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PubMed1997

[Immunohistochemical and immunogenetic analysis of ocular adnexal lymphoid proliferations].

We examined 20 cases (21 specimens) of ocular adnexal lymphoid proliferations, using the histological, immunohistochemical and molecular genetic methods. The latter two protocols were performed to detect the light chains restriction of immunoglobulin with peroxidase-antiperoxidase (PAP) methods, and the clonality of immunoglobulin heavy chain gene with the hemi-nested polymerase chain reaction (PCR) method, respectively. Although in 8 cases it could not be morphologically determined whether they were neoplastic or not, clonality was revealed in 1 case with immunohistochemistry and in 4 cases with PCR. Two cases showed discordant results between immunohistochemistry and PCR probably due to somatic mutation of the framework region of the immunoglobulin heavy chain gene. Therefore, we, concluded that examination with these methods contribute to a better understanding of the nature of the ocular adnexal lymphoid proliferations. Furthermore, the immunoglobulin gene PCR method is very useful in practical examination, as it can be used with formalin-fixed paraffin-embedded specimens.

Adult↗
PubMed1997

Transvaginal color Doppler sonography and conventional sonography in the preoperative assessment of adnexal masses.

OBJECTIVE: This investigation was undertaken to evaluate the predictive value of the blood flow velocity as measured by transvaginal color Doppler sonography (CDS) and conventional sonographic criteria in the preoperative assessment of ovarian tumors. METHODS: 98 patients who were admitted for surgery with a suspicion of an adnexal mass (69 benign tumors, 4 borderline tumors, and 25 malignant tumors) were prospectively studied with transvaginal sonography (TVS) and CDS. Pulsatility index of blood flow velocity waveforms was evaluated by CDS and compared with established sonographic criteria for discriminating between benign and malignant ovarian tumors. RESULTS: TVS had a sensitivity of 91% and a specificity of 84% in detecting malignant ovarian tumors compared with CDS with a sensitivity of 90% and a specificity of 74%, using 1.1 as a cut-off value for the pulsatility index. The specificity of CDS was higher in postmenopausal (88%) than in premenopausal (63%) patients. Using TVS and CDS combined, the sensitivity and specificity of diagnosing malignant ovarian tumors could be increased to 95% and 86%. CONCLUSION: In premenopausal patients, TVS is clearly a more sensitive and more specific technique than CDS in correctly identifying benign and malignant ovarian tumors, whereas in postmenopausal patients, CDS gives useful additional information concerning blood vessel resistance. If CDS is used as an additional technique to TVS, it can increase the sensitivity and specificity of TVS in discriminating between benign and malignant ovarian tumors.

Adnexal Diseases↗
PubMed2003

The effect of radiation therapy on microcystic adnexal carcinoma: a case report.

BACKGROUND: Microcystic adnexal carcinoma (MAC) is a rare, locally aggressive tumor. Treatment for this neoplasm typically requires extensive local excision leading to morbidity. Therefore, the temptation to use alternative treatment options remains high. METHODS: We report one case of a nasal dorsum MAC treated with external beam radiation secondary to the patient's poor health status and preference. RESULTS: After initial dramatic clinical resolution, the tumor recurred in a clinically more extensive and histologically more aggressive form. CONCLUSION: On the basis of this case and several detailed in the literature, we therefore hypothesize that radiation therapy is not only an ineffective treatment for MAC, but evidence exists that this modality may induce conversion to a histologically and clinically less favorable neoplasm.

Aged↗
PubMed2005

Mesenteric lymphangioma presenting as adnexal torsion: case report and literature review.

We report the case of a patient with a mesenteric chylous lymphangioma who presented with acute pelvic symptoms mimicking adnexal torsion. The cyst contents had no specific sonographic or CT characteristics, such as a fluid-fluid level, to aid the preoperative diagnosis; definitive diagnosis was made only upon histopathologic examination of the cyst, which was resected intact.

Adnexal Diseases↗
PubMed1994

A pelvic retroperitoneal Schwannoma presenting as an adnexal mass.

Solitary nerve sheath tumors such as benign schwannomas arising in the pelvic retroperitoneum are infrequently reported. We report a case of a benign retroperitoneal pelvic schwannoma that presented with pelvic pain and an adnexal mass. Complete surgical excision was achieved only after transection of the S1 nerve root on the left side. The adjacent vascular and urinary channels sustained no injuries and the patient had minimal neurologic deficit.

Adnexal Diseases↗
PubMed2004

[Skin adnexal and salivary gland neoplasms. Similarities and differences of selected patients].

Benign and malignant skin adnexal neoplasms, especially glandular lesions, show morphologically striking similarities to salivary gland tumors. On the other hand, histological and clinical differences are evident, and knowledge of their existence is important for adequate treatment and reliable prognostication. In this review similarities and differences of selected entities are briefly described and discussed. The following entities are reviewed: cylindroma (vs. membranous variant of basal cell adenoma), sebaceoma (vs. sebaceous adenoma), syringocystadenoma papilliferum (vs. sialadenoma papilliferum), chondroid syringoma (vs. pleomorphic adenoma), cutaneous myoepithelioma (vs. myoepithelioma of salivary glands), cutaneous malignant myoepithelioma (vs. malignant myoepithelioma of salivary glands), cutaneous adenoid cystic carcinoma (vs. adenoid cystic carcinoma of salivary glands), and mucinous eccrine carcinoma (vs. mucous carcinoma of salivary glands).

Adenoma↗
PubMed2004

CT and MR findings of a retrorectal cystic hamartoma confused with an adnexal mass on ultrasound.

We describe the imaging features of a tailgut cyst mistaken for an adnexal mass. A pelvic ultrasound in a 28-year-old woman showed a 10-cm hypoechoic left pelvic mass. Having not seen the left ovary, the radiologist concluded that the mass was an endometrioma. CT disclosed a retrorectal cystic lesion with wall calcifications and internal septa. MR confirmed the extra-ovarian location of the tumor, which was hyperintense on T2-weighted images and had an intermediate signal on T1-weighted images. Surgery revealed a retrorectal cystic hamartoma. Radiological diagnosis of a tailgut cyst requires first correct localization of the tumor and then differentiation from other retrorectal masses.

Adnexal Diseases↗
PubMed1984

Uterus didelphys. Ultrasound diagnosis in the case of an adnexal mass as a presenting symptom in early pregnancy.

Uterine anomalies are one of the various processes in the pelvic organs which present themselves as adnexal masses in pregnancy. In pregnancy associated with congenital uterine anomalies, complications are likely to occur. Ultrasonography is of great importance in early recognition of the anomalies, which can prevent unnecessary surgical intervention. A case of ultrasonic detection of uterus didelphys with unicavitary pregnancy is described.

Adnexal Diseases↗
PubMed1995

Pelvic Castleman disease mimicking an adnexal tumor.

BACKGROUND: Castleman disease, or giant lymph node hyperplasia, is a rare cause of lymph node enlargement. Only 11 cases with pelvic localization in women have been reported. CASE: A pelvic mass mimicking an adnexal tumor was detected on a routine examination in a 26-year-old woman. Surprisingly, the pelvic organs were found to be normal at laparotomy. Eight years later, the subject was examined for dyspareunia and secondary infertility that lasted 2 years. A pelvic mass, evidently the one encountered 8 years previously, was detected; it had enlarged only slightly in the intervening time. Surgical exploration of the retropubic space revealed a tumor-like mass attached to the periosteum of the left superior pubic arch. The mass was removed by simple resection. Histologic investigations confirmed a diagnosis of Castleman disease. Three months after the operation, the woman conceived without any further treatment. CONCLUSION: The possibility of Castleman disease should be considered when assessing a pelvic mass. The condition in the retropubic space in women has not been reported previously.

Adnexa Uteri↗
PubMed1995

Serial assessment of adnexal masses with transvaginal color Doppler sonography.

Transvaginal color Doppler sonography (TV-CDS) was performed on 64 women with adnexal masses at 3, 6 and 12 weeks after initial presentation. In 47 (72% of patients studied), the pelvic mass demonstrated a decrease in size and increase in pulsatility index (PI) after 12 weeks. Of the patients undergoing surgery in this group, one had a tubo-ovarian abscess, one diverticular abscess and one hydrosalpinx. In seven patients (10%), there was no change in size or PI. Three in this group had an endometrioma, whereas two had a peritoneal cyst. In five (7%), there was no change in size and an increase in PI. One of these patients had a mucinous cystadenoma. In three (5%), there was a decrease in size and PI. Two of these patients had a tubo-ovarian abscess. In two (3%) patients studied, the mass showed an increase in size and decrease in PI; both had corpora luteum cysts with acute hemorrhage. Seventy-two percent of masses with high impedance underwent regression, whereas only 21% of lesions with low impedance did. Only 20% of masses demonstrating low impedance or morphologically complex structure regressed. Sixty-five percent of lesions that regressed had a significant drop in PI, whereas all the lesions that showed no change in size or enlargement had either no change or decrease in PI. Probability of regression was the greatest in young women (less than 40 years of age) and in masses < 5 cm. Ninety-three percent of women with persistent masses that underwent progestational suppression demonstrated regression with decrease of PI and peak systolic velocity.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdominal Abscess↗
PubMed1989

Nabothian cysts stimulating an adnexal mass.

Nabothian (retention) cysts are common gynecologic findings and rarely of clinical significance. This case report describes the presence of large and numerous Nabothian cysts stimulating an adnexal mass.

Adnexal Diseases↗
PubMed2005

Artificial neural network computer prediction of ovarian malignancy in women with adnexal masses.

OBJECTIVE: Assessment of the usefulness of a neural model to predict which ovarian tumors are malignant. METHOD: Age, menopausal status, body mass index, grayscale and Doppler ultrasonographic features, as well as levels of specific markers (CA 125, tissue polypeptide specific antigen) were examined in 686 women with adnexal masses. The probability of malignancy was calculated using an artificial neural network software and the diagnostic efficiency of the received model was estimated using a receiver-operating characteristics (ROC) curve. RESULT: Of the 686 women, 431 (62.8%) had a benign and 255 (37.2%) had a malignant ovarian tumor. The significant malignancy predictors are age, menopausal status, maximum tumor diameter, internal wall structure of tumor, presence of septa and/or solid elements, tumor location, location of vessels, and blood flow indexes. The best network provided 96.0% sensitivity and 97.7% specificity. The area under the curve for the received model was 0.9716. CONCLUSIONS: An artificial neural network model based on clinical and ultrasonographic data allows to calculate the probability of tumor malignancy.

Adnexal Diseases↗
PubMed1985

Adnexal torsion.

A series of 128 cases of adnexal torsion and an additional 97 cases where the preoperative diagnosis of torsion was incorrect are reviewed. The diagnosis is uncertain and surgical intervention is likely to be delayed. The adnexa are seldom salvaged despite the fact that torsion infrequently involves a malignant neoplasm. Laparoscopy is an effective means of reducing the number of necessary laparotomies when a diagnosis of torsion is uncertain.

Adnexal Diseases↗
PubMed2003

Adnexal torsion in a patient with hydrosalpinx who underwent tubal occlusion before in vitro fertilization.

OBJECTIVE: To report a rare case of adnexal torsion in an infertile patient with bilateral hydrosalpinges who had proximal tubal occlusion performed before IVF-ET 5 years earlier. DESIGN: A case report and literature review. SETTING: Reproductive endocrine division in a community teaching hospital. PATIENT(S): A 43-year-old infertile woman with acute left-side pelvic pain. INTERVENTION(S): Laparoscopic bilateral salpingectomies. MAIN OUTCOME MEASURE(S): Diagnosis and etiology of pelvic pain with subsequent therapy to alleviate symptoms. RESULT(S): The patient experienced resolution of her pain and prophylactic prevention of further torsion status after bilateral salpingectomies. CONCLUSION(S): Although laparoscopic proximal tubal occlusion is an effective treatment of hydrosalpinges in patients undergoing IVF-ET, it carries the risk of torsion of the hydrosalpinx and the associated morbidities.

Adnexal Diseases↗
PubMed1990

Adnexal torsion of hyperstimulated ovaries in pregnancies after gonadotropin therapy.

A series of 201 cycles of ovarian hyperstimulation syndrome (OHSS) in 154 women were reviewed. Pregnancy occurred in 75 of 201 cycles. Twelve pregnant women (16%) presented with torsion of hyperstimulated ovary, but only 3 out of 126 patients (2.3%) who did not conceive had torsion. Because diagnosis of adnexal torsion is usually uncertain and surgical intervention is likely to be delayed, these infertile women risk losing their ovaries. The clinical picture of torsion of adnexa in patients with OHSS is presented here. The combination of ovarian enlargement, abdominal pain, nausea, progressive leukocytosis, and anemias might indicate torsion of adnexa. Although during operation the adnexa appears dark, hemorrhagic and ischemic, we suggest that it can be saved by simply unwinding it. In 11 such cases intraoperative unwinding of the adnexa was performed, and in 8 patients it was the only operative procedure. No postoperative complications were noted and in all the cases the ovaries were proven functional by ultrasonography. We concluded that torsion of hyperstimulated adnexa in patients who conceived after gonadotropin therapy, is a special entity that requires more attention to achieve early diagnosis. Nevertheless even with delayed diagnosis, the ovary can still be saved.

Adnexal Diseases↗
PubMed1994

Adnexal torsion: color Doppler diagnosis and laparoscopic treatment.

The present case documents normalization of ovarian perfusion after conservative laparoscopic treatment of adnexal torsion. At our institution, Doppler flow assessment in cases of suspected torsion represents an important element of diagnosis and, in this case, allowed for early diagnosis with conservative laparoscopic treatment with documented normalization of ovarian flow postoperatively.

Adnexal Diseases↗