Anaplastic carcinoma in ovarian seromucinous cystic tumor of borderline malignancy.

BACKGROUND: The mortality rate of ovarian cancer is the highest among all gynecological malignancies in Japan. Ovarian tumors are classified as benign, borderline malignant, or malignant. Anticipating the histological subtype with imaging only is often difficult because of several histological subtypes of epithelial ovarian tumors (such as serous, mucinous, endometrioid, clear cell, and Brenner tumors). In addition, the majority of mucinous tumors in the ovary are metastatic. Furthermore, mucinous tumors belong to one of the two different subclasses (i.e., intestinal and seromucinous types). Ovarian seromucinous cystic tumors of borderline malignancy are infrequent and only rarely coexist with other malignant tumors. CASE PRESENTATION: We have reported a 53-year-old Japanese woman with anaplastic carcinoma in an ovarian seromucinous cystic tumor of borderline malignancy. Her MRI and CT analysis revealed an ovarian tumor with a mural nodule, ascites, and peritoneal dissemination. Enhanced MRI revealed that the mural nodule was enhanced. Enhanced CT analysis revealed that the lymph nodes were not swollen. Intriguingly, the mural nodule crossed the cyst wall into the cavity and onto the surface. Her laboratory data revealed high serum CA 125 level. Cumulatively, these results suggested ovarian malignancy. The patient underwent hysterectomy with bilateral salpingo-oophorectomy, omentectomy, and resection of the disseminated lesions. Lymph node biopsy was omitted because of the suggestion of enhanced CT image findings and palpation during surgery. Her postoperative specimen examination determined FIGO at least stage IIIB, and accordingly, adjuvant chemotherapy was prescribed. After 3 years of the operation, the patient is presently alive without clinical tumor recurrences. CONCLUSION: Imaging studies with pathognomonic findings contributed to ovarian cancer diagnosis in this case. To the best of our knowledge, this is the first study in English literature to report detailed classification of mucinous borderline malignancy, seromucinous cystic, and anaplastic carcinoma in an ovarian seromucinous cystic tumor of borderline malignancy.

Successful endovascular treatment of iatrogenic thyrocervical trunk pseudoaneurysm with concomitant arteriovenous fistula using 0.010-inch detachable microcoils.

Pseudoaneurysms (PsA) and arteriovenous fistulae (AVF) of the thyrocervical trunk and its branches are rare complications of traumatic or iatrogenic arterial injuries. Most such injuries are iatrogenic and are associated with central venous catheterization. Historically, thyrocervical trunk PsA and AVF have been managed with open surgical repair; however, multiple treatment modalities are now available, including ultrasound-guided compression repair, ultrasound-guided thrombin injection, and endovascular repair with covered stent placement. We report a case of a 65-year-old woman with an iatrogenic thyrocervical trunk PsA with concomitant AVF that developed after attempted internal jugular vein cannulation for hemodialysis access. The PsA was successfully treated by transcatheter coil embolization using 0.010-inch detachable microcoils. Our case is the first published instance of a thyrocervical trunk PsA with concomitant AVF that was successfully treated by endovascular procedure.

Primary idiopathic chylopericardium: report of two cases.

Primary chylopericardium is an extremely rare disease. This report presents two cases of this disease, in a 47-year-old man and 21 -year-old woman. Both cases were given diagnosis of primary chylopericardium by chylous pericardial fluid examination and lymphangio-scintigraphy which demonstrated abnormal communication between the left thoracic duct and the pericardial cavity.

[Phase III additional clinical study of 111In-pentetreotide (MP-1727): diagnosis of gastrointestinal hormone producing tumors based on the presence of somatostatin receptors].

Additional phase III multicenter clinical study was performed to investigate the efficacy, safety, and usefulness of somatostatin receptor scintigraphy using 111In-pentetreotide (MP-1727), which binds to somatostatin receptors. Forty patients were included in the study; Group A: 18 patients, gastrointestinal hormone producing tumors had been detected with conventional imaging modalities, Group B: 22 patients, no tumors had been detected with conventional imaging modalities in spite of high serum hormone levels. By comparing the results of the octreotide suppression test, 12/16 cases (75.0%) of Group A and 11/19 cases (57.9%) of Group B were assessed as "effective." By comparing the results of immunohistological examination, 5/9 cases (55.6%) of Group A and 2/4 cases (50.0%) of Group B were assessed as "effective." Severe adverse events were not observed in any of the evaluable 35 cases. MP-1727 was judged as clinically useful in 11/16 cases (68.8%) of Group A and 5/19 cases (26.3%) of group B. These results suggest that MP-1727 scintigraphy is very useful for the diagnosis and decision of the therapeutic strategy of gastrointestinal hormone producing tumors.

Fitz-Hugh-Curtis syndrome: linear contrast enhancement of the surface of the liver on CT.

We present a case of Fitz-Hugh-Curtis syndrome (Chlamydia trachomatis perihepatitis). Contrast-enhanced CT demonstrated enhancement along the surface of the liver, but it was remarkable on the anterior surface. No other abnormalities suspicious for peritonitis were found. Contrast enhancement of the anterior surface of the liver on CT may support the diagnosis of Fitz-Hugh-Curtis syndrome.