RESUMO
Malignant transformation in a mature cystic teratoma of the ovary is rare. The most common malignancy is squamous cell carcinoma, which consists of about 75% of malignant transformations. In the present report, we describe a case of advanced-stage squamous cell carcinoma arising in a mature cystic teratoma. A postmenopausal 63-year-old woman with squamous cell carcinoma arising in a mature cystic teratoma is presented. The initial investigation by ultrasound showed a left adnexal mass with mixed echo pattern, which arose the suspension of malignancy. She underwent a laparotomy and left oophorectomy. Histopatholog was compatible with squamous cell carcinoma arising in a mature cystic teratoma. After a few episodes of intestinal obstruction and colostomy, she underwent partial resection of the ileum and sigmoid colon four months after the initial oophorectomy. Histopathologic study showed metastatic poorly-differentiated squamous cell carcinoma. Subsequently, she underwent two courses of combination chemotherapy with cisplatin, leucovorin, and 5-fluorouracil with no response. She died from progression of the disease nine months after the initial operation.
Assuntos
Carcinoma de Células Escamosas/diagnóstico por imagem , Neoplasias Primárias Múltiplas/diagnóstico por imagem , Neoplasias Ovarianas/diagnóstico por imagem , Teratoma/diagnóstico por imagem , Antineoplásicos/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/terapia , Quimioterapia Adjuvante , Cisplatino/uso terapêutico , Colostomia , Evolução Fatal , Feminino , Fluoruracila/uso terapêutico , Humanos , Neoplasias do Íleo/complicações , Neoplasias do Íleo/secundário , Neoplasias do Íleo/terapia , Obstrução Intestinal/etiologia , Obstrução Intestinal/cirurgia , Leucovorina/uso terapêutico , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/terapia , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/terapia , Ovariectomia , Neoplasias do Colo Sigmoide/complicações , Neoplasias do Colo Sigmoide/secundário , Neoplasias do Colo Sigmoide/terapia , Teratoma/terapia , Ultrassonografia , Complexo Vitamínico B/uso terapêuticoRESUMO
We describe a patient with a pseudoaneurysm of the right common iliac artery that on a double-contrast barium enema mimicked the appearance of metastatic tumor involving the sigmoid colon, including a mass effect and spiculated, tethered mucosal folds. In the appropriate clinical setting, computed tomography, magnetic resonance imaging, and aortography help to distinguish a pseudoaneurysm from metastatic tumor involving the bowel.
Assuntos
Aneurisma/diagnóstico por imagem , Sulfato de Bário , Enema , Artéria Ilíaca/diagnóstico por imagem , Neoplasias do Colo Sigmoide/diagnóstico por imagem , Aorta Abdominal/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Artéria Ilíaca/patologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neoplasias do Colo Sigmoide/secundário , Tomografia Computadorizada por Raios XRESUMO
Based on selected case studies the pathways of spread of malignancies arising from the pelvis are discussed. Secondary involvement of the transverse colon with characteristic lesions at the inferior border may be seen in these cases, caused by metastatic spread via the greater omentum. Ultrasonography and computed tomography may prove this diagnosis by showing peritoneal metastatic spread and tumorous infiltration of the greater omentum.