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Resumen ANTECEDENTES: Entre las neoplasias epiteliales ováricas, los cistoadenomas son los más comunes y casi todos son de buen pronóstico. Pueden aparecer a cualquier edad, aunque gran parte surgen entre los 40 y 60 años. CASO CLÍNICO: Paciente de 63 años, con necrosis seca distal en el antepié derecho, con un cistoadenofibroma seroso en el ovario izquierdo que ocluía una arteria iliaca común y causó una trombosis distal que requirió intervención quirúrgica y amputación transmetatarsiana derecha. CONCLUSIÓN: El diagnóstico y tratamiento quirúrgico oportuno son decisivos para evitar la extensión de la necrosis y lograr la conservación de la mayor parte de la extremidad afectada.
Abstract BACKGROUND: Among ovarian epithelial neoplasms, cystadenomas are the most common and almost all of them have a good prognosis. They can appear at any age, although most arise between 40 and 60 years of age. CLINICAL CASE: A 63-year-old patient with distal dry necrosis in the right forefoot, with a serous cystadenofibroma in the left ovary that occluded a common iliac artery and caused a distal thrombosis that required surgical intervention and right transmetatarsal amputation. CONCLUSION: Timely diagnosis and surgical treatment are decisive to avoid the extension of necrosis and to achieve the preservation of most of the affected limb.
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Primary retroperitoneal mucinous cystadenomas (PRMCs) are observed more frequently in women with no specific symptoms. A 35 Years old female patient presented with Intermittent abdominal pain in her left flank associated with fullness in abdomen. CECT confirmed a well-defined smoothly marginated homogenous non-enhancing unilocular cystic lesion in retroperitoneum in left lumbar region, separated from the pancreas, left kidney and ovary. On Laprotomy, the retroperitoneal tumor was completely removed, without spillage of its contents.
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Objective To investigate the value of contrast-enhanced ultrasound (CEUS) in differential diagnosis of pancreatic pseudocysts,cystadenomas and cystadenocarcinomas,so as to improve diagnostic accuracy of the condition.Methods The results of CEUS and conventional ultrasound for 71 patients with pancreatic cystic lesions were analyzed retrospectively,and compared with the finally obtained surgical-pathological examination to assess the ability of qualitative diagnosis between two methods.Results In 71 pancreatic cystic lesions,there were 32 pancreatic pseudocysts,24 cystadenomas and 15 cystadenocarcinomas.The sensitivity and accuracy of CEUS for pancreatic pseudocysts and cystadenocarcinomas were 84.4％,93.0％ and 86.7％,88.7％,which were higher than those of conventional ultrasound 56.3 ％,80.3 ％ and 53.3 ％,74.6％ (x2 =6.06,4.92,3.97,4.71,all P ＜ 0.05).Conclusion There are some similarities in terms of imaging manifestations among pancreatic pseudocysts,cystadenomas and cystadenocarcinomas.Combining conventional ultrasound with CEUS can help the differential diagnosis of pancreatic cystic lesions.
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Objective To investigate the clinicopathological features of patients with serous cystadenomas of the pancreas (SCAP).Methods The clinical and pathological features of 21 cases of SCAP were retrospectively analyzed.Results The mean age of the 21 cases was 61 years old,male:female ratio was 1∶ 1.33,18 (85.7％) patients presented with abdominal pain,bloating,abdominal mass,weight loss,and 3 (14.3％) patients were found during check-up.The tumors were located in pancreatic head in 9 patients,in pancreatic body and tail in 12 patients.The clinical manifestations were pancreatic cystic lesions.All patients underwent surgery.Histologically,the cyst wall was complete and lined with flat or cuboidal epithelium,cytoplasm was translucent,nucleus were round or oval with similar size,no significant nuclear atypia and mitotic activity was found.The pathologic diagnosis was micro-cyst type in 15 cases,single-cyst type in 6 cases.Immunohistochemistry method showed EMA,CK7,CK19 positive and PAS staining positive.The positive expression rate of Ki 67 was between 1％ and 3％.After follow-up of 19 cases ranging from 3 months to 7 years,no recurrence and metastasis was detected.Conclusions SCAP is seen predominantly in elderly female patients with significant symptoms.A majority of tumors are located in the pancreatic body and tail.SCAP presents with characteristics of pancreatic ductal epithelial,and the prognosis is excellent.
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Objective To investigate the CT radiological features of pancreatic cystadenomas and cystadenocarcinomas. Methods The CT scans from 39 patients with pathologically proven cystic pancreatic tumors (21 cases of serous cystadenomas, 12 cases of mucinous cystadenomas, and 6 cases of mucinous cystadenocarcinomas) were retrospectively analyzed. Tumor location, the number of cyst (polycystic or not) , diameter of the largest cyst, features of the cyst wall, partition within cyst, border of tumor, and the relationship between tumors and pancreatic duct were recorded. Results In 21 patients with serous cystadenomas, tumors were located at the pancreatic head and neck areas in 17 cases, at the pancreatic body and tail areas in 5 cases, and 1 case was multiple. All 21 cases were polycystic; the median diameter of the largest cyst was 1.77 cm; calcification was seen in cyst wall or partition in 4 cases and soft tissue was seen in 7 cases; mild pancreatic duct dilatation was found in 10 cases. In 12 patients with mucinous cystadenomas, tumors were located at the pancreatic head and neck areas in 6 cases, at the pancreatic body and tail areas in6 cases; 4 cases were polycystic; the median diameter of the largest cyst was 4.88cm; calcification was seen in 1 case and soft tissue was seen in 6 cases; pancreatic duct dilatation was found in 2 cases and mild duct dilatation was found in 3 cases. In 6 patients with mucinous cystadenocarcinomas, tumors were located at the pancreatic body and tail areas in 5 cases, tumor was located at the pancreatic head and neck areas in 1 case; 4 cases were polycystic; the median diameter of the largest cyst was 5.09 cm; calcification was seen in 1 case and soft tissue was seen in 5 cases; duct dilatation was found in 1 case. In all cases, there was no pancreatic duct communication. After enhancement, the soft tissue and partition of lesion was enhanced to gome extent. Conclusions There are CT radiological features of pancreatic cystadenomas and cystadenocarcinomas. However, there are still some atypical CT appearances that may challenge the diagnosis.