RESUMEN
Histopathologic diagnosis of tubal intraepithelial carcinoma (TIC) has emerged as a significant challenge in the last few years. The avoidance of pitfalls in the diagnosis of TIC is crucial if a better understanding of its natural history and outcome is to be achieved. Herein, we present a case of a 52-year-old woman who underwent a risk-reducing salpingo-oophorectomy procedure. Histologic examination of a fallopian tube demonstrated a focus of atypical epithelial proliferation, which was initially considered to be a TIC. Complete study of the case indicated that the focus was, in fact, papillary syncytial metaplasia of tubal mucosal endometriosis. Papillary syncytial metaplasia may resemble TIC and should be considered in cases of proliferative lesions of the tubal epithelium.
Asunto(s)
Carcinoma in Situ/diagnóstico , Endometriosis/patología , Enfermedades de las Trompas Uterinas/patología , Neoplasias de las Trompas Uterinas/diagnóstico , Diagnóstico Diferencial , Endometriosis/diagnóstico , Enfermedades de las Trompas Uterinas/diagnóstico , Femenino , Humanos , Metaplasia , Persona de Mediana EdadRESUMEN
BACKGROUND: Postpartum hemorrhage is an obstetric emergency and is a major preventable cause of maternal morbidity and mortality. An arteriovenous fistula is a rare cause of concealed postpartum hemorrhage. CASE: A 20-year-old woman spontaneously delivered at 40 0/7 weeks of gestation. Twelve hours after delivery, she became hemodynamically unstable, developing a large left vaginal hematoma. An angiogram revealed extravasation originating from the right pudendal artery with early filling of a draining vein, consistent with a traumatic arteriovenous fistula. Complete occlusion of the fistula was achieved by embolizing a branch of the right pudendal artery. The postprocedure course was uneventful. CONCLUSION: A vaginal arteriovenous fistula should be considered in cases of concealed postpartum hemorrhage; transcatheter arterial embolization is an effective treatment for these cases.
