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Dayan D, Ebner F, Janni W, Schochter F, Hartkopf A, Lorenz S, Lukac S. Perforated teratoma with multiple cystic lesions throughout the abdomen. Arch Gynecol Obstet 2024; 309:1109-1110. [PMID: 37453941 DOI: 10.1007/s00404-023-07145-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023]
Affiliation(s)
- Davut Dayan
- Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany.
| | - Florian Ebner
- Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany
- Gyn-Freising, Freising, Germany
| | - Wolfgang Janni
- Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany
| | - Fabienne Schochter
- Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany
| | - Andreas Hartkopf
- Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany
- Department of Women's, Health University Women's Hospital Tübingen, University Hospital Tübingen, Tübingen, Germany
| | - Stefanie Lorenz
- Department of Diagnostic and Interventional Radiology, Ulm University Hospital, Ulm, Germany
| | - Stefan Lukac
- Department of Gynecology and Obstetrics, Ulm University Hospital, Ulm, Germany
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Tambawala ZY, Saquib S, Shinko IA, Nagshabandi Z. Massive serous cyst adenoma with ovarian abscess causing fatal septicaemia. BMJ Case Rep 2023; 16:e255467. [PMID: 37989331 PMCID: PMC10660798 DOI: 10.1136/bcr-2023-255467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023] Open
Abstract
Isolated unilateral ovarian tumour without obvious concomitant tubal pathology is unlikely to cause intrabdominal abscess or septicaemia. Benign serous cystadenoma is a fairly common ovarian tumour but rarely causes fatality. We present a patient in mid-30s with massive ovarian serous cystadenoma presenting with abscess and septicaemia, leading to mortality. To our knowledge, no previous serous cystadenoma causing abscess formation has been reported before.
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Affiliation(s)
- Zenab Yusuf Tambawala
- Department of Obstetrics and Gynecology, Dubai Hospital, Dubai, UAE
- Department of Obstetrics and Gynecology, Dubai Health, Dubai, UAE
| | - Shabnam Saquib
- Department of Obstetrics and Gynecology, Dubai Hospital, Dubai, UAE
- Department of Obstetrics and Gynecology, Dubai Health, Dubai, UAE
| | - Ikram Abdelaziz Shinko
- Department of Obstetrics and Gynecology, Dubai Hospital, Dubai, UAE
- Department of Obstetrics and Gynecology, Dubai Health, Dubai, UAE
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She YM, Ge N. Diagnostic value of endoscopic ultrasonography in pelvic masses with bowel involvement. Therap Adv Gastroenterol 2023; 16:17562848231163414. [PMID: 37153498 PMCID: PMC10161300 DOI: 10.1177/17562848231163414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 02/26/2023] [Indexed: 05/09/2023] Open
Abstract
Benign and malignant pelvic masses with or without intestinal invasion are common in women of childbearing age. Patients may have nonspecific symptoms and signs or experience no symptoms. Laparoscopic resection of pelvic masses is currently the mainstream treatment; therefore, accurate preoperative evaluation is not only essential for patients suspected of having intestinal invasion, but also extremely important for the selection of follow-up treatment. Procedures, including endoscopic ultrasonography (EUS), pelvic magnetic resonance imaging, abdominal computed tomography, vaginal ultrasonography, barium enema, and colonoscopy, aid in determining the presence, depth, and histology of the disease. In particular, the wide application and continuous developments in EUS techniques have improved the diagnostic accuracy for intestinal subepithelial and peripheral organ lesions. This article reviewed the clinical value of EUS in the diagnosis of benign and malignant pelvic masses with bowel involvement.
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Affiliation(s)
- Yu Mo She
- Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, Liaoning Province, China
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Jankowska-Lombarska M, Grabowska-Derlatka L, Derlatka P. Tumor-Bowel Fistula as a Rare Form of Recurrent Ovarian Cancer-Imaging and Treatment: Preliminary Report. Curr Oncol 2022; 30:506-517. [PMID: 36661689 PMCID: PMC9857548 DOI: 10.3390/curroncol30010040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/20/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The aim of this pilot study was to evaluate the value of imaging techniques, including computed tomography (CT) and magnetic resonance imaging (MRI), in the diagnosis of a tumor-bowel fistula as a rare form of epithelial ovarian cancer (EOC) relapse. We also performed an initial assessment of the effectiveness of the treatment of this form of relapse. METHODS The study group consisted of eight patients with suspected platinum-sensitive recurrence in the form of a tumor/bowel fistula. All patients finished their first line of chemotherapy and subsequently showed complete remission for 6 months or more. To qualify patients for further treatment, CT and MRI were performed, which suggested the presence of a fistula between the recurrent tumor and intestine. DESKTOP study criteria were used to qualify patients for secondary cytoreduction. Second-line chemotherapy was given after secondary debulking. RESULTS In all patients, fistulas formed between the tumor and large bowel. On CT, the fistulas were indirectly visible. In all cases, the fistula was visible on MR images, which showed hypointensity on the T2 and T1 post-contrast sequences but did not show restricted diffusion on the diffusion-weighted imaging (DWI) sequence. Patients who were qualified for the study underwent secondary debulking with bowel resection. In all eight cases, the fistula between the tumor and surrounding organs was confirmed. During surgery, seven intestinal anastomoses and one colostomy were performed. No residual macroscopic tumor remained in seven cases (resection R0-87.5%). The progression-free survival (PFS) was 8.4-22.6 months (median 13.4). In the group with cytoreduction R0, the median PFS was 15.5 months (12-22). CONCLUSION In patients with suspected EOC recurrence with clinically suspected fistula, CT scan is not sufficient. In CT, the presence of a fistula is suspected based on indirect symptoms. MRI, as a method with much greater tissue resolution, confirms the diagnosis. In addition, MRI can identify the point of the tumor/bowel junction. This is especially true with a large infiltration covering several intestinal parts. Bowel resection with simultaneous anastomosis is a good and safe solution for these patients. However, appropriate qualification for the procedure is necessary, which will allow for surgery without residual macroscopic disease (R0 surgery). Due to the small number of cases, our results cannot be generalized. We treat them as a hypothesis that can be verified in a larger study.
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Affiliation(s)
- Melania Jankowska-Lombarska
- Second Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a St., 02-097 Warsaw, Poland
| | - Laretta Grabowska-Derlatka
- Second Department of Clinical Radiology, Medical University of Warsaw, Banacha 1a St., 02-097 Warsaw, Poland
| | - Pawel Derlatka
- Second Department Obstetrics and Gynecology, Medical University of Warsaw, Karowa 2 St., 00-315 Warsaw, Poland
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Suzuki D, Meguro S, Inagaki K, Hashimoto M, Kawasaki H, Kosugi I, Enomoto Y, Sugiyama M, Fukushima M, Iwashita T. An autopsy case of ovarian mucinous cystic tumor complicated by ovarian abscess and a review of the English literature. Clin Case Rep 2022; 10:e6507. [DOI: 10.1002/ccr3.6507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 08/25/2022] [Accepted: 10/09/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Daisuke Suzuki
- Division of Diagnostic Pathology Chutouen General Hospital Kakegawa Japan
| | - Shiori Meguro
- Department of Regenerative and Infectious Pathology Hamamatsu University School of Medicine Hamamatsu Japan
| | - Koji Inagaki
- Division of Nephrology Chutouen General Hospital Kakegawa Japan
| | | | - Hideya Kawasaki
- Institute for NanoSuit Research, Preeminent Medical Photonics Education & Research Center Hamamatsu University School of Medicine Hamamatsu Japan
| | - Isao Kosugi
- Department of Regenerative and Infectious Pathology Hamamatsu University School of Medicine Hamamatsu Japan
| | - Yasunori Enomoto
- Department of Regenerative and Infectious Pathology Hamamatsu University School of Medicine Hamamatsu Japan
| | - Miho Sugiyama
- Division of Diagnostic Pathology Hamamatsu University School of Medicine Hamamatsu Japan
| | - Mayu Fukushima
- Division of Diagnostic Pathology Hamamatsu University School of Medicine Hamamatsu Japan
| | - Toshihide Iwashita
- Department of Regenerative and Infectious Pathology Hamamatsu University School of Medicine Hamamatsu Japan
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Sheng Y, Yuan J, Wang J, Wang L, Li Y, Wang Y. Ovarian Mature Cystic Teratoma is an Independent Risk Factor for the Premature Rupture of Membranes in Pregnancy: A Single-Center Retrospective Study. Int J Womens Health 2022; 14:1477-1487. [PMID: 36277448 PMCID: PMC9586702 DOI: 10.2147/ijwh.s381297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/05/2022] [Indexed: 11/05/2022] Open
Abstract
Background Ovarian mature cystic teratomas (MCTs) are the most common tumors in pregnant women. The premature rupture of membranes (PROM) is a typical complication of pregnancy; however, the relationship between MCT and PROM is unknown. Therefore, we aimed to determine whether MCT is associated with the occurrence of PROM during pregnancy. Methods The data of patients with adnexal masses during pregnancy between January 2017 and August 2021 were retrospectively analyzed. Ovarian cystectomy was performed during cesarean delivery or after vaginal delivery. Univariate and multivariate logistic regression models were used for statistical analysis. Results A total of 234 patients with histopathological results were included. Among these patients, 21 occurred PROM during pregnancy, of which 11 were diagnosed with MCT. Compared with other subtypes, MCT (p=0.025) showed a stronger correlation with PROM and was an independent risk factor for PROM (odds ratio [OR], 2.811; 95% confidence interval [CI], 1.096-7.215; p=0.032). Furthermore, we found that MCT with a diameter >5 cm (p=0.0037) was more likely to promote the development of PROM than those that with a diameter <5 cm. Conclusion MCT was an independent risk factor for PROM during pregnancy. Positive actions and preventative clinical treatments should be fully taken into consideration by clinicians for pregnant women with MCTs, especially those ≥5 cm in diameter, to reduce the clinical complications related to MCT-associated PROM.
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Affiliation(s)
- Yaru Sheng
- Department of Gynecologic Oncology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Jiangjing Yuan
- Department of Gynecologic Oncology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Jing Wang
- Department of Gynecologic Oncology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Liya Wang
- Department of Gynecologic Oncology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Yuhong Li
- Department of Gynecologic Oncology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Yudong Wang
- Department of Gynecologic Oncology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China,Shanghai Municipal Key Clinical Specialty, Female Tumor Reproductive Specialty, Shanghai, People’s Republic of China,Shanghai Key Laboratory of Embryo Original Disease, Shanghai, People’s Republic of China,Correspondence: Yudong Wang; Yuhong Li, Department of Gynecologic Oncology, International Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, 910 Hengshan Road, Shanghai, People’s Republic of China, Tel +86-21-64070434-18602; +86-21-64070434-25517, Email ;
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Issack FH, Hassen SM, Mummed FO, Gebreselassie KH, Hassen SK, Hassen IK. Pilimiction, a Rare Presentation of Ovarian Teratoma: A Case Report. Res Rep Urol 2022; 14:57-61. [PMID: 35257005 PMCID: PMC8898156 DOI: 10.2147/rru.s356738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/23/2022] [Indexed: 11/23/2022] Open
Abstract
Background Case Presentation Conclusion
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Affiliation(s)
- Feysel Hassen Issack
- Department of Surgery, Urology Unit, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
- Correspondence: Feysel Hassen Issack, Department of Surgery, Urology Unit, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, Tel +251932511145, Email
| | - Seid Mohammed Hassen
- Department of Surgery, Urology Unit, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Ferid Ousman Mummed
- Department of Surgery, Urology Unit, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | | | - Seid Kedir Hassen
- Department of Obstetrics and Gynecology, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Ibsa Kedir Hassen
- Department of Surgery, Urology Unit, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
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Ovarian dermoid cyst complicated by small bowel obstruction, entero-ovarian fistula formation, and malignant degeneration. Clin Imaging 2019; 56:47-51. [PMID: 30878712 DOI: 10.1016/j.clinimag.2019.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 02/13/2019] [Accepted: 03/07/2019] [Indexed: 11/23/2022]
Abstract
Dermoid cysts, or mature cystic teratomas, are complicated by malignant degeneration in only 1-2% of cases. Rarely, dermoid cysts result in complications of small bowel obstruction or entero-ovarian fistula formation. In the current report we present the case of a 59-year-old female with a known dermoid cyst who presented with leukocytosis and was discovered to have a small bowel obstruction at the level of an ileo-ovarian fistula. The patient was taken to the operating room and was treated with total abdominal hysterectomy, bilateral salpingo-oopherectomy, and short segment small bowel resection. Review of the surgical pathology revealed areas of malignant degeneration within the dermoid cyst to squamous cell carcinoma. To our knowledge, this is only the second reported case of an ovarian dermoid cyst complicated by small bowel obstruction, entero-ovarian fistula formation, and malignant degeneration.
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