Ovarian tuberculosis mimicking ovarian malignancy in an unvaccinated patient: A case report.

INTRODUCTION: Ovarian tuberculosis is a rare form of extra-pulmonary tuberculosis that usually present with atypical symptoms mimicking ovarian carcinoma. CASE REPORT: We report a case of non-vaccinated 20-years-old women who present with non-specific symptoms and for whom imaging techniques weren't conclusive for ovarian tuberculosis. The ultrasound shows hydronephrosis secondary to the compressive pelvic mass. Regarding the compressive character of the mass and it's consequence on the urinary system as well as the suspicion of malignant origin, laparotomy was performed. Based on histopathological analysis of surgical biopsies a diagnosis of ovarian tuberculosis was made and the patient was put under anti-TB drugs. During the follow up there was a good response to treatment with improvement of health state, regression of the abdominopelvic mass as well as the hydronephrosis. DISCUSSION: Ovarian tuberculosis can occur even in the absence of previous pulmonary TB. The major risk with female genital tuberculosis is infertility. CONCLUSION: Ovarian tuberculosis is a rare form of extra pulmonary TB that should be always considered in differential diagnosis of ovarian TB.

Huge Abdominopelvic Mass Arising from Cervical Fibroid around an Infected Cervical Diverticulum: A Very Rare Case and a Review of Literature.

Primary uterine diverticula are a very rare congenital anomaly of the uterus with only 21 reported cases. Even rarer is the occurrence of primary cervical diverticula with only six cases reported so far. This is a unique case of a huge abdominopelvic mass arising from cervical fibroid around an infected cervical diverticulum. A 44 year-old, P4L4 came to the OPD with a eighteen weeks size abdomino-pelvic mass. She had a failed surgery 6 months back, attempted to remove the mass. Magnetic resonance imaging revealed a cervical diverticulum which possibly had a pus collection. Relaparotomy was done. It revealed a huge cervical fibroid with dense adhesions all around the mass. A pan hysterectomy was done. In the postoperative period, she developed high-grade fever owing to the development of a pelvic collection, which had to be drained by dilating the vault sutures. Histopathology report confirmed a cervical fibroid with an infected diverticulum within. Primary uterine or cervical diverticula are a very rare anamoly which possibly arise because of a weakness in the area where the two mullerian ducts fuse. Women with this rare condition may suffer from infertility, fever and pain abdomen, acute abdomen owing to torsion or hemoperitoneum, pregnancy complications, and menorrhagia. Diverticulectomy and cervical/uterine reconstruction can be done on nulliparous women while hysterectomy can be offered to perimenopausal women. To conclude, unless known by the gynecologists, radiologists, and the pathologists, this diagnosis can be easily missed out, leading to multiple preventable complications.

Diagnostic Accuracy of Ultrasonography-Guided Fine Needle Aspiration Cytology in Abdominopelvic Masses: A Prospective Study.

Introduction Accurate diagnosis of deep-seated abdominopelvic masses is crucial to distinguish malignant from non-malignant lesions for proper treatment and prognosis. Ultrasonography-guided fine needle aspiration cytology (USG-FNAC) is a cost-effective and straightforward procedure that offers rapid diagnosis, facilitating early initiation of treatment. This study aimed to determine the diagnostic accuracy of USG-FNAC in comparison to the biopsy diagnosis of various abdominopelvic masses in a resource-limited setting. Materials and methods This prospective study enrolled 208 patients with clinically and ultrasonographically confirmed abdominopelvic masses over two years. Of these, 64 cases were excluded from the study because of the non-availability of biopsy specimens. The remaining 144 cases comprised 88 males and 56 females, with a male-to-female ratio of 1.57:1. Patients' ages ranged from 1.5 to 65 years, with most male patients aged 51 to 60 years and female patients aged 41 to 50 years. USG-FNAC was performed on these patients using a 22G spinal needle and a 10cc disposable syringe, and no complications were reported during the procedure. The cytological findings were compared to histopathological results when available. Dry smears were stained with May-Grunwald-Giemsa stain, while fixed smears were stained with Papanicolaou stain for cytological investigation. Results A total of 144 cases had both cytological and histological specimens available for comparison. The overall diagnostic accuracy of USG-FNAC was 90.97%, with 91.8% sensitivity for malignant lesions, 83.33% for benign lesions, and 85.7% for inflammatory lesions. Conclusions USG-FNAC provides high diagnostic accuracy for abdominopelvic masses, making it a valuable diagnostic tool in resource-limited settings. The technique allows for rapid diagnosis, triaging specimens for ancillary immunohistochemical and molecular studies, and in many cases, obviates the need for more expensive and time-consuming procedures like laparotomy and open biopsy.

Giant Fibroid Mimicking a Gastrointestinal Stromal Tumor: A Diagnostic Dilemma.

Uterine fibroids are the most common benign pelvic tumors in females of the reproductive age group. Usually, fibroids are confined to the uterus. Here, we report an interesting and rare case of a large 17 cm abdominopelvic mass lesion that led to a diagnostic dilemma between a mesenteric gastrointestinal stromal tumor (GIST) and a uterine fibroid. We had a 26-year-old female who underwent an ultrasound examination of the abdomen as the initial imaging modality and was found to have an abnormally large solid abdominopelvic mass lesion. For further evaluation, a contrast-enhanced CT examination of the abdomen-pelvis was done. Initially, on first look, the mass was thought to be of mesenteric origin, but on further review of images, it was found to be of gynecological origin. Intraoperatively, the solid mass was seen attached to the uterine fundus and underwent excision. Histopathological examination confirmed the mass to be a uterine fibroid. This case study describes the uncommon appearance of this tumor in a young woman, including the clinical presentation, imaging, and surgical findings.

Hydrometrocolpos With Polydactyly in Consanguineous Parents: A Case Report and Review of Literature.

Neonatal hydrometrocolpos (HMC) is a cystic dilatation of a neonate's vagina and uterus occurring secondary to congenital vaginal obstruction, with or without maternal estrogenic stimulation of uterine and cervical glands causing increased secretions during the prenatal and postnatal period. Diagnosis is made using ultrasonography and further confirmed by MRI. HMC in a neonate can rarely present with congenital anomalies such as polydactyly, which may indicate a variety of underlying genetic syndromes. There is a deficit in the literature as to whether the development of HMC in a neonate of consanguineous parents is an isolated finding or solely related to an underlying syndrome. We hope to help bridge this gap by reporting a case of a 12-day-old neonate presenting with hydrometrocolpos and polydactyly, born to consanguineous parents.

Linfangioma mesentérico quístico de intestino delgado simulando tumoración ovárica / Mesenteric cystic lymphangioma of small bowel mimicking ovarian tumor

Resumen El linfangioma quístico, caracterizado por proliferación de los espacios linfáticos, es una lesión infrecuente en pacientes adultos. Menos del 1% de todos los linfangiomas corresponden a linfangiomas del intestino delgado. La presentación clínica es diversa, variando desde un quiste abdominal asintomático, diagnosticado de forma incidental, a un cuadro de abdomen agudo. Se presenta un caso de linfangioma mesentérico quístico del intestino delgado en una mujer de 30 años y quien consultó por dolor abdominal y vómitos. La ecografía y la tomografía computada abdominal mostraron un quiste con múltiples septos en el cuadrante inferior derecho simulando un tumor de ovario. En la laparotomía se encontró un tumor quístico, lobulado y marrón, procedente del mesenterio del intestino delgado. A la paciente se le realizó resección de la tumoración y del intestino delgado adyacente con reconstrucción del tránsito intestinal. La evaluación histológica confirmó el diagnóstico de linfangioma mesentérico quístico.

Abstract Cystic lymphangioma, characterized by proliferation of lymphatic spaces, is an infrequent lesion in adult patients. Less than 1% of all lymphangiomas correspond to small-bowel lymphangiomas. Clinical presentation can be diverse ranging from incidental abdominal cysts to an acute abdomen. We report a case of small bowel mesenteric cystic lymphangioma in a 30 years-old woman who presented with abdominal pain and vomiting. The abdominal ultrasound and computed tomography scan showed a cystic multiseptated mass at the right lower quadrant mimicking an ovarian tumor. Laparotomy found a lobulated, brown, cystic tumor from the small bowel mesentery. The patient underwent resection of the tumor and the adjacent small intestine with reconstruction of the intestinal transit. The histological study confirmed diagnosis of mesenteric cystic lymphangioma.

Giant cystic lymphangioma of the small bowel mesentery: case report.

Cystic lymphangioma is an uncommon mesenteric tumor which is usually reported in children. We describe a case of a 12-years old girl who was admitted in our hospital with abdominal distension and pain. Physical examination showed an abdomino-pelvic mass. Preoperative studies including abdominal ultrasonography and computed tomography failed to determine the cause of the pain. Laparotomy found a giant cystic tumor of the small bowel mesentery. Histological studies confirm the diagnosis of cystic lymphangioma. Based on this case, a review of the literature is suggested.

Pelvic lymphoma: An unusual presentation.

Pelvic lymphoma is not a common condition and aggressive recurrence of chronic lymphocytic leukemia (CLL) as a cause is rarely reported. We report a case of lymphoma of left adnexa in a postmenopausal woman, with a three week history of abdominal and left flank pain. Past medical history was consistent with diagnosis of CLL. She had received chemotherapy. Due to abdominal and flank pain and abdominopelvic mass, exploratory laparotomy was done with the impression of ovarian malignancy. A large uterus with adnexal mass and a large tumoral bladder was seen. Biopsy was done from adnexal mass which was compatible with lymphoma. The abdomen was closed and the patient was referred for chemotherapy. Lymphoma usually does not involve the pelvic organs. After laparotomy, her condition deteriorated and she expired.