ABSTRACT
Granulosa tumors (GT) are rare neoplasms, difficult to diagnose in a preoperative stage. We report a set of seven patients affected by GT admitted in Amiens University Hospital, collated with a review of the literature (n=379). Our aim was to report the clinical and radiological characteristics of GT, in order to improve preoperative diagnosis. The average age of the subjects was 50.8 years old among the bibliographical search, and 37years old for the observations reported in Amiens. The principal circumstances of diagnosis were vaginal bleeding, abdominal pain and infertility. Ultrasound was the most frequently investigation, revealing GT as a large unilateral solid and cystic mass. The computed tomodensitometry (CT) allowed to precise the locoregional extension. Magnetic Resonance Imaging (MRI) appeared to be interesting to clarify lesions, showing GT as a solid mass with a cystic component or as a multicystic mass. Hormonal assays (inhibin B and/or anti-Müllerian hormone) can provide valuable assistance in diagnosis, despite their cost and lack of availability. In view of the clinical and radiological presentation of the reported and literature review cases, we suggest hormonal assays among perimenopausal women presenting with an unusual radiological aspect of an annexial mass.
Subject(s)
Diagnostic Imaging , Granulosa Cell Tumor/diagnosis , Abdominal Pain , Adult , Anti-Mullerian Hormone/blood , Biomarkers, Tumor/blood , Female , France , Granulosa Cell Tumor/surgery , Hospitals, University , Humans , Infertility, Female , Inhibins/blood , Magnetic Resonance Imaging , Middle Aged , Ovarian Neoplasms/diagnosis , Tomography, X-Ray Computed , Ultrasonography , Uterine HemorrhageABSTRACT
Uterine arteriovenous malformations (UAVM) are rare. They mostly occur after endo-uterine trauma, or are less often congenital. When symptomatic, they may be a cause of uterine recurrent and massive bleeding. Diagnosis should be evoked in these cases, to avoid haemostatic curettage which will be useless and injurious. UAVM is often suspected by Doppler ultrasound, but pelvic MRI seems to be also relevant. Angiography confirms the diagnosis and allows concomitant embolization. Uterine embolization seems to be currently the best treatment, however surgery should still be performed in case of failure or hemodynamic instability. In this work, we aim to evaluate diagnosis and therapeutic modalities for UAVM.
