Subject(s)
Abortifacient Agents, Nonsteroidal/adverse effects , Abortion, Therapeutic/adverse effects , Fetal Death/therapy , Misoprostol/adverse effects , Uterine Hemorrhage/chemically induced , Uterine Rupture/chemically induced , Abortion, Therapeutic/methods , Adult , Female , Humans , Hysterectomy , Pregnancy , Pregnancy Trimester, SecondABSTRACT
To date, this is the first report to monitor changes of intratumor vascularization and the response to radiation and Cyberknife therapy in a patient with recurrent primary papillary serous carcinoma of the peritoneum by three dimensional (3D) power Doppler ultrasonography (PDUS). Transvaginal 3D PDUS detected a recurrent presacral tumor with abundant intratumor vascularity. Serial examinations of the tumor volume and serum CA-125 level were studied before, during, and 6 mo after therapy. Meanwhile, the intratumor blood flow was measured and expressed as vascularity indices. All of the tumor volume, intratumor vascularity indices and serum CA-125 level decreased progressively following therapy. A remaining lesion with nearly absent intratumor power Doppler signals suggested a scarring lesion posttreatment. Indeed, CT-guided tissue biopsy confirmed fibrotic change. 3D PDUS is useful to monitor the response to treatments and to differentiate residual tumors from lesions of scarring change posttreatment. It provides more accurate posttreatment information than pelvic computed tomography.
Subject(s)
Cystadenocarcinoma, Papillary/diagnostic imaging , Peritoneal Neoplasms/diagnostic imaging , Aged , Cystadenocarcinoma, Papillary/secondary , Female , Humans , Imaging, Three-Dimensional , Pelvic Neoplasms/diagnostic imaging , Pelvic Neoplasms/secondary , Tomography, X-Ray Computed , Ultrasonography, Doppler/methodsABSTRACT
OBJECTIVE: Epidermoid cyst of the presacral space is a rare congenital lesion of ectodermal origin. Presacral epidermoid cyst with hydronephrosis is even rarer and has never been reported in Taiwan. Herein, we present a patient with presacral epidermoid cyst with right hydronephrosis. CASE REPORT: A 62-year-old woman had low abdominal pain for 2 weeks and was referred to our hospital for further management. In our hospital, computed tomography revealed a multilobulated cystic tumor (20 x 15 x 12 cm) in the lower abdomen, complicated with right severe hydronephrosis. Laparotomy was undertaken and a presacral tumor was removed. The pathologic diagnosis was an epidermoid cyst. CONCLUSION: A presacral epidermoid tumor is a rare tumor and a large presacral cystic tumor may mimic an ovarian tumor in imaging. All presacral tumors with or without symptoms should be evaluated thoroughly before operation. Complete surgical excision, preserving adjacent organs' function, should be kept in mind.
