RESUMEN
We present a clinical case of a patient with left renal agenesis and ipsilateral blind hemivagina who also had one or more atretic ectopic ureters opening into supposed mesonephric duct, which in turn opened into, or joined onto, the ipsilateral hemicervix, continuing with the blind hemivagina. The diagram of this complex genitourinary malformation would strongly support our hypothesis of the embryology of the human vagina as deriving from the Wolffian ducts and the Mullerian tubercle.
Asunto(s)
Anomalías Múltiples/diagnóstico por imagen , Genitales Femeninos/anomalías , Sistema Urinario/anomalías , Anomalías Urogenitales/diagnóstico por imagen , Anomalías Múltiples/patología , Anomalías Múltiples/cirugía , Adulto , Femenino , Genitales Femeninos/diagnóstico por imagen , Genitales Femeninos/cirugía , Humanos , Imagen por Resonancia Magnética , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Sistema Urinario/patología , Sistema Urinario/cirugía , Anomalías Urogenitales/patología , Anomalías Urogenitales/cirugía , Procedimientos Quirúrgicos Urogenitales/métodos , UrografíaRESUMEN
INTRODUCTION: We report that the coincidence of ovarian tumor and pregnancy poses significant challenges that are more pronounced if the pregnancy is ectopic. CASE PRESENTATION: Here, we report a rare and interesting case of a 24-year-old nulliparous Spanish woman who experienced the coincidental occurrence of left tubal pregnancy and dysgerminoma in the right ovary. The corpus luteum settled in the right ovary. A right adnexectomy and left linear salpingostomy were performed. Remarkably, our patient became pregnant spontaneously after surgery. The pregnancy occurred prior to starting chemotherapy, and the intra-uterine pregnancy was carried to term; later, she also had another normal pregnancy. Our patient has done well without chemotherapy. CONCLUSIONS: Our report on the challenges of diagnosis and treatment faced in this case can help clinicians better understand and manage these pathologies. We have not found any similar cases in the literature.
RESUMEN
The female gubernaculum is an embryonic structure that gives rise to the uterine round ligament and seems to be important in Müllerian development. In the absence of androgens and anti-Müllerian hormone, the paramesonephric or Müllerian ducts complete their invagination and development, interfering with the connection of the tissue column that begins at the inguinal cone (the gubernaculum) and targets the mesonephric duct and caudal ligament of the gonad. The gubernaculum then grows over the Müllerian ducts, incorporating its muscular fibres. Outside and above this point, the Müllerian ducts give rise to the Fallopian tubes, whereas medially to the point of insertion of the gubernaculum, the Müllerian ducts develop into the normal uterus, the adequate formation of which is also induced by the mesonephric ducts. Diverse human anatomical and physiological characteristics such as the simplex uterus, as well as pathological conditions and certain female genital malformations, could be related to gubernaculum dysfunction. The main conclusions in this article are: (1) The female gubernaculum is the origin of the uterine round ligament but probably not of the uteroovarian ligament. Gubernacula are composed of muscular fibres that probably derive from the abdominal wall and that, when fixed and fused with the Müllerian ducts, allow or induce, together with the mesonephric ducts, the adequate development and formation of the uterus. (2) The female gubernaculum seems to be responsible for many of the specific human characteristics of Müllerian development, including the uterus simplex, the anteflexion and low intra-abdominal position of the uterus, and the disposition of uterine muscular fibres. (3) The female gubernaculum seems to be related to pathologies arising from the round ligaments and inguinal hernia. Likewise, certain uterine malformations (e.g., didelphys uterus, Rokitansky syndrome) and accessory and cavitated uterine masses might be related to gubernaculum dysfunction.
Asunto(s)
Desarrollo Embrionario , Genitales Femeninos/anomalías , Genitales Femeninos/embriología , Conducto Inguinal/embriología , Animales , Femenino , Humanos , Conductos Paramesonéfricos/anomalías , Conductos Paramesonéfricos/embriología , Ligamento Redondo del Útero/anomalías , Ligamento Redondo del Útero/embriología , Útero/anomalías , Útero/embriologíaRESUMEN
OBJECTIVE: To analyze the clinical, therapeutic, and pathologic features of published cases presenting primary squamous cell carcinoma (SCC) of the ovary associated with endometriosis. METHODS: A case report, 15 cases of infiltrating SCC of the ovary associated with or arising from endometriosis, and 1 case of synchronous carcinoma in situ in the cervix and ovary from a review of the literature were studied. RESULTS: Young age, advanced stage of the disease, and hypogastric pain were frequent at the time of diagnosis. There was no ascites, but infiltration of neighboring organs was common. The tumor was associated with 80% patient mortality in the first few months. Adjuvant chemotherapy with paclitaxel and carboplatin or cisplatin appeared to improve the results. CONCLUSION: Primary SCC of the ovary associated with endometriosis is extremely rare and has a poor prognosis. The best therapeutic results are obtained with paclitaxel and carboplatin or cisplatin after radical surgery.
Asunto(s)
Carcinoma de Células Escamosas/patología , Endometriosis/complicaciones , Neoplasias Ováricas/patología , Dolor Abdominal/etiología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carboplatino/administración & dosificación , Carcinoma de Células Escamosas/etiología , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/terapia , Quimioterapia Adyuvante/métodos , Cisplatino/administración & dosificación , Endometriosis/patología , Femenino , Humanos , Persona de Mediana Edad , Estadificación de Neoplasias , Neoplasias Primarias Múltiples , Neoplasias Ováricas/etiología , Neoplasias Ováricas/mortalidad , Neoplasias Ováricas/terapia , Paclitaxel/administración & dosificación , Pronóstico , Neoplasias del Cuello Uterino/patologíaRESUMEN
We report a 52 years old male admitted for fever lasting one month, dry cough, headache and malaise. Initial laboratory work up showed an AST of 172 U/l, and ALT of 252 U/l, a GGT of 353 U/l and alkaline phosphatases of 952 U/l. An abdominal CAT scan disclosed a mild hepatosplenomegaly. A liver biopsy showed a granulomatous hepatitis. During the evolution, the patient had a left testicle swelling with darkening of the surrounding skin. A testicular ultrasound showed a bilateral orchiepidydimitis. The patient was treated with non steroidal anti-inflammatory drugs and fever subsided. Three months later, these drugs were discontinued and the patient remained asymptomatic and with normal laboratory values until 36 months of follow up.
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Dermatitis/etiología , Epididimitis/etiología , Granuloma/complicaciones , Hepatitis/complicaciones , Orquitis/etiología , Dermatitis/tratamiento farmacológico , Epididimitis/tratamiento farmacológico , Fiebre de Origen Desconocido/etiología , Granuloma/diagnóstico , Granuloma/tratamiento farmacológico , Hepatitis/diagnóstico , Hepatitis/tratamiento farmacológico , Humanos , Masculino , Persona de Mediana Edad , Orquitis/tratamiento farmacológicoRESUMEN
We report a 52 years old male admitted for fever lasting one month, dry cough, headache and malaise. Initial laboratory work up showed an AST of 172 U/l, and ALT of 252 U/l, a GGT of 353 U/l and alkaline phosphatases of 952 U/l. An abdominal CAT scan disclosed a mild hepatosplenomegaly. A liver biopsy showed a granulomatous hepatitis. During the evolution, the patient had a left testicle swelling with darkening of the surrounding skin. A testicular ultrasound showed a bilateral orchiepidydimitis. The patient was treated with non steroidal anti-inflammatory drugs and fever subsided. Three months later, these drugs were discontinued and the patient remained asymptomatic and with normal laboratory values until 36 months of follow up
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Orquitis , Epididimitis , Exantema , Fiebre de Origen Desconocido , Hepatitis , Antiinflamatorios no EsteroideosRESUMEN
No disponible
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Anciano , Masculino , Humanos , Huésped Inmunocomprometido , Infecciones por VIH , Vacunas contra Hepatitis B , Defectos del Tubo Neural , Hiperamilasemia , Leucovorina , Adenocarcinoma , Enfermedades Fetales , Diálisis Renal , Neoplasias Pulmonares , Ácido FólicoRESUMEN
No disponible
Asunto(s)
Persona de Mediana Edad , Anciano , Masculino , Femenino , Humanos , Linfoma de Células T , Cetoacidosis Diabética , Feocromocitoma , Diagnóstico Diferencial , Diabetes Mellitus , Neoplasias Gástricas , Neoplasias de las Glándulas SuprarrenalesRESUMEN
Introducción: El objetivo de la cirugía de los tumores óseos viene siendo, desde hace varias décadas, el control local de la enfermedad conservando la mayor funcionalidad posible del miembro. Los injertos óseos procedentes de banco de hueso son una de las herramientas de las que se dispone para reparar los defectos causados al extirpar los tumores. Objetivos: Aproximar al radiólogo, desde una perspectiva multidisciplinaria, al seguimiento de los tumores óseos tratados con injertos estructurales. Describir las complicaciones más frecuentes en el seguimiento de éstos y sus hallazgos en imagen comparados con su evolución radiológica normal. Material y métodos: Se han revisado los historiales clínicos y los estudios de imagen previos a la cirugía y los realizados en el seguimiento de ésta, de 12 pacientes sometidos a cirugía de tumores óseos con injertos estructurales, que presentaron complicaciones de éstos en su evolución. Conclusiones: La monitorización mediante imagen de los injertos y de sus sistemas de fijación resulta imprescindible y permite detectar las complicaciones asociadas al procedimiento. El radiólogo debe conocer las complicaciones más frecuentes de fracaso del injerto que incluyen: la no unión, su fractura, la infección y la recurrencia tumoral, así como sus manifestaciones en imagen, y permitir la detección de éstas en tiempos precoces. Debe también integrarse en grupos multidisciplinarios, participando en el seguimiento integral de los injertos (AU)