Ovarian Manson's Schistosomiasis: Rare Diagnosis or Underestimated Prevalence? / Esquistossomose mansônica no ovário: diagnóstico raro ou prevalência subestimada?

Abstract The occurrence of Manson's schistosomiasis in organs of the female reproductive tract is an uncommon event, given that the etiological agent for this disease is a blood parasite that inhabits the mesenteric veins. In this case report, a 45-year-old female patient reported that her first symptoms had been strong pain in the left iliac region around two years earlier. An endovaginal pelvic ultrasonography showed that the left ovary was enlarged, and the report suggested that this finding might be correlated with clinical data and tumor markers. After being examined at several healthcare services, the patient was referred to an oncology service due to suspected neoplasia, where she underwent a left ovariectomy. The result from the histopathological examination showed the presence of granulomatous inflammatory processes surrounding both viable and calcified eggs of Schistosoma mansoni. There was no evidence of any neoplastic tissue. The patient was medicated and followed-up as an outpatient.

Resumo A ocorrência da esquistossomose mansônica em órgãos do aparelho reprodutor feminino é um evento pouco comum, tendo em vista que o agente etiológico desta doença é um parasito sanguíneo que habita as veias mesentéricas. Neste relato decaso, uma paciente de 45 anos referiu como primeira sintomatologia fortes dores na região ilíaca esquerda há cerca de 2 anos. Uma ultrassonografia pélvica endovaginal identificou aumento do ovário esquerdo, e o laudo sugeriu correlacionar tal achado com dados clínicos e marcadores tumorais. Após passar por vários serviços de saúde, a paciente foi encaminhada para um serviço de oncologia por suspeita de neoplasia, sendo submetida a uma ovariectomia à esquerda. O resultado do exame histopatológico evidenciou a presença de processos inflamatórios granulomatosos em torno de ovos viáveis e calcificados de Schistosoma mansoni. Não houve qualquer evidência de tecido neoplásico. A paciente foi medicada, e seguiu em acompanhamento ambulatorial.

Genital schistosomiasis mansoni concomitant to genital tumor in areas of low endemicity: challenging diagnosis

Genital infection by Schistosoma mansoni is usually misdiagnosed in individuals who reside in, or travel to endemic areas. We describe two cases of genital tumor associated with S. mansoni infection manifested by methrorragy. Surgical specimens revealed leiomyomas in both cases associated with S. mansoni. In one of them, granulomas were found in the ovary and in the other they were found in the uterine tube. Although none presented intestinal/hepatic disease, fecal egg excretion was detected in one. Both had elevated pretreatment antibody reactivity to S. mansoni antigen, but follow-up showed different outcomes. Schistosomiasis should be considered as a diagnosis in individuals with methrorragy residing in or having traveled to endemic areas. Since diagnosis follows genital amputation, and cure control is troublesome, improvement of diagnostic tools and follow-up markers are important priorities to decrease schistosomiasis morbidity.

Large hydatid cyst of ovary

Human Hydatid cyst is a wide spread disease. Its an endemic disease in Iran. It's caused by Echinococcus granulosus. Hydatid cyst although known to occur in most organs and body areas, is extremely rare in the female reproductive organs. This is a case report of ovarian Hydatid cyst in a 42-year-old woman. She presented with feeling of enlargement of abdomen and abdominal pain. On physical examination, a large mass in lower abdomen palpated. On imaging study, ultrasonography reported a large heterogeneous multicystic mass measuring 155 97 mm in pelvic cavity and hypo gastric area. The CT-scan with IV contrast reported a huge cystic lesion, containing multiple septi in pelvic cavity that could be due to ovarian lesion. After surgical procedure, histopathological examination showed typical laminated and germinative layers with hexagonal scolecies of Hydatid cyst. Since the common sites of hydaid cyst are liver and lung and the imaging studies are highly diagnostic for Hydatid cysts, this illustrated case is interesting for uncommon site, not suggested by imaging studies and with clinical [surgical] impression of malignant ovarian tumor

Ectopic schistosomiasis: description of five cases involving skin, one ovarian case and one adrenal case / Esquistossomose ectópica: descrição de cinco casos de envolvimento da pele, um do ovário e um da glândula supra-renal

Seven cases of patients with ectopic schistosomiasis from the State of Sergipe, Brazil, are presented (five involving skin, one ovarian and one adrenal). Data were collected from surveying the clinical records and anatomopathological reports in the files of the dermatology and pathology clinics of the University Hospital of the Federal University of Sergipe, from 1995 to 2005. The patients' mean age at diagnosis was 21.1 years. In the dermatological cases, full cures were achieved after treatment with oxamniquine. In the ovarian case, there was an association with embryonic carcinoma: this patient underwent surgery with adjuvant chemotherapy and praziquantel treatment, with satisfactory evolution. The adrenal case was associated with adenoma.

São apresentados sete casos de esquistossomose ectópica (cinco de pele, um de ovário e um de supra-renal) procedentes do Estado de Sergipe, coletados a partir de pesquisa de prontuários e laudos anátomo-patológicos nos arquivos dos Serviços de Dermatologia e de Patologia do Hospital Universitário da Universidade Federal de Sergipe, entre os anos de 1995 e 2005. A média de idade dos pacientes ao diagnóstico foi de 21,1 anos. Nos casos dermatológicos, houve melhora total das lesões após tratamento com oxamniquine. No caso de ovário houve associação com carcinoma embrionário; a paciente foi submetida à cirurgia com quimioterapia adjuvante e praziquantel, evoluindo satisfatoriamente. O caso de supra-renal estava associado a adenoma.

Primary ovarian hydatid disease in the Kingdom of Saudi Arabia

Human hydatid disease is caused by Echinococcus granulosus. Its distribution is world wide and it affects mainly the liver, but other organs could be involved. Primary involvement of pelvic organs is very rare. This is a case report of primary ovarian hydatid disease in a postmenopausal woman, diagnosed postoperatively. Surgical excision was adequate. Ultrasonography, particularly high frequency trans-vaginal, computed tomography scan and, more recently, magnetic resonance imaging are more frequently used in the diagnosis of Echinococcus cyst. They appear more reliable than many of the old tests of varying sensitivities. Whereas, there are anecdotal reports of obstetric and gynecological manifestations of echinococcosis from some Middle Eastern and North African countries, this is the first of such report from the Kingdom of Saudi Arabia. It is unclear why there is a lack of information about this condition among Saudi women, even though socio-cultural attitude to female involvement in sheep farming and animal husbandry is similar to that in other Arabic and Islamic countries. We endorse the recommendation that every gynecologist, radiologist and histopathologist should maintain a high index of suspicion for hydatid cyst, whenever a septate cystic pelvic mass is found