ABSTRACT
Xanthogranulomatous oophoritis (XO) is a rare pseudotumor representing a destructive chronic inflammatory process often mistaken for malignancy or tubo-ovarian abscess. Xanthogranulomatous inflammation is most commonly seen in the kidneys and gallbladder and very rarely affects the genitourinary system. Definitive treatment is with surgical removal of affected tissue. This report presents the case of a 42-year-old woman with an 8 cm complex right adnexal cyst concerning for a dermoid cyst presenting with intermittent torsion. Final pathology after right salpingo-oophorectomy demonstrated xanthogranulomatous oophoritis. This case is of clinical significance for distinguishing the condition from common benign pathology or cancer since the recommended surgical procedure is different than for a dermoid cyst or malignancy. Correct identification of the condition is crucial for appropriate treatment and to avoid unnecessary morbid procedures if the mass is mistaken for malignancy or future repeat surgery if mistaken for a dermoid cyst or other common benign condition. This case documents the presentation of xanthogranulomatous oophoritis masquerading as a dermoid cyst for a condition with very few reported cases worldwide.
ABSTRACT
INTRODUCTION: Abortion is a polarizing social and medical issue, even among physicians. Though the public may expect physicians to hold purely scientific attitudes about abortion, their attitudes and behaviors are just as strongly informed by social and political factors as the public's. In a recent survey study of physicians at an academic medical center about their abortion attitudes, most reported strong support for abortion access. However, more were unwilling to consult in abortion-related cases, and many perceived little or no professional connection to abortion and were reticent to publicly advocate for their position. METHODS: In order to investigate the nuances in physicians' abortion attitudes, we analyzed the open-ended, qualitative responses provided by physicians at the end of a quantitative survey using modified concept mapping procedures and theme generation. RESULTS: Two hundred twenty-two open-ended responses resulted in 487 data units. We categorized respondents' comments into 2 main groups: attempts to depersonalize, or distance oneself, from abortion and expressions of nuance or ambivalence about abortion. Ambivalence and nuance in abortion attitudes centered around multiple factors that varied from individual to structural. CONCLUSIONS: Our findings support previous literature suggesting that physicians' abortion attitudes are not binary and add that nuanced attitudes may be perceived as unwelcome. Acknowledging ambivalence and addressing physicians' tendency to depersonalize abortion could result in more honest, open, and nuanced discourse and contribute to addressing structural issues that result in poor health outcomes, achieving broader reproductive justice goals, and greater access to abortion services.
Subject(s)
Abortion, Induced , Physicians , Pregnancy , Female , Humans , Abortion, Legal , Surveys and Questionnaires , Attitude of Health PersonnelABSTRACT
Squamous metaplasia (SM) occurs in a variety of thyroid conditions, both neoplastic and non-neoplastic. In a small subset of benign thyroid lesions, SM can create a diagnostic pitfall by mimicking a malignant process. Here, we describe the case of a 52-year-old male with a 1.5 cm right thyroid nodule. Ultrasound-guided fine-needle aspiration biopsy showed markedly atypical, mitotically active epithelial cells which were suspicious for high-grade carcinoma. Resection of the nodule demonstrated a follicular adenoma with cystic changes and atypical SM of the cyst-lining component. As illustrated here, SM of the thyroid represents an important diagnostic pitfall for the cytopathologist, and should be included in the differential diagnosis of thyroid nodules, particularly those with potentially benign cystic changes.
