Oncocitoma quístico papilar de carúncula lagrimal

La carúncula lagrimal forma parte de los anexos oculares y es asiento ocasional de neoplasias, las cuales en su mayoría son benignas. Dentro de estos tumores se encuentran los oncocitomas, los cuales están constituidos por células oncocíticas (oxifílicas) y poseen una baja incidencia con menos del 3 % de los tumores y bajos reportes de casos en la literatura. A pesar de que existen varios estudios en Cuba de tumores de anexos oculares no hay evidencia actualizada de casos con oncocitoma. Por ello se considera necesaria la presentación de este caso. Se trata de paciente blanca, femenina de 83 años de edad con antecedentes de hipertensión arterial, compensada bajo tratamiento y de carcinoma basocelular, operada hace siete años. Acudió por presentar aumento de volumen indoloro en el ángulo interno del ojo izquierdo. Al examen físico oftalmológico se observó lesión de 1 cm, gris-rosácea, bien delimitada. Se procedió a su exéresis con sospecha clínica de carcinoma basocelular y se envió espécimen para estudio anatomopatológico, el cual concluyó como oncocitoma quístico papilar (cistoadenoma papilar eosinofílico) de carúncula.

The lacrimal caruncle is part of the ocular adnexa and is the occasional seat of neoplasms, most of which are benign. Among these tumors are oncocytomas, which are constituted by oncocytic (oxyphilic) cells and have a low incidence with less than 3% of tumors and low case reports in the literature. Although there are several studies in Cuba of ocular adnexal tumors, there is no updated evidence of cases with oncocytoma. Therefore, it is considered necessary to present this case. The patient is a white, 83-year-old female with a history of arterial hypertension, compensated under treatment and basal cell carcinoma, operated seven years ago. She presented with painless enlargement of the inner corner of the left eye. Ophthalmologic physical examination revealed a 1 cm lesion, grayish-pinkish, well demarcated. The lesion was excised with clinical suspicion of basal cell carcinoma and the specimen was sent for anatomopathologic study, which concluded as papillary cystic oncocytoma (eosinophilic papillary cystoadenoma) of the caruncle.

Clinical staging and prognostic risk factors for ocular adnexal lymphoma / 中华实验眼科杂志

Objective:To evaluate the influence of the clinical staging and different risk factors for the prognosis of ocular adnexal lymphoma.Methods:An ambispective cohort study was conducted.Seventy-four patients diagnosed with primary ocular adnexal lymphoma by pathology at Tianjin Medical University Eye Hospital from November 2010 to December 2018 were enrolled.TNM staging was performed according to local tumor extent, lymph node or systemic involvement.Ann Arbor staging was carried out according to lymph node involvement and extranodal extension.The pathological subtype was classified according to World Health Organization classification of lymphoma.The outcome of disease progression or death was analyzed.Kaplan-Meier method was used for univariate survival analysis.Cox proportional hazard model was employed for multivariate survival analysis to predict the risk factors affecting prognosis, hazard ratio ( HR) and 95% confidence interval ( CI) were estimated.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Tianjin Medical University Eye Hospital (No.2021KY[L]-32). Written informed consent was obtained from all patients before entering the cohort. Results:For TNM staging, there were 68 cases in stage <T4, accounting for 91.9%, 6 cases in T4, accounting for 8.1%, 71 cases in N0, accounting for 95.9%, 3 cases in ≥N1, accounting for 4.1%, and no case was in stage M. For Ann Arbor staging, there were 72 cases in stage ⅠE, accounting for 97.3%, and 2 cases in stage ⅡE, accounting for 2.7%.As for pathological classification, 64 cases had mucosa-associated lymphoid tissue (MALT) lymphoma, accounting for 86.5% and 10 cases had non-MALT lymphoma, accounting for 13.5%.The follow-up of the patients was 3 to 117 months, with a median follow-up of 53 months.There were 6 cases dying of disease and 19 cases progressed.The 3-year and 5-year overall survival rates were 96.6% and 86.6%, respectively.The 3-year and 5-year progression-free survival rates were 75.6% and 65.9%, respectively.According to single-factor analysis, T4 stage, non-MALT type and Ki67 positive rate ≥10% were related to declined overall survival rate ( P<0.05). T4 stage, ≥N1 stage, ≥Ann Arbor Ⅱ stage, non-MALT type and Ki67 positive rate ≥10% were related to declined progression-free survival rate ( P<0.05). According to multiple-factor analysis, pathological type ( HR=33.193, 95% CI: 3.388-325.156, P=0.003) was the independent risk factor for overall survival rate.N stage ( HR=11.683, 95% CI: 2.720-50.173, P=0.001) and pathological type ( HR=11.337, 95% CI: 3.841-33.464, P<0.001) were independent risk factors for progression-free survival rate. Conclusions:TNM staging and pathological type are important clinical prognostic indicators for ocular adnexal lymphoma.Patients with high TNM stage or non-MALT lymphoma should be monitored closely.

Assessing the diagnostic performance of four ovarian malignancy prediction risk models in differentiating benign and malignant ovarian masses in a tertiary hospital / Philippine Journal of Obstetrics and Gynecology

Introduction@#Ovarian cancer is considered the most lethal gynecologic malignancy because it is difficult to diagnose in its early stages. Ovarian malignancy prediction models may be useful in discriminating between benign and malignant masses, allowing for accurate and timely referral as well as proper therapeutic care@*Objective@#To evaluate the diagnostic performance of the four ovarian prediction models: Risk of Malignancy Index‑4 (RMI‑4), Risk of Ovarian Malignancy Algorithm (ROMA), Copenhagen Index (CPH‑I), and International Ovarian Tumor Analysis (IOTA)‑Assessment of Different NEoplasias in the AdneXa (ADNEX) in identifying malignant and benign ovarian masses@*Materials and Methods@#This was a retrospective, cross‑sectional, analytical diagnostic study in a tertiary hospital between January 2017 and December 2020. Receiver operating characteristic (ROC) curves, area under the curves (AUCs), sensitivities, specificities, positive and negative predictive values, and positive and negative likelihood ratios were used to assess the diagnostic performance of the prediction models.@*Results@#We analyzed a total of 248 patients. One hundred and sixty‑one (65%) had benign tumors, 28 (11%) had borderline, and 59 (24%) had malignant tumors. The AUCs of all models were all above 90%, but when compared to the other models, CPH‑I had the best estimate. RMI‑4 had the highest sensitivity (98.3%) in diagnosing malignancy. For appropriately diagnosing benign disease, the IOTA‑ADNEX model exhibited the highest specificity (92.1%). Overall, RMI‑4 had the lowest diagnostic accuracy (74.6%), whereas IOTA‑ADNEX had the greatest (93.2%).@*Conclusion@#The four malignancy prediction models in this study were all useful tools in discriminating between benign and malignant ovarian tumors. IOTA‑ADNEX, CPH‑I, and ROMA all demonstrated overlapping diagnostic performances indicating that they are equal in that regard. In terms of sensitivity in predicting malignancy, RMI‑4 was the most sensitive. CPH‑I is the predictor with the best overall estimate. Lastly, IOTA‑ADNEX was the most specific, and displayed highest diagnostic accuracy among the four

Oncocitoma em carúncula: relato de caso / Oncocytoma of the caruncle: a case report

RESUMO O oncocitoma é um tipo de neoplasia rara na prática clínica e descrito na literatura, principalmente quando localizado no olho. Quando localizado nos anexos oculares, é mais frequentemente na carúncula. Analisou-se o caso de uma paciente de 74 anos, caucasiana, que relatou desconforto visual no olho esquerdo, e cujo exame físico mostrou lesão tumoral na carúncula esquerda, com volume moderado, presença de neovascularização e secreção excessiva. A excisão cirúrgica da lesão foi realizada sob sedação, e a peça foi enviada para avaliação anatomopatológica. A lesão foi diagnosticada histologicamente como oncocitoma, sem malignidade, e a paciente não apresentou recidiva após o procedimento. Embora raro, esse tumor deve ser reconhecido pelos oftalmologistas, devido ao risco já relatado de desenvolvimento de adenocarcinoma.

ABSTRACT Oncocytoma is a neoplasm rarely observed in clinical practice and reported in the literature, especially when located in the eye. When described in the ocular adnexa, it is most often located in the caruncle. The case of a 74-year-old Caucasian female patient is reported. She complained of visual discomfort in the left eye, and physical examination showed a tumoral lesion in the left caruncle, of moderate volume, presence of neovascularization, and excessive secretion. Surgical excision of the lesion was performed under sedation, and the specimen was sent for pathological examination. The lesion was histologically diagnosed as oncocytoma with no malignancy, and the patient presented no recurrence after the procedure. Although rare, this tumor must be recognized by ophthalmologists due to the risk of developing adenocarcinoma, as already reported.

Acute abdomen with adnexal masses in the reproductive age group: diagnosis and management

Background: Women with adnexal masses can present with acute symptoms such as abdominal pain, nausea and vomiting. As there is insufficient evidence on the frequency, presentation and management of adnexal masses we conducted this study to evaluate the clinical profile, surgical findings and histopathology of adnexal masses in women presenting with acute abdomen and needing surgical intervention.Methods: In this prospective observational study, history, examination, investigations and ultrasound of abdomen and pelvis were evaluated in women presenting with acute abdomen with adnexal mass and needing surgical intervention. Diagnosis was confirmed from the operative findings and histopathology. Etiology and its correlation with clinical symptoms and signs and radiological diagnosis formed the primary objective of the study.Results: Of the 79 patients enrolled in the study, the mean age was 30.82±6.69 years. Younger women were likely to have ectopic pregnancy while older women (>35 years) other tubal pathologies. Pain abdomen (n=70) and nausea (n=53), bleeding per vagina(n=33), menstrual irregularities (n=18), fever (n=10) abdominal distension (n=10) and dysuria (4) were the common symptoms. Etiology of the adnexal mass was ectopic pregnancy (57%), ovarian mass (34%), tubal mass (7.5%), tube and ovary (2.5%) in 46, 25, 6 and 2 patients respectively. 61% (n=48) of the women underwent laparoscopic management. Women with ruptured ectopic pregnancy were more likely to have abdominal distension, pallor, hypotension, cervical motion tenderness and need for blood transfusions.Conclusions: In women from reproductive age group with adnexal mass and needing surgery, ectopic pregnancies and benign ovarian tumours were the common etiologies. Urine pregnancy test and ultrasound are useful tests to differentiate ectopic from ovarian and tubal pathology.

Sensitivity and specificity of frozen section diagnosis in orbital and adnexal malignancies

Purpose: To analyze the diagnostic accuracy of frozen section in orbital and adnexal malignancies. Methods: A total of 55 cases between January 2006 and December 2011 for which intraoperative frozen section was performed for various orbital and adnexal lesions were included in the study. The frozen section diagnosis was compared with the permanent section diagnosis. Margin clearance was also compared between the two. Data were analysed using SPSS version 14. Odds ratio and cross-tabulation was used to perform the analysis. Results: The mean age at presentation was 51.46 � 20 years. Eyelid was the most common site of involvement. Out of 55 cases, diagnosis was deferred in four cases (7.27%) on frozen section. Among 51 cases, 44 (86%) cases were concordant, whereas 7 (13%) cases were discordant. The sensitivity and specificity of frozen section compared to permanent section for diagnosis of malignancy was found to be 87.2% and 87.5%, respectively. The sensitivity and specificity of frozen section for diagnoses of basal cell carcinoma was found to be 100%, while it was 83.3% and 100% respectively for sebaceous gland carcinoma and 87.5% and 94.9% respectively for squamous cell carcinoma. Conclusion: Frozen section had high sensitivity and specificity when compared with permanent section for all three parameters studied. It is an important intraoperative tool that is increasingly being used in histopathological examination of ophthalmic lesions. However, it should not be used as a substitute for the permanent section and critical decisions based on it are best avoided.

To Evaluate Role of Transvaginal Sonography over Transabdominal Sonography in Delineating Adnexal Masses

To compare and find diagnostic accuracy of Transvaginal sonography (TVS) over Transabdominalsonography (TAS) in evaluation of adnexal lesions. A cross sectional comparative study of 50 patientsincluding both pre and postmenopausal women who were clinically suspected to have adnexal masswere scanned on Logiq GE C5 Premium ultrasonography unit. TAS was performed with 3.5MHzelectronic macro convex probe followed by TVS with 6.5 MHz end firing electronic TVS probe. TVSwas found to be superior in diagnosing adnexal lesions. In comparison with TAS, TVS diagnosedbenign cystic teratomas (100% versus 40%), endometriomas (90% versus 57.1%), haemorrhagic ovarian cysts (85.7% versus 50%, hydrosalpinx (75% versus 25%), pyosalpinx/tubo-ovarian mass (75%versus 75%), and ectopic pregnancy (100% versus 77.7%). In our study ovarian cancers were betterdetected by TAS due to their large size. TVS was found to be superior in diagnosing adnexal masses ascompared to TAS with more accurate delineation of internal architectural features as wall thicknessand complexity, nodules, septae, papillary projections, internal echoes thereby narrowing the differentials.

Diagnosis and treatment progress of ocular adnexa mucosa-associated marginal zone lymphoma / 白血病·淋巴瘤

Primary ocular adnexal mucosa-associated marginal zone lymphoma is the most common ocular adnexal lymphoma. In recent years, its incidence has been increasing, and some techniques of immunology and molecular biology can make us better identify lymphoma with other lymphadenopathies, and some imaging tools can better judge the stage. In addition to radiotherapy and chemotherapy, antibiotic therapy and immune therapy have made progresses in treatment. This paper reviews the research progress of the diagnosis, staging and treatment of the disease.

MRI findings and clinical characteristics of adnexal torsion in pregnancy / 中国医学影像技术

Objective:To explore MRI findings and clinical characteristics of adnexal torsion (AT) in pregnancy. Methods: Clinical and MRI data of 14 patients in pregnancy with pathologically confirmed AT were retrospectively analyzed. Results: There were 2 cases of primary AT and 12 cases of secondary AT (5 with ovarian cyst, 4 with ovarian teratoma, 2 with hydrosalpinx and 1 with tubal mesothelial cyst). AT occurred on the right side in 5 cases and on the left in 9 cases, with torsion angles ranged from 180° to 1 720°. MRI showed that except for 3 cases of solitary AT, ovarian enlargement occurred in 11 cases. Mass in pelvic or abdominal cavity was found in 12 cases, including 8 cystic masses and 4 cystic solid masses. The torsional pedicle next to the masses presented typical "beak sign" in 6 cases, while 1 case showed whirlpool sign, all showed mixed high signal in DWI. Adnexal hemorrhage was noticed in 6 cases and pelvic effusion in 8 cases. The pregnancy outcome was 6 full-term healthy fetuses and 8 preterm infants. Conclusion: MRI findings of AT in pregnancy have certain characteristics, which are helpful to diagnosis of AT combined with clinical manifestations.

Hamartoma fibroanexial em cadela - Relato de caso / Fibroadnexal hamartoma in a bicth ­ Case report / Hamartoma fibroanexial en perra ­ Relato de caso

A pele é o maior órgão do corpo do animal, atuando como uma barreira entre o meio externo e interno e suas afeccções perfazem a média de 30% de todo atendimento clínico realizado em pequenos animais. Dentre as lesões não neoplásicas, encontram-se os hamartomas, que são oriundos de um crescimento excessivo de células e tecidos normais no local em que naturalmente se encontram, podendo ocorrer em qualquer tecido ou órgão. O hamartoma fibroanexial pode se apresentar como nódulo solitário, firme, circunscrito, séssil ou de aspecto polipoide, com ou sem alopecia parcial e ulceração. Os anexos cutâneos que se destacam nesse tipo de hamartoma são os folículos pilosos e as glândulas sebáceas, podendo aparecer em aspectos normais ou bizarros, como os folículos pilosos císticos rodeados por lóbulos sebáceos. O objetivo do presente trabalho foirelatar um caso de hamartoma fibroanexial em uma cadela sem padrão racial definido, de aproximadamente sete anos que foi levada à Unidade Hospitalar Veterinária da Universidade Estadual do Ceará (UECE), devido à presença de nódulo em região distal lateral do membro pélvico direito com crescimento lento e progressivo durante um ano. A paciente foi encaminhada para exames complementares de citologia e pré-cirúrgicos. Após excisão cirúrgica, o nódulo foi enviado para avaliação histopatológica. Microscopicamente, a lesão exibiu uma estrutura nodular intradérmica composta por tecido fibroso abundante, envolvendo e segmentando estruturas anexiais incompletas, representadas por glândulas sebáceas e folículos pilosos, alguns destes rôtos, suscitando intenso processo inflamatório piogranulomatoso. Os achados macro e microscópicos foram determinantes para o diagnóstico da lesão como hamartoma fibroanexial.(AU)

Skin is the largest organ of the animal body, acting as a barrier between the external and internal environment, and infections to it consisting of an average 30% of all clinical care performed. Hamartomas are among the non-neoplastic lesions in the skin, originating from an excessive growth of normal cells and tissues in the place they are naturally found, which can take place in any tissue or organ. Fibroadnexal hamartoma may be presented as solitary, firm, circumscribed, sessile or polyp-like nodules, with or without partial alopecia and ulceration. The adnexal structures mostly observed are hair follicles and sebaceous glands, with normal or bizarre structures, such as cystic hair follicles surrounded by sebaceous lobes. This study has the purpose of reporting a case of fibroadnexal hamartoma in a 7-year-old bitch taken to the Veterinary Hospital of the State University of Ceará (UECE) due to a nodule in the lateral distal region of the right pelvic limb with slow and progressive growth over one year. The patient was referred to cytology and pre-surgical examinations. After surgical excision, the nodule was sent for histopathological evaluation. Microscopically, the lesion exhibited an intradermal nodular structure composed of abundant fibrous tissue, involving and segmenting incomplete adnexal structures, represented by sebaceous glands and hair follicles, some of these ruptured, leading to intense piogranulomatous inflammatory reaction. Macro- and microscopic findings were determinant for diagnosing this lesion as a fibroanexial hamartoma.(AU)

La piel es el órgano más grande del cuerpo del animal y actúa como barrera entre el ambiente externo e interno, representando un promedio del 30% de toda la atención clínica realizada en pequeños animales. Entre las lesiones no neoplásicas se encuentran los hamartomas, que se originan a partir de un crecimiento excesivo de células y tejidos normales al lugar donde ocurren naturalmente, pudiendo ocurrir en cualquier tejido u órgano. El hamartoma fibroanexial puede presentarse como nódulos solitarios, firmes, circunscritos, sésiles o en forma de pólipos, con o sin alopecia parcial y ulceración. Las estructuras anexas más vistas son los folículos pilosos y las glándulas sebáceas, que aparecen en aspectos normales o anormales, como los folículos pilosos císticos rodeados de lóbulos sebáceos. El objetivo del presente estudio ha sido relatar un caso de Hamartoma fibroanexial en una perra sin patrón racial de aproximadamente siete años que fue llevada al Hospital Veterinario de la Universidad Estatal de Ceará (UECE), debido a un nódulo en la región distal lateral del miembro pélvico derecho con crecimiento lento y progresivo de un año. La paciente fue enviada para citología y los exámenes pre quirúrgicos. Después de la extirpación quirúrgica el nódulo fue enviado para evaluación histopatológica. Microscópicamente, la lesión exhibió una estructura nodular intradérmica compuesta de abundante tejido fibroso, involucrando y segmentando estructuras anéxales incompletas, representadas por glándulas sebáceas y folículos pilosos, algunas de ellas rotas, provocando intenso proceso inflamatorio piogranulomatoso. Los hallazgos macroscópicos y microscópicos fueron determinantes para el diagnóstico de la lesión como hamartoma fibroanexial.(AU)

Comparison of SASSONE Scoring and ADNEX Model in Differentiating Benign and Malignant Ovarian Neoplasm in a University Hospital

Background@#Ovarian cancer is the second most common gynecologic cancer worldwide and are usually diagnosed in advanced stages where prognosis is very poor. Ultrasound has been widely used to screen and differentiate benign and malignant ovarian neoplasm. There are several ultrasound scoring system designed to aid in the diagnosis, however, there is still no standard method accepted for screening of ovarian cancer. @*Objective@#To compare the accuracy of SASSONE Scoring and ADNEX Model in differentiating benign and malignant ovarian neoplasm in the University of Santo Tomas Hospital.@*Methodology@#Sixty-eight women who presented with an ovarian neoplasm by history and physical examination were recruited from January to October 2017. Ultrasound was requested to further characterize the mass. Sassone scoring and ADNEX Model were applied and computed based on the sonologic fi ndings to differentiate whether the ovarian neoplasm was benign or malignant. The gold standard was the histopathologic examination of the mass after surgery. @*Results@#There was no signifi cant difference in the accuracy of Sassone Scoring and ADNEX model in pre-operatively differentiating benign and malignant ovarian neoplasm with 88% and 89% accuracy rate, respectively. Sassone scoring has a sensitivity of 62.5% and specifi city of 91.67% while ADNEX has a sensitivity and specifi city of 37.5% and 96.67%, respectively@*Conclusion@#There is no signifi cant difference in using SASSONE and ADNEX model in differentiating benign and malignant ovarian neoplasm prior to surgery. Both may be used as an ultrasound scoring system for predicting ovarian malignancy. However, in cases of suspicious tumors, ADNEX model is more useful in discriminating the type and stage of malignancy.

Pattern of mechanical ocular injuries in patients visiting a rural referral centre / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM:To study the pattern of mechanical ocular injuries in patients visiting a rural referral center.·METHODS:The study was conducted in the department of Ophthalmology, Dr. Rajendra Prasad Government Medical College ( RPGMC ) , Kangra ( Himachal Pradesh ) for a period of 12mo from 1st Jan 2013-31st Dec 2013 which included data collection, data organization, presentation, data analysis and data interpretation followed by a period of follow up extending to a period of 1mo. A total of 200 patients were studied which included all patients of mechanical ocular injuries that visited our department either directly or were referred from other public or private institutions during the study period. It was a prospective study in which all the patients were interviewed with the aid of a questionnaire and underwent a detailed ocular examination. The injuries were classified according to the international ocular trauma classification into open globe and closed globe injuries. The injuries of the lid and adnexa and the cranial nerve palsies were considered as separate entities and data analysis was done with MS Excel 2007 worksheet using the Epi info7 software.·RESULTS: A total of 21,710 patients attended the out-patient department( OPD) during the study period out of which 200 patients were of mechanical ocular trauma which formed 0. 921% of the total OPD attendance. The patients ranged in age from 1-80y with a mean age and standard deviation of 33. 12 ± 20. 48y. In those patients 151 patients ( 75. 5%) were males and 49 ( 24. 5%) were females. The male to female ratio was 3:1. Out of the 200 patients studied, 100 were injured at home, 19 in the playground, 29 had occupational injuries, 38 were injured in road side accidents, 10 were injured due to assault, 3 at school and 1 patient was injured during a stampede that occurred in a religious camp. The visual acuity at presentation was upto 6/12 in 47%, <6/12 to 6/36 in 13. 5%, <6/36-1/60 in 6%, <1/60 to PL ( perceive light ) positive in 22% and PL negative in 4 % patients. In 7. 5 %patients the visual acuity could not be assessed on the Snellen's chart. Most of the patients had closed globe injuries (54. 5%) followed by involvement of the lid and adnexa (23%). And 19. 5% had open globe injuries and 3% had involvement of the cranial nerves.· CONCLUSION: Ocular injuries are common and preventable causes of monocular blindness.

Torsión anexial: presentación clínica y manejo en una serie retrospectiva de 17 años

Objetivos: Analizar y presentar la epidemiología descriptiva de pacientes con antecedente de torsión anexial. Diseño: Estudio observacional, descriptivo y retrospectivo. Institución: Hospital Universitario Doctor Peset, Valencia, España. Participantes: Mujeres diagnosticadas de torsión anexial. Intervenciones: Diagnóstico y tratamiento de 54 mujeres de entre 11 y 64 años entre el 1/02/1997 y 30/06/2014. Resultados: En las 54 pacientes incluidas, la edad media al diagnóstico fue 31,7 años; 6 (11 ,1 %) pacientes habían sido intervenidas quirúrgicamente por patología anexial previa. El anexo más afectado fue el derecho; 34 (62,9%) pacientes presentaban masas anexiales. El síntoma de presentación en todas las pacientes fue el dolor pélvico agudo, y el tiempo medio transcurrido desde la aparición de la clínica hasta el trata­ miento fue de 24 a 72 horas. En 14 (25,9%) pacientes se realizó laparotomía y en 40 (74,1%) laparoscopia; 3 (5,6%) pacientes presentaron recidiva de la torsión de forma posterior. Conclusiones: El cuadro de torsión anexial debe tenerse en cuenta en toda mujer que acude a urgencias con dolor abdominal agudo. Esta patología es considerada una urgencia quirúrgica, y un retraso en el diagnóstico y tratamiento puede dar lugar a la pérdida del anexo afecto. Hoy en día, la vía laparoscópica es la de elección para su tratamiento en estas pacientes.

Objectives: To present the descriptive epidemiology in a group of women with adnexal torsion. Design: Observational, descriptive and retrospective study. Setting: Hospital Universitario Doctor Peset, Valencia. Spain. Participants: Women diagnosed of adnexal torsion. Interventions: Between February 1997 and june 2014, 54 patients 11-64 years old with adnexal torsion were included. Results: The mean onset age was 31.7 years old. Previous adnexal surgerywas reported in 6 cases (11.1 %). The right adnexal region was the most affected; 34 (62.9%) patients were adnexal mass carriers. The most common presenting symptom was acute pelvic pain, and the mean lag time between onset of symptoms and confirmation of diagnosis was 24-72 hours. Fourteen (25.9%) patients were treated by laparotomy and 40 (74.1 %) by laparoscopy. Recurrence occurred in 3 patients (5.6%). Conclusions: Adnexal torsion should be considered in everywoman complaining of pelvic pain in emergency services. A prompt surgical intervention is required to avoid irreversible ovarian damage. Nowadays, conservative therapy by laparoscopy is preferred in these patients.

Beta therapy with 90strontium as single modality therapy for canine squamous cell carcinoma in third eyelid / Betaterapia com estrôncio-90 como modalidade única de terapia para o carcinoma de células escamosas na terceira pálpebra em cães

The purpose was to evaluate the effectiveness of beta-radiation with strontium-90 as single modality treatment of canine third eyelid squamous cell carcinoma (SCC). Nine dogs diagnosed with third eyelid SCC were treated with strontium-90. Radiation therapy was administered in four fractions of 100cGy per site every four days and at a depth of 0.2cm (Strontium-90 build' up) in each fraction. Radiation with beta therapy was well tolerated in all animals with no occurrence of radiation induced cataracts. In all cases, there were increased signs of conjunctival inflammation around the mass, which subsided with topical anti-inflammatory. Two dogs required surgical treatment for local tumor recurrence at 150 days and 352 days. In the remaining seven cases, disease free interval ranged from 1239 days to 2555 days. Beta therapy using 90Sr may be a valid alternative for the treatment of third eyelid SCC in dogs.

O objetivo foi avaliar a eficácia da betaterapia com estrôncio-90 como modalidade única de tratamento em carcinomas de células escamosas (CEC) da terceira pálpebra de cães. Nove cães foram diagnosticados com CEC de terceira pálpebra, que foram tratados com estrôncio-90. A radioterapia foi administrada em quatro frações de 100cGy por local, a cada quatro dias e a uma profundidade de 0,2cm em cada fração. A betaterapia foi bem tolerada por todos os animais, sem ocorrência de catarata induzida pela radiação. Em todos os casos, houve um aumento dos sinais de inflamação da conjuntiva ao redor da neoformação, as quais cederam com o uso de anti-inflamatório tópico. Em dois cães houve a necessidade de tratamento cirúrgico, pois houve recorrência local do tumor aos 150 dias e aos 352 dias. Nos outros sete casos, o intervalo livre de doença variou entre 1.239 dias e 2.555 dias. Betaterapia usando 90Sr pode ser uma alternativa válida para o tratamento do CEC da terceira pálpebra em cães.

Ultrasonography of adnexal causes of acute pelvic pain in pre-menopausal non-pregnant women

Acute-onset pelvic pain is an extremely common symptom in premenopausal women presenting to the emergency department. After excluding pregnancy in reproductive-age women, ultrasonography plays a major role in the prompt and accurate diagnosis of adnexal causes of acute pelvic pain, such as hemorrhagic ovarian cysts, endometriosis, ovarian torsion, and tubo-ovarian abscess. Its availability, relatively low cost, and lack of ionizing radiation make ultrasonography an ideal imaging modality in women of reproductive age. The primary goal of imaging in these patients is to distinguish between adnexal causes of acute pelvic pain that may be managed conservatively or medically, and those requiring emergency/urgent surgical or percutaneous intervention.

Added Value of Using a CT Coronal Reformation to Diagnose Adnexal Torsion

OBJECTIVE: To evaluate the increased value of using coronal reformation of a transverse computed tomography (CT) scan for detecting adnexal torsion. MATERIALS AND METHODS: This study included 106 woman suspected of having adnexal torsion who underwent CT with coronal reformations and subsequent surgical exploration. Two readers independently recorded the CT findings, such as the thickening of a fallopian tube, twisting of the adnexal pedicle, eccentric smooth wall thickening of the torsed adnexal mass, eccentric septal thickening of the torsed adnexal mass, eccentric poor enhancement of the torsed adnexal mass, uterine deviation to the twisted side, ascites or infiltration of pelvic fat, and the overall impression of adnexal torsion with a transverse scan alone or combined with coronal reformation and a transverse scan. The areas under the receiver operating characteristic curves (AUCs), sensitivity, specificity, and positive predictive value were used to compare diagnostic performance. RESULTS: Fifty-two patients were confirmed to have adnexal torsion. The addition of coronal reformations to the transverse scan improved AUCs for readers 1 and 2 from 0.74 and 0.75 to 0.92 and 0.87, respectively, for detecting adnexal torsion (p < 0.001 and p = 0.004, respectively). Sensitivity of CT for detecting twisting of the adnexal pedicle increased significantly for readers 1 and 2 from 0.27 and 0.29 with a transverse scan alone to 0.79 and 0.77 with a combined coronal reformation and a transverse scan, respectively (p < 0.001 and p < 0.001, respectively). CONCLUSION: Use of a coronal reformation with transverse CT images improves detection of adnexal torsion.

Caracterización clínica e histopatológica de los tumores de los anexos oculares / Clinical and histopathological characterization of ocular adnexa tumors

OBJETIVO: determinar las características clínicas e histopatológicas de los tumores en los anexos oculares durante el período 2009 al 2010. MÉTODOS: se realizó un estudio observacional descriptivo longitudinal retrospectivo en un grupo de 166 pacientes con diagnóstico de tumor de anexos oculares, escogidos en consulta de Oculoplastia en Holguín. RESULTADOS: predominó la edad comprendida entre 41 a 50 años, con 37,35 %. El sexo más afectado fue el femenino con 53,61 %. La mayor cantidad de lesiones se encontró en los párpados de 114 pacientes. El tipo histológico mayormente identificado fue el nevus con 25,90 %, seguido por el carcinoma basal con 18,07 %. Se obtuvo una concordancia de 83,13 % entre el diagnóstico clínico y el histológico. CONCLUSIONES: en los pacientes estudiados las lesiones tumorales de los anexos se expresan comúnmente en el sexo femenino con una edad riesgosa a partir de la cuarta década de la vida donde los parpados son los más susceptibles. El nevus y el carcinoma basocelular se comportaron como un problema de salud por su predominante frecuencia, con una buena utilidad del método clínico en su diagnóstico.

OBJECTIVE: to describe the clinical and histopathological signs of ocular adnexa tumors detected in the 2009-2010 period. METHODS: retrospective, longitudinal, descriptive and observational study of 166 patients presenting with some adnexa tumors, who were chosen at the oculoplasty service located in Holguin province. RESULTS: the 41 to 50 years-old group accounted for 37,35 %. The most affected patients were females with 53,61 %. The greatest amount of injures was found in the eyelids of 114 individuals; the mostly identified histological type was nevus which represented 25,90 % of cases, followed by basal carcinoma with 18,07 %. An agreement of 83,13 % between the clinical and the histopathological diagnosis was reached. CONCLUSIONS: the tumor lesions of adnexa found in the studied patients commonly occur in females at risky ages as of the 40 years when the eyelids are more sensitive. Nevus and basocelular carcinoma became health problems due to their predominant frequency, and they were correctly diagnosed by the clinical method.

Diagnóstico clínico e histopatológico de los tumores de los anexos oculares / Clinical, histological and pathological diagnosis of tumors of the ocular adnexas

Se realizó un estudio observacional, descriptivo, prospectivo y longitudinal de 92 pacientes con tumores de los anexos oculares, que acudieron a la consulta de Oculoplastia en el Centro Oftalmológico del Hospital General "Dr. Juan Bruno Zayas Alfonso" de Santiago de Cuba, desde enero del 2008 hasta enero del 2009, con vistas a determinar los tipos más frecuentes de estos tumores, a través de biopsias para confirmar histopatológicamente el diagnóstico de sospecha. En la investigación predominaron la edad avanzada, el sexo masculino y el color de la piel blanco; asimismo, todos los afectados presentaron aumento de volumen, aunque la mayoría estaban asintomáticos. Los tumores se localizaron con mayor frecuencia en los párpados (52,2 %) y, en menor cuantía, en la conjuntiva (45,7 %), con primacía del carcinoma basocelular como neoplasia maligna y la verruga vulgar como tumor benigno en los primeros, así como de las lesiones pigmentadas benignas y el granuloma piogénico en la segunda.

An observational, descriptive, prospective and longitudinal study of 92 patients with ocular tumors of the adnexa who visited the Oculoplasty Department of "Dr. Juan Bruno Zayas Alfonso" General Hospital in Santiago de Cuba was carried out from January, 2008 to January, 2009, aimed at determining the most frequent types in these tumours, through biopsies to confirm histopathologically the suspected diagnosis. Advanced age, male sex and the white color of the skin prevailed in the investigation; also, all the affected patients presented an increase of volume, although most were asymptomatic. Tumors were frequently located in the lids (52.2%) and, in a lower number, in the conjunctiva (45.7%) with predominance of the basocelular carcinoma as malignant tumor and the vulgar wart as benign lesion, in a lower number in the first ones, as well as of the benign pigmented lesions and the pyogenic granuloma.

Multidetector Computed Tomography for the Assessment of Adnexal Mass: Is Unenhanced CT Scan Necessary?

OBJECTIVE: To compare the diagnostic performance and radiation dose between contrast-enhanced CT (ECT) alone, and combined unenhanced and contrast-enhanced CT (UE + ECT) for the assessment of adnexal mass. MATERIALS AND METHODS: This retrospective study was approved by the Institutional Review Board. A total of 146 consecutive patients (mean age, 41.1 years) who underwent preoperative unenhanced and contrast-enhanced multidetector CT of the pelvis and had adnexal masses found at surgery were included. Two readers independently evaluated the likelihood of adnexal malignancy on a 5-point scale on two different imaging datasets (ECT alone and UE + ECT). The area under the receiver operating characteristic curve (AUC) was used to evaluate diagnostic performance. Radiation dose to patients was calculated by the volume CT dose index (CTDIvol) and the dose length products (DLP) on each dataset. RESULTS: Of the total 178 adnexal masses, 133 masses were benign and 45 masses were malignant. For both readers, there is no significant difference of AUC values between ECT alone and UE + ECT for the detection of adnexal malignancy (reader 1, 0.93 vs. 0.95; reader 2, 0.92 vs. 0.91) (p > 0.05). The mean CTDIvol (12.6 +/- 2.2 mGy) and DLP (641.2 +/- 137.2 mGy) of ECT alone was significantly lower than the mean CTDIvol (21.5 +/- 2.7 mGy) and DLP (923.6 +/- 158.8 mGy) of UE + ECT (p < 0.0001). CONCLUSION: The use of unenhanced CT scan in addition to contrast-enhanced CT scan does not improve the detection of adnexal malignancy, but increases radiation exposure.

The influence of detorsion of adnexal torsion on melondialdehyde, peroxidase catalase, and catalase of ovarian tissue in rabbits / 解放军医学杂志

Objective To observe the influence of reperfusion after adnexal torsion (AT) on malondialdehyde (MDA), glutathione peroxidase catalase (GSH-Px) and catalase (CAT) contents of ovarian tissue in rabbits. Methods Forty female Japanese long-eared white rabbits were randomly divided into study group (n=32) and control group (n=8). The left adnexa of rabbits in the study group was clockwise twisted three laps, and then fixed on the left abdominal walls. Adnexal detorsion was then done 24 hours after adnexal torsion in the study group, and then the rabbits were divided into 4 groups (8 each). Both ovaries of each group were removed 24h, 48h, 72h and 96h, respectively, after reperfusion. The rabbits in the control group received sham-operation and both ovaries were removed 96h later. The removed left ovaries were used for biochemical detection of GSH-Px, CAT and MDA. All the right ovaries were used as experimental internal-control. Results The activity of GSH-Px declined significantly 24h to 72h after adnexal detorsion (P0.05). The activity of CAT declined significantly 24h and 48h after adnexal detorsion (P0.05). Conclusions Detorsion after adnexal torsion can affect the degree of oxidative stress injury in rabbits' ovaries as shown by the changes in the activities of GSH-Px, CAT and MDA. With the elongation of detorsion time, ovarian injury will be gradually alleviated.