RESUMO
A 71-year-old man was referred to our hospital for treatment of a 2 cm-sized right renal mass incidentally found by computed tomography (CT) and was diagnosed with right renal cell carcinoma cT1aN0M0. Contrast-enhanced CT revealed that the aorta was completely occluded below the inferior mesenteric artery origin, and Leriche syndrome was diagnosed. CT angiography showed several collateral arteries along the abdominal wall. A robot-assisted laparoscopic partial nephrectomy was performed to treat renal cell carcinoma. Preoperatively, we marked the collateral arteries using ultrasonography to avoid injury during trocar insertion. We did not observe any decrease in blood flow in the right leg during the operation. The pathological diagnosis was clear cell renal cell carcinoma. Leriche syndrome is a chronic occlusive disease involving the infrarenal aorta and the iliac arteries. Since lower limb blood flow is dependent on collateral circulation, it is important to avoid injuring the collateral arteries during surgery.
Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Laparoscopia , Síndrome de Leriche , Robótica , Idoso , Carcinoma de Células Renais/complicações , Carcinoma de Células Renais/diagnóstico por imagem , Carcinoma de Células Renais/cirurgia , Humanos , Neoplasias Renais/complicações , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/cirurgia , Síndrome de Leriche/complicações , Síndrome de Leriche/diagnóstico por imagem , Síndrome de Leriche/cirurgia , Masculino , NefrectomiaRESUMO
A 79-year-old woman who presented with right hydronephrosis was referred to our hospital. Abdominal computed tomography (CT) showed a right ureteral tumor (cT3N0M0). Right nephroureterectomy and partial cystectomy were performed. Pathological examination revealed small cell carcinoma (mixed type ; INFb, pT3, ly1, v1, u-rt0, ur0, RM0). Cystoscopy showed intravesical recurrence of the tumor 3 months after the surgery. Transurethral resection was performed, and histopathological examination revealed small cell carcinoma (pT2). We recommended postoperative chemotherapy ; however, the patient and her family refused consent for chemotherapy. Liver and lymph node metastases developed, and the patient died 2 months after the transurethral resection.
Assuntos
Carcinoma de Células Pequenas , Hidronefrose , Neoplasias Ureterais , Idoso , Cistectomia , Feminino , Humanos , Recidiva Local de NeoplasiaRESUMO
A 72-year-old female with left renal cell carcinoma and lymphadenopathy had undergone hand-assisted laparoscopic left nephrectomy and dissection of the lymph node (papillary renal cell carcinoma, type 2, pT3a pN2 M1). She had been treated with adjuvant chemotherapy with sunitinib, temsirolimus and pazopanib. However, the patient was started on nivolumab due to disease progression. After receiving 5 cycles of nivolumab, she was admitted to our emergency room for chest discomfort and appetite loss. Since computed tomographic (CT) scan showed pericardial effusion, we performed pericardiocentesis. Cytological examination of the pericardial effusion demonstrated leukocytes and no malignant cells. CT scan two weeks after cardiocentesis showed no recurrent pericardial effusion. She became stable with nivolumab, but the administration of nivolumab was discontinued and she started receiving axitinib.
Assuntos
Antineoplásicos , Carcinoma de Células Renais , Neoplasias Renais , Derrame Pericárdico , Idoso , Antineoplásicos/efeitos adversos , Carcinoma de Células Renais/tratamento farmacológico , Feminino , Humanos , Neoplasias Renais/tratamento farmacológico , Nivolumabe/efeitos adversos , Derrame Pericárdico/induzido quimicamenteRESUMO
A 74-year old man presented to us with difficulty urinating. The laboratory examinations revealed an elevated prostate-specific antigen (PSA) level. A prostate biopsy revealed prostate adenocarcinoma. The computed tomography scan showed metastasis to lymph nodes in the pelvic cavity and both adrenal glands. Combined androgen blockade therapy was started, and PSA levels began to decrease gradually. However, 2 months later, he was hospitalized for treatment of cellulitis and was found to have hypertension, hyperglycemia, and hypokalemia. Endocrinological studies showed elevated serum adrenocorticotropic hormone (ACTH) and serum and urinary cortisol levels. The plasma cortisol level was not reduced by either the 1 mg or 8 mg dexamethasone suppression test, and the plasma cortisol and ACTHlevels did not respond to the corticotropin-releasing hormone test. Computed tomography indicated increased metastasis, and endocrinological studies and other examinations suggested a diagnosis of ectopic ACTHsyndrome. Combined androgen blockade therapy was continued, and inhibitors of adrenocortical synthesis were also administered. However, 16 weeks later, he died of prostate cancer. On autopsy, the histological examination revealed small cell carcinoma in the prostate and adrenal glands and other sites of metastasis, while immunohistochemistry findings revealed that the tumors in the prostate and adrenal glands were strongly positive for ACTH.
Assuntos
Síndrome de ACTH Ectópico , Antagonistas de Androgênios , Carcinoma de Células Pequenas , Neoplasias da Próstata , Síndrome de ACTH Ectópico/etiologia , Hormônio Adrenocorticotrópico , Idoso , Antagonistas de Androgênios/uso terapêutico , Androgênios , Carcinoma de Células Pequenas/diagnóstico , Humanos , Masculino , Neoplasias da Próstata/complicações , Neoplasias da Próstata/tratamento farmacológicoRESUMO
A 68-year-old man underwent an inguinal orchiectomy for a right testicular tumor and the pathological diagnosis was atypical lipomatous tumor. Nine years later, a resection procedure was performed for local recurrence. Five years after that second surgery, abdominal computed tomography (CT) findings revealed a low density mass 40 mm in size on the back side of the right kidney and enlarged fat in the retroperitoneal space. We performed a laparoscopic tumor resection under a diagnosis of lipoma or liposarcoma recurrence, and the pathological diagnosis was well differentiated liposarcoma. Treatment with pazopanib was started, as a CT examination showed that the tumor remained, after which we performed an open nephroureterectomy and resected the remaining tumor portion. Pazopanib treatment was continued and no obvious signs of recurrence were seen at 8 months after the most recent surgery. Although well differentiated liposarcoma usually recurs in the original tumor region, multicentric recurrence in other parts is possible.
Assuntos
Lipossarcoma/secundário , Neoplasias Retroperitoneais/secundário , Neoplasias Testiculares/patologia , Idoso , Inibidores da Angiogênese/uso terapêutico , Quimioterapia Adjuvante , Humanos , Indazóis , Lipossarcoma/diagnóstico por imagem , Lipossarcoma/tratamento farmacológico , Lipossarcoma/cirurgia , Masculino , Orquiectomia , Pirimidinas/uso terapêutico , Recidiva , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/cirurgia , Sulfonamidas/uso terapêutico , Neoplasias Testiculares/tratamento farmacológico , Neoplasias Testiculares/cirurgia , Fatores de Tempo , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVES: The aims of this study were to predict pelvic lymph node metastasis in uterine cervical cancer before surgery and to evaluate the potential efficacy of omitting pelvic lymphadenectomy. MATERIALS AND METHODS: A total of 163 patients with invasive uterine cervical cancer in FIGO stage IA2 to IIB, all of whom underwent primary radical hysterectomy with pelvic lymphadenectomy, participated in this study. RESULTS: The incidences of pelvic lymph node metastasis in stage IA2, stage IB1, stage IB2, stage IIA, and stage IIB cervical cancer were 0% (0/12), 17% (13/76), 22% (6/27), 33% (8/24), and 63% (15/24), respectively. A significant difference was observed in overall survival with nodal metastasis status (P < 0.0001). Univariate analysis revealed that parametrial invasion (P < 0.0001), tumor markers (P = 0.0006), tumor size greater than 2 cm (P < 0.0001), tumor size less than 3 cm (P = 0.0009), and tumor size greater than 4 cm (P = 0.0024) were correlated with pelvic lymph node metastasis. However, multivariate analysis revealed that parametrial invasion (P = 0.01; odds ratio, 3.37; 95% confidence interval, 1.31-9.0) and tumor size greater than 2 cm (P = 0.005; odds ratio, 4.93; 95% confidence interval, 1.54-22.01) were independently associated with nodal metastasis. CONCLUSIONS: Pelvic lymphadenectomy may be avoided in patients with negative parametrial invasion and a tumor size less than 2 cm, thereby minimizing postoperative complications.
Assuntos
Adenocarcinoma/cirurgia , Carcinoma de Células Escamosas/cirurgia , Excisão de Linfonodo , Linfonodos/cirurgia , Pelve/cirurgia , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/cirurgia , Adenocarcinoma/mortalidade , Adenocarcinoma/secundário , Adulto , Idoso , Biomarcadores Tumorais/análise , Carcinoma de Células Escamosas/mortalidade , Carcinoma de Células Escamosas/secundário , Feminino , Seguimentos , Humanos , Histerectomia , Incidência , Linfonodos/patologia , Metástase Linfática , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Pelve/patologia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/epidemiologia , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Neoplasias do Colo do Útero/mortalidade , Adulto JovemRESUMO
Objectives: In Japan, caudal block with 1% lidocaine is commonly used for transrectal prostate biopsy. Although 10 mL of 1% lidocaine is commonly used, the appropriate dosage of 1% lidocaine has not been studied. Our hospital routinely uses two different doses (5 or 10 mL) of 1% lidocaine for caudal block for transrectal prostate biopsy. Herein, we retrospectively evaluated the efficacy and safety of both doses of 1% lidocaine. Methods: This retrospective study included 869 patients who underwent transrectal prostate biopsy with caudal block at our hospital. The amount of 1% lidocaine was determined by the day of the week on which the biopsy was performed, and the patient voluntarily chose the day of the biopsy, unaware of the dose of 1% lidocaine used on that day. Pain, anal sphincter tonus, cancer diagnosis rate, and early complications were compared. Results: In total, 466 and 403 patients received 5 and 10 mL of 1% lidocaine for a caudal block, respectively. After propensity-score matching for patient characteristics, each group contained 395 patients. The pain score, anal sphincter tonus score, or prostate cancer diagnosis rate were not significantly different between the two groups. However, rectal bleeding was significantly more frequent and severe in the 10-mL than the 5-mL group (p=0.018 and p=0.0036, respectively). The incidence of other complications was not significantly different between the groups. Conclusions: Our results suggest that 5 mL of 1% lidocaine may be more suitable than 10 mL for caudal block during transrectal prostate biopsy.
RESUMO
The incidence of iatrogenic parasitic uterine myomas associated with the use of a laparoscopic morcellator has been increasing over the past decade. Recently, we encountered a very rare case with a large parasitic myoma measuring 12 cm in diameter in the abdominal subcutaneous adipose tissue along an abdominal longitudinal surgical scar. The patient had twice undergone abdominal myomectomy for multiple fundal myomas. This is the first report describing a case with as large a parasitic myoma presenting in the suprafascial adipose tissue under the surgical scar after laparotomy. In such a case demonstrating a solid tumor of unknown cause after a gynecologic surgical procedure, a parasitic myoma must be included in the differential diagnosis.
Assuntos
Cicatriz/cirurgia , Histerectomia , Leiomiomatose/cirurgia , Neoplasias Lipomatosas/cirurgia , Gordura Subcutânea Abdominal/cirurgia , Cicatriz/patologia , Feminino , Humanos , Leiomiomatose/patologia , Pessoa de Meia-Idade , Neoplasias Lipomatosas/patologia , Gordura Subcutânea Abdominal/patologia , Resultado do TratamentoRESUMO
Malignant fibrous histiocytoma (MFH) of the vulva is extremely rare; to date, there have been nine case reports. Almost all of these cases involved middle-aged women. We encountered a 21-year-old woman with a 4.5 × 2.6 cm superficial, localized, exophytic tumor of the right vulva. Microscopic findings on punch biopsy of the tumor initially suggested a vulvar sarcoma. The patient underwent wide local excision of the vulva. The extirpated specimen demonstrated the pleomorphic type of MFH with myxoid stroma of the vulva. The clinical stage was found to be IIB, based on the American Joint Committee on Cancer staging system. Chromosomal analysis of the tumor using the conventional G-band method was normal (46XX). This seems to be a very rare case of MFH of the vulva in a young woman. Physicians should therefore include MFH in the differential diagnosis of vulvar tumors, even though it is a rare disease.
Assuntos
Histiocitoma Fibroso Maligno/patologia , Neoplasias Vulvares/patologia , Feminino , Histiocitoma Fibroso Maligno/cirurgia , Humanos , Neoplasias Vulvares/cirurgia , Adulto JovemRESUMO
AIM: The present study investigated the clinical outcome of stage Ia1 squamous cell carcinoma (SCC) of the uterine cervix at a single institute. MATERIALS AND METHODS: Subjects were 84 patients with cervical SCC, International Federation of Gynecology and Obstetrics stage Ia1 diagnosed according to conization findings between January 2000 and June 2009. Correlations between clinical outcome and pathological findings on initial conization were investigated. RESULTS: Of 65 hysterectomy (without pelvic lymphadenectomy) patients, two (3.1%) showed metastasis to the vaginal wall, and two (3.1%) to the pelvic lymph nodes. Five patients (6.0%) showed lymphovascular invasion, and three (3.6%) showed confluent patterns of stromal invasion (confluent invasion) on initial conization findings. All of these five patients were included in the hysterectomy group. Of 19 patients with conization alone, two showed vaginal metastasis. Of four patients with vaginal metastasis, two showed lymphovascular invasion and one showed confluent invasion despite negative conization margin. In patients with nodal metastasis, stromal invasion of 3.0 mm and 2.8 mm, and horizontal spread of 6.8 mm and 6.9 mm were observed on conization, respectively. All patients are currently alive due to adequa\e therapy including chemo-radiation for six patients with recurrent disease. CONCLUSIONS: In patients showing stromal invasion of nearly 3.0 mm and horizontal spread of nearly 7.0 mm in stage Ia1 cervical SCC, pelvic lymphadenectomy may be considered. Even for patients showing a negative conization margin, careful follow up is necessary, because vaginal metastasis sometimes occurs.
Assuntos
Carcinoma de Células Escamosas/cirurgia , Colo do Útero/cirurgia , Conização , Neoplasias do Colo do Útero/cirurgia , Adulto , Carcinoma de Células Escamosas/patologia , Colo do Útero/patologia , Feminino , Seguimentos , Humanos , Histerectomia , Excisão de Linfonodo , Pessoa de Meia-Idade , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Resultado do Tratamento , Neoplasias do Colo do Útero/patologiaRESUMO
BACKGROUND: Inguinal hernia containing uterus and endometriosis is exceedingly rare. Most inguinal endometriosis is located at an extrapelvic site near the round ligament. We report a case of a patient with inguinal hernia containing rudimentary uterine horn and endometriosis. CASE: A young, nulliparous, regularly menstruating woman manifested right inguinal mass and pain in the mass during menstruation. At 20 years old, she underwent a surgical procedure for right inguinal mass. Postoperative pathology findings demonstrated inguinal endometriosis. Based on the findings of magnetic resonance imaging, a history of inguinal endometriosis, and the occurrence of inguinal pain during menstruation, she was diagnosed as having incarcerated inguinal hernia containing anomalous uterus and endometriosis. A functioning, noncommunicating, rudimentary uterine horn and endometriosis were surgically removed from the hernia sac. Laparoscopy demonstrated intraabdominal unicornuate uterus, but no pelvic endometriosis. CONCLUSION: Functioning, incarcerated hernia uterus inguinale may be associated with müllerian abnormality and concomitant occurrence of inguinal endometriosis.
Assuntos
Endometriose/patologia , Virilha/anormalidades , Hérnia Inguinal/patologia , Útero/anormalidades , Feminino , Hérnia Inguinal/etiologia , Humanos , Adulto JovemRESUMO
BACKGROUND: Abdominal pregnancy with massive bleeding is life-threatening. Thus, multimodal treatment approaches are necessary. CASE: A 36-year-old woman with abdominal pregnancy at 14 weeks of gestation presented with abdominal pain due to intraabdominal bleeding. Laparotomy demonstrated massive bleeding from the placenta implanted in the right lower quadrant involving the posterior uterine wall, right adnexa, and small intestine. Because attempted removal of the placenta aggravated the bleeding, only the fetus was removed. To stop abdominal bleeding, embolization of the placental vasculature was successfully performed with a 2.0-F microcatheter after identification of the bleeding point with computed tomography arteriography. The patient was the treated with methotrexate. CONCLUSION: Super-selective arterial embolization with a microcatheter is a useful treatment of abdominal bleeding due to abdominal pregnancy.
Assuntos
Embolização Terapêutica , Hemorragia/etiologia , Gravidez Abdominal/terapia , Adulto , Feminino , Hemorragia/terapia , Humanos , GravidezRESUMO
Intrauterine globe-shaped metreurynter tamponade has been used for some time to treat massive postpartum hemorrhage (PPH). More recently, the Bakri balloon has come into use to treat PPH. It is made of silicon, possesses a drainage lumen, and has a sausage-like spindle shape. The aim of the present study was to investigate the clinical usefulness of Bakri balloon tamponade for massive PPH. Subjects in the present study comprised 5 patients with uterine atony, 3 with placenta previa, and 2 with low-lying placenta. All patients exhibited massive PPH and resistance to conventional hemostatic managements. Bakri balloon tamponade was appliedto these 10 patients. The mean amounts of uterine bleeding (average ± SD) before and after Bakri insertion were2,732 ± 1,397 mL and 380 ± 376 mL, respectively. The median (third-first quartile ranges) volume of salineinflating the balloon was 200 mL (300-150 mL). The median (third-first quartile ranges) indwelling duration of Bakri balloon was 24 hours (24-11 hrs). The overall success rate of Bakri balloon tamponade was 90% (9/10).There were no cases of slipping out or complications regarding balloon placement. Our findings suggest that Bakri balloon tamponade may be applied to the treatment of massive PPH in uterine atony and placenta previa.The Bakri balloon appears to have the following merits: (1) easy insertion into the uterine cavity and low rate of slipping out, (2) proper conformability to the hemorrhagic area due to its spindle shape, (3) ability to monitor blood loss through the drainage lumen even after insertion.
Assuntos
Hemorragia Pós-Parto/terapia , Tamponamento com Balão Uterino/métodos , Adulto , Desenho de Equipamento , Feminino , Humanos , Hemorragia Pós-Parto/diagnóstico , Hemorragia Pós-Parto/etiologia , Gravidez , Índice de Gravidade de Doença , Fatores de Tempo , Resultado do Tratamento , Tamponamento com Balão Uterino/efeitos adversos , Tamponamento com Balão Uterino/instrumentação , Adulto JovemRESUMO
BACKGROUND: Threatened premature labor (TPL) often results in preterm birth (PB). The aim of the present study was to evaluate the associations of periodontal and general health conditions with TPL and PB in relation to serum cytokine levels and the composition of subgingival plaque. METHODS: Eighty-eight women were enrolled in the study. Systemic conditions were assessed, and subgingival plaque samples obtained for bacterial analysis. Periodontal examinations included assessments of plaque, gingivitis, clinical attachment level, probing depth, and bleeding on probing. Serum cytokine levels also were analyzed. Gestational age at delivery was recorded, and the mothers were divided into a TPL or non-TPL group, and into a non-TPL-TB (term birth), non-TPL-PB, TPL-TB, or TPL-PB group, accordingly. RESULTS: Forty subjects were classified as TPL and 18 as TPL-PB. There were significant differences between the TPL and non-TPL subjects in several of the systemic and periodontal parameters and serum cytokine levels. Significant differences were observed between the TPL-TB and TPL-PB groups in the percentage of Tannerella forsythensis (Tf, formerly Bacteroides forsythus), and the serum interleukin (IL)-8 and IL-1beta levels. Significant negative correlations between the gestational age at delivery and several periodontal parameters and serum IL-8 and IL-1beta levels, and significant positive correlations between periodontal status and serum IL-8 and IL-1beta levels, were observed. CONCLUSIONS: The TPL women revealed worsened periodontal conditions and elevated serum IL-8 and IL-1beta levels compared to the non-TPL women. The elevated levels of serum IL-8 and IL-1beta could have affected the maintenance of the proper uterine-fetus relationship, resulting in premature uterine contractions.
Assuntos
Citocinas/sangue , Trabalho de Parto Prematuro/etiologia , Doenças Periodontais/complicações , Adulto , Análise de Variância , Bacteroides/isolamento & purificação , Placa Dentária/microbiologia , Feminino , Idade Gestacional , Nível de Saúde , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Interleucina-1/sangue , Interleucina-6/sangue , Interleucina-8/sangue , Masculino , Trabalho de Parto Prematuro/sangue , Doenças Periodontais/sangue , Índice Periodontal , Gravidez , Estatísticas não Paramétricas , Fator de Necrose Tumoral alfa/análiseRESUMO
Uterine arteriovenous malformation (AVM) is a rare and potentially life-threatening disease. The present report describes a postmenopausal patient with uterine AVM manifesting recurrent, massive genital bleeding. Uterine artery embolization (UAE) was scheduled before hysterectomy, but UAE was unsuccessful due to the dilated, tortuous internal iliac arteries, and extremely rapid arterial blood flow. Hysterectomy appeared to carry a potential risk of massive blood loss due to multiple dilated vessels around the uterine corpus and cervix. Therefore, six arteries feeding the uterus were surgically ligated. At 10 months after the operation there have been no episodes of atypical genital bleeding.
Assuntos
Artérias/anormalidades , Malformações Arteriovenosas/patologia , Útero/irrigação sanguínea , Artérias/diagnóstico por imagem , Artérias/cirurgia , Malformações Arteriovenosas/diagnóstico por imagem , Malformações Arteriovenosas/cirurgia , Embolização Terapêutica/métodos , Feminino , Humanos , Ligadura/métodos , Pessoa de Meia-Idade , Ultrassonografia , Útero/diagnóstico por imagem , Útero/cirurgiaRESUMO
Aggressive angiomyxoma of the vulva is uncommon and the pathogenesis remains unclear. Recently, a few cytogenetic studies demonstrated chromosomal abnormalities in aggressive angiomyxoma of the vulva. A 45-year-old Japanese woman complaining of right-side vulva tumor measuring 3 cm in diameter was referred to our hospital. The mass was located at the right side of the rectovaginal septum and was closely adherent to the rectal serosa and the levator muscle ani. The tumor was completely resected. A pathological examination demonstrated aggressive angiomyxoma of the vulva. Chromosomal analysis of the tumor demonstrated a sole t(5;8)(p15;q22) translocation. This is the first case of an aggressive angiomyxoma of the vulva with a sole t(5;8)(p15;q22) translocation.
Assuntos
Cromossomos Humanos Par 5/genética , Cromossomos Humanos Par 8/genética , Mixoma/genética , Translocação Genética , Neoplasias Vulvares/genética , Aberrações Cromossômicas , Feminino , Humanos , Pessoa de Meia-Idade , Mixoma/metabolismo , Mixoma/patologia , Neoplasias Vulvares/metabolismo , Neoplasias Vulvares/patologiaRESUMO
AIM: To investigate the clinical outcome of uterine sarcomas, particularly in patients with pulmonary and abdominal metastasis, treated at a single institute. METHODS: We identified five patients with uterine leiomyosarcoma (LMS), one patient with endometrial stromal sarcoma (ESS), and three patients with carcinosarcoma (CS) between 2003 and 2006. RESULTS: All patients underwent at least hysterectomy and bilateral adnectomy. All five LMS cases (two patients in International Federation of Obstetrics and Gynecology stage I and three in stage III) recurred: one patient showed metastasis to the lung and four patients showed metastasis to the abdomen 16.6 months (mean) after hysterectomy. Two of three (66.7%) CS recurred: one patient showed metastasis to the lung and the other to the abdomen 5 months (mean) after hysterectomy. The ESS (stage I) patient showed metastasis to the lung 11 months after hysterectomy. Five patients with metastases received surgical interventions (two pulmonary resections and three abdominal resections), and all of these patients are currently alive 1.1-5.1 years postoperatively. Two patients with CS (stage I) and one patient with LMS (stage III) died of sarcoma dissemination, but neither of these three patients had undergone surgical intervention after hysterectomy (one for pulmonary and two for abdominal metastases). CONCLUSIONS: Resection of lung and abdominal metastases in uterine LMS and CS is beneficial to improve patient survival.
Assuntos
Neoplasias Abdominais/secundário , Carcinossarcoma/secundário , Leiomiossarcoma/secundário , Neoplasias Pulmonares/secundário , Neoplasias Uterinas/patologia , Neoplasias Abdominais/cirurgia , Adulto , Idoso , Carcinossarcoma/cirurgia , Feminino , Humanos , Histerectomia , Leiomiossarcoma/cirurgia , Neoplasias Pulmonares/cirurgia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Neoplasias Uterinas/cirurgiaRESUMO
A case of a 23-year-old, nulliparous female with a very rare isolated adenomyotic cyst inducing severe dysmenorrhea was seen. Transvaginal ultrasonographic tomography and magnetic resonance imaging (MRI) showed a 3 x 3-cm cystic mass within the left anterior wall of the uterine corpus. The cystic space was filled with hyperintense fluid on T1-weighted images, which was surrounded by hypointense tissue beside the right uterine corpus on T2-weighted images. The case was preliminarily diagnosed using MRI as having cavitated rudimentary uterine horn. However, hysterosalpingography excluded the possibility of uterine anomaly. A hemorrhagic adenomyotic cyst measuring 3 cm within the left anterior wall of the uterine corpus was surgically removed. There was no evidence of diffuse adenomyosis uteri. Dysmenorrhea completely disappeared postoperatively.
Assuntos
Adenomioma/complicações , Cistos/complicações , Dismenorreia/etiologia , Miométrio/patologia , Neoplasias Uterinas/complicações , Adenomioma/patologia , Adulto , Cistos/patologia , Feminino , Humanos , Neoplasias Uterinas/patologiaRESUMO
We encountered a patient with giant ovarian cancer with a tumor weight of 100 kg. The patient's girth measured 198 cm after approximately 4 years' duration, and she complained of dyspnea and inability to walk. Adnectomy was performed with intensive intraoperative monitoring. The ovarian cancer was entirely adherent to the parietal peritoneum. However, 10 h after adnectomy, she died of massive abdominal bleeding from extremely redundant parietal peritoneum caused by disseminated intravascular coagulation.
Assuntos
Neoplasias Ovarianas/diagnóstico , Carga Tumoral , Adulto , Evolução Fatal , Feminino , Humanos , Complicações Intraoperatórias , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/cirurgia , PrognósticoRESUMO
We encountered a 10-year-old prepubertal girl with a normal ovary and oviduct torsion. Hemorrhagic infarction of the ovary and oviduct occurred, and these structures were laparoscopically removed. Torsion of the normal ovary and oviduct in a prepubertal girl is discussed.