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Buechel J, Bruder E, Manegold-Brauer G. Three-dimensional imaging of rare mesenchymal tumor of umbilical cord. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2020; 55:279-280. [PMID: 31115104 DOI: 10.1002/uog.20349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 05/01/2019] [Accepted: 05/10/2019] [Indexed: 06/09/2023]
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Cerdeira AS, Tome M, Moore N, Lim L. Seeing red degeneration in uterine fibroids in pregnancy: proceed with caution. Lancet 2019; 394:e37. [PMID: 31777390 DOI: 10.1016/s0140-6736(19)32322-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/08/2019] [Accepted: 10/04/2019] [Indexed: 11/23/2022]
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Tarannum A, Sheikh H, Appiah-Sakyi K, Lindow SW. The diagnostic use of magnetic resonance imaging for acute abdominal and pelvic pain in pregnancy. Eur J Obstet Gynecol Reprod Biol 2019; 246:177-180. [PMID: 31955872 DOI: 10.1016/j.ejogrb.2019.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 11/19/2019] [Accepted: 11/21/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVES Acute abdomino-pelvic pain in pregnancy represents a diagnostic challenge. In many cases, radiological and laparoscopic diagnostic modalities are hazardous or contraindicated. Magnetic Resonance Imaging (MRI) is not commonly used for this indication and the results are not widely published. DESIGN AND SETTING A single-center retrospective observational study. POPULATION 34 cases of pregnant women with abdomino-pelvic pain who underwent MRI as an additional modality when clinical, laboratory and ultrasound (USS) findings were indeterminate. METHODS Case notes were reviewed where pregnant women underwent a MRI investigation for abdominal-pelvic pain. Primary Obstetric indications for an MRI eg placenta accreta were excluded. MAIN OUTCOME MEASURES The differential diagnosis after; 1) history and physical examination and 2) with the addition of USS and 3) with the further addition of an MRI were all individually compared to the eventual diagnosis. RESULTS The diagnoses reached by MRI corresponded with the final diagnosis in 22 out of 23 cases. In the remaining 11 cases MRI accurately ruled out presence of pathology. MRI was inaccurate in 1 case. CONCLUSION The additional use of MRI was more accurate than clinical assessment and USS combined. The accurate exclusion of pathology in 11 cases is particularly significant. MRI should be considered in cases of abdomino-pelvic pain in pregnant women.
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Goidescu I, Nemeti G, Caracostea G, Eniu DT, Chiorean A, Pintican R, Cruciat G, Muresan D. The role of imaging techniques in the diagnosis, staging and choice of therapeutic conduct in pregnancy associated breast cancer. MEDICAL ULTRASONOGRAPHY 2019; 21:336-343. [PMID: 31476214 DOI: 10.11152/mu-1958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Breast cancer diagnosed during pregnancy is at increasing incidence due to the increased frequency of obesity, the postponement of the first pregnancy to later decades of life and the advances of diagnostic techniques. Clinical and imaging diagnosis is difficult during gestation due to adaptive changes of the maternal organism , the mammary glads in particular. Furthermore, the therapeutic approach is limited both by the possible side effects on the fetus and by the skepticism of the couple over these therapeutic regimens.The present paper aims to review the main diagnostic steps to confirm pregnancy associated breast cancer, as well as the therapeutic possibilities during this period, related to the potential adverse effects concerning pregnancy.
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Taşkın F, Polat Y, Erdoğdu İH, Soyder A. Pregnancy-associated breast cancer: A review of 47 women. Clin Imaging 2019; 58:182-186. [PMID: 31404824 DOI: 10.1016/j.clinimag.2019.07.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 07/25/2019] [Accepted: 07/30/2019] [Indexed: 11/19/2022]
Abstract
PURPOSE Pregnancy-associated breast cancer (PABC) is a rare disease. However, its expected incidence tends to be increased because of delayed maternal age. The purpose of this study was to describe the clinical, radiological, and histopathological characteristics of PABC cases diagnosed in our center. METHODS The clinical-radiological findings and histopathological characteristics of patients diagnosed and treated with PABC at our institution between January 2011 and January 2017 were retrospectively evaluated. RESULTS Mammography and ultrasonography were performed in all patients. MRI examination was performed in 18 patients. Nine (19.1%) out of 47 patients were diagnosed with breast cancer during pregnancy, and 38 (80.9%) were in their first year after delivery. The most frequent finding (95.7%) during imaging was one or more masses. Mammography-detected pure or accompanying microcalcifications were found in 12 (25.5%) patients. MRI detected additional multifocal and multicentric disease in 14 (29.8%) patients and contralateral cancer in one (2.1%) patient. CONCLUSIONS Pregnancy-related breast cancer tends to be diagnosed in an advanced stage with poor prognosis. Any breast abnormalities observed in this period should alert clinicians, and a meticulous radiological evaluation is mandatory. The early diagnosis of this disease would increase the chances of successful treatment.
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Sutton PA, Rooney P, Ali N, Chandrasekar CR. Surgical management of large abdominal wall fibromatosis during pregnancy. BMJ Case Rep 2019; 12:e227811. [PMID: 31331925 PMCID: PMC6663169 DOI: 10.1136/bcr-2018-227811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2019] [Indexed: 11/04/2022] Open
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Nieto AJ, Trochez L, Ramírez D, Arguello P, Guzman G, Pachajoa H, Escobar Vidarte MF. Paraganglioma in pregnancy: interdisciplinary management during pregnancy. Gynecol Endocrinol 2019; 35:567-570. [PMID: 30786782 DOI: 10.1080/09513590.2019.1576619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Paragangliomas are tumors that originate from the extra-adrenal neural crest, the incidence of which during pregnancy is not more than two to eight cases per million people per year and are known to be highly morbid. The purpose of this report is to describe the experience and results obtained during management of a primigravida diagnosed with paraganglioma on week 21.2 and received both medical and surgical management with good maternal and perinatal outcomes. This case report evidences the importance of practicing interdisciplinary management of patients with clinical suspicion of paragangliomas or pheochromocytomas during pregnancy at high-complexity centers even in a medium-income country.
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Quddusi A, Shamim MS, Virani Q. Effect of pregnancy on growth of intracranial meningiomas. J PAK MED ASSOC 2019; 69:1057-1058. [PMID: 31983749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Meningiomas are the most common benign primary intracranial tumours in adults. Their rapid growth during pregnancy has been well reported. Moreover, the relationship of increased progesterone expression during pregnancy and extensive tumour growth has been debated. In this review, we discuss not only the effect of progesterone on meningiomal growth but also other mechanisms involved in gestational meningiomas.
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Dell'Atti L, Borghi C, Galosi AB. Laparoscopic Approach in Management of Renal Cell Carcinoma During Pregnancy: State of the Art. Clin Genitourin Cancer 2019; 17:e822-e830. [PMID: 31227431 DOI: 10.1016/j.clgc.2019.05.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 05/19/2019] [Accepted: 05/20/2019] [Indexed: 01/13/2023]
Abstract
Renal cell carcinoma (RCC) is extremely rare in pregnant women. However, this is one of the most reported urologic tumors during pregnancy. The aim of this review was to evaluate RCC during pregnancy in terms of epidemiology, risk factors, diagnosis, natural history of disease, and the safety of laparoscopic approach in the management of this tumor. RCC presentation is frequently made incidentally during an ultrasonography performed for other reasons, such as hydronephrosis owing to non-neoplastic causes. The optimal time for surgery during pregnancy and the consequences of surgery on the maternal and fetal well-being are major considerations. Risks for adverse pregnancy outcomes should be explained, and the patient's decision about pregnancy termination should be considered. Ultrasound is good in diagnosing renal masses, with a sensitivity comparable to that of computed tomography only for exophytic masses larger than 3 cm. Magnetic resonance imaging is reproducible and a good, though expensive, alternative to computed tomography scans for the evaluation of renal lesions in pregnant women. Radical nephrectomy or nephron-sparing surgery are essential treatments for management of RCC. Laparoscopic surgery has historically been considered dangerous during pregnancy and avoided whenever possible, because of concerns regarding surgery-related risks, such as uterine injury, miscarriage, teratogenesis, preterm birth, and hypercapnia. The laparoscopic treatment during pregnancy is becoming increasingly accepted where feasible with low morbidity. However, the combination of a multidisciplinary approach, multi-specialty communication, and skilled surgeons can give the best possible outcomes for mother and fetus.
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Pepe F, Valenti O, Insalaco G, Zigarelli MMG, Pepe L, Piana M. Struma ovarii complicating pregnancy. Case report and literature review. G Chir 2019; 40:199-207. [PMID: 31484009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A 19-year-old woman at 12th week of pregnancy was referred to our hospital with severe acute abdominal pain, nausea and vomiting. Patient's abdomen was untreatable. Routine examinations, except neutrophilic leukocytosis, were normal. Ultrasound imaging showed the presence of intrauterine pregnancy corresponding to amenorrhea and a right complex ovarian mass, with well defined margins without papillary projection, 14x12 cm in diameter. No free fluid was evident. Due to untreatable abdomen and suspecting torsion of the ovarian tumor the patient underwent laparotomy under general anesthesia. The pregnant uterus was normal. The right ovary had increased volume for a cystic-solid mass of the size of 14 cm with smooth surface and twisted on the vascular peduncle. A right adnexectomy was performed. Intraoperative frozen section was negative for malignancy and postoperative histological examination revealed a struma ovarii without atypia of the follicular cells. Postoperative course was normal. The patient was discharged after three days and she delivered at term a normal baby. Mostly struma ovarii represents an incidental finding during cesarean section, but in rare case it may be cause of complications such as torsion, rupture, hypertiroidism and rarely may be a malignant tumor. The AA describe literature data on struma ovarii diagnosed in pregnancy.
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Scharf Z, Momah-Ukeh I, Kim AY. Trans-Radial Embolization of Bleeding Renal Angiomyolipoma in Pregnant 30-Year-Old Female - A Case Report. J Radiol Case Rep 2019; 13:34-42. [PMID: 31565170 DOI: 10.3941/jrcr.v13i2.3511] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Trans-radial access offers several unique advantages and is being used more frequently for interventional radiology procedures. We report the use of trans-radial arterial access to embolize a large bleeding angiomyolipoma in a 30-year-old pregnant patient presenting in the first trimester. Trans-radial approach was chosen to minimize the effects of radiation on the fetus. Subsequent postprocedural pregnancy course was uneventful with stability of the angiomyolipoma and no further hemorrhage. This case highlights the benefits of trans-radial embolotherapy in gravid patients to reduce the risk of radiation exposure to the fetus.
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Khalil N, Fowler C. Misconceptions surrounding pregnancy-associated breast cancer. BMJ Case Rep 2018; 11:e226719. [PMID: 30567280 PMCID: PMC6301761 DOI: 10.1136/bcr-2018-226719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2018] [Indexed: 11/03/2022] Open
Abstract
This case report describes a 31-year-old woman who presented with a right painless breast lump. A mammogram and ultrasound scan showed the lump was suspicious of cancer. Core biopsy and immunohistochemistry of the lump confirmed a triple negative, poorly differentiated, invasive ductal carcinoma of the right breast. One week following her diagnosis, the patient found out she was pregnant. The patient was worried about what the implications this diagnosis would have on both her baby and her own cancer treatment.
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MESH Headings
- Adult
- Breast Neoplasms/diagnosis
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/therapy
- Carcinoma, Ductal, Breast/diagnosis
- Carcinoma, Ductal, Breast/diagnostic imaging
- Carcinoma, Ductal, Breast/therapy
- Combined Modality Therapy
- Delivery, Obstetric
- Diagnosis, Differential
- Female
- Humans
- Infant, Newborn
- Mammography
- Pregnancy
- Pregnancy Complications, Neoplastic/diagnosis
- Pregnancy Complications, Neoplastic/diagnostic imaging
- Pregnancy Complications, Neoplastic/therapy
- Pregnancy Trimester, First
- Triple Negative Breast Neoplasms/diagnosis
- Triple Negative Breast Neoplasms/diagnostic imaging
- Triple Negative Breast Neoplasms/therapy
- Ultrasonography, Prenatal
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Refardt J, Farina P, Hoesli I, Meier C. Hypercalcemic crisis in third trimenon: evaluating the optimal treatment strategy. Gynecol Endocrinol 2018; 34:833-836. [PMID: 29658374 DOI: 10.1080/09513590.2018.1462314] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Hypercalcemia due to primary hyperparathyroidism during pregnancy is a rare condition and associated with increased morbidity and mortality for the mother and the unborn child. Whereas parathyroidectomy is favored during the second trimester, no clear recommendations exist for its management during the third trimenon. We here report the case of a 26-year-old woman in the 29th week of her first pregnancy, who was admitted to our clinic with hypertension, intra-uterine growth retardation and polyhydramnios. Severe hypercalcemia due to primary hyperparathyroidism was diagnosed (total calcium 3.34 mmol/l; PTH 216 pg/ml), but no enlarged parathyroid gland could be localized by ultrasound. Treatment with calcitonin and cinacalcet could not control hypercalcemia. Therefore explorative surgery was performed and a single parathyroid adenoma was resected, resulting in normalization of serum calcium levels. The surgical procedure was tolerated well by the mother and fetus. Hypercalcemia-induced hypertension and polyhydramnios ameliorated before C-section was performed two weeks later and unrelated to the intervention. This case report underlines the importance of early diagnosis and treatment of primary hyperparathyroidism during pregnancy. If diagnosed in the third trimenon, an interdisciplinary approach is crucial. If medical treatment fails to sufficiently control hypercalcemia, surgical parathyroid exploration should be considered even in cases of unsuccessful localization of adenomatous parathyroid glands.
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Wang X, Yang L, Shi M, Liu X, Liu Y, Wang J. Retroperitoneal ganglioneuroma combined with scoliosis: A case report and literature review. Medicine (Baltimore) 2018; 97:e12328. [PMID: 30212980 PMCID: PMC6156057 DOI: 10.1097/md.0000000000012328] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
RATIONALE Ganglioneuroma (GN) is a rare tumour arising from the sympathetic nervous system. GN is constantly asymptomatic, easily ignored and likely damages other organs during tumour progression. PATIENT CONCERNS The case report involved a 21-year-old girl who was admitted to a hospital because of a computed tomography result after her pregnancy examination showed retroperitoneal tumour and scoliosis. The scoliosis was considered as a tumour complication. DIAGNOSES The tumour was finally diagnosed as GN by pathological examination. INTERVENTIONS We carried out surgical treatment and performed a pathological examination on postoperative tumour specimens. OUTCOMES The patient was followed up for 19 months and did not show tumour recurrence. However, the condition of the scoliosis did not improve. LESSONS This paper reports a case of GN with scoliosis at the same time. GN is a benign tumour consisting of cells with a special origin. GN grows extensively and leads to different complications. Presently, pathological examination after an operation is the only approach to formulate an exact diagnosis. We should consider the possibility of retroperitoneal tumour, especially GN, if a patient suffers from scoliosis with an unknown cause. Thus, CT and MRI are needed to provide additional information that would help formulate a diagnosis.
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Papaioannou GK, Evangelinakis N, Kourtis P, Konstantinidou A, Papantoniou N. Giant chorioangioma treated with interstitial laser coagulation. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2018; 52:280-281. [PMID: 29072331 DOI: 10.1002/uog.18941] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Revised: 10/02/2017] [Accepted: 10/14/2017] [Indexed: 06/07/2023]
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Łubińska M, Hoffmann M, Jendrzejewski J, Kobiela P, Kobiela J, Sworczak K. Successful surgical treatment of pheochromocytoma during pregnancy. Pol Arch Intern Med 2018; 128:322-323. [PMID: 29657311 DOI: 10.20452/pamw.4247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Kudlicki J, Kania A, Frania-Baryluk A, Tomaszewski A, Wysokiński A, Czekajska-Chehab E. Right atrial angiosarcoma in a pregnant woman: diagnostic and therapeutic dilemmas. Pol Arch Intern Med 2018; 128:129-131. [PMID: 29511149 DOI: 10.20452/pamw.4208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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De Nola R, Di Naro E, Schonauer LM, Lucarelli G, Battaglia M, Fiore MG, Mastrolia SA, Loverro G. Clinical management of a unique case of PNET of the uterus during pregnancy, and review of the literature. Medicine (Baltimore) 2018; 97:e9505. [PMID: 29480840 PMCID: PMC5943895 DOI: 10.1097/md.0000000000009505] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
RATIONALE PNETs (primitive neuroectodermal tumors) are a family of highly malignant neoplasms characterized by small round cells of neuroepithelial origin. They usually involve bone and soft tissues, and have a higher incidence in childhood. PATIENT CONCERNS In this case report, we describe the obstetric and oncological outcome of a huge mass diagnosed as a leiomyoma in a 39-year-old pregnant woman who complained of low back pain, dysuria, and urinary frequency at 22 weeks of gestation. DIAGNOSES During the 25th week of pregnancy, the patient was referred to our hospital at night with severe anemia and suspected hemoperitoneum. She underwent an emergency caesarean section, delivering a female fetus weighing 400 g, with an Apgar score of 7 at 1 minute and 9 at 5 minutes. INTERVENTION During surgery, we found a huge uterine sarcoma-like metastatic tumor, invading the pelvic peritoneum and parametria bilaterally; the adnexae seemed disease-free. We performed a type B radical hysterectomy, bilateral salpingo-oophorectomy, pelvic peritonectomy, omentectomy, appendectomy, and excision of a bulky lymph node. Seven days after delivery, staging computed tomography (CT) scan demonstrated a large lombo-aortic lymph node compressing the left renal vein and we completed debulking with a second surgery, including diaphragmatic peritonectomy and excision of a huge lymph node by lombo-aortic lymphadenectomy, requiring partial reconstruction of an infiltrated renal vein. OUTCOME Ten days after the second surgery, echo-color Doppler showed a regular microcirculation in the left kidney. The patient was discharged after 10 days, and the baby after 1 month, both in good health.Histological examination revealed a uterine body cPNET (central primitive neuroectodermal tumor) orienting the clinical management toward chemotherapy with cisplatin and etoposide. LESSONS PNETs are aggressive neoplasms, usually diagnosed at an advanced stage. Due to their low incidence, universally accepted guidelines are still unavailable. Radical surgery leaving no macroscopic residual disease is mandatory in advanced stages. A good fertility-sparing procedure can be performed only in young women at early stages of disease, when the wish for childbearing is not yet fulfilled.
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Moro F, Mascilini F, Casella E, Pasciuto T, Scambia G, Testa AC. Small cell lung cancer metastatic to the ovary diagnosed during pregnancy. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2017; 50:802-803. [PMID: 28233352 DOI: 10.1002/uog.17437] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 02/15/2017] [Accepted: 02/17/2017] [Indexed: 06/06/2023]
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Ozdemir O, Sarı ME, Atalay CR, Kurban Y, Asgarova V, Unal DT. Cystic lymphangioma of the lesser omentum in a pregnant woman: a case report and review of the literature. JOURNAL OF EXPERIMENTAL THERAPEUTICS AND ONCOLOGY 2017; 11:155-158. [PMID: 28976139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Accepted: 06/12/2015] [Indexed: 06/07/2023]
Abstract
Lymphangiomas are rare benign tumors which are generally seen in pediatric population and the etiopathogenesis has not yet been understood. They occasionally occur in the head and neck or axillary region with only 5% of them being located in the abdominal or mediastinal cavity. These tumors may be asymptomatic or may cause acute abdominal symptoms due to the location and extention. In the English literature, only 4 cases of lymphangioma were reported to have occurred in the pregnancy period. Herein, we report a case of cystic lymphangioma of the lesser omentum detected incidentally on the ultrasonogram of a 21 year-old, 26-week pregnant woman. The patient was followed up uneventfully during pregnancy. Caesarean section was performed due to transverse presentation of the fetus, and the tumor was completely resected during the same session. The patient is recurrence-free after 1 year of postoperative follow-up.
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Mascilini F, Savelli L, Scifo MC, Exacoustos C, Timor-Tritsch IE, De Blasis I, Moruzzi MC, Pasciuto T, Scambia G, Valentin L, Testa AC. Ovarian masses with papillary projections diagnosed and removed during pregnancy: ultrasound features and histological diagnosis. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2017; 50:116-123. [PMID: 27484484 DOI: 10.1002/uog.17216] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 05/30/2016] [Accepted: 07/11/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To elucidate the ultrasound features that can discriminate between benign and malignant ovarian cysts with papillary projections but no other solid component in pregnant women. METHODS Thirty-four women with an ultrasound diagnosis of an ovarian cyst with papillary projections but no other solid component that had been removed surgically during pregnancy were identified from the databases of four ultrasound units. Some clinical and ultrasound information was collected prospectively. Missing information was obtained retrospectively from ultrasound images, ultrasound reports and patient records. Using prospectively and retrospectively collected data, the ultrasound appearance of the tumors was described using the terms and definitions of the International Ovarian Tumor Analysis group. The ultrasound characteristics were compared with the histological diagnosis. RESULTS Of the 34 cases included, 19 (56%) lesions were benign (16 decidualized endometriomas, one cystadenofibroma, one simple cyst, one struma ovarii), 12 (35%) were borderline tumors and three (9%) were primary invasive tumors (two immature teratomas, one endometrioid cystadenocarcinoma). The contour of the cyst papillations was smooth in 79% (15/19) of benign tumors vs 27% (4/15) of malignant tumors (P = 0.002). The cystic content showed ground-glass echogenicity in 74% (14/19) of benign tumors vs 13% (2/15) of malignant tumors (P = 0.0006). All ovarian masses with smooth papillations and ground-glass content (n = 12) were decidualized endometriomas. The papillary projections were vascularized and the color score was 3 or 4 in 88% (14/16) of decidualized endometriomas vs 42% (5/12) of borderline tumors (P = 0.013). CONCLUSIONS In pregnant women, ovarian cysts with ground-glass echogenicity and papillations with a smooth contour on ultrasound are most likely to be decidualized endometriomas. Cysts with anechoic or low-level echogenicity and papillations with an irregular contour suggest borderline malignancy. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
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Sparks A, Carlan SJ, Wilson J, Busowski J. Adrenal Mass Diagnosed in the Third Trimester of Pregnancy: A Case Report. THE JOURNAL OF REPRODUCTIVE MEDICINE 2017; 62:207-210. [PMID: 30230798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Satcher RL, Ravi V, Wang WL, Oates S. Postpartum Treatment of Metastatic Recurrent Giant Cell Tumor of Capitate Bone of Wrist. AMERICAN JOURNAL OF ORTHOPEDICS (BELLE MEAD, N.J.) 2017; 46:E269-E275. [PMID: 28856360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Giant cell tumors (GCTs) are aggressive benign lesions that occur in the bone epiphysis. They are most often found in the long bones of the lower extremities. Wrist bone involvement is rare, capitate bone involvement exceedingly rare. Treatment in the wrist usually consists of excision, local adjuvant treatment, and cementing and/or bone grafting. GCTs also metastasize to the lungs; pulmonary lesions are excised and systemic therapy provided. We present the case of a 19-year-old woman with GCT of the capitate bone. After initial excision and cementing, the GCT recurred with lung metastases during a pregnancy. Rapid expansion of the GCT during pregnancy was reversed with systemic treatment with denosumab after pregnancy. Excellent response to this chemotherapy permitted limb-sparing surgery and wrist reconstruction with structural cortical autogenous bone graft. Resection of pulmonary metastases after a year of treatment with denosumab revealed lung parenchyma with calcification and ossification and limited viable tumor.
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Fujibuchi T, Matsumoto S, Shimoji T, Ae K, Tanizawa T, Gokita T, Hayakawa K, Motoi N. Two-stage surgery on pregnant woman with a giant cell tumor of bone who refused blood transfusion: A case report. J Orthop Sci 2017; 22:169-172. [PMID: 26740439 DOI: 10.1016/j.jos.2015.06.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 04/09/2015] [Accepted: 04/09/2015] [Indexed: 11/17/2022]
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Giasna GK, Micu MC, Micu R. Schwannoma of the median nerve mimicking carpal tunnel syndrome in a pregnant patient. Case report. MEDICAL ULTRASONOGRAPHY 2016; 18:521-523. [PMID: 27981288 DOI: 10.11152/mu-883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In patients with symptoms of a peripheral neuropathy especially during pregnancy, use of imaging techniques such as Ultrasound (US) and Magnetic Resonance Imaging (MRI) may be essential for the diagnostic accomplishment. A 30-weekspregnant diabetic female attending US evaluation due to intermittent hand pain, numbness, and weakness bilaterally. Although, the US evaluation revealed the median nerve (MN) normal size, echogenicity and echo-texture within the right carpal tunnel; the US assessment applied proximally to the carpal tunnel, revealed a hypoechoic tumor-like mass and increased MN cross section area. In transverse view, the MN was detected as an eccentric, hypoechoic structure compressed by the aforementioned mass. A presence of MN schwannoma or neurofibroma was suspected. US has been proved to be extremely useful to determine location, extent as well as the type of nerve lesion.
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