery can be performed for both diagnostic and therapeutic purposes. If patients with elevated liver function tests and bilirubin have long-term abdominal pain, SOS should be bear in mind.


2019 ◽  
Vol 3 (2) ◽  
pp. 130-136
Author(s):  
Arif Fadillah ◽  
Andi Friadi

Background : Malignant ovarian tumor are still the number one cause of death and the second most  of incidents for gynecological malignant tumors. The principles of management of ovarian cancer are the same as the principles of handling other malignant diseases, for the treatment of primary lesions operatively and the handling of potential sites of tumor metastases with chemotherapy. Histopathological examination is still considered a gold standard for diagnosis and definitive treatment of malignant ovarian tumors. If histopathologic results are obtained, then the patient will be planned to undergo postoperative chemotherapy. The mismatch between the preoperative and intraoperative clinical features, and the results of postoperative histopathological examination is a problem in managing cases of ovarian malignant tumors.Objective : Report a case of residive ovarian carcinoma with no appearance of malignancy marker in the previous postoperative histopathological examination.Method : Case reportCase : We report the case of a 45-year-old woman with a history of two previous laparotomy. The first operation was carried out in February 2014 on the indication of an extra ovarian cyst, resulting in the impression of a "Follicular Cysts" based on histopathological examination. The second operation was performed in March 2015, performed surgical staging tumors with an indication of malignant ovarian tumors with clinical metastases, but from histopathological examination it was found that "Cystadenoma Ovarii Muscinosum Multiloculare" and "no visible signs of malignancy", so the patient was not managed with postoperative chemotherapy. In April 2019 patients came with complaints of new mass growth, from CT-Scan and USG investigations there was a suspicious impression of a residive ovarian tumor with metastases into the omentum and massive ascites. On May 16, 2019 an optimal debulking was performed with the findings of residive mass, ascites, and mass metastases in the intra operative peritoneum. From the results of histopathological examination, it was found that "Muscinous Carcinoma with metastases to the umbilicus, peritoneum, and ascitic fluidKeywords: Malignant residive ovarian tumor, mucinous ovarian carcinoma


2018 ◽  
Vol 69 (7) ◽  
pp. 1813-1816 ◽  
Author(s):  
Ovidiu Gabriel Bratu ◽  
Radu Dragos Marcu ◽  
Bogdan Socea ◽  
Tiberiu Paul Neagu ◽  
Camelia Cristina Diaconu ◽  
...  

Retroperitoneal space is called sometimes no man�s land�and for a good reason: this is disputed anatomical territory for many surgical and medical specialties. Their wide histological diversity and unspecific clinical presentation make them a challenge for the surgeon. In order to improve their detection immunohistochemistry seems to show promising results. Methods of detection have evolved over time to identify as much as possible the histological type of tumor. Because of this extreme variability immunohistochemistry through its various markers is the one that often sets the definitive diagnosis, the simple histopathological examination being insufficient. This paper aims to highlight the main markers used in retroperitoneal tumors. As it can be seen there is a huge histologic areal for these tumors. Some have proven some of them still not. Given the fact that there is a tendency toward personalized therapy it is imperative to identify the histological type of tumor as soon as possible.


Author(s):  
Bruno Ramalho de Carvalho ◽  
Geórgia Fontes Cintra ◽  
Taise Moura Franceschi ◽  
Íris de Oliveira Cabral ◽  
Leandro Santos de Araújo Resende ◽  
...  

AbstractWe report a case of ultrasound-guided ex vivo oocyte retrieval for fertility preservation in a woman with bilateral borderline ovarian tumor, for whom conventional transvaginal oocyte retrieval was deemed unsafe because of the increased risk of malignant cell spillage. Ovarian stimulation with gonadotropins was performed. Surgery was scheduled according to the ovarian response to exogenous gonadotropic stimulation; oophorectomized specimens were obtained by laparoscopy, and oocyte retrieval was performed ∼ 37 hours after the ovulatory trigger. The sum of 20 ovarian follicles were aspirated, and 16 oocytes were obtained. We performed vitrification of 12 metaphase II oocytes and 3 oocytes matured in vitro. Our result emphasizes the viability of ex vivo mature oocyte retrieval after controlled ovarian stimulation for those with high risk of malignant dissemination by conventional approach.


Author(s):  
João Machado Nogueira ◽  
Inês Fonseca ◽  
Marco Duarte

Cannabinoid hyperemesis syndrome (CHS) is characterized by episodic bursts of nausea, vomiting and abdominal pain, affecting chronic cannabis users. The clinical picture mimics an acute abdomen, usually leading to multiple assessments in the emergency department. Several complementary diagnostic examinations are performed with non-specific results, making differential diagnosis puzzling. We present a case of a 42-year-old man, who has been admitted multiple times to the emergency department in the last 3 months for abdominal pain, nausea and vomiting, without triggering factors and improving only with hot water baths. He was evaluated by different specialties, the various complementary diagnostic tests performed showed no significant results, and no definitive diagnosis was obtained. Treatment resulted only in a partial and transient resolution of symptoms. A more detailed medical history revealed cannabis use for more than 5 years, with a recent increase in the amount consumed. After psychoeducation, explaining the risks associated with consumption and its relationship with the clinical symptoms, which resulted in complete suspension of cannabis, there have been no new symptomatic episodes since then. We present an illustrative case of a poorly reported clinical entity despite having a probable significant prevalence, raising awareness in order that clinicians identify and properly manage these cases.


2018 ◽  
Vol 31 (1) ◽  
pp. 48-54 ◽  
Author(s):  
Krista J. Childress ◽  
Ninad Mohan Patil ◽  
Jodi A. Muscal ◽  
Jennifer E. Dietrich ◽  
Rajkumar Venkatramani

2021 ◽  
Vol 14 (10) ◽  
pp. e244603
Author(s):  
Swaminathan Perinkulam Sathyanarayanan ◽  
Khizar Hamid ◽  
Kayla Hoerschgen ◽  
Tony Oliver

Solitary fibrous tumours (SFTs) are rare mesenchymal tumours that are mostly seen in the pleura. Lately, they have also been described in other locations. Recent discovery of the NAB2-STAT6 fusion gene which is specific for SFTs has led to an accurate diagnosis of SFTs. The occurrence of SFTs in the mesentery is very rarely reported in the literature. We report a case of a 63-year-old female who presented with abdominal pain, rectal bleeding and Fusobacterium bacteraemia, who was ultimately found to have a mesenteric SFT.


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