1
|
Wen J, Zhao Y, Tang F, Cheng W, Peng J, Li Q, Pan H, Li H, Chen L. Full-term pregnancy with retroperitoneal giant mucinous cyst: A case report and literature review. Medicine (Baltimore) 2024; 103:e36979. [PMID: 38457602 PMCID: PMC10919471 DOI: 10.1097/md.0000000000036979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/22/2023] [Indexed: 03/10/2024] Open
Abstract
RATIONALE Retroperitoneal benign cysts during pregnancy are extremely rare and often remain asymptomatic until they attain a very large size. Diagnosis typically relies on a pathological tissue biopsy. The decision to pursue 1-step or 2-step surgical treatment should be tailored to each individual case rather than generalized. PATIENT CONCERNS This case report presents the unique scenario of a pregnant woman with a confirmed pregnancy complicated by a large retroperitoneal cyst. The patient had a retroperitoneal cyst during her initial pregnancy, which went undetected during the first cesarean section. However, it was identified during her second pregnancy by which time it had grown to 13.0 cm × 15.0 cm × 25.0 cm, and extended from the liver margin to right ovarian pelvic infundibulopelvic ligament. Consequently, it was removed smoothly during her second cesarean section. DIAGNOSES Postoperative pathology results indicated a massive retroperitoneal mucinous cystadenoma. INTERVENTIONS The giant retroperitoneal cyst was smoothly excised during the second cesarean delivery for 1-step surgical treatment. OUTCOMES Under the combined spinal and epidural anesthesia, a live female infant was delivered at 38 3/7 gestational weeks and the neonatal weight was 3200g. Under general anesthesia with endotracheal intubation, the giant retroperitoneal cyst was excised smoothly without complications. LESSONS The findings of this case report contribute to the understanding of the diagnostic modalities, surgical approaches and postoperative considerations of giant retroperitoneal cysts associated with pregnancy.
Collapse
Affiliation(s)
- Jiao Wen
- Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Wuhan University of Science and Technology, Wuhan, China
| | - Yun Zhao
- Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fei Tang
- Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenxing Cheng
- Wuhan University of Science and Technology, Wuhan, China
| | - Jing Peng
- Department of Obstetrics, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qianyi Li
- Wuhan University of Science and Technology, Wuhan, China
| | | | - Hao Li
- Huazhong University of Science and Technology, Wuhan, China
| | - Lei Chen
- Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
2
|
Champion B, Foo T, Kikiros C, Charles A. Mullerian Serous Cystadenoma Occurring in the Scrotum Post-Orchidopexy: A Rarely Reported Yet Distinctive Entity. Pediatr Dev Pathol 2024:10935266231221029. [PMID: 38178317 DOI: 10.1177/10935266231221029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
Serous cystadenoma is a rare lesion in the para-testicular tissue, with even rarer reports of this entity occurring in the scrotum post-orchidopexy. We present such an occurrence, adding support for its existence as a distinct entity.
Collapse
Affiliation(s)
- Benjamin Champion
- Department of Anatomical Pathology, PathWest, Perth Children's Hospital, Nedlands, WA, Australia
| | - Tiffany Foo
- Department of Anatomical Pathology, PathWest, Perth Children's Hospital, Nedlands, WA, Australia
| | - Colin Kikiros
- Department of General Paediatric Surgery, Perth Children's Hospital, Nedlands, WA, Australia
| | - Adrian Charles
- Department of Anatomical Pathology, PathWest, Perth Children's Hospital, Nedlands, WA, Australia
| |
Collapse
|
3
|
Rodrigues-Martins D, Castro F, Costa F, Castro DM. Voluminous bilateral adnexal cysts in a young female: the challenge of fertility preservation. JBRA Assist Reprod 2023; 27:572-575. [PMID: 37417850 DOI: 10.5935/1518-0557.20220061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023] Open
Abstract
An ovarian benign cyst is a common finding in women of reproductive age. However both the disease and its treatment may have an impact on ovarian reserve, resulting in a significant risk of premature ovarian insufficiency. The counselling on fertility preservation is of paramount importance in such cases. We report the management of a young woman with giant bilateral benign adnexal cysts, highlighting the complexity of fertility preservation in such scenario.
Collapse
Affiliation(s)
- Diana Rodrigues-Martins
- Department of Women´s Health and Reproductive Medicine, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto, Largo da Maternidade de Júlio Dinis, Porto, Portugal
| | - Fabiana Castro
- Departmet of Gynaecology and Obstetrics, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal
| | - Fernanda Costa
- Departmet of Gynaecology and Obstetrics, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal
| | - Diana Melo Castro
- Departmet of Gynaecology and Obstetrics, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal
| |
Collapse
|
4
|
Zhang L, Xuan J, Li M, Zhang M, Song Y, Pan Z, Fan B, Lu L, Zhou H, Li Y. Case report: Misdiagnosis of primary mucinous cystadenoma of the testicle by ultrasound. Front Oncol 2023; 13:1206697. [PMID: 37731639 PMCID: PMC10508290 DOI: 10.3389/fonc.2023.1206697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 08/21/2023] [Indexed: 09/22/2023] Open
Abstract
Testicular mucinous cystadenoma is a rare benign testicular tumor with the characteristics of being potentially malignant and showing atypical clinical symptoms; this article reports a case of a primary testicular mucinous cystadenoma misdiagnosed as testicular teratoma by ultrasound. A 69-year-old man was admitted to the hospital because of a 1-year history of left-sided testicular enlargement with scrotal swelling and no obvious abnormalities on laboratory tests. Ultrasound examination revealed solid-mass lesions in the left testicle, suggesting a high probability of teratoma, and contrast-enhanced magnetic resonance imaging (MRI) examination suggested an increased possibility of epidermoid cysts. Contrast-enhanced computed tomography (CT) and contrast-enhanced MRI of the preoperative abdomen and pelvis showed no other primary adenocarcinoma. Doctors performed radical resection of the left testicle. The postoperative pathological diagnosis was mucinous cystadenoma, and calcification as well as partially mildly atypical epithelial cells were discovered. Furthermore, there were no neoplastic lesions in the epididymis or spermatic cord. No metastatic lesions were found after 6 months postoperative follow-up, and the patient's prognosis remains good.
Collapse
Affiliation(s)
- Linlin Zhang
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jianyuan Xuan
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Manxi Li
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Mei Zhang
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yu Song
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Ziang Pan
- Department of Pathology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Bo Fan
- Department of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Lin Lu
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Hongyan Zhou
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yang Li
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| |
Collapse
|
5
|
Nate T, Hatano K, Kato T, Kawashima A, Abe T, Fukuhara S, Uemura M, Kiuchi H, Imamura R, Nonomura N. Mucinous cystadenoma of the renal parenchyma presenting as a Bosniak IIF complex renal cyst. IJU Case Rep 2023; 6:150-153. [PMID: 36874994 PMCID: PMC9978073 DOI: 10.1002/iju5.12576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/07/2023] [Indexed: 01/20/2023] Open
Abstract
Introduction A primary retroperitoneal mucinous cystadenoma should be surgically resected because of the risk of malignant transformation. However, mucinous cystadenoma of the renal parenchyma is very rare, and preoperative imaging mimics complicated renal cysts. Case presentation A 72-year-old woman presented with a right renal mass on computed tomography that was followed up as a Bosniak IIF complicated renal cyst. One year later, the right renal mass gradually increased in size. Abdominal computed tomography showed an 11 × 10 cm mass in the right kidney. A laparoscopic right nephrectomy was performed because cystic carcinoma of the kidney was suspected. Pathologically, the tumor was diagnosed as mucinous cystadenoma of the renal parenchyma. Eighteen months after resection, the disease has not recurred. Conclusion Here, we experienced a case of a renal mucinous cystadenoma as a slowly enlarging Bosniak IIF complex renal cyst.
Collapse
Affiliation(s)
- Takanori Nate
- Department of Urology Osaka University Graduate School of Medicine Suita Japan
| | - Koji Hatano
- Department of Urology Osaka University Graduate School of Medicine Suita Japan
| | - Taigo Kato
- Department of Urology Osaka University Graduate School of Medicine Suita Japan
| | - Atsunari Kawashima
- Department of Urology Osaka University Graduate School of Medicine Suita Japan
| | - Toyofumi Abe
- Department of Urology Osaka University Graduate School of Medicine Suita Japan
| | - Shinichiro Fukuhara
- Department of Urology Osaka University Graduate School of Medicine Suita Japan
| | - Motohide Uemura
- Department of Urology Osaka University Graduate School of Medicine Suita Japan
| | - Hiroshi Kiuchi
- Department of Urology Osaka University Graduate School of Medicine Suita Japan
| | - Ryoichi Imamura
- Department of Urology Osaka University Graduate School of Medicine Suita Japan
| | - Norio Nonomura
- Department of Urology Osaka University Graduate School of Medicine Suita Japan
| |
Collapse
|
6
|
Londhe M, Garg S, Gurwale S, Gore C. Cystic presentation of primary hepatic neuroendocrine tumour: a case report with a brief review of literature. Explor Target Antitumor Ther 2023; 4:266-272. [PMID: 37205311 PMCID: PMC10185437 DOI: 10.37349/etat.2023.00133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 02/13/2023] [Indexed: 05/21/2023] Open
Abstract
Neuroendocrine tumours (NETs) are a rare type of tumours that arise from the neuroendocrine cells which are distributed throughout the body. Of all the gastrointestinal tumours only 1-2% account for NETs. They have an extremely low incidence of 0.17% arising in the intrahepatic bile duct epithelium. Majority of hepatic NETs occur as a result of metastases from the primary NETs. Most cases of primary hepatic NET (PHNET) present as a solid nodular mass. However, predominantly cystic PHNET is extremely rare which mimics other cystic space-occupying lesions clinically and radiologically as seen in this case.
Collapse
Affiliation(s)
- Mangesh Londhe
- Department of Pathology, Dr. D.Y. Patil Medical College, Hospital and Research Center, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, Maharashtra, India
| | - Sakshi Garg
- Department of Pathology, Dr. D.Y. Patil Medical College, Hospital and Research Center, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, Maharashtra, India
- Correspondence: Sakshi Garg, Department of Pathology, Dr. D.Y. Patil Medical College, Hospital and Research Center, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, Maharashtra, India.
| | - Sushama Gurwale
- Department of Pathology, Dr. D.Y. Patil Medical College, Hospital and Research Center, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, Maharashtra, India
| | - Charusheela Gore
- Department of Pathology, Dr. D.Y. Patil Medical College, Hospital and Research Center, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune 411018, Maharashtra, India
| |
Collapse
|
7
|
Muacevic A, Adler JR, Olasinde YT, Mobolaji-Ojibara MU, Adelaja-ojulari N. Giant Ovarian Cyst in a Term Pregnancy Simulating a Massive Ascites: A Case Report. Cureus 2022; 14:e33199. [PMID: 36726894 PMCID: PMC9887232 DOI: 10.7759/cureus.33199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/31/2022] [Indexed: 01/02/2023] Open
Abstract
The diagnosis of ovarian mass during pregnancy may be missed if early ultrasonographic assessments of pregnancy are not done, resulting in late detection and management. Hence, this case report is aimed at underscoring the possibility of misdiagnosis of a giant ovarian mass for massive ascites in pregnancy. We present the case of a 35-year-old unbooked multigravida woman who was referred to our centre on account of polyhydramnios in labour, misdiagnosed as a massive ascites on admission. The incidental intraoperative diagnosis of a right giant ovarian cyst resulted in the right salpingo-oophorectomy of a huge cyst with the histological diagnosis of a benign ovarian serous cystadenoma. Huge cystic ovarian tumours coexisting with a normal pregnancy may simulate massive ascites resulting in a misleading diagnosis as reported in this case study. We report this case to awaken the suspicion index of a giant ovarian cyst in any patient presenting with massive ascites in pregnancy.
Collapse
|
8
|
Cathcart AM, Nezhat FR, Emerson J, Pejovic T, Nezhat CH, Nezhat CR. Adnexal masses during pregnancy: diagnosis, treatment, and prognosis. Am J Obstet Gynecol 2022:S0002-9378(22)02179-2. [PMID: 36410423 DOI: 10.1016/j.ajog.2022.11.1291] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/15/2022] [Accepted: 11/15/2022] [Indexed: 11/21/2022]
Abstract
Adnexal masses are identified in pregnant patients at a rate of 2 to 20 in 1000, approximately 2 to 20 times more frequently than in the age-matched general population. The most common types of adnexal masses in pregnancy requiring surgical management are dermoid cysts (32%), endometriomas (15%), functional cysts (12%), serous cystadenomas (11%), and mucinous cystadenomas (8%). Approximately 2% of adnexal masses in pregnancy are malignant. Although most adnexal masses in pregnancy can be safely observed and approximately 70% spontaneously resolve, a minority of cases warrant surgical intervention because of symptoms, risk of torsion, or suspicion of malignancy. Ultrasound is the mainstay of evaluation of adnexal masses in pregnancy because of accuracy, safety, and availability. Several ultrasound mass scoring systems, including the Sassone, Lerner, International Ovarian Tumor Analysis Simple Rules, and International Ovarian Tumor Analysis Assessment of Different NEoplasias in the adneXa scoring systems have been validated specifically in pregnant populations. Decisions regarding expectant vs surgical management of adnexal masses in pregnancy must balance the risks of torsion or malignancy with the likelihood of spontaneous resolution and the risks of surgery. Laparoscopic surgery is preferred over open surgery when possible because of consistently demonstrated shorter hospital length of stay and less postoperative pain and some data demonstrating shorter operative time, lower blood loss, and lower risks of fetal loss, preterm birth, and low birthweight. The best practices for laparoscopic surgery during pregnancy include left lateral decubitus positioning after the first trimester of pregnancy, port placement with respect to uterine size and pathology location, insufflation pressure of less than 12 to 15 mm Hg, intraoperative maternal capnography, pre- and postoperative fetal heart rate and contraction monitoring, and appropriate mechanical and chemical thromboprophylaxes. Although planning surgery for the second trimester of pregnancy generally affords time for mass resolution while optimizing visualization with regards to uterine size and pathology location, necessary surgery should not be delayed because of gestational age. When performed at a facility with appropriate obstetrical, anesthetic, and neonatal support, adnexal surgery in pregnancy generally results in excellent outcomes for pregnant patients and fetuses.
Collapse
Affiliation(s)
- Ann M Cathcart
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR
| | - Farr R Nezhat
- Weill Cornell Medical College, Cornell University, New York, NY; New York University Long Island School of Medicine, Mineola, NY.
| | - Jenna Emerson
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR; Division of Gynecologic Oncology, Oregon Health & Science University, Portland, OR
| | - Tanja Pejovic
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR; Division of Gynecologic Oncology, Oregon Health & Science University, Portland, OR
| | - Ceana H Nezhat
- Atlanta Center for Minimally Invasive Surgery and Reproductive Medicine, Atlanta, GA
| | - Camran R Nezhat
- Center for Special Minimally Invasive and Robotic Surgery, Palo Alto, CA; University of California San Francisco, San Francisco, CA; Stanford University Medical Center, Palo Alto, CA
| |
Collapse
|
9
|
Fang X, Jiang H, Cao K, Li J, Liu F, Wang L, Lu J, Shao C, Bian Y. Distinguishing pancreatic solid serous cystadenomas from nonfunctional pancreatic neuroendocrine tumors by computed tomography: A propensity score analysis. Medicine (Baltimore) 2022; 101:e30523. [PMID: 36123910 PMCID: PMC9478255 DOI: 10.1097/md.0000000000030523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This study aims to evaluate the utility of calculated computed tomography (CT) attenuation value ratio (AVR) and enhancement pattern in distinguishing pancreatic solid serous cystadenomas (SCAs) from nonfunctional pancreatic neuroendocrine tumors (NF-pNETs). A total of 142 consecutive patients with 22 solid SCAs and 120 NF-pNETs confirmed by pathology were included in this retrospective study. All patients underwent preoperative contrast-enhanced CT and were categorized into 2 groups, solid SCA and NF-pNET groups. Patients with NF-pNETs were matched to patients with solid SCAs via propensity scores. AVR was measured and defined as: attenuation value of tumor/attenuation value of normal pancreas. AVR and enhancement pattern performance were assessed according to the discriminative abilities of patients. After matching, 29 patients were allocated to the NF-pNET group. Before matching, sex, age, and the peak enhanced value phase were significantly different between solid SCA and NF-pNET patients (P < .05). After matching, no significant difference was observed between both groups (P > .05). Solid SCAs AVRs were significantly smaller than NF-pNETs AVRs in all unenhanced, arterial, portal venous, and delayed phases (P < .05). Solid SCAs showed significantly more wash-in and wash-out enhancement patterns than NF-pNETs (P < .05). For unenhanced, arterial, portal venous, and delayed phases, and enhancement pattern, the area under the curve (AUC) values were 0.96, 0.72, 0.80, 0.85, and 0.86, respectively. Low AVR on unenhanced CT and wash-in and wash-out enhancement patterns were useful for differentiating solid SCAs from NF-pNETs and may be useful for clinical decisions, a clearer opinion will be formed with further studies to be conducted with larger patient numbers.
Collapse
Affiliation(s)
- Xu Fang
- Department of Radiology, Changhai Hospital of Shanghai, Naval Medical University, Shanghai, China
| | - Hui Jiang
- Department of Pathology, Changhai Hospital of Shanghai, Naval Medical University, Shanghai, China
| | - Kai Cao
- Department of Radiology, Changhai Hospital of Shanghai, Naval Medical University, Shanghai, China
| | - Jing Li
- Department of Radiology, Changhai Hospital of Shanghai, Naval Medical University, Shanghai, China
| | - Fang Liu
- Department of Radiology, Changhai Hospital of Shanghai, Naval Medical University, Shanghai, China
| | - Li Wang
- Department of Radiology, Changhai Hospital of Shanghai, Naval Medical University, Shanghai, China
| | - Jianping Lu
- Department of Radiology, Changhai Hospital of Shanghai, Naval Medical University, Shanghai, China
| | - Chengwei Shao
- Department of Radiology, Changhai Hospital of Shanghai, Naval Medical University, Shanghai, China
| | - Yun Bian
- Department of Radiology, Changhai Hospital of Shanghai, Naval Medical University, Shanghai, China
- *Correspondence: Yun Bian, Department of Radiology, Changhai Hospital of Shanghai, Naval Medical University, Changhai Road 168, Shanghai 200434, China (e-mail: )
| |
Collapse
|
10
|
Suh-Burgmann E, Nakhaei M, Gupta S, Brook A, Hecht J, Hung YY, Levine D. Ovarian Cystadenomas: Growth Rate and Reliability of Imaging Measurements. J Ultrasound Med 2022; 41:2157-2167. [PMID: 34846072 DOI: 10.1002/jum.15895] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/04/2021] [Accepted: 10/07/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES To evaluate the growth rate of benign ovarian cystadenomas and the degree of variability in ultrasound measurements. METHODS Two independent retrospective cohorts of women found to have benign cystadenomas at surgery were identified. To assess growth rate, ultrasounds on women in a community-based health system were reviewed and the growth rate was determined based on the maximum reported size dimension using a mixed effect model. To assess measurement variability, two radiologists independently measured presurgical adnexal imaging findings for women in a tertiary care referral setting. Interobserver, intra-observer, and intermodality (cine clip versus still images) variability in measurements was determined using correlation coefficients (CC) and Bland-Altman analysis, with the proportion of measurements varying by more than 1 cm calculated. RESULTS For growth rate assessment, 405 women with 1412 ultrasound examinations were identified. The median growth rate was 0.65 cm/year with mucinous cystadenomas growing faster at 0.83 cm/year compared to 0.51 cm/year for serous cystadenomas (median test P < .0001). To evaluate measurement variability, 75 women were identified with 176 ultrasound studies. The within-subject standard deviations for ultrasound measurements were 0.74 cm for cine clip images and 0.41 cm for static images, with 11% of measurements overall differing by more than 1 cm. CONCLUSIONS Cystadenomas grow on average 0.65 cm/year, which is similar in magnitude to the inherent error observed in measurement on ultrasound, suggesting that repeat ultrasound at intervals of longer than a year will often be needed to accurately assess growth if a cyst represents a benign cystadenoma.
Collapse
Affiliation(s)
- Elizabeth Suh-Burgmann
- Division of Gynecologic Oncology, The Permanente Medical Group, Walnut Creek, CA, USA
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Masoud Nakhaei
- Department of Radiology, Beth Israel Lahey Health, Boston, MA, USA
| | - Sonia Gupta
- Department of Radiology, Beth Israel Lahey Health, Boston, MA, USA
| | - Alexander Brook
- Department of Radiology, Beth Israel Lahey Health, Boston, MA, USA
| | - Jonathan Hecht
- Department of Radiology, Beth Israel Lahey Health, Boston, MA, USA
| | - Yun-Yi Hung
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Deborah Levine
- Department of Radiology, Beth Israel Lahey Health, Boston, MA, USA
| |
Collapse
|
11
|
Abstract
Giant multilocular prostatic cystadenoma (GMC) is an extremely rare, benign tumor seen in both adult and pediatric males. The neoplasm originates from prostatic tissue and is typically found within the rectovesical pouch, varying in both size and morphology. Microscopically, GMC contains both glandular and cystic prostatic tissue lined by cuboidal and columnar epithelium. Symptoms often arise once the pelvic mass begins to obstruct the surrounding structures and organs, although invasion into surrounding tissue is unlikely. Common symptoms include abdominal pain, urinary retention, and dysuria. The standard treatment for GMC is surgical removal of the mass with good outcomes and only 1 known case of recurrence. Here we present the case of a 14-year-old male with GMC-the youngest patient reported to date-who presented with abdominal pain, difficulty voiding, and hydroureteronephrosis.
Collapse
Affiliation(s)
- Mark Quiring
- 12376University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Stacey Berry
- Department of Pathology and Laboratory Medicine, 14488Cook Children's Medical Center, Fort Worth, TX, USA
| | - John Uffman
- Department of Pediatric Surgery, 14488Cook Children's Medical Center, Fort Worth, TX, USA
| | - Kirk Pinto
- Department of Pediatric Urology, 14488Cook Children's Medical Center, Fort Worth, TX, USA
| | - Jonathan Kaye
- Department of Pediatric Urology, 14488Cook Children's Medical Center, Fort Worth, TX, USA
| |
Collapse
|
12
|
Kvashilava A, Kobalava B, Giorgobiani G. Laparoscopic Central Pancreatectomy With Pancreaticogastrostomy: Our Initial Experience. Cureus 2022; 14:e24542. [PMID: 35651384 PMCID: PMC9138204 DOI: 10.7759/cureus.24542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2022] [Indexed: 11/15/2022] Open
Abstract
Pancreatic parenchyma-preserving procedures performed for benign and low-grade malignant tumors of the neck or body of this organ significantly reduce the incidence of postoperative exocrine and endocrine insufficiency compared to distal pancreatectomy. Tumor enucleation spares pancreatic parenchyma, but it can have positive surgical margins, and postoperative leakage after it is significant. We present our initial successful experience of laparoscopic central pancreatectomy. A patient was operated on for cystadenoma of the pancreatic neck. The organ was transected proximally with a linear stapler but distally with ultrasonic shares, and a caudal stump was used for the creation of the pancreaticogastrostomy. The postoperative period was uneventful. The four-month follow-up did not reveal any exocrine or endocrine insufficiency.
Collapse
Affiliation(s)
| | - Badri Kobalava
- General Surgery, Aversi Clinic, Tbilisi, GEO
- Surgery Department #3, Faculty of Medicine, Tbilisi State Medical University, Tbilsi, GEO
| | - Giorgi Giorgobiani
- General Surgery, Aversi Clinic, Tbilisi, GEO
- Surgery Department #3, Faculty of Medicine, Tbilisi State Medial University, Tbilisi, GEO
| |
Collapse
|
13
|
Pigatto JAT, Silva AF, Seibel MP, Vargas EVB, Azevedo MG, Silva TC. Trichloroacetic Acid Injection for Treatment of Eyelid Apocrine Hidrocystomas in a Cat. Top Companion Anim Med 2021; 46:100594. [PMID: 34715377 DOI: 10.1016/j.tcam.2021.100594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 10/19/2021] [Accepted: 10/21/2021] [Indexed: 10/20/2022]
Abstract
Apocrine hidrocystoma (AH) is a benign cystic lesion infrequently reported in the eyelids of cats. There are several reports of application of trichloroacetic acid (TCA) for treatment of eyelid apocrine hidrocystomas with high success rates in humans. This is the first report of intralesional injection of TCA for the treatment of eyelid AH in a feline. A 12-year-old Persian female spayed cat has been presented for evaluation of cystic masses on the eyelids. The cat had signs of ocular discomfort and two large cysts on the lower eyelid of the right eye. Ophthalmic examination was suggestive of eyelid AH. The cat underwent general anesthesia, and TCA 20 % was injected intracystically. The diagnosis of AH was confirmed by cytology. Two years later, there was no recurrence of the cyst. This case highlights the successful treatment of a large AH in the eyelids of a cat with TCA. Findings suggest that chemical ablation with TCA may be a useful treatment for AH in cats.
Collapse
Affiliation(s)
- João A T Pigatto
- Department of Animal Medicine, Faculty of Veterinary Sciences, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil.
| | - Alessandra F Silva
- Department of Animal Medicine, Faculty of Veterinary Sciences, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
| | - Maiara P Seibel
- Department of Animal Medicine, Faculty of Veterinary Sciences, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
| | - Eduarda V B Vargas
- Department of Animal Medicine, Faculty of Veterinary Sciences, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
| | - Mariane G Azevedo
- Department of Animal Medicine, Faculty of Veterinary Sciences, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
| | - Tanise C Silva
- Department of Animal Medicine, Faculty of Veterinary Sciences, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre, Brazil
| |
Collapse
|
14
|
Frederick RP, Patel AG, Young SW, Dahiya N, Patel MD. Growth Rate of Ovarian Serous Cystadenomas and Cystadenofibromas. J Ultrasound Med 2021; 40:2123-2130. [PMID: 33320368 DOI: 10.1002/jum.15597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 12/02/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES We analyzed growth rates of benign ovarian serous cystadenomas and cystadenofibromas to understand what percentage would show a volume doubling time (DT) of less than 3 years, between 3 and 5 years, or greater than 5 years. METHODS We retrospectively reviewed pathology records (January 1, 2014, to June 30, 2019) to find all surgically excised ovarian serous cystadenomas and cystadenofibromas. Imaging records were then reviewed to identify those that had been confidently identified with ultrasound imaging, magnetic resonance imaging, or computed tomography at least twice before surgical removal, with at least a 60-day interval between studies. Three orthogonal measurements were recorded on the first and last imaging studies on which the mass was detected, with volume calculations by the prolate formula (product of 3 measurements multiplied by 0.52). The volume DT was calculated and grouped into 1 of 5 categories: (1) DT of less than 1 year; (2) DT of 1 to 3 years; (3) DT of 3 to 5 years; (4) DT of 5 to 10 years; and (5) no growth (any mass with a DT >10 years or showing a decrease in volume). RESULTS A total of 102 of 536 cystadenomas and 44 of 227 cystadenofibromas met inclusion criteria. Of the 146 tumors, 40 (27.4%) had a DT of less than 1 year; 38 (26.0%) had a DT of 1 to 3 years; 22 (15.1%) had a DT of 3 to 5 years; 10 (6.8%) had a DT of 5 to 10 years; and 36 (24.7%) showed no growth. CONCLUSIONS A total of 53.4% of ovarian serous cystadenomas/cystadenofibromas have a DT of less than 3 years; 15.1% have a DT between 3 and 5 years; and 31.5% have a DT of greater than 5 years or show no growth.
Collapse
Affiliation(s)
- Ross P Frederick
- Department of Radiology, Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Anika G Patel
- Department of Radiology, Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Scott W Young
- Department of Radiology, Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Nirvikar Dahiya
- Department of Radiology, Mayo Clinic Arizona, Phoenix, Arizona, USA
| | - Maitray D Patel
- Department of Radiology, Mayo Clinic Arizona, Phoenix, Arizona, USA
| |
Collapse
|
15
|
Gundogdu F, Orhan N, Ozgul N, Usubutun A. Recurrent mucinous neoplasm arising in cesarean scar: A case report and review of literature. Int J Gynaecol Obstet 2021; 157:564-567. [PMID: 34498288 DOI: 10.1002/ijgo.13924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 08/30/2021] [Accepted: 09/08/2021] [Indexed: 11/08/2022]
Abstract
Ovarian mucinous tumors are one of the common epithelial tumors in the ovary, but their recurrence is extremely rare. In a 37-year-old female patient who had had five operations in 7 years due to recurrent mucinous neoplasms, a mass extending to the umbilicus was recently detected during a routine examination. With this finding the patient underwent cystectomy, total abdominal hysterectomy, and left salpingo-oophorectomy. Two of the five operations were performed during cesarean delivery. In the recent surgical procedure, two cysts were removed. A 20 cm cyst in the pelvic region was diagnosed as a mucinous cystadenoma. The other cyst located in the myometrium was a mucinous cystadenoma with focal borderline change and arose in the previous cesarean scar. The authors present what is believed to be the first case of recurrent mucinous neoplasm arising within a cesarean scar. A review of the literature concerning the topic is also presented.
Collapse
Affiliation(s)
- Fatma Gundogdu
- Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nazlı Orhan
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nejat Ozgul
- Department of Obstetrics and Gynecology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Alp Usubutun
- Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| |
Collapse
|
16
|
Nizam W, Shah AA, Cornwell EE, Naab T, Williams M. Postmenopausal virilization secondary to a large ovarian cystadenoma with stromal hyperthecosis. Clin Case Rep 2021; 9:e04774. [PMID: 34584697 PMCID: PMC8457409 DOI: 10.1002/ccr3.4774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 06/02/2021] [Accepted: 06/25/2021] [Indexed: 12/21/2022] Open
Abstract
Ovarian cystadenomas may present in a functional manner. Biochemical workup of seemingly benign ovarian lesions should be considered in the appropriate clinical context.
Collapse
Affiliation(s)
- Wasay Nizam
- Department of SurgeryHoward University College of MedicineWashingtonDistrict of ColumbiaUSA
| | - Adil Aijaz Shah
- Department of SurgeryHoward University College of MedicineWashingtonDistrict of ColumbiaUSA
| | - Edward E. Cornwell
- Department of SurgeryHoward University College of MedicineWashingtonDistrict of ColumbiaUSA
| | - Tammey Naab
- Department of PathologyHoward University College of MedicineWashingtonDistrict of ColumbiaUSA
| | - Mallory Williams
- Department of SurgeryHoward University College of MedicineWashingtonDistrict of ColumbiaUSA
| |
Collapse
|
17
|
Soni S, Pareek P, Narayan S, Varshney V. Mucinous cystic neoplasm of the liver (MCN-L): a rare presentation and review of the literature. Med Pharm Rep 2021; 94:366-371. [PMID: 34430860 DOI: 10.15386/mpr-1543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 01/19/2020] [Accepted: 02/06/2020] [Indexed: 11/23/2022] Open
Abstract
Mucinous cystic neoplasms of the liver (MCN-L, (previously referred to as cystadenomas or cystadenocarcinoma) are rare cystic tumors that occur within the liver parenchyma, or less frequently, in the extrahepatic bile ducts. They are reported to account for <5% of all liver cysts. The differential diagnosis of MCN-L includes intraductal papillary neoplasm of the bile duct (IPNB), intrahepatic cholangiocarcinoma with cystic change, echinococcal cyst, and a simple cyst. Invasive MCNs can only be differentiated from non-invasive MCNs by microscopic evaluation for the presence of ovarian-type stroma. Intraoperative biopsy and frozen section(s) are essential to differentiate MCNs from other cystic liver lesions. The treatment of choice is complete excision and can result in excellent survival with initial correct diagnosis. But its rare presentation and insufficient recognition frequently lead to an incorrect initial or delayed diagnosis or misdiagnosis.
Collapse
Affiliation(s)
- Sweta Soni
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rajasthan, India
| | - Puneet Pareek
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rajasthan, India
| | - Satya Narayan
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rajasthan, India
| | - Vaibhav Varshney
- Department of Gastrointestinal Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| |
Collapse
|
18
|
Choi TS, Lee DG, Yoo KH, Min GE. Rapid Recurrence of Giant Multilocular Prostatic Cystadenoma after Laparoscopic Excision for Primary Case: A Case Report. Medicina (Kaunas) 2021; 57:870. [PMID: 34577793 DOI: 10.3390/medicina57090870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/23/2021] [Accepted: 08/24/2021] [Indexed: 11/16/2022]
Abstract
Giant multilocular prostatic cystadenoma is a rare benign tumor of the prostate gland that presents as a large retroperitoneal pelvic mass. The mass is usually located between the urinary bladder and rectum, and results in obstructive voiding symptoms and a change in bowel habits. Complete surgical excision is the treatment of choice. We present a case of rapid recurrent giant multilocular prostatic cystadenoma after laparoscopic excision for primary case. A previously healthy 54-year-old man presented with acute urinary retention. Prostate MRI showed a large cystic mass approximately 13 cm in size, multiple septa and lobulation in the prostate, and no visible solid lesions. Laparoscopic marsupialization of giant multilocular prostatic cystadenoma cysts was performed. One year later, the patient presented with local recurrence. Repeated laparoscopic complete resection was performed without any complications and further recurrence. Giant multilocular prostatic cystadenoma has the risk of recurrence in case of incomplete resection. Surgical treatment should be performed with the goal of complete removal following the same principles as cancer surgery.
Collapse
|
19
|
Lawgaly SA, Eldruki S. A rare case of mucinous cystadenoma of the spleen in Libya. Qatar Med J 2021; 2020:41. [PMID: 33447540 PMCID: PMC7784710 DOI: 10.5339/qmj.2020.41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 11/29/2020] [Indexed: 12/05/2022] Open
Abstract
This is a case of benign mucinous cystadenoma of the spleen in Benghazi, Libya. It is the first reported in Libya and most probably the fourth in Africa. Primary mucinous cystadenoma of the spleen is an extremely unique benign cystic lesion. Only a very few number of cases have been reported. These cysts are assumed to arise from invagination of the splenic capsular epithelium or from the ectopic pancreatic tissue. We report a rare case of primary mucinous cystadenoma of the spleen without evidence of pancreatic tissue in the specimen. Despite being a rare condition, mucinous cystadenoma of the spleen should remain in the differential diagnosis of any splenic cysts.
Collapse
Affiliation(s)
- Sami A Lawgaly
- Department of Medicine, Benghazi Medical Center, Benghazi, Libya E-mail:
| | - Soad Eldruki
- Pathology Department - Benghazi Medical Center, Benghazi, Libya
| |
Collapse
|
20
|
Abstract
Mucocele of the appendix is a very rare disease entity that often discovered incidentally during surgery. It can result from both non-neoplastic and neoplastic lesions and histopathological examination is needed for confirmation. Failure to make an early preoperative diagnosis may results in its rapture and spillage of mucin contents into the peritoneal cavity leading to a disastrous complication of pseudomyxoma peritonei (PMP) that has a very bad prognosis. A clear pathological terminology and management strategies of appendiceal mucocele (AM) is lacking. This literature review aims to derive detailed information related to clinical significance of AM to avoid complication of PMP and plan appropriately during surgery according to the current evidence. The relevant articles from scientific databases such as Medline, PubMed, Google Scholar were searched and extracted using the keywords “mucocele appendix” “cystadenoma%”. Data based on epidemiology, clinical manifestations, complications, pathology, diagnostic work up and management were analyzed and summarized. A meticulous surgical excision is the mainstay of treatment and open surgical approach is still preferred over laparoscopy. Preoperative diagnosis of AM is very imperative as it may harbour neoplasm and can be made utilising the imaging tools like computed tomography and ultrasonography. Primary care physicians can have a crucial role in making early detection and timely referral for appropriate management in order to avoid complications. After appendectomy, 5-year survival rate for the simple AM is 91%-100% but it reduces to 25% for the malignant AM.
Collapse
|
21
|
Johan S, Hassan MF, Hayati F, Azizan N, Payus AO, Edwin See UH. Huge Retroperitoneal Cyst Masquerading as Ovarian Tumour: A Case Report. Front Surg 2020; 7:585411. [PMID: 33195391 PMCID: PMC7642373 DOI: 10.3389/fsurg.2020.585411] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 09/03/2020] [Indexed: 11/24/2022] Open
Abstract
Retroperitoneal cystic mass is a rare surgical condition that is often misdiagnosed preoperatively. Here, we report a case of a 56-year-old woman who presented with abdominal swelling for a 1-year duration, which was associated with lower abdominal pain for 6 months. Her abdominal radiograph showed a huge radiopaque lesion, and contrast-enhanced computed tomography scan of the abdomen reported it as a left ovarian serous cystadenoma causing local mass effect to the left ureter leading to mild left hydronephrosis. She underwent exploratory laparotomy and noted there was a huge retroperitoneal cystic mass. The histopathological assessment finding was consistent with a benign retroperitoneal cyst. This case report aims to share the rare case of primary retroperitoneal lesions, which can cause a diagnostic challenge preoperatively to all clinicians despite advanced achievement in medical imaging.
Collapse
Affiliation(s)
- Syamim Johan
- Department of Surgery, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Malaysia
| | - Muhammad Firdaus Hassan
- Department of Surgery, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Malaysia
| | - Firdaus Hayati
- Department of Surgery, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Nornazirah Azizan
- Department of Pathobiology and Medical Diagnostic, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Alvin Oliver Payus
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Un Hean Edwin See
- Department of Surgery, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Malaysia
| |
Collapse
|
22
|
Kogi S, Onodera K, Tsunoda N, Kawai T, Miyamoto I, Takeda Y, Yamada H. Cystadenoma of the tongue: report of a case with long-term follow-up. J Surg Case Rep 2020; 2020:rjaa269. [PMID: 32904727 PMCID: PMC7458143 DOI: 10.1093/jscr/rjaa269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 06/29/2020] [Indexed: 11/13/2022] Open
Abstract
Cystadenoma is a rare benign salivary gland neoplasm characterized by a predominantly multicystic growth pattern. The parotid gland is involved in about 45–50% of cystadenoma cases, with the minor glands of the lip and buccal mucosa being the next most common sites. The tongue is rarely involved; only one congenital case is reported in the literature. Here, we report a 63-year-old man who was referred to our hospital for a nodule on the right edge of his tongue that developed into an elastic soft mass, 4 mm in diameter. It was clinically diagnosed as a benign tumour and removed under local anaesthesia. Microscopically, the lesion was composed of multiple cysts of various sizes and shapes, with or without papillary intraluminal short projections. It was diagnosed as cystadenoma. The postoperative course was uneventful, and we found no evidence of recurrence at the postoperative 14-year follow-up.
Collapse
Affiliation(s)
- Shintaro Kogi
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, Morioka, Japan
| | - Kei Onodera
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, Morioka, Japan
| | - Naoko Tsunoda
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, Morioka, Japan
| | - Tadashi Kawai
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, Morioka, Japan
| | - Ikuya Miyamoto
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, Morioka, Japan
| | - Yasunori Takeda
- Division of Clinical Pathology, Department of Oral and Maxillofacial Reconstructive Surgery, School of Dentistry, Iwate Medical University, Morioka, Japan
| | - Hiroyuki Yamada
- Division of Oral and Maxillofacial Surgery, Department of Reconstructive Oral and Maxillofacial Surgery, School of Dentistry, Iwate Medical University, Morioka, Japan
| |
Collapse
|
23
|
Mulita F, Tavlas P, Maroulis I. A giant ovarian mass in a 68-year-old female with persistent abdominal pain and elevated serum CA-125 level. Prz Menopauzalny 2020; 19:108-110. [PMID: 32802022 PMCID: PMC7422285 DOI: 10.5114/pm.2020.97870] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Accepted: 05/05/2020] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Ovarian masses are common findings in general gynecology. However giant ovarian mass is a rare finding. In the literature, a few cases of giant ovarian mass have been mentioned sporadically, especially in elderly patients. CASE REPORT We report a 68-year-old postmenopausal woman with a giant right ovarian mass measuring 38 × 31 × 29 cm. She presented to our department with complaints of massive abdominal distention which started gradually 6 months ago. The patient also complained of difficulty in breathing and ambulation. There were no other gastrointestinal, urinary, or gynecological symptoms CA-125 marker was slightly elevated. Because of elevation of serum CA-125 levels, ovarian malignancy was included in differential diagnosis. We performed an ovarian cystectomy without any significant complication. On histopathological examination, the mass was confirmed as benign serous cystadenoma of the right ovary. CONCLUSIONS Giant ovarian mass is a rare finding in general gynecology. Physicians must maintain heightened awareness and index of suspicion when approaching a woman with pain in any region of the abdomen or pelvis. Further investigation with abdominal and pelvic ultrasonography and magnetic resonance imaging or computed tomography is necessary. Benign lesions can be found even in patients presenting with giant masses and higher CA-125 than normal levels.
Collapse
Affiliation(s)
- Francesk Mulita
- Corresponding author: Francesk Mulita, Department of Surgery, General University Hospital of Patras, Patras 265 04, Greece, e-mail:
| | | | | |
Collapse
|
24
|
Pan S, Ding Z, Zhang L, Ruan M, Shan Y, Deng M, Pang P, Shen Q. A Nomogram Combined Radiomic and Semantic Features as Imaging Biomarker for Classification of Ovarian Cystadenomas. Front Oncol 2020; 10:895. [PMID: 32547958 PMCID: PMC7277787 DOI: 10.3389/fonc.2020.00895] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 05/06/2020] [Indexed: 12/26/2022] Open
Abstract
Objective: To construct and validate a combined Nomogram model based on radiomic and semantic features to preoperatively classify serous and mucinous pathological types in patients with ovarian cystadenoma. Methods: A total of 103 patients with pathology-confirmed ovarian cystadenoma who underwent CT examination were collected from two institutions. All cases divided into training cohort (N = 73) and external validation cohort (N = 30). The CT semantic features were identified by two abdominal radiologists. The preprocessed initial CT images were used for CT radiomic features extraction. The LASSO regression were applied to identify optimal radiomic features and construct the Radscore. A Nomogram model was constructed combining the Radscore and the optimal semantic feature. The model performance was evaluated by ROC analysis, calibration curve and decision curve analysis (DCA). Result: Five optimal features were ultimately selected and contributed to the Radscore construction. Unilocular/multilocular identification was significant difference from semantic features. The Nomogram model showed a better performance in both training cohort (AUC = 0.94, 95%CI 0.86–0.98) and external validation cohort (AUC = 0.92, 95%CI 0.76–0.98). The calibration curve and DCA analysis indicated a better accuracy of the Nomogram model for classification than either Radscore or the loculus alone. Conclusion: The Nomogram model combined radiomic and semantic features could be used as imaging biomarker for classification of serous and mucinous types of ovarian cystadenomas.
Collapse
Affiliation(s)
- Shushu Pan
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhongxiang Ding
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lexing Zhang
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Mei Ruan
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yanna Shan
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Meixiang Deng
- Department of Radiology, Women's Hospital School of Medicine Zhejiang University, Hangzhou, China
| | - Peipei Pang
- Department of Pharmaceuticals Diagnosis, GE Healthcare, Hangzhou, China
| | - Qijun Shen
- Department of Radiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| |
Collapse
|
25
|
Abstract
PRACTICAL RELEVANCE Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. The biliary tree encompasses the liver, gall bladder and bile ducts, although only diseases affecting the latter two are discussed here. Diseases of the bile ducts and gall bladder are more common than those of the liver parenchyma and ultrasound plays an important role in their diagnosis. CLINICAL CHALLENGES Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even differentiating between normal variation and pathological changes can be challenging for all but the most experienced. In addition, a lack of pathological change does not necessarily rule out disease; for example, absence of gall bladder and/or extrahepatic biliary distension is not sufficient to exclude the possibility of biliary obstruction, and in many cases of cholangitis the liver and biliary tree are unremarkable on ultrasound examination. EQUIPMENT Ultrasound facilities are readily available to most practitioners, although use of ultrasonography as a diagnostic tool is highly dependent on operator experience. AIM This review, part of an occasional series on feline abdominal ultrasonography, discusses the appearance of the normal and diseased biliary system. It is aimed at general practitioners who wish to improve their knowledge and confidence in feline abdominal ultrasound and is accompanied by high-resolution images. Percutaneous ultrasound-guided cholecystocentesis is also covered. Ultrasound examination of the liver was discussed in an article published in January 2019 and an upcoming article will cover hepatic vascular anomalies. EVIDENCE BASE Information provided in this article is drawn from the published literature and the author's own clinical experience.
Collapse
Affiliation(s)
- Sally Griffin
- Radiology Department, Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull B90 4NH, UK
| |
Collapse
|
26
|
Abdelazim IA, AbuFaza M, Bekmukhambetov Y, Zhurabekova G, Shikanova S. Postmenopausal adnexal torsion: rare case report. Prz Menopauzalny 2020; 19:49-51. [PMID: 32699544 DOI: 10.5114/pm.2020.95295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 02/28/2020] [Indexed: 02/08/2023]
Abstract
Most ovarian and/or adnexal torsions occur in reproductive age and are less common in postmenopausal age. A 49-year-old menopausal woman presented to the Emergency Department with abdominal pain. She had a palpable pelvi-abdominal mass and abdominal tenderness on examination. Departmental ultrasound and magnetic resonance imaging (MRI) showed a large multilocular right adnexal cyst (15 × 12 cm) containing fluid with variable signal intensities on both T1 and T2 sequences (stained glass appearance) - most probably mucinous cystadenoma. The studied woman signed an informed consent form and agreed to exploratory laparotomy and adnexectomy. After the pre-operative investigations, which were done according to the hospital protocol, including CA-125 (26 IU/ml) and anaesthesia consultation, she was scheduled for laparotomy. At laparotomy an ovarian cyst originating from the right ovary was found with evidence of torsion of the infundibulopelvic and utero-ovarian ligaments (adnexal torsion). The right adnexa including the right ovary containing the ovarian cyst and the right fallopian tube was excised (adnexectomy). The histological examination of the excised adnexa confirmed the diagnosis of mucinous cystadenoma of the ovary. This report represents a rare case of an adnexal torsion in postmenopausal woman, to highlight that adnexal torsion can occur at any age and that the presence of ovarian mass or cyst predispose to adnexal torsion at any age.
Collapse
|
27
|
王 骁, 李 兆, 范 焕, 魏 莉, 郭 旭, 郭 娜, 王 彤. [A rare case of cystadenoma in the small intestine]. Beijing Da Xue Xue Bao Yi Xue Ban 2020; 52:382-384. [PMID: 32306027 PMCID: PMC7433445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Indexed: 09/20/2023]
Abstract
In recent years, there have been more and more reports about cystadenoma. Cystadenoma can occur in many parts of the body, and cystadenoma in different parts may show different clinical symptoms, however, some patients with cystadenoma have no symptoms. The vast majority of cystadenomas are benign lesions, but a small number of cystadenomas can be malignant. For example, a small number of ovarian cystadenomas and pancreatic cystadenomas may be malignant. This study reported a patient with small intestinal cystadenoma diagnosed by pathology. The patient's physical examination revealed a lesion in the left upper abdomen. He had only abdominal distension and no other discomfort. His laboratory examination results were basically normal, i.e. blood routine, urine routine, stool routine, liver function, kidney function, myocardial enzyme, tumor marker, etc. The patient underwent sectional small intestine resection and the pathological sample was analyzed. The histological findings of the resected intestinal sample were consistent with cystadenoma. Computed tomography scan of the abdomen was performed 4 months after the surgery. No recurrence of the tumor was found. The patient recovered in good condition. By consulting the literature, I found very few reports of small intestinal cystadenoma before, it was very rare. This article described the clinical manifestation, diagnosis and differential diagnosis, treatment and prognosis of a case of small intestinal cystadenoma, it suggested that cystadenoma can occur in the small intestine, other than the ovary, pancreas, liver, lung, thyroid, prostate, seminal vesicle, skin, etc. The cystadenoma in small intestine is easy to be mistaken with other tumors, such as small intestine stromal tumor, small intestine adenocarcinoma, small intestine lipoma, small intestine hemangiomas, etc., and it is difficult to fully confirm through imaging examinations, such as computed tomography and magnetic resonance imaging. Laparotomy and histopathological examination are necessary before definitive diagnosis. This disease can be treated by small bowel resection at the affected region and good prognosis can be achieved.
Collapse
Affiliation(s)
- 骁 王
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
| | - 兆星 李
- 河北医科大学附属河北省肿瘤医院外三科, 石家庄 050011The Third Surgery Department, Hebei Tumor Hospital Affiliated to Hebei Medical University, Shijiazhuang 050011, China
| | - 焕芳 范
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
| | - 莉瑛 魏
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
| | - 旭瑾 郭
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
| | - 娜 郭
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
| | - 彤 王
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
| |
Collapse
|
28
|
王 骁, 李 兆, 范 焕, 魏 莉, 郭 旭, 郭 娜, 王 彤. [A rare case of cystadenoma in the small intestine]. Beijing Da Xue Xue Bao Yi Xue Ban 2020; 52:382-384. [PMID: 32306027 PMCID: PMC7433445 DOI: 10.19723/j.issn.1671-167x.2020.02.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Indexed: 06/11/2023]
Abstract
In recent years, there have been more and more reports about cystadenoma. Cystadenoma can occur in many parts of the body, and cystadenoma in different parts may show different clinical symptoms, however, some patients with cystadenoma have no symptoms. The vast majority of cystadenomas are benign lesions, but a small number of cystadenomas can be malignant. For example, a small number of ovarian cystadenomas and pancreatic cystadenomas may be malignant. This study reported a patient with small intestinal cystadenoma diagnosed by pathology. The patient's physical examination revealed a lesion in the left upper abdomen. He had only abdominal distension and no other discomfort. His laboratory examination results were basically normal, i.e. blood routine, urine routine, stool routine, liver function, kidney function, myocardial enzyme, tumor marker, etc. The patient underwent sectional small intestine resection and the pathological sample was analyzed. The histological findings of the resected intestinal sample were consistent with cystadenoma. Computed tomography scan of the abdomen was performed 4 months after the surgery. No recurrence of the tumor was found. The patient recovered in good condition. By consulting the literature, I found very few reports of small intestinal cystadenoma before, it was very rare. This article described the clinical manifestation, diagnosis and differential diagnosis, treatment and prognosis of a case of small intestinal cystadenoma, it suggested that cystadenoma can occur in the small intestine, other than the ovary, pancreas, liver, lung, thyroid, prostate, seminal vesicle, skin, etc. The cystadenoma in small intestine is easy to be mistaken with other tumors, such as small intestine stromal tumor, small intestine adenocarcinoma, small intestine lipoma, small intestine hemangiomas, etc., and it is difficult to fully confirm through imaging examinations, such as computed tomography and magnetic resonance imaging. Laparotomy and histopathological examination are necessary before definitive diagnosis. This disease can be treated by small bowel resection at the affected region and good prognosis can be achieved.
Collapse
Affiliation(s)
- 骁 王
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
| | - 兆星 李
- 河北医科大学附属河北省肿瘤医院外三科, 石家庄 050011The Third Surgery Department, Hebei Tumor Hospital Affiliated to Hebei Medical University, Shijiazhuang 050011, China
| | - 焕芳 范
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
| | - 莉瑛 魏
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
| | - 旭瑾 郭
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
| | - 娜 郭
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
| | - 彤 王
- 河北中医学院附属河北省中医院肿瘤科, 石家庄 050011Department of Oncology, Hebei Hosptical of Traditional Chinese Medicine Affiliated to Hebei University of Traditional Chinese Medicine, Shijiazhuang 050011, China
| |
Collapse
|
29
|
Cafaro MA, Yaryura Montero JG, Bianco A, Petersen ML, Cárdenas Villa RD, Cardozo Dutra B, Badra RM. [Appendiceal collision tumor: Mucinous epithelial neoplasm and neuroendocrine tumor]. ACTA ACUST UNITED AC 2020; 77:113-6. [PMID: 32558515 DOI: 10.31053/1853.0605.v77.n2.25071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 12/20/2019] [Indexed: 11/21/2022]
Abstract
Introduction An appendiceal collision tumor is defined as the presence of histologically distinct types of tumors in the appendix without transition between them. Appendiceal tumors are rare, with epithelial neoplasms and neuroendocrine tumors being the most common. Objective Report the case of woman with acute appendicitis and diagnosis of an appendiceal collision tumor. Case presentation A 35 years old woman, who consulted for a 24 hours of continuous epigastric pain with migration to the right iliac fossa; the routine blood test showed leukocytosis with neutrophilia and an ultrasound scan abdomen demonstratedsigns in favor of acute appendicitis; a diagnosis of acute appendicitis and surgical treatment. The anatomopathological study and immunostaining revealed well-differentiated neuroendocrine neoplasia and low-grade mucinous epithelial neoplasia. A follow-up with postsurgical tumor markers was performed with normal results, in addition to computed tomography and postoperative colonoscopy without alterations. Discussion Appendiceal collision tumor is infrequently. Generally the diagnosis is made with anatomopathological study and supposes great challenges for postoperative control because there are no guidelines to follow up. Conclusion: More research should be done in order to have recommendations for this disease. Conclusion More research should be done in order to have recommendations for this disease.
Collapse
|
30
|
Abstract
PRACTICAL RELEVANCE Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. Ultrasound examination of the liver can be key in the diagnosis of diseases such as hepatic lipidosis and hepatic neoplasia. CLINICAL CHALLENGES Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even differentiating between normal variation and pathological changes can be challenging for all but the most experienced. When assessing the liver via ultrasound, a diffuse alteration in liver echogenicity may be difficult to detect unless the change is marked and, although comparisons can be made with the spleen and kidneys, this relies on these organs being normal. EQUIPMENT Ultrasound facilities are readily available to most practitioners, although use of ultrasonography as a diagnostic tool is highly dependent on operator experience. AIM This review, the first in an occasional series on feline abdominal ultrasonography, discusses ultrasonographic examination of the normal and diseased liver, with focus on the liver parenchyma. It is aimed at general practitioners who wish to improve their knowledge of and confidence in feline abdominal ultrasound and is accompanied by high-resolution images. Ultrasound-guided sampling of the liver is also covered. Future articles will discuss the biliary tree and hepatic vascular anomalies. EVIDENCE BASE Information provided in this article is drawn from the published literature and the author's own clinical experience.
Collapse
Affiliation(s)
- Sally Griffin
- Radiology Department, Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull B90 4NH, UK
| |
Collapse
|
31
|
Yang J, Guo X, Ou X, Zhang W, Ma X. Discrimination of Pancreatic Serous Cystadenomas From Mucinous Cystadenomas With CT Textural Features: Based on Machine Learning. Front Oncol 2019; 9:494. [PMID: 31245294 PMCID: PMC6581751 DOI: 10.3389/fonc.2019.00494] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/24/2019] [Indexed: 02/05/2023] Open
Abstract
Objectives: This study was designed to estimate the performance of textural features derived from contrast-enhanced CT in the differential diagnosis of pancreatic serous cystadenomas and pancreatic mucinous cystadenomas. Methods: Fifty-three patients with pancreatic serous cystadenoma and 25 patients with pancreatic mucinous cystadenoma were included. Textural parameters of the pancreatic neoplasms were extracted using the LIFEx software, and were analyzed using random forest and Least Absolute Shrinkage and Selection Operator (LASSO) methods. Patients were randomly divided into training and validation sets with a ratio of 4:1; random forest method was adopted to constructed a diagnostic prediction model. Scoring metrics included sensitivity, specificity, accuracy, and AUC. Results: Radiomics features extracted from contrast-enhanced CT were able to discriminate pancreatic mucinous cystadenomas from serous cystadenomas in both the training group (slice thickness of 2 mm, AUC 0.77, sensitivity 0.95, specificity 0.83, accuracy 0.85; slice thickness of 5 mm, AUC 0.72, sensitivity 0.90, specificity 0.84, accuracy 0.86) and the validation group (slice thickness of 2 mm, AUC 0.66, sensitivity 0.86, specificity 0.71, accuracy 0.74; slice thickness of 5 mm, AUC 0.75, sensitivity 0.85, specificity 0.83, accuracy 0.83). Conclusions: In conclusion, our study provided preliminary evidence that textural features derived from CT images were useful in differential diagnosis of pancreatic mucinous cystadenomas and serous cystadenomas, which may provide a non-invasive approach to determine whether surgery is needed in clinical practice. However, multicentre studies with larger sample size are needed to confirm these results.
Collapse
Affiliation(s)
- Jing Yang
- State Key Laboratory of Biotherapy, Department of Biotherapy, West China Hospital, Cancer Center, Sichuan University, Chengdu, China
| | - Xinli Guo
- West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China
| | - Xuejin Ou
- State Key Laboratory of Biotherapy, Department of Biotherapy, West China Hospital, Cancer Center, Sichuan University, Chengdu, China
| | - Weiwei Zhang
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xuelei Ma
- State Key Laboratory of Biotherapy, Department of Biotherapy, West China Hospital, Cancer Center, Sichuan University, Chengdu, China
| |
Collapse
|
32
|
Vetshev FP, Osminin SV, Chesarev AA, Lerner YV, Puzakov KB, Petukhova NV, Dergunova AP. [Laparoscopic appendectomy for mucinous cystadenoma of the appendix]. Khirurgiia (Mosk) 2019:61-65. [PMID: 31120449 DOI: 10.17116/hirurgia201904161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Treatment of acute and chronic appendicitis is still an actual problem. There are some rare courses of the disease besides well-known complications of appendicitis. Mucocele is one of the rarest forms of chronic appendicitis. Mucocele is not accompanied by clinical symptoms and diagnosed accidentally in more than 25% of cases. The most serious complication of mucocele of the appendix is malignization observed in up to 36% of cases. Ultrasound, CT and colonoscopy are the most effective methods of perioperative diagnosis. Unclear symptoms, delayed diagnosis and surgical treatment increase the risk of complications (i.e. cystadenocarcinoma).
Collapse
Affiliation(s)
- F P Vetshev
- Chair of Faculty-Based Surgery #1, Sechenov First Moscow State Medical University of Ministry of Health of the Russia, Moscow, Russia
| | - S V Osminin
- Chair of Faculty-Based Surgery #1, Sechenov First Moscow State Medical University of Ministry of Health of the Russia, Moscow, Russia
| | - A A Chesarev
- Chair of Faculty-Based Surgery #1, Sechenov First Moscow State Medical University of Ministry of Health of the Russia, Moscow, Russia
| | - Yu V Lerner
- Strukov Chair of pathological anatomy Sechenov First Moscow State Medical University of Ministry of Health of theRussia, Moscow, Russia
| | - K B Puzakov
- Radiology Department of the University's Clinical Hospital #2, Sechenov First Moscow State Medical University of Ministry of Health of the Russia, Moscow, Russia
| | - N V Petukhova
- Chair of Faculty-Based Surgery #1, Sechenov First Moscow State Medical University of Ministry of Health of the Russia, Moscow, Russia
| | - A P Dergunova
- Chair of Faculty-Based Surgery #1, Sechenov First Moscow State Medical University of Ministry of Health of the Russia, Moscow, Russia
| |
Collapse
|
33
|
Dong X, Zhan K, Hossain MA, Kuang Y, Gao S, Tong H, Li X, Huang X, He W. Laparoscopic vesiculectomy for large seminal vesicle cystadenoma. Andrologia 2018; 51:e13209. [PMID: 30488974 DOI: 10.1111/and.13209] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 10/20/2018] [Accepted: 10/30/2018] [Indexed: 11/29/2022] Open
Abstract
Cystadenomas of the seminal vesicles are extremely rare. Here, we report a large seminal vesicle cystadenoma. A 37-year-old man presented a 6-month history of haemospermia, 10 days of Lower Urinary Tract symptoms (LUTSs) and gross haematuria. Transabdominal ultrasonography, computed tomography and magnetic resonance imaging were performed and revealed a large solid-cystic pelvic mass morphometrically measured 7.0 cm × 11.9 cm × 8.6 cm on the right seminal vesicle, which caused hydronephrosis of the right kidney. The prostate-specific antigen of the patient was 27.860 ng/dl. Laparoscopic exploration found the capsule of tumour was complete and the tumour came from the right seminal vesicle, in addition, the mass had a certain space with the bladder and prostate, which could be separated. So a nerve-sparing Laparoscopic Vesiculectomy was performed at last, even though the intraoperative frozen section analysis could not make sure the nature of the tumour either. The postoperative pathology revealed cystadenoma of the seminal vesicle.
Collapse
Affiliation(s)
- Xiaoyong Dong
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Kai Zhan
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mohammad Arman Hossain
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Youlin Kuang
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shun Gao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hang Tong
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiujun Li
- Department of Pathology, Chongqing Medical University, Chongqing, China
| | - Xiaolong Huang
- Department of Urology, People's Hospital of Chongqing Hechuan, Chongqing, China
| | - Weiyang He
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| |
Collapse
|
34
|
Emre A, Sertkaya M, Kale İT. Clinicopathological analysis of appendiceal mucinous tumors: A single-center experience. Turk J Surg 2017; 33:274-278. [PMID: 29260132 DOI: 10.5152/turkjsurg.2017.3582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 05/25/2016] [Indexed: 11/22/2022]
Abstract
Objective Appendiceal mucinous tumors can be encountered in four different types. The clinical approach varies according to these types and the severity of the present disease. We aimed to share clinical, radiological, and pathological features and surgical options of the patients diagnosed with mucinous tumors at our center. Material and Methods Between August 2009 and March 2016, 757 patients underwent appendectomy for presumed diagnosis of acute appendicitis at the Department of Surgery, Kahramanmaraş Sütçü İmam University School of Medicine, Kahramanmaraş, Turkey. Among them, demographic, clinical, and histopathological characteristics of patients who diagnosed with appendiceal mucinous tumors were retrospectively analyzed. This study was approved by our faculty's human ethics committee. Results Incidence of mucinous tumor was 1.71%. Mean age of a total of 13 cases including 6 women and 7 men was 52.4±21.6 years (Range: 25-83 years). On preoperative diagnosis, acute appendicitis was detected in 8 patients, perforated appendicitis and periappendiceal abscess in two patients, and suspicious cecal mass in two patients. One patient had an operation for uterine leiomyoma. On histopathological examination, four patients were diagnosed with simple mucinous cyst, four with mucinous cystadenoma, three with mucosal hyperplasia, and two with mucinous cystadenocarcinoma. Mean duration of hospital stay was 5.1±4.7 days. One patient died from septic shock on first day, one from respiratory failure on 14th day, and one from cardiac arrest on 20th day. The average follow-up duration for the other 10 patients was 44 months (ranging from 1 to 78 months). No recurrence or death occurred in these patients over the course of follow-up. Conclusion Intraoperative clinical diagnosis of appendiceal mucinous tumors is rarely seen. Close histopathological and cytological examination of the specimen is required to separate malignant tumors from benign ones. The treatment varies depending on different types and the severity of the disease.
Collapse
Affiliation(s)
- Arif Emre
- Department of General Surgery, Kahramanmaraş Sütçü İmam University School of Medicine, Kahramanmaraş, Turkey
| | - Mehmet Sertkaya
- Department of General Surgery, Kahramanmaraş Sütçü İmam University School of Medicine, Kahramanmaraş, Turkey
| | - İlhami Taner Kale
- Department of General Surgery, Kahramanmaraş Sütçü İmam University School of Medicine, Kahramanmaraş, Turkey
| |
Collapse
|
35
|
Bonaroti JW, Doane S, McCue PA, Winter JM. Intraoperative Frozen Section Analysis of the Pancreas: A Case Report and Review of the Literature. Case Rep Pancreat Cancer 2016; 2:71-74. [PMID: 30631821 PMCID: PMC6319693 DOI: 10.1089/crpc.2016.0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Intraoperative frozen section analysis is frequently used to obtain a histological diagnosis at the time of resection and to assess resection margins. Although many surgeons perceive a clinical benefit, particularly with respect to the transected resection margins, the limitations and pitfalls of frozen section analysis have not been well documented. Case: Here, we report a case of serous cystadenoma with background pancreatitis masquerading on frozen section as an invasive pancreatic ductal adenocarcinoma. This interpretation was a surprise in light of preoperative imaging that was highly suggestive of a benign cystic tumor, but nevertheless prompted intraoperative consideration of a more radical operation to ensure a complete resection was achieved. Conclusions: Frozen section analysis is an imperfect test, and misdiagnoses can potentially impact patient outcomes adversely. Intraoperative decisions must carefully integrate the preliminary pathological interpretation with the overall clinical context. Further studies are warranted to more fully characterize the accuracy, utility, and cost-effectiveness of intraoperative frozen section analysis for pancreatic surgery.
Collapse
Affiliation(s)
- Jillian W Bonaroti
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Stephen Doane
- Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Peter A McCue
- Department of Surgical Pathology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| | - Jordan M Winter
- Department of Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
| |
Collapse
|
36
|
Hasan R, Kumar S, Rao AC, Kadavigere R. Rare Presentation of Pseudomyxoma Retroperitonei: Stretching the Limits. Malays J Med Sci 2016; 23:79-85. [PMID: 27660549 PMCID: PMC5025067 DOI: 10.21315/mjms2016.23.4.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2016] [Accepted: 06/13/2016] [Indexed: 10/20/2022] Open
Abstract
A 55-year-old woman presented with a mucopurulent sinusal discharge from the right supragluteal region, with symptoms over the previous five months. This abscess began as a slowly swelling growth, which eventually turned into a discharging sinus, and she was diagnosed with a gluteal abscess. The patient underwent incisional drainage, and intra-operatively, the sinus tract could be seen extending to the retroperitoneum. A subsequent CT scan and an MRI of the abdomen revealed a large heterogeneous retroperitoneal cystic mass on the right side of midline, extending inferiorly into the anterior thigh along the iliopsoas. Superiorly, a tubular projection extended from the lesion, indenting the ileocaecal junction, while a fluid filled cutaneous fistulous tract was seen, extending to the right flank. A diagnosis of pseudomyxoma retroperitonei, likely of retrocaecal appendicular origin, was proposed. An explorative laparotomy with an appendectomy, and the evacuation of the retroperitoneal collection were completed. The subsequent histopathology confirmed the diagnosis of appendicular mucinous cystadenoma, with pseudomyxoma retroperitonei.
Collapse
Affiliation(s)
- Roumina Hasan
- Department of Pathology, Melaka Manipal Medical College, Manipal University, Manipal 576104, India
| | - Sandeep Kumar
- Department of Radiology, Kasturba Medical College, Manipal University, Manipal 576104, India
| | - Anuradha ck Rao
- Department of Pathology, Kasturba Medical College, Manipal University, Manipal 576104, India
| | - Rajagopal Kadavigere
- Department of Pathology, Melaka Manipal Medical College, Manipal University, Manipal 576104, India
| |
Collapse
|
37
|
Mohamed H, Dorra B, Hela B, Cherif A, Azza S, Karim S, Khadija B, Adnen C. [Pancreatic serous cystadenoma associated with pancreatic heterotopia]. Pan Afr Med J 2016; 23:94. [PMID: 27231505 PMCID: PMC4867731 DOI: 10.11604/pamj.2016.23.94.8533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 01/14/2016] [Indexed: 11/17/2022] Open
Abstract
Les hétérotopies pancréatiques (HP) sont rares. Elles peuvent se voir à tout âge avec une légère prédominance masculine. ces lésions sont le plus souvent asymptomatiques, de découverte fortuite lors d'une endoscopie digestive haute ou basse ou lors de l'examen anatomopathologique d'un organe réséqué pour d'autres motifs, et peuvent être isolée ou associée à une pathologie digestive. Nous rapportons, à travers notre observation, l'association d'une HP à un cystadénome séreux du pancréas découverte lors de l'exploration des douleurs épigastriques isolées. A travers cette observation nous nous proposons d’étudier les particularités cliniques et histologiques de cette pathologie rare.
Collapse
Affiliation(s)
- Hedfi Mohamed
- Service de Chirurgie Générale Hôpital Des FSI La Marsa, Tunisie
| | | | - Bouhafa Hela
- Service de Chirurgie Générale Hôpital Des FSI La Marsa, Tunisie
| | | | - Sridi Azza
- Service de Chirurgie Générale Hôpital Des FSI La Marsa, Tunisie
| | - Sassi Karim
- Service de Chirurgie Générale Hôpital Des FSI La Marsa, Tunisie
| | - Bellil Khadija
- Service Anatomie Pathologique Hôpital des FSI La Marsa, Tunisie
| | - Chouchene Adnen
- Service de Chirurgie Générale Hôpital Des FSI La Marsa, Tunisie
| |
Collapse
|
38
|
Abstract
CONCLUSION Some variation from the 'classical' clinical picture for Warthin's tumours is evident in these patients. A predilection for the parotid tail and a propensity for multiplicity has been confirmed. OBJECTIVES This study sought to analyse demographic and clinical features of a Warthin's patient population. METHODS Retrospective review of patients presenting with a benign parotid tumour. The group of Warthin's tumours was compared with the group of patients with other benign parotid tumours. RESULTS Of 170 primary parotid tumours, 41 (24%) were Warthin's tumour. Mean age of Warthins patients was significantly older (60 years vs 48 years, p = 0.001) and male gender more prevalent (61% vs 33%, p = 0.015) than in other benign tumours. Most (86%) Warthin's tumours were found in the parotid tail, compared with 61% of other benign tumours (p = 0.002). There was no significant ethnic predilection for Warthin's tumours. Bilaterality (30%) and multiplicity (27%) were common. Significance of gender differences disappeared with logistic regression analysis.
Collapse
Affiliation(s)
- Depak K Patel
- a Department of Otolaryngology Head and Neck Surgery , Counties Manukau District Health Board , Auckland , New Zealand
| | - Randall P Morton
- a Department of Otolaryngology Head and Neck Surgery , Counties Manukau District Health Board , Auckland , New Zealand
| |
Collapse
|
39
|
Nascimento LA, Ferreira JAS, Pio RB, Takano GHS, Miziara HL. Synchronous bilateral warthin tumors: a case report. Int Arch Otorhinolaryngol 2015; 18:217-20. [PMID: 25992094 PMCID: PMC4297016 DOI: 10.1055/s-0033-1351676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Accepted: 02/18/2013] [Indexed: 11/29/2022] Open
Abstract
Introduction Warthin tumor is described as papillary cystadenoma lymphomatosum and is the second most common tumor of the parotid glands. Bilateral synchronous incidence is rare, occurring in 7 to 10% of the cases. It is more common in males between 60 and 70 years of age and is closely related to smoking. There is slow growth and the condition is a delimited nodule of regular outlines; it has low rates of malignant progression and recurrence. Objective Report a case of synchronous bilateral Warthin tumor occurring in an elderly patient, and review incidence and peculiarities of this tumor. Case Report A 78-year-old man who used to smoke had a history of mild pain in the topography of right parotid three weeks ago. Patient with hypertension, diabetes and a longtime smoker (smoking a pack per day for 32 years) noticed a progressive bulging in the right parotid region for about 2.5 years ago, and noticed another progressive bulging (althought in the left parotid region), for about one year ago. Patient denied fever, redness, skin lesions and pain during this period until last three weeks, when he sought medical attention for a mild pain in the right facial region. The patient underwent cervical magnetic resonance imaging that showed tumor lesions in both parotids. Fine needle aspiration revealed a typical lesion of epithelial oxyphilic cells associated with reactive lymphoid proliferation, suggesting Warthin tumor. The patient underwent two superficial parotidectomies, and the histopathologic result from both tumors of parotid glands showed papillary cystadenoma lymphomatosum. Conclusion The occurrence of synchronous bilateral Warthin tumor is extremely rare, and anamnesis and physical examination, as well as some complementary examinations, are important means for diagnostic evaluation. Confirmation of the diagnosis can only be obtained through a histopathologic study. A superficial or total parotidectomy is the recommended treatment for the disease.
Collapse
Affiliation(s)
- Luiz Augusto Nascimento
- Department of Otolaryngology Head and Neck Surgery, Hospital Universitário de Brasília (UnB), Brasília/DF, Brazil
| | | | - Raquel Baptista Pio
- Student, Department of Medicine, Universidade Católica de Brasília, Brasília/DF, Brazil
| | | | - Hélcio Luiz Miziara
- Doctor Degree, Department of Medical Pathology, Universidade Católica de Brasília, Brasília/DF, Brazil
| |
Collapse
|
40
|
Baloi P, Del Chicca F, Ruetten M, Gerber B. The human Bosniak model applied to a cat with renal cystadenoma. A classification to differentiate benign and malignant cystic renal masses via computed tomography and ultrasound. Tierarztl Prax Ausg K Kleintiere Heimtiere 2015; 43:45-9. [PMID: 25599531 DOI: 10.15654/tpk-140268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 07/10/2014] [Indexed: 11/13/2022]
Abstract
A 13-year-old domestic shorthair cat was presented with weight loss and azotemia. Abdominal ultrasound revealed a large cystic space- occupying lesion with multiple septae in the left kidney. A core needle biopsy yielded a renal cystadenoma originating from the epithelial cells. This report describes the clinical, ultrasonographic and computed tomographic features and the growth progression of a renal cystadenoma. We describe the first attempt to apply the human Bosniak classification to a cat with renal cystic neoplasia to differentiate between benign and malignant lesions. Cystadenoma should be a differential diagnosis in cases of renal cystic space-occupying lesions. Other differentials, imaging features to differentiate benign and malignant lesions and the risk of malignant transformation will be discussed.
Collapse
Affiliation(s)
- P Baloi
- Penelope Baloi, Department of Diagnostic Imaging, Animal Health Trust, Newmarket, United Kingdom,
| | | | | | | |
Collapse
|
41
|
Abstract
Cystic tumors of the pancreas are rare and can be confused with hydatid cyst especially in endemic areas like ours. We present a 30-year-old woman with a huge mucinous cystadenoma of the pancreas initially diagnosed and prepared on table as hydatid cyst. After incising the cyst the diagnosis of cystic tumor was considered and underwent total excision with spleen and healthy pancreatic margin. Histologically and biochemistry of fluid confirmed potentially benign mucinous cystic tumor of pancreas tumor excision after histological diagnosis. Sensitivity of radiological imaging values in differentiating between cystic pancreatic tumors and other limited. Cyst wall histology is diagnostic and biopsy of cyst wall should be done in cases with inconclusive preoperative diagnosis or questionable operative findings.
Collapse
Affiliation(s)
- Sadaf Ali
- Department of Surgical GE, SKIMS, Soura, Srinagar, Jammu and Kashmir, India
| | - Atthar Bashir
- Department of Surgical GE, SKIMS, Soura, Srinagar, Jammu and Kashmir, India
| |
Collapse
|
42
|
Paraskevakou H, Orfanos S, Diamantis T, Konstantinidou A, Patsouris E. Primary retroperitoneal mucinous cystadenoma. A rare case with two cysts and review of the literature. Hippokratia 2014; 18:278-281. [PMID: 25694766 PMCID: PMC4309152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Primary retroperitoneal mucinous cystadenoma is a rare neoplasm, with benign biological behavior. Delay in diagnosis and treatment of this tumor may be fatal for the patient, because of complications, such as rupture, infection and malignant transformation. CASE PRESENTATION We present a 23-year-old woman, who was admitted to the hospital because of a palpable abdominal mass and discomfort since 4 months. Computed Tomography and Magnetic Resonance Imaging scans were performed and showed two retroperitoneal cystic masses, which were excised by laparoscopy. Histological and immunohistochemical examination revealed that the inner surfaces of the cysts were lined by epithelium with features of mesothelial cells, in addition to ovarian mucinous cystadenoma. This is the 29(th) case and the second reported case with two contemporary cysts. CONCLUSION The origin of retroperitoneal mucinous cystadenomas is still unclear. Pathological and immunohistochemical findings proved that these tumors resemble ovarian mucinous cystadenomas but are unattached to the ovary and can arise at any location in the retroperitoneum. Surgical excision of the aforementioned tumors is the treatment of choice. Hippokratia 2014; 18 (3): 278-281.
Collapse
Affiliation(s)
- H Paraskevakou
- 1 Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - S Orfanos
- 1 Department of Surgery, University of Athens, Laiko Athens General Hospital,Athens, Greece
| | - T Diamantis
- 1 Department of Surgery, University of Athens, Laiko Athens General Hospital,Athens, Greece
| | - A Konstantinidou
- 1 Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - E Patsouris
- 1 Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| |
Collapse
|
43
|
Kılıç MÖ, İnan A, Bozer M. Four mucinous cystadenoma of the appendix treated by different approaches. Ulus Cerrahi Derg 2014; 30:97-9. [PMID: 25931904 DOI: 10.5152/ucd.2014.2397] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Accepted: 11/20/2013] [Indexed: 01/04/2023]
Abstract
Appendiceal mucocele is a rare clinical entity characterized by dilatation of the appendiceal lumen due to abnormal mucinous secretion. It may be of inflammatory or tumoral origin. It may occur as a result of mucoceles, mucosal hyperplasia, mucinous cystadenoma or mucinous cystadenocarcinoma. Mucinous cystadenoma of the appendix is the most common form, although it manifests itself in many different clinical presentations. It is detected in 0.6% of appendectomy specimens. Preoperative diagnosis is difficult, and it is often detected at laparotomy. Despite existing reservations due to the risk of rupture, laparoscopic surgery is gaining acceptance. Although there is no consensus on the choice of surgery, either appendectomy or right hemicolectomy is applied. In this article, we discussed four patients with appendix mucinous cystadenoma where different surgical methods were applied in light of the literature.
Collapse
Affiliation(s)
- Murat Özgür Kılıç
- Department of General Surgery, Turgut Özal University Faculty of Medicine, Ankara, Turkey
| | - Aydın İnan
- Department of General Surgery, Turgut Özal University Faculty of Medicine, Ankara, Turkey
| | - Mikdat Bozer
- Department of General Surgery, Turgut Özal University Faculty of Medicine, Ankara, Turkey
| |
Collapse
|
44
|
Zhao SH, Qiang JW, Zhang GF, Wang SJ, Qiu HY, Wang L. MRI in differentiating ovarian borderline from benign mucinous cystadenoma: pathological correlation. J Magn Reson Imaging 2013; 39:162-6. [PMID: 24123278 DOI: 10.1002/jmri.24083] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 01/22/2013] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To investigate MRI in differentiating borderline mucinous cystadenoma (MC) from benign MC of the ovary. MATERIALS AND METHODS We studied MR images of 26 benign MCs and 24 borderline MCs of the ovary. The following MRI features of tumors were evaluated and compared between two groups: laterality, shape, size, loculation, signal intensity of the fluid, thickness of the septation and the wall, and vegetations. The results of the MRI were then compared with the pathological findings. RESULTS Honeycomb loculi, high signal intensity on T1WI, and low signal intensity on T2WI of the intracystic content, thickened septation or wall (≥5 mm), and vegetations (≥5 mm) were significantly more common in borderline MC than in benign MC with the sensitivity and specificity of identifying borderline MC of 50.0% and 80.8%, 41.7% and 96.2%, 45.8% and 96.2%, and 62.5% and 96.2%, respectively. The presence of any one of the following features-honeycomb loculi with a low signal intensity on T2WI, thickened septation or wall (≥5 mm), and vegetations (≥5 mm)-yielded the sensitivity, specificity, and accuracy of identifying borderline MC of 91.7%, 92.3%, and 92.0%, respectively. CONCLUSION MRI has the ability to accurately demonstrate the morphological characteristics of ovarian MC and reliably differentiate borderline MC from benign MC.
Collapse
Affiliation(s)
- Shu Hui Zhao
- Department of Radiology, Jinshan Hospital, Fudan University, Shanghai, China
| | | | | | | | | | | |
Collapse
|
45
|
Zheng J, Geng M, Li P, Li Y, Cao Y. Ovarian mucinous cystic tumor with sarcoma-like mural nodules and multifocal anaplastic carcinoma: a case report. Int J Clin Exp Pathol 2013; 6:1688-1692. [PMID: 23923090 PMCID: PMC3726988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 06/29/2013] [Indexed: 06/02/2023]
Abstract
A 48-year-old woman presented with left abdominal pain and fullness. Computed tomography scan revealed a multicystic mass with multifocal mural nodules. Histologic examination showed a mucinous cystic tumor with cystadenoma, borderline malignant cystadenoma and cystadenocarcinoma, which were associated with sarcoma-like mural nodules (SLMNs) and multifocal anaplastic carcinoma. Mural nodules showed a positive reaction for CD56 and vimentin, but were negative for cytokeratin 7 and SMA. She underwent postoperative chemotherapy and is currently under follow-up; no recurrence or metastases were found in the first year of follow-up. Ovarian mucinous cystic tumor with SLMNs and foci of anaplastic carcinoma is extremely rare. To our knowledge, this case reports the most complex neoplastic and reactive components. Our findings shed some light on the pathogenesis of this rather rare carcinoma. We think that the formation of SLMNs may be the result of the reactive proliferation of undifferentiated mesenchymal cells, while the anaplastic carcinoma may be derived from mucinous epithelium. Moreover, because of difficulties encountered in their differential diagnosis, we think that the existence of foci of anaplastic carcinoma along with SLMNs necessitates careful histologic and immunohistochemical analysis of mural nodules for the determination of treatment and prognosis.
Collapse
Affiliation(s)
- Jinfeng Zheng
- Department of Pathology, General Hospital of Jinan Military CommandJinan, China
| | - Ming Geng
- Department of Pathology, General Hospital of Jinan Military CommandJinan, China
| | - Peifeng Li
- Department of Pathology, General Hospital of Jinan Military CommandJinan, China
| | - Yi Li
- Department of oncology, Kunming General Hospital of Chengdu Military CommandKunming, China
| | - Yongcheng Cao
- Department of Pathology, General Hospital of Jinan Military CommandJinan, China
| |
Collapse
|
46
|
Olaoye IO, Adesina MD. Huge mucinous cystadenoma of the pancreas mistaken for a pseudocyst. Pan Afr Med J 2013; 15:6. [PMID: 23847703 PMCID: PMC3708325 DOI: 10.11604/pamj.2013.15.6.2494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 03/31/2013] [Indexed: 11/11/2022] Open
Abstract
Cystic tumors of the pancreas are rare and can be confused with pseudocysts.We present a 50 year old woman with a huge mucinous cystadenoma of the pancreas initially diagnosed and managed with a cystojejunostomy and cyst wall biopsy. She required another laparotomy and tumor excision after histological diagnosis. Sensitivity of radiological imaging in differentiating between cystic pancreatic tumors and pseudocysts is limited. Cyst wall histology is diagnostic and biopsy of cyst wall should be done in cases with inconclusive preoperative diagnosis or questionable operative findings.
Collapse
|
47
|
Fei Z, Zhou Y, Peng A, Wu B, Sun M, Wu S. Asymptomatic hepatobiliary cystadenoma of the hepatic caudate lobe: a case report. J Biomed Res 2013; 27:336-8. [PMID: 23885274 PMCID: PMC3721043 DOI: 10.7555/jbr.27.20120069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 12/25/2012] [Accepted: 02/08/2013] [Indexed: 12/31/2022] Open
Abstract
Human hepatobiliary cystadenoma is a rare benign cystic tumor of the liver, and is extremely rare in the caudate lobe. We herein present a case of a 70-year-old male with a hepatobiliary cystadenoma originating from the caudate lobe.
Collapse
|
48
|
Demirci RK, Habibi M, Karakaş BR, Buluş H, Akkoca M, Öner OZ. Appendix mucocele mimicking a complex ovarian cyst. Ulus Cerrahi Derg 2013; 31:58-60. [PMID: 25931937 DOI: 10.5152/ucd.2013.17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Accepted: 03/07/2012] [Indexed: 11/22/2022]
Abstract
Appendiceal mucocele is a rare entity which is characterized by cystic dilatation due to abnormal accumulation of mucus in the lumen of the appendix. Patients are often diagnosed incidentally by abdominal screening or abdominal surgery for other causes. Pain in the right lower quadrant of the abdomen, which may present as acute or chronic appendicitis, is the most common symptom of appendix mucocele, when the patient is symptomatic. This study describes the case of a 26-year-old female for whom surgical intervention for a complex ovarian cyst was planned, but who instead underwent laparoscopic appendectomy because appendiceal mucocele was determined during laparoscopic exploration.
Collapse
Affiliation(s)
| | - Mani Habibi
- Clinic of General Surgery, Antalya Training and Research Hospital, Antalya, Turkey
| | - Barış Rafet Karakaş
- Clinic of General Surgery, Antalya Training and Research Hospital, Antalya, Turkey
| | - Hakan Buluş
- Clinic of General Surgery, Keçiören Training and Research Hospital, Ankara, Turkey
| | - Muzaffer Akkoca
- Clinic of General Surgery, Keçiören Training and Research Hospital, Ankara, Turkey
| | - Osman Zekai Öner
- Clinic of General Surgery, Antalya Training and Research Hospital, Antalya, Turkey
| |
Collapse
|
49
|
Abstract
BACKGROUND Liver cysts are common, occurring in up to 5% of the population. For many types of cysts, a variety of different treatment options exist and the preferred management is unclear. METHODS A PubMed and Medline literature review was undertaken and articles pertaining to the diagnosis and management of cystic lesions within the liver were retrieved. RESULTS Therapy for symptomatic cysts may incorporate aspiration with sclerotherapy or de-roofing. Polycystic liver disease presents a unique management problem because of the high morbidity and mortality rates from intervention and high rates of recurrence. Careful patient counselling and assessment of symptom index is essential before embarking on any treatment. New medical treatments may ameliorate symptoms. Acquired cystic lesions in the liver require a thorough work-up to fully characterize the abnormality and direct appropriate treatment. Hydatid cysts are best treated by chemotherapy, followed by some form of surgical intervention (either aspiration and sclerotherapy or surgery). Liver abscesses can be effectively treated by aspiration or drainage. CONCLUSION All patients with cystic lesions in the liver require discussion at multidisciplinary meetings to confirm the diagnosis and determine the most appropriate method of treatment.
Collapse
Affiliation(s)
- Giuseppe Garcea
- Department of Hepatobiliary and Pancreatic Surgery, University Hospitals of Leicester, Leicester, UK.
| | | | | |
Collapse
|
50
|
Abstract
BACKGROUND/AIM Pancreatic cystic neoplasms are being increasingly identified with the widespread use of advanced imaging techniques. In the absence of a good radiologic or pathologic test to preoperatively determine the dianosis, clinical characteristics might be helpful. The objectives of this analysis were to define the incidence and predictors of malignancy in pancreatic cysts. PATIENTS AND METHODS Patients with true pancreatic cysts who were treated at our institution were included. Patients with documented pseudocysts were excluded. Demographic data, clinical manifestations, radiological, surgical, and pathological records of those patients were reviewed. RESULTS Eighty-one patients had true pancreatic cyst. The mean age was 47 ± 15.5 years. There were 28.4% serous cystadenoma, 21% mucinous cystadenoma, 6.2% intraductal papillary tumors, 8.6% solid pseudopapillary tumors, 1.2% neuroendocrinal tumor, 3.7% ductal adenocarcinoma, and 30.9% mucinous cystadenocarcinoma. Malignancy was significantly associated with men (P = 0.04), older age (0.0001), cysts larger than 3 cm in diameter (P = 0.001), presence of solid component (P = 0.0001), and cyst wall thickening (P = 0.0001). The majority of patients with malignancy were symptomatic (26/28, 92.9%). The symptoms that correlated with malignancy included abdominal pain (P = 0.04) and weight loss (P = 0.0001). Surgical procedures were based on the location and extension of the lesion. CONCLUSION The most common pancreatic cysts were serous and mucinous cysts. These tumors were more common in females. Old age, male gender, large tumor, presence of solid component, wall thickness, and presence of symptoms may predict malignancy in the cyst.
Collapse
Affiliation(s)
- Ehab Atef
- Gastroenterology Surgical Center, Mansoura University, Egypt
| | - Ayman El Nakeeb
- Gastroenterology Surgical Center, Mansoura University, Egypt,Address for correspondence: Prof. Ayman El Nakeeb, Gastroenterology Surgical Center, Mansoura University, Egypt. E-mail:
| | - Ehab El Hanafy
- Gastroenterology Surgical Center, Mansoura University, Egypt
| | | | - Emad Hamdy
- Gastroenterology Surgical Center, Mansoura University, Egypt
| | - Ahmed El-Geidie
- Gastroenterology Surgical Center, Mansoura University, Egypt
| |
Collapse
|