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Villaescusa D, Rodríguez-Gandía MÁ, Garrido E, Burgos D, López J, Téllez L, Lledó JL, Albillos A. Hepatic cystadenoma as cause of secondary Budd-Chiari syndrome. Gastroenterol Hepatol 2024; 47:179-180. [PMID: 36967083 DOI: 10.1016/j.gastrohep.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/03/2023] [Accepted: 03/14/2023] [Indexed: 04/16/2023]
Affiliation(s)
- David Villaescusa
- Gastroenterology and Hepatology Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Centro de Investigación Biomédica en Red (CIBEREHD), Universidad de Alcalá, Madrid, Spain.
| | - Miguel Ángel Rodríguez-Gandía
- Gastroenterology and Hepatology Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Centro de Investigación Biomédica en Red (CIBEREHD), Universidad de Alcalá, Madrid, Spain
| | - Elena Garrido
- Gastroenterology and Hepatology Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Centro de Investigación Biomédica en Red (CIBEREHD), Universidad de Alcalá, Madrid, Spain
| | - Diego Burgos
- Gastroenterology and Hepatology Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Centro de Investigación Biomédica en Red (CIBEREHD), Universidad de Alcalá, Madrid, Spain
| | - Julia López
- Gastroenterology and Hepatology Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Centro de Investigación Biomédica en Red (CIBEREHD), Universidad de Alcalá, Madrid, Spain
| | - Luis Téllez
- Gastroenterology and Hepatology Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Centro de Investigación Biomédica en Red (CIBEREHD), Universidad de Alcalá, Madrid, Spain
| | - José Luis Lledó
- Gastroenterology and Hepatology Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Centro de Investigación Biomédica en Red (CIBEREHD), Universidad de Alcalá, Madrid, Spain
| | - Agustín Albillos
- Gastroenterology and Hepatology Department, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), Centro de Investigación Biomédica en Red (CIBEREHD), Universidad de Alcalá, Madrid, Spain
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Balhara K, Mallya V, Khurana N, Tempe A. Coexisting ovarian serous cystadenoma with fibroma: A very unusual combination. J Cancer Res Ther 2023; 19:1474-1476. [PMID: 37787335 DOI: 10.4103/jcrt.jcrt_2319_21] [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: 11/04/2022]
Abstract
Surface epithelial neoplasms are the most common ovarian tumors, constituting around 60% of all ovarian malignancies. They are classified as benign, borderline, and malignant. Ovarian cystadenomas are common benign epithelial neoplasms which carry an excellent prognosis. Ovarian thecoma-fibroma groups are uncommon sex cord-stromal neoplasms, constituting 1.0%-4.0% of all ovarian tumors. Most of them are benign and often found in postmenopausal patients. Combination tumors in the ovary are known. The most common combination is mucinous cystadenoma which occurs in association with Brenner tumor, mature cystic teratoma, Sertoli-Leydig cell tumor, or even a serous cystadenoma. A combination of surface epithelial and thecoma-fibroma group is very rarely encountered. A case of one such combination of serous cystadenoma and fibroma of the ovary is being presented here in a postmenopausal woman.
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Affiliation(s)
- Kirti Balhara
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Varuna Mallya
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Nita Khurana
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Anjali Tempe
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
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Damásio IL, Leite VAPH, Santos RJAMD. Giant ovarian cystadenoma in association with Cowden syndrome. Endokrynol Pol 2022; 73:796-797. [PMID: 35971940 DOI: 10.5603/ep.a2022.0066] [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] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 01/22/2022] [Indexed: 06/15/2023]
Abstract
Not required for Clinical Vignette.
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Affiliation(s)
- Inês Lemos Damásio
- Instituto Português de Oncologia de Lisboa Francisco Gentil, Lisboa, Portugal.
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Cubro H, Cengic V, Burina N, Kravic Z, Beciragic E, Vranic S. Mucocele of the appendix presenting as an exacerbated chronic tubo-ovarian abscess: A case report and comprehensive review of the literature. Medicine (Baltimore) 2019; 98:e17149. [PMID: 31574819 PMCID: PMC6775329 DOI: 10.1097/md.0000000000017149] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 12/23/2022] Open
Abstract
RATIONALE Appendiceal mucocele is a rare entity of mucinous cystic dilatation of the appendix. It has no typical clinical presentation and is considered a potentially premalignant condition. PATIENT CONCERNS We present a case of accidental intraoperative finding of an appendiceal mucocele in a 54-year old woman that clinically presented with an exacerbated chronic tubo-ovarian abscess. DIAGNOSES Trans-vaginal ultrasonography showed an encapsulated, oval, unilocular mass above the uterus with a heteroechogenic structure, homogeneous fluid content, and smooth regular walls without inner proliferation. The histopathologic diagnosis was consistent with an appendiceal cystadenoma. INTERVENTIONS The patient underwent a simple appendectomy. OUTCOMES There were no clinical, biochemical or imaging signs of the disease recurrence at 6 months follow up. LESSONS To our knowledge, this is the only well-documented case of appendiceal mucocele mimicking exacerbated chronic tubo-ovarian abscess reported in the literature. Awareness of a rare entity such as an appendiceal mucocele, which is frequently misdiagnosed as a potential cause of acute abdomen, is necessary for the appropriate management strategy in order to prevent complications.
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Affiliation(s)
- Hajrunisa Cubro
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota
| | | | | | - Zlatko Kravic
- Department of General Surgery, General Hospital “Prim.dr. Abdulah Nakas”, Sarajevo, Bosnia and Herzegovina
| | | | - Semir Vranic
- College of Medicine, Qatar University Health, Qatar University, Doha, Qatar
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Abstract
Von Meyenburg complexes (multiple bile-duct microhamartomas) are formed by numerous groups of small bile-ducts comprised in a fibrous stroma. Together with other bile-duct hamartomas, such as cholangioadenomas and cholangiocystadenomas (often included under the heading of von Meyenburg complexes), they are closely related pathogenetically to polycystic disease of the liver. The frequent association of other developmental anomalies, both of the liver (hemangiomas) and of other organs (namely cystic disease of the kidney), confirms the malformative origin. The possible malignant transformation of von Meyenburg complexes has recently been reported. Seven cases of hepatic cholangiohamartomas are reported: three multiple bile-duct microhamartomas (1 associated with cystic disease of the kidney), two cholangioadenomas (1 associated with hepatic hemangioma) and two biliary cystadenomas.
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Fernández Gómez-Cruzado L, Prieto Calvo M, Pérez González C, Larrea Oleaga J. Diverticulitis of the appendix as debut of appendicular cystadenoma and carcinoid tumor. Rev Esp Enferm Dig 2017; 109:145-146. [PMID: 28211279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Appendiceal diverticulosis is a rare condition with a frequency of 0.004% to 2.1%, and is sometimes an occasional finding during anatomopathologic study of the surgical specimen. It may be presented acutely as a right lower quadrant pain, similar to acute appendicitis for which differential diagnosis must be carried out, and it is associated with appendicular tumors. We report a case of diverticulitis of the appendix as debut of appendicular cystadenoma and carcinoid tumor with representative iconography, being unusual the association of both diseases and even more its preoperative diagnosis.
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Affiliation(s)
| | - Mikel Prieto Calvo
- Servicio de Cirugía General y del Ap. Digestivo , Hospital Universitario de Cruces
| | | | - Jasone Larrea Oleaga
- Servicio de Cirugía General y del Ap. Digestivo, Hospital Universitario de Cruces
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Pandi E, Maxim LS, Cristian A, Hogea MD, Dochit CM, Scarneciu CC, Scarneciu I, Mironescu A. Acute urinary retention due to a prostatic cystadenoma. Case report. Urol J 2016; 13:2797-2799. [PMID: 27576889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 02/04/2016] [Indexed: 06/06/2023]
Affiliation(s)
- Eduard Pandi
- 3rd General Surgical Unit, Emergency Clinical County Hospital, Brasov, 500365, Romania
| | - Laurian Stefan Maxim
- Department of Urology, Emergency Clinical County Hospital, Brasov, 500365, Romania
| | - Adrian Cristian
- 3rd General Surgical Unit, Emergency Clinical County Hospital, Brasov, 500365, Romania
| | - Mircea Daniel Hogea
- 3rd General Surgical Unit, Emergency Clinical County Hospital, Brasov, 500365, Romania
| | - Corina Maria Dochit
- Department of Pathology, Emergency Clinical County Hospital, Brasov, 500365, Romania
| | | | - Ioan Scarneciu
- Department of Urology, Emergency Clinical County Hospital, Brasov, 500365, Romania
| | - Aurel Mironescu
- Pediatric Surgical Unit, Clinical Children's Hospital, Brasov, 500365, Romania
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Affiliation(s)
- Takafumi Taguchi
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, 783-8505, Japan.
| | - Takeki Sugimoto
- Division of Community Medicine, Department of Surgery, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Yoshio Terada
- Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, 783-8505, Japan
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Yang ZZ, Li Y, Liu J, Li KF, Yan YH, Xiao WD. Giant biliary cystadenoma complicated with polycystic liver: A case report. World J Gastroenterol 2013; 19:6310-6314. [PMID: 24115833 PMCID: PMC3787366 DOI: 10.3748/wjg.v19.i37.6310] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 08/13/2013] [Accepted: 08/29/2013] [Indexed: 02/06/2023] Open
Abstract
Biliary cystadenoma (BCA) is a rare hepatic neoplasm. Although considered a benign cystic tumor of the liver, BCA has a high risk of recurrence with incomplete excision and a potential risk for malignant degeneration. Correct diagnosis and complete tumor excision with negative margins are the mainstay of treatment. Unfortunately, due to the lack of presenting symptoms, and normal laboratory results in most patients, BCA is hard to distinguish from other cystic lesions of the liver such as biliary cystadenocarcinoma, hepatic cyst, hydatid cyst, Caroli disease, undifferentiated sarcoma, intraductal papillary mucinous tumor, and hepatocellular carcinoma. Ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) may be necessary. They demonstrate intrahepatic cystic lesions with features such as mural nodules, varying wall thickness, papillary projections, and internal septations. Nevertheless, surgery is still the only means of accurate diagnosis. Definitive diagnosis requires histological examination following formal resection. We describe a 57-year-old woman initially diagnosed with polycystic liver who was subsequently diagnosed with giant intrahepatic BCA in the left hepatic lobe. This indicates that both US physicians and hepatobiliary specialists should attach importance to hepatic cysts, and CT or MRI should be performed for further examination when a diagnosis of BCA is suspected.
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Ishikawa H, Kiyokawa T, Takatani T, Wen WG, Shozu M. Giant multilocular sex cord tumor with annular tubules associated with precocious puberty. Am J Obstet Gynecol 2012; 206:e14-6. [PMID: 22000894 DOI: 10.1016/j.ajog.2011.09.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Accepted: 09/20/2011] [Indexed: 11/20/2022]
Abstract
We report a case of sex cord tumor with annular tubules featuring a giant multilocular cyst, grossly similar to cystadenoma, in the ovary of an 8.5 year old girl. Estrogen-related symptoms, including precocious puberty and irregular uterine bleeding, immediately improved after tumor resection.
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Affiliation(s)
- Hiroshi Ishikawa
- Department of Reproductive Medicine, Graduate School of Medicine, Chiba University, Japan.
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Tam CC, Harrington AC. What is your diagnosis? Syringocystadenoma papilliferum. Cutis 2011; 88:120-134. [PMID: 22017063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Christine C Tam
- Department of Dermatology, Johns Hopkins University, Baltimore, Maryland, USA
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Hennessey DB, Traynor O. Extrahepatic biliary cystadenoma with mesenchymal stroma: a true biliary cystadenoma? A case report. J Gastrointestin Liver Dis 2011; 20:209-211. [PMID: 21725521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
UNLABELLED Biliary cystadenomas are benign but potentially malignant cystic neoplasms, which classically contain mesenchymal stroma similar to ovarian tissue. We report a case of an extra-hepatic biliary cystadenoma with mesenchymal stroma along with a discussion of current pathological opinion. CASE PRESENTATION A 54-year-old female presented with abdominal pain, abnormal liver function tests and a mass on ultrasound. Computerized Tomography identified a complex multi-locular cyst in the common hepatic duct. Radical excision of the lesion and a Roux-en-Y loop bilio-enteric anastomosis was performed. Histology confirmed the presence of a benign biliary cystadenoma with ovarian type stroma. CONCLUSION Biliary cystadenomas classically contain mesenchymal stroma similar to ovarian tissue. It now appears that cystadenomas without mesenchymal stroma appear to be more akin to similar cystic lesions of the pancreas, and may represent a dissimilar neoplasm. Therefore, malignant transformation can occur, so complete excision is recommended.
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Affiliation(s)
- Derek B Hennessey
- Department of Hepatobiliary and Liver Transplant Surgery, St. Vincent's University Hospital, Elm Park, Dublin, Ireland.
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Doepker M, Chang CK, Engel A. Biliary cystadenoma: case series and review of the literature. Am Surg 2011; 77:505-506. [PMID: 21679569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Matthew Doepker
- Department of Surgery, Good Samaritan Hospital, Cincinnati, Ohio 45220, USA
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Erdemoğlu M, Kuyumcuoglu U, Guzel AI. Clinical experience of adnexal torsion: evaluation of 143 cases. J Exp Ther Oncol 2011; 9:171-174. [PMID: 22070047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
We conducted this retrospective study to evaluate the outcomes, indications and post-operative findings of adnexal torsion cases and compared the features of benign cystic teratoma with the other cases. We analyzed a series of 143 cases of adnexal torsion from 2000 to 2009 at current clinic, retrospectively. The data were collected from the patient's specific files and hospital records descriptively. The demographic characteristics, sonographic findings and post-operative invention were evaluated. Statistical analyses were carried out by using the statistical packages for SPSS 15.0 for Windows (SPSS Inc., Chicago, IL, USA). A total of 143 cases were operated for adnexal torsion during the study period at our clinic. The clinical and demographic characteristics of the cases are shown in table 1. Of all patients, forty of them were diagnosed as benign cystic teratoma and this group of the adnexal torsion cases had statistically different gravidy, mass size and torsion number from the non-benign cystic teratoma group. Age was not a statistically different between two groups. According to this study, benign cystic teratoma increases risk of adnexal torsion. When detecting benign cystic teratoma the patients should be informed about the risk of torsion and explained the signs of this situation. The early diagnosis and appropriate surgical management of adnexal torsion is the only way to prevent complications and to preserve future fertility. Being aware of the different sonographic findings of torsionated adnexa may assist in the correct diagnosis of these patients.
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Bürgueser MV, Diller A, Bustos ME, Debernardi DM, Bernabeu F. [Spontaneous mediastinal hematoma as initial presentation of cystic adenoma of ectopic parathyroid]. Rev Fac Cien Med Univ Nac Cordoba 2011; 68:164-168. [PMID: 22668569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
Spontaneous mediastinal hematoma as initial presentation of cystic adenoma of ectopic parathyroid Atraumatic spontaneous mediastinal hematomas are uncommon. They are secondary to trauma, rupture of great vessels or heart and associated to iatrogenic events. We report a case of a 61 year-old woman who consults for mediastinal hematoma without previous trauma. Imaging studies ruled out cardiac or vascular lesions. At exploratory thoracotomy, a large mediastinal hematoma was evidenced without obvious mass or bleeding vessel. The material sent to the Pathology service was diagnosed as cystic adenoma of ectopic parathyroid gland. Mediastinal hematomas are related to traumatic causes, cardiac or great vessels rupture or iatrogenic proceedings. Once these causes are ruled out, an injury of ectopic parathyroid tissue must be considered in the differential diagnosis because mediastinum is the most frequent ectopic location. Histopathological and immunohistochemical studies are useful in determining the cause-related hematoma, as in this case determined the parathyroid origin of the lesion, and to rule out involvement by other tumors.
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Saravanan MN, Singh B, Ravindranath K, Raghavendra RRV. Episodic jaundice due to an intrahepatic biliary cystadenoma with biliary stricture masquerading as hydatid cyst. Trop Gastroenterol 2010; 31:332-335. [PMID: 21568156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- M N Saravanan
- Department of Surgical Gastroenterology, HPB Surgery & Liver Transplant Unit, Global Hospital, Hyderabad, India
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Li Petri S, Pagano D, Echeverri GJ, Cintorino D, Gruttadauria S, Traina M, Caruso S, Spangler E, Gridelli B, Spada M. Different surgical approach to treat hepatobiliary cystadenomas presenting as an acute abdomen. Am Surg 2010; 76:E170-E172. [PMID: 21396276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
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Hernández-Ramírez DA, Portela-Rubio G, Suárez-Moreno RM, Salazar-Lozano CR, Madrazo-Navarro M. [Mucocele of the appendix: an unusual finding in a patient with ulcerative colitis]. CIR CIR 2010; 78:357-360. [PMID: 21167104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Patients with ulcerative colitis (UC) or Crohn's disease (CD) have an increased risk for the development of colorectal dysplasia and carcinoma. Although appendiceal inflammation occurs histologically in 40-86% of colectomy specimens from patients with inflammatory bowel disease (IBD), appendiceal neoplasms have been reported only infrequently, and the notion of a direct association between IBD and appendiceal neoplasia is speculative. CLINICAL CASE A 54-year-old male patient developed abdominal pain and bloody diarrhea 3 years prior. Colonoscopy and biopsy established the diagnosis of UC (proctosigmoiditis). Disease activity was moderate at the beginning and the patient initially received medical treatment with mesalazine and prednisone. He was admitted to our clinic for right lower abdominal pain. Physical examination revealed tenderness on palpation at this site. Laboratory tests were normal (including serum carcinoembryonic antigen and CA 19-9). Colonoscopy showed intrinsic compression of the cecum. The patient underwent partial cecum resection and extirpation of the mucocele. He presented postsurgical ileus resolved with medical treatment. Final histological report revealed cystadenoma of the appendix. At the 20-month follow-up, the patient was in satisfactory condition. CONCLUSIONS We present the eighth patient, to our knowledge, with a primary cystadenoma of the appendix and UC. Special attention should be paid to patients with extraordinary symptoms during follow-up, even in UC patients.
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Watanabe D, Miura K, Goto T, Nanjo H, Yamamoto Y, Ohnishi H. Solid pseudopapillary tumor of the pancreas with concomitant pancreas divisum. A case report. JOP 2010; 11:45-48. [PMID: 20065552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
CONTEXT Solid pseudopapillary tumor of the pancreas is a rare neoplasm which affects young women. On the other hand, pancreas divisum is an anomaly which develops at 7 weeks of gestation. Here, we report a case of a solid pseudopapillary tumor of the pancreas with concomitant pancreas divisum. CASE REPORT A 26-year-old woman was diagnosed as having a pancreatic tumor with solid and cystic components in the pancreatic head. Pancreatograms obtained by ERCP and MRCP showed no communication between the ventral and dorsal pancreatic ducts, indicating that pancreas divisum was present. Microscopically, the resected tumor had solid and cystic components. Immunohistochemical study demonstrated that the tumor cells were positive for alpha-1-antitrypsine, vimentin and progesterone receptors but negative for estrogen receptors, NSE, insulin or glucagon. The tumor was diagnosed as a solid pseudopapillary tumor of the pancreas. Although more than 700 cases of solid pseudopapillary tumors of the pancreas have been reported in the English literature, a search of PubMed turned up no reports of concomitant solid pseudopapillary tumor and pancreas divisum. CONCLUSION Solid pseudopapillary tumors of the pancreas with concomitant pancreas divisum are extremely rare.
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Affiliation(s)
- Daisuke Watanabe
- Department of Gastroenterology, Noshiroyamamoto Medical Association Hospital, Noshiro, Japan
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Arias-Santiago S, Aceituno-Madera P, Aneiros-Fernández J, Gutiérrez-Salmerón MT, Naranjo-Sintes R. Syringocystoadenoma papilliferum associated with apocrine hidrocystoma and verruca. Dermatol Online J 2009; 15:9. [PMID: 19951645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
Syringocystoadenoma papilliferum is a benign adnexal tumor usually located in head and neck that occurs during childhood or adolescence. A case of a syringocystoadema papilliferum associated with apocrine hydrocystoma and verruca is presented. It is unusual to see the occurrence of three histopathologic types of tumors coexisting in one cutaneous lesion.
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Ray S, Khamrui S, Mridha AR, Mukherjee B. Extrahepatic biliary cystadenoma: an unusual cause of recurrent cholangitis. Am J Surg 2009; 199:e3-4. [PMID: 19837391 DOI: 10.1016/j.amjsurg.2009.03.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2009] [Revised: 03/06/2009] [Accepted: 03/06/2009] [Indexed: 11/18/2022]
Abstract
Extrahepatic biliary cystadenoma is a rare benign lesion with malignant potential. Fewer than 100 cases have been reported in the literature. The most common clinical presentation is obstructive jaundice. Frank cholangitis is extremely rare. The authors report a case of extrahepatic biliary cystadenoma in a 55-year-old woman who presented with recurrent episodes of cholangitis.
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Affiliation(s)
- Sukanta Ray
- Division of Surgical Gastroenterology, School of Digestive and Liver Diseases, Institute of Postgraduate Medical Education and Research, Kolkata, India.
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Vázquez Camacho EE, Alfán Guzmán F, Carbajal Ocampo D. [Ovarian cystadenoma and ectopic pregnancy. A case report]. Ginecol Obstet Mex 2009; 77:387-392. [PMID: 19902630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A 40-year-old woman without symptoms, with a three-week amenorrhea, and with no previous pregnancy history. Three months before she followed treatment with clomifeno and no other risk factors. A measure of beta fraction is performed, finding a probable pregnancy of 3-4 weeks. A new measure of beta fraction is made three weeks later with an ultrasound, finding an important increment in measure, but without evidence of intrauterine pregnancy in the ultrasound. A new ultrasound is made seven weeks after her last period, finding a mass in the left ovary, but without increment in beta fraction. At week ten, she presents an uterine bleeding during a trip, which is diagnosed as a probable mole without any further medical treatment and from the 12th week, there is a considerable decrement in the beta fraction measure, without any other symptom, but the persistent adnexal mass at the left ovary, with irregular septum images at ultrasound. A laparotomy is performed finding an ectopic pregnancy surrounded by a serum cystadenoma.
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Votanopoulos KI, Goss JA, Swann RP, O'Mahony CA, Jaffe BM, Bellows CF. Massive abdominal distension resulting from a giant hepatobiliary cystadenoma. Am Surg 2009; 75:438-439. [PMID: 19445302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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25
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Thomsen P, Vasehus Madsen P, Moesgaard F, Lykkegaard Nielsen MC. Biliary cystadenoma of the common bile duct with secondary biliary cirrhosis. Report of a case. Acta Med Scand 2009; 216:327-30. [PMID: 6496190 DOI: 10.1111/j.0954-6820.1984.tb03812.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
A case of cystadenoma of the common bile duct is described. An erroneous diagnosis made in a young woman caused secondary biliary cirrhosis with fatal outcome. The diagnosis of cirrhosis should never be established without thorough visualization of the entire biliary tract in patients with biochemical or clinical jaundice of unknown origin.
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26
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Gentile M, Guarino V, Mosella F, Carbone G, Beneduce L, Mosella G. [Giant mucocele of the appendix. Case report and review of the literature]. Ann Ital Chir 2008; 79:293-297. [PMID: 19093633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Mucocele is a rare pathology of the appendix characterized by expansion of the lumen for a slow storage of mucous. Represents the 0.2-0.3% of all the appendectomies. Clinical signs and the symptoms are similar to those of the acute appendicitis, while the disease is occasionally recorded and the diagnosis is essentially histological. AIM OF STUDY To recall the clinical and anatomopathological features of mucocele evaluating the possible evolutions of this rare appendicular pathology according to the updating reports of the literature. MATERIALS AND METHODS Study of a clinical case. DISCUSSION In this study diagnostic chriteria and prognostic factors are revised. Authors evaluate anatomopathological classification, possibility of evolution in a preneoplastic and neoplastic lesion and association with other colon cancers. The surgical treatment is evaluated too. CONCLUSIONS A correct preoperative mucocele diagnosis is emphasized as indispensable in the choice of the proper surgical treatment since a good prognosis is consequent to a radical treatment.
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Affiliation(s)
- Maurizio Gentile
- Dipartimento Universitario di Chirurgia Generale, Geriatria, Oncologica e Tecnologie Avanzate, Università degli Studi di Napoli Federico II.
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27
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Diekman MJM, Weis-Potters A, van Rijssel RH. [Virilisation due to an ovarian mucinous cystadenoma]. Ned Tijdschr Geneeskd 2008; 152:1349. [PMID: 18663806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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28
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Scheper H, van Dillen J, Blok P, Berning B. [Virilisation due to an ovarian mucinous cystadenoma]. Ned Tijdschr Geneeskd 2007; 151:2792-2796. [PMID: 18232200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
An 82-year-old postmenopausal woman presented with severe clinical hyperandrogenism related to testosterone overproduction, possibly as a result of a mucinous cystadenoma. The cystadenoma was successfully removed in toto. The patient was discharged in good health. Plasma testosterone levels normalised 6 weeks after surgery. Ovarian mucinous cystadenomas are a rare cause ofhyperandrogenism.
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Affiliation(s)
- H Scheper
- Afd. Obstetrie en Gynaecologie, HagaZiekenhuis, Den Haag
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Chatti S, Ben Brahim E, Sidhom O, Ben Othman M, Zidi Y, Salah MB, Sassi S, Regaya SM, Touinsi H. [Comparative study of appendical mucocela and pseudomyxoma peritonei. About 25 cases]. Tunis Med 2007; 85:1044-1049. [PMID: 19170385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
AIM to study the clinicopathological features of the different types of appendical mucocele and to compare them with those of pseudomyxoma peritonei. METHODS 25 cases of appendical mucocele were operated in the Cap-Bon region in Tunisia during a period of 13 years from 1994 to 2006. RESULTS 9 retentionnal cysts, 13 mucinous cystadenomas, one serrated adenoma, one hyperplasia of the mucosa and one cystadenocarcinoma were diagnosed. Five cystadenomas as well as the only case of cystadenocarcinoma were associated with pseudomyxoma peritonei. Pseudomyxoma peritonei occurred 20 years later than in simple appendiceal mucocèle and complicated 5 cases of cystadenoma with low grade dysplasia and 1 case of cystadenocarcinoma. CONCLUSION Preoperative diagnosis of appendical mucocele and pseudomyxoma peritonei should be made on scannographic features in order to assess the adequate surgical management.
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Affiliation(s)
- Samia Chatti
- Service d'Anatomie et de Cytologie Pathologiques, Service de Chirurgie, Hôpital MT Maâmouri, Route de Mrezka, 8000, Nabeul, Tunisie
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30
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Thongtang N, Plengvidhaya N, Lertwattnarak R, Peepatdit T. Primary hyperparathyroidism due to cystic parathyroid adenoma: a case report. J Med Assoc Thai 2007; 90 Suppl 2:79-84. [PMID: 19230428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Raw Cystic parathyroid adenoma is a rare cause of primary hyperparathyroidism. The authors report one case of cystic parathyroid adenoma, who presented with progressive right hip pain for one year. The patient had severe hypercalcemia at the first presentation and was misdiagnosed as having metastatic cancer at first. An iliac bone biopsy was performed and showed a giant cell tumor. Parathyroid hormone level was evaluated later and was found to be high, 1,555 pg/ml (15-65 pg/ml). An MRI study of the neck was done and revealed a cystic mass 38 x 36 x 40 mm in diameter just below the left lower pole of the thyroid gland. Tc-99m MIBI scan demonstrated increase and retention of radioactivity uptake at the same area. Hyperfunctioning parathyroid gland was considered. Parathyroidectomy was done and histopathology revealed cystic parathyroid adenoma. Serum calcium was normal and hip pain was markedly improved after the surgery.
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Affiliation(s)
- Nuntakorn Thongtang
- Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
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31
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Abstract
Giant multilocular prostatic cystadenoma (GMPC) is a rare benign tumor involving the prostate gland. Microscopically, it masquerades phyllodes tumor or transitional zone hyperplasia. We report one case of GMPC arising from the prostate central zone (CZ), presenting with long-standing aspermia associated with seminal vesicle fibrous obliteration.
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Affiliation(s)
- Jong-Pil Park
- Department of Pathology, Yonsei University College of Medicine, Brain Korea 21 Project for Medical Science, Seoul, Korea
| | - Nam Hoon Cho
- Department of Pathology, Yonsei University College of Medicine, Brain Korea 21 Project for Medical Science, Seoul, Korea
| | - Young Tack Oh
- Department of Radiology, Yonsei University College of Medicine, Brain Korea 21 Project for Medical Science, Seoul, Korea
| | - Young Deuk Choi
- Department of Urology, Yonsei University College of Medicine, Brain Korea 21 Project for Medical Science, Seoul, Korea
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32
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Johnson JR, Lee C, Carnett S, Vadakekut E. Laparoscopic management of enlarged serous cystadenoma in advanced pregnancy. J Minim Invasive Gynecol 2007; 14:247-9. [PMID: 17368265 DOI: 10.1016/j.jmig.2006.09.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2006] [Revised: 09/13/2006] [Accepted: 09/15/2006] [Indexed: 11/27/2022]
Abstract
Operative laparoscopy is changing the methods of treatment of the acute abdomen in advanced pregnancy. Diagnostic capabilities in identification of benign disease are becoming more sensitive with the use of advanced imaging ultrasound scanning and magnetic resonance imaging. This has changed the deciding factors in the handling of advanced-size adnexal masses with minimally invasive techniques for the conservative management and treatment in advancing pregnancies. This case shows the successful removal of a 6198-g ovarian serous cystadenoma by use of minimally invasive techniques.
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Affiliation(s)
- Joseph R Johnson
- Department of Obstetrics and Gynecology, Oklahoma State University, Tulsa Regional Medical Center, Tulsa, Oklahoma 74127-9005, USA.
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Baudin G, Novellas S, Buratti MS, Saint-Paul MC, Chevallier P, Gugenheim J, Bruneton JN. Atypical MRI features of a biliary cystadenoma revealed by jaundice. Clin Imaging 2006; 30:413-5. [PMID: 17101411 DOI: 10.1016/j.clinimag.2006.04.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2006] [Accepted: 04/13/2006] [Indexed: 01/15/2023]
Abstract
We report on the case of a patient admitted for epigastric pain. An abdominal ultrasound revealed a voluminous cystic lesion of the left hepatic lobe. In magnetic resonance imaging, the mass had a liquid-liquid level that was spontaneously hyperintense on T(1)-weighted images and hypointense on T(2)-weighted images. Magnetic resonance cholangiography identified bilateral intrahepatic bile duct dilatation. A left hepatectomy finally revealed a mucinous cystadenoma with pseudo-ovarian stroma that had a pedunculated intraductal extension to the biliary convergence.
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Affiliation(s)
- Guillaume Baudin
- Service d'Imagerie Médicale, Centre Hospitalier Régional et Universitaire de Nice, Hôpital Archet 2, F-06202 Nice Cedex 3, France.
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Lee YT, Wu HS, Hung MC, Lin ST, Hwang YS, Huang MH. Ruptured appendiceal cystadenoma presenting as right inguinal hernia in a patient with left colon cancer: a case report and review of literature. BMC Gastroenterol 2006; 6:32. [PMID: 17074081 PMCID: PMC1634861 DOI: 10.1186/1471-230x-6-32] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2006] [Accepted: 10/30/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mucoceles resulting from cystadenomas of the appendix are uncommon. Although rare, rupture of the mucoceles can occur with or without causing any abdominal complaint. There are several reports associating colonic malignancy with cystadenomas of the appendix. Herein, we report an unusual and interesting case of right inguinal hernia associated with left colon cancer. CASE PRESENTATION A case of ruptured mucocele resulting from cystadenoma of the appendix was presented as right inguinal hernia in a 70-year-old male. The patient underwent colonoscopy, x-ray, ultrasound and computed tomography. Localized pseudomyxoma peritonei associated with adenocarcinoma of the descending colon was diagnosed. The patient underwent segmental resection of the colon, appendectomy, debridement of pseudomyxoma and closure of the internal ring of right inguinal canal. He is free of symptoms in one year follow-up. CONCLUSION Synchronous colon cancer may occur in patients with appendiceal mucoceles. In such patients, the colon should be investigated and colonoscopy can be performed meticulously in cases of ruptured mucoceles and localized pseudomyxoma peritonei. Surgical intervention is the current choice of management.
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Affiliation(s)
- Yueh-Tsung Lee
- Department of Surgery, Division of general surgery, Chang-Bing Show Chwan Memorial Hospital, Lu-Gang, Taiwan
| | - Hurng-Sheng Wu
- Department of Surgery, Division of general surgery, Chang-Hua Show Chwan Memorial Hospital, Chang-Hua, Taiwan
| | - Min-Chang Hung
- Department of Surgery, Division of general surgery, Chang-Hua Show Chwan Memorial Hospital, Chang-Hua, Taiwan
| | - Shang-Tao Lin
- Department of Pathology, Chang-Hua Show Chwan Memorial Hospital, Chang-Hua, Taiwan
| | - Yome-Shine Hwang
- Department of Surgery, Division of general surgery, Chang-Hua Show Chwan Memorial Hospital, Chang-Hua, Taiwan
| | - Min-Ho Huang
- Department of Surgery, Division of general surgery, Chang-Hua Show Chwan Memorial Hospital, Chang-Hua, Taiwan
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Naganuma H, Funaoka M, Fujimori S, Niwa M, Ishida H, Komatsuda T, Yamada M, Furukawa K. Contrast-enhanced sonographic findings in a case of hepatobiliary cystadenoma with intracystic bleeding. J Clin Ultrasound 2006; 34:412-5. [PMID: 16944488 DOI: 10.1002/jcu.20262] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Intracystic slow bleeding is very difficult to diagnose using conventional sonography; consequently, a new sonographic technique has been sought. We present a histologically proven hepatobiliary cystadenoma with intracystic bleeding in which contrast-enhanced sonography (CEUS) showed microbubbles oozing from the cyst wall into the cystic cavity 10 minutes after intravenous injection of contrast medium. CEUS is an important diagnostic tool for diagnosing liver tumors, but the CEUS finding of slow intracystic bleeding has not been reported. Our observation suggests that this technique may be a new diagnostic tool for this purpose.
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Affiliation(s)
- Hiroko Naganuma
- Department of Internal Medicine, Yokote Municipal Hospital, 5-31 Negishi-cho, Yokote, Akita, Japan
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Gläsker S, Tran MGB, Shively SB, Ikejiri B, Lonser RR, Maxwell PH, Zhuang Z, Oldfield EH, Vortmeyer AO. Epididymal cystadenomas and epithelial tumourlets: effects of VHL deficiency on the human epididymis. J Pathol 2006; 210:32-41. [PMID: 16841375 DOI: 10.1002/path.2029] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Although epididymal cystadenomas (ECAs) are among the most frequent VHL disease-associated tumours, fundamental questions about their pathogenesis have remained unanswered. Classification of ECAs is controversial, and the cell of origin is unknown. It is also unknown whether ECAs-like other VHL disease-associated tumours-arise as a result of VHL gene inactivation, and whether ECAs exhibit subsequent activation of hypoxia-inducible factor HIF. Moreover, the morphological spectrum of earliest ECA formation is unknown. In a detailed molecular pathological analysis of a series of epididymides collected from VHL patients at autopsy, we found that ECAs are true neoplasms that arise secondary to inactivation of the wild-type copy of the VHL gene, followed by early and simultaneous activation of HIF1 and HIF2 associated with up-regulation of downstream targets, including CAIX and GLUT-1. The observations also indicate that ECA formation evolves from a variety of microscopic epithelial tumourlets, and that these tumourlets are confined to the efferent ductular system. Although genetic and immunohistochemical analysis of precursor structures consistently revealed VHL gene inactivation and activation of HIF in the precursor lesions, only a small subset appears to progress into frank cystadenoma. Thus, ECA tumorigenesis in VHL disease shares fundamental principles with tumorigenesis in other affected organ systems.
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Affiliation(s)
- S Gläsker
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, 10 Center Drive, Bethesda, MD 20892, USA
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Abstract
Hepatobiliary cystadenomas (HBC) and cystadenocarcinomas are rare cystic lesions. Most patients with these lesions are asymptomatic, but presentation with obstructive jaundice may occur. The first patient presented with intermittent colicky pain and recurrent obstructive jaundice. Imaging studies revealed a polypoid lesion in the left hepatic duct. The second patient had recurrent jaundice and cholangitis. Endoscopic retrograde cholangiopancreatography (ERCP) showed a cystic lesion at the confluence of the hepatic duct. In the third patient with intermittent jaundice and cholangitis, cholangioscopy revealed a papillomatous structure protruding into the left bile duct system. In the fourth patient with obstructive jaundice, CT-scan showed slight dilatation of the intrahepatic bile ducts and dilatation of the common bile duct of 3 cm. ERCP showed filling of a cystic lesion. All patients underwent partial liver resection, revealing HBC in the specimen. In the fifth patient presenting with obstructive jaundice, ultrasound examination showed a hyperechogenic cystic lesion centrally in the liver. The resection specimen revealed a hepatobiliary cystadenocarcinoma. HBC and cystadenocarcinoma may give rise to obstructive jaundice. Evaluation with cross-sectional imaging techniques is useful. ERCP is a useful tool to differentiate extraductal from intraductal obstruction.
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Affiliation(s)
- Deha Erdogan
- Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
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38
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Øgard CG, Nielsen SL, Jakobsen H, Leth-Espensen P, Vestergaard H. [Mediastinal parathyroid cystadenoma--a rare cause of primary hyperparathyroidism]. Ugeskr Laeger 2006; 168:2921-2. [PMID: 16982024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Parathyroid cysts located in the mediastinum are rare. They may be non-functioning or associated with primary hyperparathyroidism (PHPT). We present a patient with persistent PHPT despite previous parathyroid surgery. Parathyroid scintigraphy with 99mTc sestamibi showed no focus with radioactivity retention, but MRI revealed a large parathyroid cystadenoma in the mediastinum, which was successfully removed. In general, MRI is not the first choice for parathyroid imaging, but when the adenoma is localized at ectopic sites, MRI is a good imaging modality.
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Marana R, Muzii L, Ferrari S, Catalano GF, Zannoni G, Marana E. Management of adnexal cystic masses with unexpected intracystic vegetations detected during laparoscopy. J Minim Invasive Gynecol 2006; 12:502-7. [PMID: 16337577 DOI: 10.1016/j.jmig.2005.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2005] [Accepted: 07/14/2005] [Indexed: 11/16/2022]
Abstract
STUDY OBJECTIVE To evaluate a prospective series of consecutive patients with unexpected intracystic vegetations detected during operative laparoscopy for adnexal masses. DESIGN Prospective series of consecutive patients (Canadian Task Force classification: II-2). SETTING Tertiary care university hospitals. PATIENTS Consecutive patients found during surgery to have unexpected intracystic vegetations and treated by operative laparoscopy, out of a total series of 667 patients under 40 years of age with ultrasonographic evidence of an adnexal cystic mass without thick septa, internal wall papillarities, or solid components. INTERVENTIONS Operative laparoscopy and follow-up. MEASUREMENTS AND MAIN RESULTS Thirty-five (5.2%) of 667 patients were found at surgery to have unexpected intracystic vegetations. A frozen section was sent for pathologic analysis in all 35 patients. Frozen section diagnosis was benign in 32 patients and borderline in 3 patients. Final pathology diagnosis was borderline ovarian tumor in five of the 35 patients (14.3%), and benign in 30 patients (85.7%). No case of invasive carcinoma was diagnosed either at frozen section or at final pathology examination. The patients with borderline tumors are alive with no evidence of disease after a mean follow-up of 60 months. CONCLUSIONS In the present series, with accurate preoperative selection, the rate of adnexal cysts with unexpected intracystic vegetations was 5%, of which 14% were borderline tumors. The laparoscopic management of these adnexal masses did not adversely affect the prognosis.
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Affiliation(s)
- Riccardo Marana
- Department of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Italy.
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Klimek M, Skotniczny K, Banas T, Wicherek L. A case of left interstitial pregnancy after left adnexectomy--why surgical management? Neuro Endocrinol Lett 2006; 27:288-9. [PMID: 17159812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/23/2005] [Accepted: 01/15/2006] [Indexed: 05/12/2023]
Abstract
Interstitial pregnancy is a rare condition of tubal pregnancy with a mortality rate of 2-2.5% [4] that can easily be misdiagnosed. The prevalence of interstitial pregnancy is 0.8% in normal population and it increased during the past few decades due to reproduction techniques development even up to 11% in groups of women after in vitro fertilization. A comprehensive MEDLINE and OLDMEDLINE search covering years 1950-2005 using query terms "interstitial", "pregnancy" and "adnexectomy" identified only 10 cases reported in worldwide literature. The first treatment of interstitial pregnancy used to be a resection of the uterus body via laparotomy. Along with the evolution of sensitive biochemical assays, imaging technologies and the development of operative techniques, the management of interstitial pregnancy became less invasive. We report a case of spontaneous left interstitial pregnancy after left adnexectomy due to left ovarian tumor of borderline malignancy.
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Affiliation(s)
- Marek Klimek
- Department of Gyneacology and Infertility, Jagiellonian University, 23 Kopernika Street, 31-501 Krakow, Poland.
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41
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Affiliation(s)
- Douglas Potoka
- Division of Pediatric Surgery, Department of Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA
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Veroux M, Fiamingo P, Cillo U, Tedeschi U, Brolese A, Veroux P, Basso S, Buffone A, D'Amico DF. Cystadenoma and laparoscopic surgery for hepatic cystic disease: a need for laparotomy? Surg Endosc 2005; 19:1077-81. [PMID: 16021374 DOI: 10.1007/s00464-004-2229-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2004] [Accepted: 02/11/2005] [Indexed: 12/24/2022]
Abstract
BACKGROUND This study aimed to evaluate the incidence of cystadenoma diagnosis in a series of laparoscopic treatments for nonparasitic liver cysts, as well as its management. METHODS From 1996 to 2004, 26 patients with a nonparasitic cyst of the liver were selected for laparoscopic liver surgery. Solitary nonparasitic liver cysts were, whenever feasible, completely enucleated. RESULTS In four patients, the histopathologic examination showed a cystadenoma. Three patients with 13, 9, and 12-cm cysts, respectively, had undergone complete enucleation of the lesion, with no evidence of recurrence in the follow-up visit. One patient with multicystic liver experienced a recurrence and required an open hepatic resection. CONCLUSIONS When a complete laparoscopic enucleation of the cyst can be ensured, a strict follow-up assessment should be considered as the definitive treatment, with surgical intervention demanded only in the case of recurrence or high suspicion for malignancy.
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Affiliation(s)
- M Veroux
- Department of Surgery, Transplantation, and Advanced Technologies, University Hospital of Catania, Via S.Sofia, Catania, 78 95123, Italy.
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Lakatos PL, Gyori G, Halasz J, Fuszek P, Papp J, Jaray B, Lukovich P, Lakatos L. Mucocele of the appendix: An unusual cause of lower abdominal pain in a patient with ulcerative colitis-. A case report and review of literature. World J Gastroenterol 2005; 11:457-9. [PMID: 15637769 PMCID: PMC4205363 DOI: 10.3748/wjg.v11.i3.457] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The authors report the case of a 60-year-old male patient. In November 2001 he developed intestinal symptoms of bloody diarrhea and abdominal pain. Colonoscopy and biopsy established the diagnosis of ulcerative colitis (proctosigmoiditis). The disease activity was moderate at the beginning. No significant laboratory alterations were found (including CEA, CA19-9), and mesalazine was started orally. He was in remission until November 2003, when he was admitted to our Outpatient Clinic for upper and right lower abdominal pain and bloody diarrhea. Colonoscopy found proctosigmoiditis with a moderate activity, gastroscopy revealed chronic gastritis, laboratory data was normal. Treatment was amended with mesalazine clysma and methylprednisolone (16 mg) orally. Symptoms ameliorated; however, right lower abdominal pain persisted. US and CT examination demonstrated a pericecal cystic mass (11 cm×3.5 cm). At first pericecal abscess was suspected, as the previous US examination (6 mo earlier) had revealed normal findings. Fine needle aspiration was performed. Cytology confirmed the diagnosis of mucocele. The patient underwent partial cecum resection and extirpation of the mucocele. He recovered well and the final histology revealed a cystadenoma of the appendix. Follow up was started. The patient is now free of symptoms. Although primary adenocarcinoma of the appendix is uncommon, the authors emphasize that preoperative diagnosis of an underlying malignancy in a mucocele is important for patient management; however, it is difficult on imaging studies.
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44
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Abdelbaqi M, Wellman G, Veillon DM, Heldmann M, Hood D, Zibari GB, Albores-Saavedra J. Young woman with jaundice and itching. Bilary cystadenoma. J La State Med Soc 2005; 157:15-7. [PMID: 15887662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
- Maisoun Abdelbaqi
- Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, USA
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45
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Shima Y, Horimi T, Shibuya Y, Sakurama K, Nishie M, Morita S. Resected cystadenoma of the common bile duct. ACTA ACUST UNITED AC 2004; 11:438-40. [PMID: 15619023 DOI: 10.1007/s00534-004-0923-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2004] [Accepted: 06/09/2004] [Indexed: 10/26/2022]
Abstract
Biliary cystadenoma in the extrahepatic bile ducts is a very rare tumor. A 62-year-old woman with jaundice was admitted to our hospital. Imaging studies revealed a 4-cm cystic lesion around the hepatic hilum, compressing the common bile duct (CBD). When laparotomy was performed, a cystic tumor was detected in the hepatic hilum, filling the lumen of the CBD. Bile duct resection that included the tumor was performed, followed by biliary reconstruction. Microscopically, the cyst wall was lined by a single layer of cuboidal epithelial cells, covering an ovarian-like stroma. The degree of atypia was low and warranted the diagnosis of cystadenoma.
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Affiliation(s)
- Yasuo Shima
- Department of Surgery, Kochi Municipal Central Hospital, 2-7-33 Sakurai, Kochi 780-0821, Japan
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Hokama A, Makishi T, Tomiyama R, Kinjo F, Saito A, Yamashiro S, Kinjo I, Miyagi K, Kuniyoshi Y, Koja K. A calcified caecal mass. Gut 2004; 53:1063, 1081. [PMID: 15247166 PMCID: PMC1774155 DOI: 10.1136/gut.2003.034009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Affiliation(s)
- A Hokama
- First Department of Internal Medicine, University of the Ryukyus, 207 Uehara, Nishihara, Okinawa 903-0215, Japan.
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Abstract
Biliary cystadenoma (BCA) is a rare neoplasm of the bile duct with malignant potential. We report a case of intrahepatic BCA with an unusual presentation of obstructive jaundice. Computed tomography scan of the abdomen revealed a dilated common bile duct and intrahepatic ducts with internal septa. Endoscopic retrograde cholangiography showed an oval filling defect in the bile duct causing the obstruction. At laparotomy, this proved to be a multiloculated mucinous polyp in the common bile duct, with its origin in the left intrahepatic duct, detected using intraoperative choledochoscopy. A left hemihepatectomy was performed, and histology confirmed intrahepatic mucinous BCA with mesenchymal stroma. The imaging process and surgical options for BCA are discussed.
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Storms TN, Beazley SL, Schumacher J, Ramsay EC. Thyroid cystadenoma, colloid goiter, and hypothyroidism in an American black bear (Ursus americanus). J Zoo Wildl Med 2004; 35:82-7. [PMID: 15193079 DOI: 10.1638/03-033] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A 178-kg, 14-yr-old captive female American black bear (Ursus americanus) was examined because of lethargy, inappetance, obesity, and alopecia. Serum chemistry and complete blood count values were within normal limits. Based on serum levels for total thyroxine (T4), free T4 by equilibrium dialysis (fT4ED), and canine thyroid-stimulating hormone concentrations, using assays validated for domestic dogs, hypothyroidism was diagnosed presumptively, and therapy with levothyroxine sodium (0.022 mg/kg p.o. b.i.d.) was initiated. Haircoat, body weight, appetite, and activity level improved within 30 days. The levothyroxine dose was decreased twice (to 0.018 mg/kg p.o. b.i.d. and then to 0.011 mg/kg p.o. b.i.d.) during the course of treatment based on monitoring of serum T4 and fT4ED concentrations. After euthanasia for severe refractory lameness, postmortem examination revealed bilateral thyroid lobe enlargement and a fluid-filled cyst within the right lobe. Histologically, colloid goiter was present in both lobes, and a follicular cystadenoma had replaced one third of the cranial pole of the right lobe. The goiter and cystadenoma likely contributed to the hypothyroid condition in this bear and fT4ED was a more sensitive indicator of hypothyroidism than was T4. The recommended canine dosage of levothyroxine may be too high for the treatment of hypothyroidism in American black bears; 0.011 mg/kg p.o. b.i.d. may be a more appropriate dosage.
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Affiliation(s)
- Timothy N Storms
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee 37996-4544, USA
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Stiefelhagen P. [Acute abdominal pain in a Turkish patient after abdominal surgery. What has the surgeon overlooked?]. MMW Fortschr Med 2004; 146:10. [PMID: 15346928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
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Varras M, Tsikini A, Polyzos D, Samara C, Hadjopoulos G, Akrivis C. Uterine adnexal torsion: pathologic and gray-scale ultrasonographic findings. CLIN EXP OBSTET GYN 2004; 31:34-8. [PMID: 14998184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
INTRODUCTION Uterine adnexal torsion is a rare and potentially lethal condition that may arise most unexpectedly in women of any age. It may be partial or complete, the later often resulting in necrosis, gangrene and peritonitis if untreated. The purpose of the study was to determine the spectrum of the histologic and gray-scale sonographic pictures in a series of surgically proven cases of uterine adnexal torsion. METHODS The study population for the pathologic analysis of twisted uterine adnexa included 92 patients with surgical confirmation of torsion of the uterine adnexa; all the patients were treated radically. All the pathology records were reviewed retrospectively over a 10-year period (from 1992 to 2002) by the coding of ovarian, fallopian tube or adnexal torsion. The gray-scale sonographic findings were analysed in 20 patients who underwent sonographic examination before surgery and adnexal torsion was confirmed at surgery. RESULTS Neoplasms constituted 46% (42/92) and cysts formed 48% (44/92) of all the twisted uterine adnexa. Normal-sized twisted adnexa were found in five patients (5%) while in one patient simultaneous torsion of both normal fallopian tubes was found (1%). The prevalence of the twisted neoplasms was 16 mature teratomas, nine serous cystadenomas, five mucinous cystadenomas, three serous borderline carcinomas, two fibroma/thecomas, two mucinous borderline carcinomas, two malignant granulosal-stromal cell tumours, one malignant dysgerminoma, one immature teratoma and one clear cell adenocarcinoma. The twisted cysts were 18 serous cysts, 11 paraovarian cysts, nine corpus luteum cysts, three hydrosalpinges, one mucinous cyst and one endometrioma. In one case the torsion of the right ovary was due to hyperstimulation of the ovaries with gonadotropin therapy for IVF treatment. Gray-scale sonographic examination demonstrated cystic lesions in 80% (16/20), solid masses in 5% (1/20) and normal adnexa in 15%; cul-de-sac fluid was present in 55% (11/20). Laparotomy revealed reactive cul-de-sac fluid in ten of these cases (50%) and haemoperitoneum in one (5%). CONCLUSION Adnexal torsion is most commonly associated with benign processes (89%) and usually occurs in patients under 50 years old (80%). The spectrum of sonographic findings varies due to the adnexal pathology, the degree and the duration of adnexal torsion.
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Affiliation(s)
- M Varras
- Department of Gynaecology, George Gennimatas General State Hospital, Athens, Greece
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