Laparoscopic surgery for primary ovarian and retroperitoneal hydatid disease: A case report

RATIONALE

Cystic echinococcosis (CE) is a parasitic zoonosis caused by echinococcus larvae. Manifestations of the disease include a severe damage to the liver and lung. Damages to the mesentery, omentum, spleen, brain, heart, bone, thyroid, kidney, and uterus are rarely observed. Moreover, primary ovarian and retroperitoneal hydatid disease is extremely rare, and is easily ignored or misdiagnosed.

PATIENT CONCERNS

We present a case of CE in a 34-year-old female who presented with an adnexal mass detected by B-ultrasound. Adnexal and retroperitoneal masses were removed by laparoscopic surgery. Postoperative pathological report (retroperitoneal cyst) Echinococcus granulosus.

DIAGNOSES

Primary ovarian and retroperitoneal hydatid disease.

INTERVENTIONS

The patient received intravenous injection of dexamethasone (10 mg) before cyst resection to prevent allergic reactions and oral albendazole (600 mg BID) for 14 days to prevent relapse postsurgery.

OUTCOMES

The patient revealed no recurrence of disease and no reportable significant changes in 3 months.

LESSONS

We present here a case report of CE. This case described herein inhabited a nonendemic region. Gentle and careful operation, and avoiding cyst rupture is the key to insuring success of the surgery. For safety, dexamethasone may be used before cyst resection to prevent anaphylaxis, and mebendazole can be used postoperatively to prevent relapse.

Genital schistosomiasis mansoni concomitant to genital tumor in areas of low endemicity: challenging diagnosis

Genital infection by Schistosoma mansoni is usually misdiagnosed in individuals who reside in, or travel to endemic areas. We describe two cases of genital tumor associated with S. mansoni infection manifested by methrorragy. Surgical specimens revealed leiomyomas in both cases associated with S. mansoni. In one of them, granulomas were found in the ovary and in the other they were found in the uterine tube. Although none presented intestinal/hepatic disease, fecal egg excretion was detected in one. Both had elevated pretreatment antibody reactivity to S. mansoni antigen, but follow-up showed different outcomes. Schistosomiasis should be considered as a diagnosis in individuals with methrorragy residing in or having traveled to endemic areas. Since diagnosis follows genital amputation, and cure control is troublesome, improvement of diagnostic tools and follow-up markers are important priorities to decrease schistosomiasis morbidity.

[Hydatid cyst of ovary. Report of 7 cases]

Hydatid disease is a wide spread disease. It is endemic in Tunisia. Man is contaminated by digestif way and by living with dogs. The disease affects usually liver and lung. Other localisations are rare. Hydatid cyst of the ovary is uncommon and clinically they present like malignant tumour of ovary. We present 7 cases of hydatid cyst of the ovary and we discuss the characteristics of this site of the hydatic disease.

Adnexal fascioliasis masquerading as ovarian cancer

BACKGROUND

Preoperative diagnosis of ovarian cancer is still problematic as multiple disease processes may present with pelvic mass. Fascioliasis is a parasitic disease producing unique clinical manifestations.

CASE REPORT

A 49-year-old female patient admitted to our hospital with the complaint of occasional abdominal pain. Pelvic examination revealed a right adnexal mass. Serum CA-125 level was elevated. Explorative laparotomy was performed with the initial diagnosis of ovarian tumor. Final diagnosis was adnexal fascioliasis.

CONCLUSION

In the setting of a newly diagnosed pelvic mass, care should be taken when interpreting an elevated CA-125 level. While ovarian cancer is high on the list of differential diagnoses, atypical clinical presentation of fasciola may give rise to a misdiagnosis of malignancy.

Abdominal and pelvic hydatid disease during pregnancy

BACKGROUND

Hydatid disease is an infection of sheep and cattle. Affected human beings are only chance intermediate hosts. It is a rare condition in pregnancy.

CASE REPORT

We present a 15-week pregnant patient with cysts in the liver and in the right adnexa identified by ultrasonography and magnetic resonance imaging. Diagnosis of hydatid disease was confirmed by an indirect hemagglutination test.

OUTCOME

The patient underwent laparotomy and a healthy baby was delivered at term.

[Enterobiasis of the female pelvi-genital tract: a report of three cases]

Ectopic localization of oxyuriasis is rare and frequently does not cause clinical problems. It has been reported in the vagina, endometrium, fallopian tube, peritoneal surface and ovary; In these localizations it often causes pseudo-tumoral granulomas. The aim of our study was to describe etiopathogenic and clinical criteria of this rare pathology. We report one case of endometrial enterobiasis which developed in a 28-year-old women and two cases of tubo-ovarian pseudotumoral abscesses containing the ova of enterobius which appeared as a latero-uterin mass in women aged 28 and 38 years. Enterobius vermicularis may cause tubo-ovarian abscess formation with necrotizing epitheloid granulomas mimicking tumors. Antihelminth therapies are successful.

Early developmental stages of a protozoan parasite, Marteilioides chungmuensis (Paramyxea), the causative agent of the ovary enlargement disease in the Pacific oyster, Crassostrea gigas

A paramyxea, Marteilioides chungmuensis, causes the irregular enlargement of the ovary in the Pacific oyster, Crassostrea gigas in Korea and Japan. The knowledge about the life cycle of the parasite has been limited to the sporulation stages within the oocyte of oysters. In this study, we used the parasite-specific DNA probes and electron microscopy to experimentally infected oysters in a field and successfully clarified early developmental stages of the parasite. The parasite invaded the oysters through the epithelial tissues of the gills, mantle and labial palps. Extrasporogony repeatedly occurred in the connective tissues by binary fusion. The inner cell of the extrasporogonic stage migrated into the gonadal epithelium, invaded the oocyte to start sporulation.

A case of ovarian enterobiasis

A 36-year old Korean woman consulted a clinic for a regular gynecological examination, and a mass was noticed in her pelvis. She was referred to the Asan Medical Center, Seoul where transvaginal ultrasonography confirmed a pelvic mass exceeding 10 cm in diameter. She received total abdominal hysterectomy and bilateral salpingoophorectomy, and a borderline serous neoplasm with micropapillary features involving the left ovary and right ovarian serosa was histopathologically confirmed. In addition, a section of a nematode with numerous eggs was found in the parenchyma of the left ovary. The worm had degenerated but the eggs were well-preserved and were identified as those of Enterobius vermicularis. She is an incidentally recognized case of ovarian enterobiasis.

Lymphatic filariasis of the ovary and mesosalpinx

We report 2 cases of filariasis, one in the ovary and the other in the mesosalpinx. In the first case, the patient underwent panhystrectomy and in the second case, right ovarian cystectomy with right salpingectomy were performed under general anaesthesia. Histopathology showed adult filarial worms in the dilated lymphatics of the right ovary, in the first case and in the mesosalpinx, in the second case. Both patients presented with complaints related to gynecological problems and not filariasis. Reports of filariasis in the literature and possible treatments and prevention strategies are also discussed.

[Hydatidosis: apropos of several uncommon locations]

Most hydatid cysts are found in the liver or lungs but occurrence in other locations is possible. The purpose of this report is to describe three cases involving cysts locate in the ovary, joint, and thyroid. Clinical findings associated with these uncommon locations were poorly specific and diagnosis required histological examination after surgical exploration. Imaging and serology were useful to differentiate hydatid cyst from benign or malignant tumor disease but often failed to achieve definitive differential diagnosis. Thorough investigation is necessary to rule out more common locations in the liver or lung. Continued surveillance is needed for early detection of recurrence. Preventive campaigns are necessary in endemic areas, such as Morocco.

[Bilateral tubo-ovarian abscess caused by Enterobius vermicularis. Presentation of a case]

We present the case of a 33-year-old patient who had undergone hysterectomy due to an in situ carcinoma of the uterine cervix; exploratory laparotomy was carried out for a suspected abscessed pelvic tumor. It was confirmed that the two Fallopian tubes and ovaries were abscessed and exeresis was carried out. The anatomicopathological study of these showed granulomas containing gravid female specimens of the Enterobius vermicularis species.

Asherman syndrome caused by schistosomiasis

BACKGROUND

Rare causes of Asherman syndrome include infections of the endometrium, such as tuberculosis and schistosomiasis.

CASE

A 27-year-old Zulu woman, para 1, presented with secondary amenorrhea after an uncomplicated cesarean delivery. Hormone levels were in the normal ranges. Laparoscopy revealed some pelvic adhesions with patent fallopian tubes, and biopsy of the ovary showed schistosomiasis. Diagnostic D&C revealed a uterine cavity partially obliterated by adhesions. The patient was treated with praziquantel.

CONCLUSION

Schistosomiasis should be considered as a possible cause of infertility and Asherman syndrome in those parts of the world where it is endemic.

[Genital Schistosoma mansoni bilharziasis in women: apropos of 2 cases in Guadeloupe]

Schistosoma mansoni is the only cause of bilharziasis in Guadeloupe (French West Indies). Ectopic ovarian and endometrial involvement is rare with only one case of bilharziasis of the endometrium having previously been described in the literature. This report describes two cases of Schistosoma mansoni bilharziasis revealed by genital tract involvement. In one case involvement was endometrial and led to metrorrhagia. Histological examination of the biopsy sample obtained by curettage of the endometrium demonstrated the presence of eggs with lateral spurs. In the other case ovarian involvement was detected during assessment for associated infertility and chronic pelvic pain. Celioscopic examination showed pelvic and perihepatic adhesions secondary to sexually transmissible infection. Histologic examination of an ovarian growth demonstrated the presence of Bilharzia eggs. Both patients underwent antiparasitic treatment using oxamniquine (Vansil) which led to the resolution of metrorrhagia in the first case.

Tubo-ovarian abscess containing tapeworm proglottids and ova: a case report

We report a case of pelvic inflammatory disease complicated by a tubo-ovarian abscess containing Taenia spp. proglottids and ova which migrated through a fistula with the sigmoid colon.