Melanosis tubae et ovarii: An overlooked entity?

Melanosis is a rare benign entity defined by the deposition of brownish-black pigment in a wide variety of organs especially the gastrointestinal tract, peritoneum, fallopian tubes and ovaries. Melanosis of the fallopian tube is widely known as pigmentosis tubae. Literature has mentioned ovarian teratomas and serous cystadenomas to be associated with the ovarian and peritoneal melanosis. We report five such cases of tubo-ovarian melanosis. The cases include mature teratoma and serous cystadenoma as well as melanosis of the fallopian tubes with otherwise normal ovarian histology. The importance of recognising this entity lies in its differential diagnosis.

Schwannoma pancreático como tumor sincrónico. Reporte de caso / Pancreatic schwannoma as a synchronous tumor. Case report

Los Schwannomas son tumores derivados de las células de Schwann de las vainas de los nervios periféricos. Se pueden localizar en cualquier región anatómica que contenga tejido nervioso periférico, siendo más frecuentes en la región craneofacial y las extremidades. Los Schwannomas pancreáticos son entidades sumamente infrecuentes de las cuales solo se han descrito 68 casos a nivel mundial. En el presente trabajo se presenta el caso de un paciente con hallazgo incidental de tres tumores sincrónicos dentro de los cuales se encuentra un Schwannoma pancreático.Caso clínico : Paciente femenino de 66 años de edad con antecedente de diabetes mellitus tipo 1 y enfermedad diverticular pancolónica quien acude presentando cuadro clínico compatible con absceso lumbar izquierdo. Se realiza TC de abdomen y pelvis con doble contraste que evidencia extensa área de colección heterogénea en región retroperitoneal que diseca hacia región lumbar y glútea izquierda, además de la presencia de tumor hipodenso de bordes lobulados en mesogastrio. Se realiza colonoscopia que reporta lesión exofítica ulcerada en unión rectosigmoidea. El resto de paraclínicos y estudios de extensión se encontraban dentro de límites normales. Se decide resolución quirúrgica mediante drenaje percutáneo de absceso y laparotomía exploradora. Informe histopatológico: cistoadenoma seroso microquístico de cuerpo de páncreas, Schwannoma de cola de páncreas y adenocarcinoma moderadamente diferenciado de colon sigmoides.Conclusión : Los Schwannomas pancreáticos son entidades sumamente infrecuentes que pueden presentarse con una amplia variedad de manifestaciones clínicas, sin embargo, deben tenerse en cuenta como posible diagnóstico diferencial ante el hallazgo de un tumor pancreático(AU)

Schwannomas, also called Neurilemmomas or Neurinomas, are tumors derived from Schwann cells of the peripheral nerve sheaths. They can be located in any anatomical region that contains peripheral nervous tissue, being more frequent in the craniofacial region and the extremities. Pancreatic Schwannomas are extremely rare entities of which only 68 cases have been described worldwide. In the present study we present the case of a patient with an incidental finding of three synchronous tumors, including a pancreatic Schwannoma.Clinical case : A 66-year-old female patient with a history of type 1 diabetes mellitus and pancolonic diverticular disease who presented with symptoms compatible with left lumbar abscess. A double-contrast CT of the abdomen and pelvis was performed, which revealed a large area of heterogeneous collection in the retroperitoneal region that dissected towards the left lumbar and gluteal region, in addition to the presence of a hypodense tumor with lobulated borders in the mesogastrium. A colonoscopy was performed, which reported an ulcerated exophytic lesion at the rectosigmoid junction. The rest of the paraclinical and extension studies were within normal limits. Surgical resolution is decided by percutaneous abscess drainage and exploratory laparotomy. Histopathological report: microcystic serous cystadenoma of the body of the pancreas, Schwannoma of the pancreas tail, and moderately differentiated adenocarcinoma of the sigmoid colon.Conclusion : Pancreatic Schwannomas are extremely rare entities that can present with a wide variety of clinical manifestations, however, they should be taken into account as a possible differential diagnosis when a pancreatic tumor is found(AU)

Quiste de ovario gigante y embarazo / Giant Ovarian Cyst and Pregnancy

Introducción: Los quistes en los ovarios son una afección frecuente en las mujeres en edad fértil. Objetivo: Presentar el caso de una mujer con embarazo a la que se le diagnostica un quiste gigante de ovario, de interés para los especialistas debido al tamaño y la favorable evolución. Presentación de caso: Paciente femenina de 28 años de edad, procedencia rural, con embarazo único. Se realizó captación del embarazo a las 11,4 semanas y se detectó al examen ginecológico una tumoración anexial que se corrobora por ultrasonido, donde se reporta una imagen quística que llega a la región umbilical que mide 18 centímetros, de paredes finas, multitabicada con un grosor de los tabiques de 2,3 milímetros, con vascularizazión a este nivel. Se decidió su ingreso para tratamiento quirúrgico a las 17,5 semanas de gestación, se realizó de forma electiva laparotomía exploradora. Los hallazgos operatorios fueron: quiste gigante de ovario de aproximadamente 20 centímetros. Fue dada de alta al tercer día con una evolución satisfactoria. Continúa su atención prenatal en en el consultorio del médico y la enfermera de la familia. Los resultados anatomopatológicos fue: cistodenoma seroso papilar de ovario de 20 por 20 centímetros, no se observan estigmas de malignidad. Se realiza parto eutócico a las 39,1 semanas de gestación, con un peso de 3800 gramos. Conclusiones: Se hace descripción clínico y quirúrgica del diagnóstico, la evolución, la intervención y el seguimiento de una mujer en quien coexistieron un embarazo y un cistodenoma seroso papilar de ovario, con resultados favorables(AU)

Introduction: Ovarian cysts are a frequent condition in women at fertile age. Objective: To present the case of a pregnant woman diagnosed with a giant ovarian cyst, of interest to specialists due to its size and favorable evolution. Case presentation: 28-year-old female patient, of rural origin, with a single pregnancy. During the first pregnancy consultation, at 11.4 weeks, the gynecological examination permitted to identify an adnexal tumor, a diagnosis corroborated by ultrasound imaging, reporting an 18-cm multi-septated cystic image that reaches the umbilical region, with thin walls, septa thickness of 2.3 millimeters and vascularization at this level. The patient was decided to be hospitalized for surgical treatment at 17.5 weeks of gestation; exploratory laparotomy was performed electively. The operative findings were a giant ovarian cyst of approximately twenty centimeters. She was discharged on the third day, with a satisfactory evolution. She continues to receive prenatal care in the family doctor and nurse's office. The anatomopathological results were an ovarian papillary serous cystadenoma measuring 20 per 20 cm; no stigmata of malignancy were observed. Eutocic delivery was performed at 39.1 weeks of gestation, the offspring weighing 3800 grams. Conclusions: A clinical and surgical description is made of the diagnosis, evolution, intervention and follow-up of a pregnant woman with an ovarian papillary serous cystadenoma, reporting favorable outcomes(AU)

Ovarian mass in pregnancy: case series

Ovarian masses in pregnancy are not uncommon. Ovarian masses during pregnancy should be accurately evaluated to identify the patients who need surgical interventions from those where it can be managed conservatively. Ultrasound and magnetic resonance imaging (MRI) are safe diagnostic tools during pregnancy. The overall incidence of ovarian tumours in pregnancy is 2.4-5.7%. Most masses are functional and asymptomatic and up to 70% resolve spontaneously in the second trimester. Both open surgery and laparoscopy can be performed considering the tumour diameter, gestational age and associated complications. A multidisciplinary approach is necessary in case of high suspicion of malignancy. This study evaluates the clinical features, course in pregnancy, management and pregnancy outcome in patients with ovarian masses diagnosed during pregnancy. This was a retrospective analysis of medical records of 6 patients diagnosed with ovarian mass during pregnancy in the department of Obstetrics and Gynaecology at Kanachur Institute of Medical Sciences, Mangalore from June 2019 to June 2020.

Quiste gigante de ovario / Giant cyst of ovary

Introducción: Los tumores de gran tamaño han sido descritos a través de la historia, entre ellos los ginecológicos y los de ovario cuando pesan más de 12 kg constituyen una rareza médica. Las masas tumorales en hemiabdomen inferior son causas frecuentes de consulta en cirugía general. Dentro de estas, los quistes de ovarios son los que con más frecuencia se diagnostican. Objetivo: Describir el caso de un quiste gigante de ovario en una paciente que fue atendida en consulta de cirugia general por aumento de tamaño en el abdomen de varios años de evolución. Caso clínico: Se expone el caso de una paciente femenina, con antecedentes de salud, que acude al servicio de cirugía general por aumento de volumen del abdomen, progresivo, insidioso de 2 años de evolución. Se diagnostica masa quística dependiente de ovario y en el transoperatorio se constata una tumoración quística del ovario que en el análisis histopatológico informa un cistoadenoma seroso de ovario. Conclusión: Los tumores del ovario no son tan frecuentes como los del útero y los de la mama, pero constituyen el tercer grupo de tumores benignos y malignos de la mujer. Se presentó el caso por lo infrecuente que resulta, la escasa frecuencia de reporte de estos casos lo cual aporta conocimiento a la comunidad médica sobre el tema(AU)

Introduction: Large tumors have been described throughout history, including gynecological tumors, and ovarian tumors when they weigh more than 12 kg constitute a medical rarity. Tumor masses in lower hemiabdomen are frequent causes of consultation in general surgery. Within these, ovarian cysts are the most frequently diagnosed. Objective: To describe the case of a giant ovarian cyst in a patient who was treated in a general surgery consultation due to an increase in abdomen size of several years of evolution. Clinical case: The case of a female patient, with a history of health, which goes to the general surgery service due to an increase in abdomen volume, progressive, insidious of 2 years of evolution, is presented. Ovarian-dependent cystic mass is diagnosed and a cystic tumor of the ovary is found in the transoperative period, which in the histopathological analysis reports a serous ovarian cystadenoma. Conclusion: Ovarian tumors are not as frequent as those of the uterus and those of the breast, but they constitute the third group of benign and malignant tumors of women. The case was presented because of the infrequent result, the low frequency of reporting these cases, which brings knowledge to the medical community on the subject(AU)

Quiste gigante de ovario / Giant cyst of ovary

RESUMEN Históricamente, se describen como tumores de gran tamaño aquellos que pesan más de 12 Kg, entre ellos los ginecológicos y los de ovario; sobre todo antes del advenimiento de la ecografía y en poblaciones de mala situación socioeconómica y nivel cultural, como en los países del continente africano. Se presentó un caso de quiste gigante del ovario, en una paciente de 45 años de edad, que fue atendida en el Servicio de Cirugía General del Hospital Municipal de Bocoio, provincia de Benguela, República de Angola, en el año 2015. Se presentó por un aumento de tamaño del abdomen de varios años de evolución Se le diagnosticó una masa quística dependiente de ovario, por ultrasonografía por no contar con otro medio de diagnostico imagenologico. Se confirmó a través de una laparotomía exploradora la presencia de una tumoración quística gigante del ovario de 20 kg de peso. Esta patología es poco frecuente en la actualidad debido al desarrollo de la Cirugía y de los medios de diagnósticos que permiten su detección precoz. El estudio anatomopatológico ulterior informó un cistoadenoma seroso de ovario izquierdo. La evolución de la paciente fue favorable. Se consideró un caso interesante por lo infrecuente, la poca existencia de reporte de estos casos en la literatura, sobre todo en Cuba, lo que contribuye a aportar conocimientos a la comunidad médica (AU).

ABSTRACT Through the history those tumors weighting more than 12 kg have been described as great size tumors, among them the gynecological and the ovarian ones, especially before the appearance of the ultrasonography, and among populations of bad socio-economic situation and low cultural level, like in the countries of the African continent. The authors presented the case of a giant ovarian cyst in a patient aged 45 years, who assisted in the Service of General Surgery of the Municipal Hospital of Bocolo, province of Benguela, Republic of Angola, in 1915. She arrived to the consultation due to an increase of the abdominal size of several years of evolution. By ultrasonography because there was no other mean of imaging diagnosis, the diagnosis was an ovary-dependent cystic mass. Using laparoscopy it was confirmed the presence of a giant cystic tumor of the ovary of 20 kg weight. This disease is few frequent nowadays due to the development of Surgery and diagnostic means allowing a precocious detection. The subsequent anatomopathologic study informed a serous cystadenoma of the left ovary. The patient had a satisfactory evolution. The case was considered interesting given its infrequency, the scarce existence of reports of cases like this in the literature, especially in Cuba, contributing with knowledge for the medical community (AU).

Collision Tumour of Ovary: A Report of Two Cases.

Collision tumour is defined as the presence of two distinct tumours in the same organ without any histological intermixing. Such tumours involving ovaries are extremely rare. We are presenting report of two cases of ovarian collision tumour. Our first case revealed features of mature cystic teratoma with mucinous cystadenoma. The second case showed components of both mature cystic teratoma and serous cystadenoma. Correct diagnosis of collision tumour will guide the surgeon towards proper treatment and favorable prognosis of patient.

Tratamento cirúrgico de lesões císticas do pâncreas: uma experiência unicêntrica / Surgical management of cystic lesions of the pancreas: a single-centre experience

ABSTRACT BACKGROUND: Cystic lesions of the pancreas represent a group of pancreatic diseases with great histological heterogeneity, varying from benign lesions, some of them with malignant potential, to overt malignant lesions. OBJECTIVE: To describe the cases of cystic lesions of the pancreas which underwent surgical intervention at a tertiary university hospital. METHODS: This is a retrospective population-based study (historical cohort) which was carried out enrolling individuals attended at the Outpatient service of Pancreas Surgery of the Hospital de Clínicas of Unicamp. The individuals underwent surgical procedures performed from January 2012 through December 2016. RESULTS: In the period evaluated, 39 cases of cystic lesions of the pancreas which underwent surgery were identified, 26 (66.6%) of which were female. The average age at diagnosis was 47.4±16.4 years (range, 18-73). In regards to symptoms, 35 (89.7%) were symptomatic. The average length of hospital stay was 10 days (range 4-76). Surgeries performed to treat the lesions depended on the localization and type of the lesions: cystojejunostomy (41%), distal pancreatectomy (36%), pancreaticoduodenectomy (15.4%), drainage of ruptured and/or infected pseudocyst (5.2%) and central pancreatectomy (2.6%). CONCLUSION: Cystic lesions of the pancreas are a group of lesions with a highly varying presentation and diagnostic approach and may require an also highly variable surgical treatment. An appropriate preoperative imaging diagnosis is essential for their management.

RESUMO CONTEXTO: As lesões císticas do pâncreas representam um grupo de doenças pancreáticas com grande heterogeneidade histológica, variando desde lesões benignas, algumas com potencial pré-maligno, até outras degeneradas para formas malignas. OBJETIVO: Descrever os casos de LCPs submetidos à intervenção cirúrgica em um hospital universitário terciário. MÉTODOS: Trata-se de um estudo retrospectivo populacional (coorte histórica) realizado com a participação de indivíduos atendidos no Ambulatório de Cirurgia do Pâncreas do Hospital de Clínicas da Unicamp. Os indivíduos foram submetidos a procedimentos cirúrgicos realizados no período de janeiro de 2012 a dezembro de 2016. RESULTADOS: No período avaliado, foram identificados 39 casos de lesões císticas do pâncreas operados, sendo 26 (66,6%) do sexo feminino. A idade média no diagnóstico foi de 47,4±16,4 anos. Em relação aos sintomas, 35 (89,7%) eram sintomáticos. O tempo médio de internação foi de 10 dias (variação de 4-76). As cirurgias realizadas para o tratamento das lesões dependeram da localização e do tipo das lesões: derivação pseudocisto-jejunal (41%), pancreatectomia distal (36%), pancreaticoduodenectomia (15,4%), drenagem de pseudocistos rotos e/ou infectados (5,2%) e pancreatectomia central (2,6%). CONCLUSÃO: As lesões císticas do pâncreas são um grupo de lesões cuja apresentação e abordagem diagnóstica são altamente heterogêneas e que podem requerer um tratamento cirúrgico altamente complexo e variável. Um diagnóstico pré-operatório adequado é essencial para definir o seu tratamento.

Rare huge serous cystadenoma of broad ligament: A case report and literature review / 吉林大学学报(医学版)

Objective: To analyze the clinical data and surgical treatment procedures of a patient vyith rare huge serous cystadenoma of broad ligament, to clarify its diagnostic and treatment characteristics, and to explore the present situation and advantages of laparoscope in the operation of broad ligament tumor. Methods: The patient vyas admitted to hospital due to abdominal distension for 2 years and aggravated ulness for 2 months. The diagnosis result vyas pelvic and abdominal mass arising from ovarian according to the preoperative color Doppler ultrasound and physical examination. Based on the laparotomy and intraoperative rapid pathological results, the patient was diagnosed as huge serous cystadenoma of broad ligament. The location of ureter and uteri artery and vein were carefully identified during the operation and they were ligated for hemostasis at the basal part of tumor. The operation was successful Results: The ultrasonography image of the huge serous cystadenoma of broad ligament was very similar to that of large ovarian tumor. The misdiagnosis rate of ultrasound was high, and CT and MRI were important for the identification of large broad ligament tumor; the accuracy rate of preoperative diagnosis could be improved by CT and MRI Carefully blunt separation close to the tumor surface during the operation could avoid the ureteral injury. The patient recovered well and discharged from hospital. Conclusion: The symptoms of huge serous cystadenoma of broad ligament patient are lack of specificity. The accuracy rate of preoperative diagnosis should be improved in combination with the medical history and imageological findings of the patient The operation plan should be chosen reasonably and the operation should be carefully performed to avoid the occurrence of secondary injuries.

Histopathological pattern of neoplastic ovarian lesions

Introduction: Ovarian neoplasm is the most fascinating tumor of women in terms of its histogenesis, clinical behavior and malignant potential. The ovary is the third most common site of primary malignancy in female genital tract after cervix and endometrium accounting for 30% of all cancers of female genital tract. Aim and objectives: To study frequency and distribution of different histological types of ovarian tumors and to analyse age distribution of these tumors and to find out frequency of benign and malignant neoplasms of ovary. Material and methods: The present study was based on histopathological evaluation of 97 cases of ovarian neoplastic lesions received at the Department of Histopathology, B.J. Medical College, Ahmedabad during October 2012 to October 2013. The gross specimens received were fixed in 10 percent formalin for 24 hours and multiple sections from each specimen were taken to include the representative area for histological examination. Sections were processed by routine paraffin method, blocks were cut at five micron thickness and the sections were stained with conventional Haematoxylin and Eosin (H&E) stain. The lesions were then classified and studied according to WHO Classification of ovarian tumors. (ICD - 9 th edition). Results: A total number of 97 cases were studied. Among these, 82 cases (84.5%) were benign, 2 cases (2.1%) were borderline and 13 cases (13.4%) were malignant tumors. Benign neoplasms were most commonly seen in 3rd to 5th decade, whereas malignant neoplasms were commonly seen in 5th decade. Serous cystadenoma (52.7%) was the commonest benign tumor followed by Mucinous Modi D, Rathod GB, Delwadia KN, Goswami HM. Histopathological pattern of neoplastic ovarian lesions. IAIM, 2016; 3(1): 51-57. Page 52 cystadenoma (28.4%). Among the malignant surface epithelial tumors, serous cystadenocarcinomas (8.1%) were most common followed by Mucinous cystadenocarcinomas (4.1%). Conclusion: Benign ovarian tumors were more common than malignant ones for all age groups. Surface epithelial tumors were the most common class of tumors. Serous cystadenoma was the most common ovarian tumor overall as well as the most common benign tumor, whereas serous cystadenocarcinoma was the most common ovarian malignancy. Malignant ovarian tumors were more common above 40 years.

Tratamiento laparoscópico de cistoadenoma seroso de cola de páncreas: reporte de un caso / Laparoscopic treatment of serous cystadenoma in tail of pancreas: report of one case

Introducción: Los tumores quísticos representan el 1% de todos los tumores primarios del páncreas y sólo el 15% de las lesiones quísticas. Los cistoadenomas serosos (SCA) son lesiones casi siempre benignas con un tamaño promedio de 4 cm, sin embargo en raros casos existen lesiones de mayor tamaño que ocasionalmente producen síntomas relacionados al efecto de masa y compresión de estructuras vecinas, se presenta el caso de una paciente con imagen tomográfico de lesión en cola de páncreas de 10 cm. de diámetro que se le realizó pancreatectomía caudal y esplenectomía video laparoscópica. Se confirmó el diagnóstico por anatomía patológica. Se realiza una revisión bibliográfica de la enfermedad, opciones diagnósticas y terapeúticas.

Introduction: Cystic tumors represent 1% of all primary Pancreatic Tumors and only 15% of cystic lesions. The serous cystadenomas (SCA) are almost always benign lesions with an average size of 4 cm, however in rare cases there are larger lesions which occasionally produce symptoms related to the mass effect and compression of surrounding structures, arises the tomographic image patient case of injury in tail of pancreas of 10 cm. in diameter that caudal pancreatectomy and video-assisted laparoscopic Splenectomy were performed. The diagnosis was confirmed by pathology. He is a literature review of disease, diagnostic options, and therapeutic.

A Case of Solid Variant of Serous Cystadenoma Misdiagnosed as a Neuroendocrine Tumor of the Pancreas / 대한내과학회지

Rapid advancements, access to and use of imaging techniques have increased the frequency of identification of pancreatic cystic neoplasms in clinical practice. However, a diagnostic dilemma among pancreatic cystic neoplasms remains. Solid variant serous cystadenoma is extremely rare and difficult to accurately diagnose preoperatively, as they are commonly mistaken for malignant solid tumors of other types. Here, we present a case of a solid variant serous cystadenoma preoperatively misdiagnosed as a neuroendocrine tumor of the pancreas with a review of the relevant literature.

The relative frequency and histopathological pattern of ovarian masses - 11 year study at tertiary care centre.

Background: Ovarian tumours are one of the major cause of gynaecological problems in females and present marked variation in their histological types. Relative frequency of these lesions is different for Western and Asian countries. Aims & Objective: This study was designed to find out frequency of various histological patterns of ovarian tumours in patients attending Pathology department of a teaching institute in Gujarat. Material and Methods: A retrospective – series study was conducted on 337 cases of ovarian masses, reported from January 2002 to December 2012. Results: Mean age of the subjects was 33.6 years, ranging from 8 to 70 years. In a total 337 cases of ovarian masses, 197 (58.46%) were non-neoplastic and 140 (41.54%) were neoplastic. Among neoplastic lesions, 77.14% (108/140) were benign, 3.57% (5/140) were borderline and 19.29% (27/140) were malignant. The commonest non-neoplastic lesion was luteal cyst (59/197) followed by simple serous cyst (56/197). The commonest malignant tumour was serous cystadenocarcinoma (11/27) followed by mucinous cystadenocarcinoma (5/27). The commonest borderline tumour was borderline serous tumour (4/5). Conclusion: Non-neoplastic lesions were more common than neoplastic lesions. Among neoplastic lesions benign tumours were common. The commonest benign tumour was serous cystadenoma and malignant was serous cystadenocarcinoma. The commonest non-neoplastic lesion was luteal cyst. Among histological types of ovarian tumours, surface epithelial tumours dominated the other types.

Tumores quísticos del páncreas: visión quirúrgica y cohorte de pacientes / Cystic tumors of the pancreas: surgical vision and a patient cohort

Se presenta una cohorte retrospectiva de diez pacientes con tumores quísticos del páncreas, intervenidos en su mayoría – algunos por laparoscopia –, haciendo énfasis en su estudio, diagnóstico y tratamiento quirúrgico, mostrando algunas de las variables evaluadas en su manejo y con especial mención de su enfoque quirúrgico con base en una revisión sistemática de la literatura.

We present a retrospective study of a cohort of ten patients with cystic tumors of the pancreas, most of whom underwent surgery. The study emphasizes study, diagnosis, and treatment of the four who underwent laparoscopic surgery. It presents some of the variables analyzed in their management and pays special attention to their surgery treatment. A systematic review of the literature is also included.

Serous Cystic Neoplasm: Do We Have to Wait Till It Causes Trouble?

Serous cystic neoplasm (SCN) of the pancreas is considered a benign tumor with almost no malignant potential. Most surgeons agree that asymptomatic SCN requires only regular observation. However, several complexities and interference with organ preservation during the operation, may develop when a huge symptomatic tumor is treated with surgery. So, the purpose of this study is to develop a potential management plan based on a literature review and by describing three recent cases of SCN of the pancreas. We suggest that SCNs be responded to with a timely and appropriate surgical intervention - before they require clinical attention.

Differentiating Pancreatic Ductal Adenocarcinoma from Pancreatic Serous Cystadenoma, Mucinous Cystadenoma, and a Pseudocyst with Detailed Analysis of Cystic Features on CT Scans: a Preliminary Study

OBJECTIVE: To determine whether or not detailed cystic feature analysis on CT scans can assist in the differential diagnosis of pancreatic ductal adenocarcinoma (PDAC) from serous cystadenoma (SCN), mucinous cystadenoma (MCN), and a pseudocyst. MATERIALS AND METHODS: This study received Institutional Review Board approval and informed patient consent was waived. Electronic radiology and pathology databases were searched to identify patients with PDAC (n = 19), SCN (n = 26), MCN (n = 20) and a pseudocyst (n = 23) who underwent pancreatic CT imaging. The number, size, location, and contents of cysts, and the contour of the lesions were reviewed, in addition to the wall thickness, enhancement patterns, and other signs of pancreatic and peripancreatic involvement. Diagnosis was based on lesion resection (n = 82) or on a combination of cytological findings, biochemical markers, and tumor markers (n = 6). Fisher's exact test was used to analyze the results. RESULTS: A combination of the CT findings including irregular contour, multiple cysts, mural nodes, and localized thickening, had a relatively high sensitivity (74%) and specificity (75%) for differentiating PDAC from SCN, MCN, and pseudocysts (p < 0.05). Other CT findings such as location, greatest dimension, or the presence of calcification were not significantly different. CONCLUSION: The CT findings for PDAC are non-specific, but perhaps helpful for differentiation. PDAC should be included in the general differential diagnosis of pancreatic cystic neoplasms.

A case of laparoscopic treatment of collision tumor: Huge serous cystadenoma and dermoid cyst arising in the same ovary / 대한산부인과학회지

Collision tumor means the coexistence of two adjacent, but histologically distinct tumors without histologic admixture in the same tissue and is rare incidence involving ovary. Because of their incidence of occurrence, benign cystic teratomas often occur coincidentally with other abnormalities of the ovary. Most common histologic combination of collision tumor in the ovary is coexistence of teratoma with mucinous tumors. But its association with serous tumor has been noted rare and incidence is unknown. We have experienced a case laparoscopic treatment of a huge serous cystadenoma combined with ovarian benign cystic teratoma in right ovary, and report it with a brief review of literature.

Simultaneous occurrence of a granulosa cell tumor and a serous cystadenoma in the same ovary: A case report / 대한산부인과학회지

This is the first case report of a patient with a large serous cystadenoma accompanied by a juvenile granulosa cell tumor that was discovered in the remaining ovarian tissue. A 25-year-old female was presented with constipation and amenorrhea. Ultrasonography revealed a large cystic mass in the left ovary with a normal uterus. The remaining ovarian tissue seemed normal at first look after cystectomy, but showed abnormal consistency on palpation. The remaining ovarian tissue was removed and granulosa cell tumor was confirmed by pathologic examination. The patient has been followed up for 30 months without evidence of recurrence. We would like to emphasize the importance of inspection, and palpation of remaining ovarian tissue during operation to avoid risks of remaining ovarian pathology.

Can EUS Help to Differentiate Macrocystic Serous Cystadenoma from Mucinous Cystadenoma of the Pancreas by Its Morphologic Characteristics? / 대한소화기내시경학회지

BACKGROUND/AIMS: A macrocystic variant of a serous cystadenoma (M-SCA) is usually indistinguishable from a mucinous cystadenoma (MCA) as a result of their morphologic similarity on conventional imaging studies. However, a MCA requires a resection due to its malignant potential. The aim of this study was to determine the EUS morphological characteristics of a M-SCA to determine if they could be used to help differentiate it from MCA. METHODS: The clinical and EUS morphologic characteristics were examined in 31 consecutive patients with M-SCA and MCA who underwent surgery. RESULTS: Resected specimens were available from 11 M-SCAs and 20 MCAs. Significant differences were observed with regard to the age and location within the pancreas. On EUS, most of the M-SCA contained microcysts (82%) compared with only 15% of MCA cases, and a lobulated configuration of the cyst was observed more frequently in the M-SCA cases than in the MCA (91% vs. 25%). The combination of microcysts and the lobulated configuration of the cysts had a 100% specificity and positive predictive value for differentiating M-SCA from MCA. CONCLUSIONS: M-SCA tends to occur at a relatively younger age than MCA, and is located mainly in the head of the pancreas. Although there is considerable morphological similarity between M-SCA and MCA on the conventional imaging modalities, the morphological characteristics obtained from EUS including microcysts with a lobulated configuration may help to make a distinction between M-SCA and MCA.

A Case of Ovarian Abscess Caused by Salmonella Typhi infection / 대한산부인과학회지

Samonella infection is usually a short febrile self-limiting disease localized to the gut, acquired by ingestion of contaminated food or water. The infection is seldom accompanied by extraintestinal complication. If such a complication does occur, the abscess is often located in bone and periost. Isolated suppurative ovarian infections are rare, but have descirbed, particularly in dermoid cysts, cystadenomas or endometrioma. We report a case of a patient with a Salmonella typhi infection in a serous cystadenoma.