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Green J, Biglione A. Fibroid Degeneration During Pregnancy Presenting as Appendicitis. Cureus 2024; 16:e57660. [PMID: 38707152 PMCID: PMC11070206 DOI: 10.7759/cureus.57660] [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] [Accepted: 04/05/2024] [Indexed: 05/07/2024] Open
Abstract
Uterine fibroid degeneration is a rare cause of abdominal pain during pregnancy. It can cause complications during pregnancy, including placental abruption, fetal growth restriction, and preterm delivery. Myxoid degeneration is an unusual form of fibroid degeneration. We present a case of a 38-year-old female, G1P0, who presented at 13 weeks gestation to the emergency department at the request of her obstetrician due to abdominal pain with concern about appendicitis. A diagnosis of myxoid degeneration was made. The patient was treated with analgesics and discharged to continue her management in the outpatient setting.
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Affiliation(s)
- Jamie Green
- College of Medicine, Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, USA
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Vescovo M, Pesci L, Lapenna L, De Santis E, Di Nardo D, de Anna L, Mongardini FM, Ascoli V, Mongardini M, De Santis A, Giordano C. Severe rectal prolapse and solitary rectal ulcer in a young anorectic woman with myxoid degeneration of visceral adipose tissue. Pathologica 2022; 113:475-480. [PMID: 34974555 PMCID: PMC8720390 DOI: 10.32074/1591-951x-253] [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: 01/09/2021] [Accepted: 01/27/2021] [Indexed: 11/30/2022] Open
Abstract
Rectal prolapse is a disorder in which the rectum protrudes from the anal canal. Solitary rectal ulcer may coexist. Both conditions have been associated with chronic constipation and excessive straining during defecation. Rectal prolapse has been rarely reported in women suffering from anorexia nervosa. Lack of rectal support because of loss of ischiorectal fat has been proposed as one of the possible mechanisms in this condition, together with chronic constipation and abuse of laxative. We report the case of an anorexic woman with a severe rectal prolapse and bleeding requiring urgent Altmeier’s procedure. Surgery was complicated by dehiscence of the anastomosis and volvulus, requiring ileostomy and laciniae debridement. Pathological analysis of all the surgical samples taken from different abdominal sites highlighted changes in the visceral adipose tissue consisting in nodular aggregates of small adipocytes dispersed in a myxoid matrix surrounding blood vessels within abundant fibrosis. The morphologic features resemble those observed in primordial fetal fat and are comparable to those observed in cancer associated cachexia. The diffuse myxoid degeneration of visceral adipose tissue may play a role in the pathogenesis of rectal prolapse in patients with anorexia nervosa. Besides starvation, the mechanism sustaining myxoid degeneration of the adipose tissue is not entirely clear. Whenever possible improving nutritional and clinical conditions should be ideal before any surgical approach.
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Affiliation(s)
- Mariavittoria Vescovo
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Ludovica Pesci
- Department of Precision and Translation Medicine, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Lucia Lapenna
- Department of Precision and Translation Medicine, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Emanuela De Santis
- Department of Precision and Translation Medicine, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Domenico Di Nardo
- Department of General and Plastic Surgery, and Orthopedics, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Livia de Anna
- Department of General and Plastic Surgery, and Orthopedics, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Federico Maria Mongardini
- Department of General and Plastic Surgery, and Orthopedics, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Valeria Ascoli
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Massimo Mongardini
- Department of General and Plastic Surgery, and Orthopedics, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Adriano De Santis
- Department of Precision and Translation Medicine, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Carla Giordano
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
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Abstract
Oral focal mucinosis (OFM) is a rare connective tissue disorder characterized by myxoid degeneration of submucosal connective tissue. It usually presents as gingival or mucosal overgrowth. Due to its uncommon occurrence and lack of pathognomonic clinical or radiological features, diagnosis mainly relies on histopathological evaluation. The paper reports a rare case of large OFM in a 58-year-old female patient involving the posterior maxilla and hard palate. Diagnosis of the lesion was established based on histopathological and immunohistochemical analysis. The lesion was excised surgically and showed no recurrence at 1 year follow-up. The cases presented intend to bring OFM to the attention of oral pathologists and clinicians while considering the differential diagnosis of myxoid lesions of oral cavity.
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Affiliation(s)
- Kumar Nilesh
- Department of Oral and Maxillofacial Surgery, School of Dental Sciences, KIMSDU, Karad, Maharashtra, India
| | | | - Rahul Patil
- Department of Oral Pathology, KBH Dental College and Hospital, Nashik, Maharashtra, India
| | - R C Pramod
- Department of Oral Pathology, College of Dental Sciences, Davangere, Karnataka, India
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Li HJ, Han HX, Feng DF. Rapid increase in cystic volume of an anaplastic astrocytoma misdiagnosed as neurocysticercosis: A case report. Oncol Lett 2016; 12:2825-2827. [PMID: 27698865 DOI: 10.3892/ol.2016.4986] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 04/17/2015] [Accepted: 07/20/2016] [Indexed: 11/06/2022] Open
Abstract
Reports describing a rapid increase in the cystic volume of anaplastic astrocytoma (AA) in a short time frame are rare. The present study reports the case of a 68-year-old male who was admitted to the No. 9 People's Hospital, Shanghai Jiaotong University School of Medicine (Shanghai, China), with a small cystic brain lesion and positive immunological testing for cysticercosis. Head magnetic resonance imaging (MRI) showed a cystic lesion, 6 mm in diameter, in the left frontal lobe. Neurocysticercosis was suspected and the patient was treated with a clinical trial of albendazole and steroids. A period of 25 days later, the patient's condition had deteriorated, and MRI revealed a cystic lesion in the left frontal lobe; thereafter, the cystic lesion was removed and a diagnosis of AA was established. The tumor was soft, ivory white and gelatinous due to myxoid degeneration. In this case, tumor-related angiogenesis and microvascular extravasation (blood-brain barrier disruption) may have been the main cause of the rapid increase in the cystic volume in such a short time frame. The similarity of the glioma and cysticercus antigens may have been the cause of the positive reactions in the cystic fluid. The present study reports the rare occurrence of a rapid increase of cystic volume and potential diagnostic difficulties.
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Affiliation(s)
- Hong-Jiang Li
- Department of Neurosurgery, No. 9 People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201999, P.R. China
| | - Hong-Xiu Han
- Department of Pathology, No. 9 People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201999, P.R. China
| | - Dong-Fu Feng
- Department of Neurosurgery, No. 9 People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 201999, P.R. China
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