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The commonest diagnosis of a cystic mass in the pelvis is ovarian cyst, here we report a case of cystic degeneration of broad ligament fibroid mimicking as a ovarian cyst. A 45-year-old lady presented with abdominal discomfort. On evaluation, a pelvic mass of 20 weeks size of varying consistency was noted. Ultra sonogram and Magnetic Resonance Imaging gave a differential diagnosis of right sided broad ligament fibroid and ovarian cyst. Anticipating possible ovarian mass owing to its size, laparotomy was performed and noted a large false broad ligament fibroid which has undergone cystic degeneration. Total abdominal hysterectomy and bilateral salpingo-oopherectomy was performed, however a differential diagnosis of ovarian mass should always be made before surgery.
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This paper reported a rare case of hypercalcemic crisis caused by a parathyroid adenoma with hemorrhage and cystic degeneration. Preoperative imaging examination of the patient was unable to determine the histological origin of the cervical cystic lesion. Despite aggressive medical treatment and hemodialysis, hypercalcemic crisis could not be relieved. Therefore, surgical exploration and excision of the cervical lesion were performed, and final diagnosis of parathyroid adenoma with hemorrhage and cystic degeneration was confirmed by pathology. Blood calcium level and renal function returned to normal after the surgery.
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Objective: To analyze the computed tomography (CT) and magnetic resonance imaging (MRI) features of solid pseudopapillary tumor of pancreas (SPTP) and to study the growth characteristics, so as to improve the understanding and diagnosis of SPTP. Methods: The clinical data, and CT and MRI data of 103 patients with SPTP confirmed by postoperative pathology, who underwent surgical resection in our hospital between May 2012 and Nov. 2018, were analyzed retrospectively. The gender, age, tumor maximum diameter, tumor location, tumor shape, pseudocapsule, cystic degeneration, intratumoral hemorrhage and calcification were analyzed, and the stratified analysis was carried out according to gender, age, tumor maximum diameter and tumor location. Results: A total of 104 lesions (25 lesions in males and 79 in females) of 103 SPTP patients (25 [24.3%] males and 78 [75.7%] females) were included. The average ages of the males and females were (40.4 ± 11.3) years old and (32.9± 12.0) years old, respectively, and the difference was significant (P = 0.004). The mean tumor maximum diameters of the males and females were (36.8 ± 25.3) mm and (50.0 ± 31.2) mm, respectively, and the difference was significant (P = 0.046). The results of stratified analysis showed that the females were more likely to have pseudocapsule (62 cases), cystic degeneration (41 cases) and intratumoral hemorrhage (37 cases) compared with the males (13 cases, 3 cases and 6 cases, respectively), and the differences were significant (all P 3 cm are more likely to have pseudocapsule, cystic degeneration, hemorrhage and calcification.
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OBJECTIVE: To retrospectively assess conventional magnetic resonance imaging (MRI) features that differentiate malignant pure mesenchymal uterine tumors (MPMUT); endometrial stromal sarcoma (ESS) and leiomyosarcoma (LMS) from uterine leiomyoma with cystic degeneration (ULCD). METHODS: We retrospectively reviewed magnetic resonance (MR) images of 30 patients with ULCD, 18 with ESS, and 15 with LMS, to assess tumor location, margin, T2 signal intensity (SI), speckled appearance, and peripheral band using univariate and multivariate analyses. RESULTS: ULCD more frequently showed subserosal location (53.3%), well-defined margin (96.7%), and speckled appearance (90.0%) compared with ESS (0%, 33.3%, and 33.3%, respectively) or LMS (20.0%, 33.3%, and 60.0%, respectively). In quantitative T2 SI comparisons, the T2 SI ratio of the main solid tumor portion to gluteus maximus muscle differed significantly among the three groups, with ULCD showing a lower SI ratio (0.62) compared with ESS (2.44) and LMS (1.13). On multivariate analysis, an ill-defined margin (odds ratio [OR]=44.885; p=0.003) and high T2 SI (OR=4.396; p=0.046) were the significant MR differentiators. CONCLUSION: An ill-defined tumor margin and high T2 SI ratio of the main solid tumor-to-gluteus maximus muscle were useful MRI features in the differentiation of MPMUT from ULCD.
Subject(s)
Humans , Leiomyoma , Leiomyosarcoma , Magnetic Resonance Imaging , Multivariate Analysis , Retrospective Studies , Sarcoma, Endometrial StromalABSTRACT
Objective To investigate etiology and pathological morphological characteristics of sudden death caused by non-atherosclerotic aortic dissection. Propose accurate diagnosis of non-atherosclerotic aortic dissection by a proper method to autopsy. Methods A total of 8 cases of non-atherosclerotic aortic dissection from 2007 to 2015 were evaluated and analyzed in the present study. Results Non-atherosclerotic aortic dissection rupture is more common in men under the age of 40. It is lack of a typical clinical symptoms and had no marked history of hypertension. There are no related pathological changes of hypertension observed in autopsy. The pathological type is mainly DeBakey 1, in the main arteries,where it was found that decrease of elastic fibers and smooth muscle, cystic degeneration, inflammatory cell infiltration and other changes in media membrane. These changes were also found in the media arteries in 5 cases. Conclusion The etiology of non-atherosclerotic aortic dissection is complex, which is closely associated with many factors, such as genetics and inflammation. It affects the vessels systemically. In addition, systematic examination of large vessels is necessary as well as the examination of the middle arteries during autopsy. It is suggested that genetic tests are carried out for definite diagnosis.
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Resumen: ANTECEDENTES: el leiomioma uterino es el tumor benigno más frecuente en mujeres en edad fértil que puede ser asiento de fenómenos de degeneración y causa de confusión o error en el diagnóstico. CASO CLÍNICO: paciente de 48 años de edad que ingresó por antecedente de dolor en el hipogastrio, con irradiación hacia ambas fosas y flancos e incremento del perímetro abdominal. En la revisión inicial el abdomen se encontró "globoso", con tumoración dependiente de hueco pélvico, que va desde la sínfisis del pubis hasta debajo de la cicatriz umbilical, de consistencia sólida, bordes regulares, móvil. En la exploración ginecológica, a la palpación bimanual, no se logró delimitar el fondo uterino, ni el origen de la tumoración. Los estudios paraclínicos solicitados, incluidos los marcadores tumorales, se reportaron normales. El ultrasonido abdómino-pélvico reportó que el útero estaba normal, con una gran tumoración de forma redonda, márgenes lisos y debidamente delimitados, compatibles con cistoadenoma, sin que se haya determinado el lado de ubicación de la lesión. En la laparotomía exploradora se observó que el útero medía 22 x 16 cm, con un mioma con probable degeneración quística en la cara anterior, anexos de aspecto macroscópicamente normales, sin líquido libre; se realizó histerectomía abdominal total. CONCLUSIÓN: se demuestra que a pesar de que el leiomioma tiene unas imágenes típicas en la mayor parte de los casos, cuando hay cambios degenerativos estos pueden asemejar una tumoración quística ovárica, por ello deben considerarse en el diagnóstico diferencial de las masas anexiales.
Abstract: BACKGROUND: The fibroid or uterine fibroid is the most frequent benign tumor in women of childbearing age, with relative frequency, leiomyoma may be the site of degenerative phenomena, which may lead to confusion or error in diagnosis. CASE REPORT: A 48-year-old female, admitted to our service by the emergency department for a history of hypogastric pain radiating to both pits and flanks and an increase in the abdominal perimeter for a month And medium, negates weight loss, no history of chronic-degenerative diseases, or surgical. On abdominal examination, "globose" at the expense of adipose panicle and pelvic egg-dependent tumor, extending from symphysis pubis to below umbilical scar, solid consistency, regular edges, mobile, soft abdomen, not found Data of peritoneal irritation, during gynecological examination, external genitalia normal to speculum is found, mobile eutrophic cervix, non-painful, without endophytic or exophytic lesions, free sack bottoms, biimanual palpation is not possible to delimit uterine fundus or origin of The tumor, the results of requested paraclinics, including blood count, blood chemistry, liver function tests, coagulation tests and ovarian tumor markers were normal. The abdomino-pelvic ultrasound reports a normal uterus, well delimited margins, size 59 x 35 mm, with endometrium of 7 mm, as well as the presence of a large round-shaped tumor, the margins are smooth and well delimited, this lesion Presents liquid content with internal echoes, in addition to the presence of septa some up to 4 mm thick. Color Doppler is applied and there is only evidence of some thin vessels in peripheral form, the septa do not reveal vascularity, being compatible as first choice, with a cystadenoma, without being able to determine which side is the lesion. In the exploratory laparotomy, a 22 x 16 cm uterus is observed, with presence of myoma with probable cystic degeneration in the anterior face, macroscopically normal appendages, no free fluid is observed, total abdominal hysterectomy is performed. CONCLUSION: Our case shows that, although the myoma presents typical images in most cases, when there are degenerative changes that distort the normal structure of the tumor, it may resemble an ovarian cystic tumor, and should therefore be Considered within the differential diagnosis of the adnexal masses.
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@#Objective To observe the relationship between spinal cord cystic degeneration, spinal cord movement improvement and apparent diffusion coefficient (ADC) values after early cervical spinal cord injury. Methods 18 patients with early cervical spinal cord injury were examined with MRI T1WI, T2WI and diffusion weighted imaging (DWI). Then ADC values and ADC maps were obtained. Their ASIA motor scores were also recorded. The relationship between spinal cord cystic degeneration and spinal cord movement improvement and ADC values was analyzed. Results ADC values were lower in those with cystic degeneration than without cystic degeneration in early cervical spinal cord injury, and the cut-off point was 700×10-6 mm2/s. ADC values were positively correlated with age. The movement improvement did not obviously correlate with ADC values. Conclusion ADC values of early cervical spinal cord injury are less than 700×10-6 mm2/s when cystic degeneration happened. Motor function recovery of patients with early cervical spinal cord injury cannot be estimated by measuring ADC values.
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Objective To observe the relationship between spinal cord cystic degeneration, spinal cord movement improvement and ap-parent diffusion coefficient (ADC) values after early cervical spinal cord injury. Methods 18 patients with early cervical spinal cord injury were examined with MRI T1WI, T2WI and diffusion weighted imaging (DWI). Then ADC values and ADC maps were obtained. Their ASIA motor scores were also recorded. The relationship between spinal cord cystic degeneration and spinal cord movement improvement and ADC values was analyzed. Results ADC values were lower in those with cystic degeneration than without cystic degeneration in early cervi-cal spinal cord injury, and the cut-off point was 700×10-6 mm2/s. ADC values were positively correlated with age. The movement improve-ment did not obviously correlate with ADC values. Conclusion ADC values of early cervical spinal cord injury are less than 700×10-6 mm2/s when cystic degeneration happened. Motor function recovery of patients with early cervical spinal cord injury cannot be estimated by mea-suring ADC values.
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Two females aged 70 years and 45 years presented in OPD of Dept. of Gynecology with large abdominal lump and ascites. In both cases, clinical and radiological diagnosis of malignant ovarian tumor was made. Ascitic fluid cytology revealed absence of malignant cells. Panhysterectomy was performed. On histopathological examination, both cases were diagnosed as benign fibrothecoma with extensive cystic change. Postoperative follow-up for about six months was uneventful and both patients recovered completely.
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To present a rare case of a cystic giant schwannoma of the sacrum mimicking aneurysmal bone cyst (ABC). A 54-year-old man visited our institute complaining left leg weakness and sensory change for several years. Magnetic resonance imaging revealed a large multilocular cystic mass with canal invasion and bone erosion confined to left S1 body. The lesion showed multiple septal enhancement without definite solid component. Initially the tumor was considered as ABC. The patient underwent grossly-total tumor resection with lumbosacral reconstruction via posterior approach. The tumor was proved to be a cystic schwannoma. The postoperative course was uneventful and the patient was relieved from preoperative symptoms. We present a rare case of pure cystic giant schwannoma confined to sacrum mimicking ABC. The surgical treatment is challenging due to the complex anatomy of the sacrum. Schwannoma should be considered in the differential diagnosis of osteolytic sacral cysts.
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Humans , Middle Aged , Aneurysm , Bone Cysts , Diagnosis, Differential , Leg , Magnetic Resonance Imaging , Neurilemmoma , SacrumABSTRACT
Cystic liver metastasis, which lacks specific clinical manifestations and standardized treatment, rarely occurs after radical gastrectomy. This study presented two gastric cancer cases with cystic liver metastasis treated in Wuxi People's Hospital from September 2008 to November 2012. The two female patients were 66 and 65 years old, respectively. Poorly differentiated ulcerated adenocarcinoma classified as stage III B [Tumor, Node, and Metastasis Classification (T4aN2M0)] and clinical manifestations of abdominal distension and ascites were detected in both patients. Cyst fluids were subjected to cytological analysis. Results confirmed the presence of liver metastasis of gastric cancer. The two patients benefited from local intracavitary chemotherapy or systemic intravenous chemotherapy.
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Adenomyoma is a benign tumor composed of smooth muscle and benign endometrium. These tumors typically originate within the uterus. An extrauterine adenomyoma is a rare entity. Cystic degeneration of adenomyoma is also very rare case. We report a case of huge extrauterine endometrioid-type adenomyoma with cystic change with brief review of literature.
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Female , Adenomyoma , Endometrium , Muscle, Smooth , UterusABSTRACT
Uterine leiomyoma is common benign tumor in reproductive age woman. And secondary degeneration of uterine leiomyoma can be occurred usually during midpregnancy and the puerperium. But, spontaneous perforation of uterine leiomyoma with cystic degeneration is very rare. We have experienced a case of spontaneous perforation of a huge cystic degenerative uterine leiomyoma associated with massive hemoperitoneum in a menopausal woman, and report it with a brief review of literature.
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Female , Humans , Hemoperitoneum , Leiomyoma , Postpartum PeriodABSTRACT
Imaging studies, notably ultrasound or MRI may aid in clinical evaluation. However, in some circumstances such imaging studies can be misleading. Here we are reporting with a brief review, an experienced case where uterine submucosal myoma with cystic degeneration is successfully diagnosed and treated with hysteroscopy.
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Female , Pregnancy , Abortion, Missed , Diagnosis , Hysteroscopy , Magnetic Resonance Imaging , Myoma , UltrasonographyABSTRACT
Pleomorphic adenoma is the most common tumor to arise in the parotid gland, generally presenting as a slowly-enlarging, firm, well-circumscribed, painless nodule. In the dermatologic department, it can be clinically misdiagnosed as an epidermal cyst or various dermal or subcutaneous tumors. The vast majority of these tumors are solid, but a few examples have rarely been associated with cystic degeneration. Diagnosis and therapy become difficult, when the tumor undergoes cystic degeneration. We describe a 43-year-old man with a tender, cystic mass on the right cheek. Under an impression of an epidermal cyst, total surgical excision was done. Histopathological findings of the tumor mass revealed pleomorphic adenoma with cystic degeneration. There has been no evidence of recurrence in the following two years since the removal. In the dermatologic field, we emphasize that pleomorphic adenoma should be included in the diagnosis of tumors on the face.
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Adult , Humans , Adenoma, Pleomorphic , Cheek , Diagnosis , Epidermal Cyst , Parotid Gland , RecurrenceABSTRACT
The incidence of uterine myoma with cystic degeneration is 4% and symptomatic uterine myoma requires surgical management. We experienced a case of intraligamentary leiomyoma with huge cystic degeneration with its total weight 2526gm in 48 years old woman and brief review of the case and its literatures are presented.
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Female , Humans , Middle Aged , Incidence , LeiomyomaABSTRACT
Intracranial germinomas are malignant neoplasms arising from remnants of primitive germ cells that have failed to migrate to the genital crest during embryonic life. They are usually solid tumors, but focal cysts may occasionally be found within them and are thought to represent proteinaceous fluid. Cystic degeneration of the whole tumor, however, that is caused by intratumoral hemorrhage, has not yet been reported. We present a case of cystic degeneration of solid suprasellar germinoma. During surgery, cyst content was shown to be liquefied hematoma, and bleeding of the tumor had occurred. The exact time of intratumoral hemorrhage in the presented case is unknown, but since there had been no episode of apoplexy, we believe that degeneration occurred chronically. The patient's postoperative course was uneventful. On the basis of our findings we suggest that in diagnosing suprasellar cystic tumors, the possibility of germinomas must be taken into consideration and that spontaneous cystic degeneration of suprasellar germinoma can occur as a result of tumor bleeding.
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Central Nervous System Cysts , Germ Cells , Germinoma , Hematoma , Hemorrhage , StrokeABSTRACT
Leiomyorrw is the mest cunmon in the uterine hunor. Smooth muscle tumors of the female genital taact arise mostly from the uterine myometrium and only rarely from the broad ligament. We experienced a cases of huge leiomyoma of the broad ligarnent with secondary cystic degeneration. In the respect of rarity, we report this case with a brief review.