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At least 595 records · Page 33Linked to original sources
PubMed1994

Magnetic resonance imaging of benign adnexal conditions.

Magnetic resonance imaging can be used to demonstrate a variety of benign adnexal diseases. However, the real utility and efficacy of MR imaging in benign pelvic disease has not been investigated thoroughly. This is the challenge for future research. Presently, particularly in light of changes in the health care system, it is incumbent upon radiologists, gynecologists, and other clinicians to determine what additional information MR imaging will add to the diagnostic evaluation already completed before performing MR imaging. One must ask several questions. Will MR imaging provide additional information? Will that information affect care and treatment of the patient? Will the treatment be beneficial to the care of the patient? Will the patient agree to the management? Many times these questions are not asked. And if asked, the answers are unknown or under investigation. However, using one's best clinical judgment and armed with the knowledge at hand, if answers to the above questions are yes, then MR imaging may prove useful.

Adnexa Uteri↗
PubMed1995

[Laparoscopic treatment of adnexal abscesses. A series of 39 patients].

OBJECTIVE: Evaluate short- and long-term follow-up of patients treated by laparoscopy and antibiotherapy for tubo-ovarian abscess. METHODS: We report a retrospective study of 39 patients treated from January 1983 to December 1992. Clinical files were examined and a questionnaire was mailed to patients. RESULTS: None of the patients needed to be reoperated for failure of the first laparoscopic treatment. A laparoscopic control after 3 month was done in 35 cases, which allowed complete adhesiolysis in every patients. We performed distal tubal surgery in 17 patients at that time and oriented 6 patients directly towards IVF. Subsequent fertility, in 19 patients followed without contraception, demonstrated a rate of spontaneous intra-uterine pregnancy of 63%. CONCLUSION: This study confirms that laparoscopy remains the technique of choice in initial management of adnexal abscesses.

Abscess↗
PubMed1993

Laparoscopic treatment of adnexal torsion.

Adnexal torsion remains an infrequent and difficult to diagnose gynecologic emergency. Until recently, laparoscopic diagnosis was followed by laparotomy. Now, with proper laparoscopic technique, it is possible to untwist the adnexa or to remove it with excellent results. We report herein our cumulative four year experience with laparoscopic detorsion or removal of the adnexa in 41 patients. Ten patients were simultaneously pregnant, seven having the ovarian hyperstimulation syndrome, six with paraovarian cysts and 18 with idiopathic torsion. All of the women had an uneventful recovery, with 14 of 19 patients who claimed desire for pregnancy becoming pregnant within one year after the procedure, emphasizing its advantages and safety.

Adnexa Uteri↗
PubMedDate not supplied

Cytology of benign cystic uterine adnexal masses.

The findings from a cytologic examination of 26 surgically removed cystic adnexal masses (1-11.5 cm) aspirated with a 22-gauge needle were correlated with the histopathologic findings. The mean age of the patients was 48 years. Examination of the Papanicolaou-stained cytospin preparations showed that all but three were cellular. Benign epithelial cells were identified in fluid aspirated from the mass from one patient with hydrosalpinx and from three with paramesonephric and one with simple cysts; they were also found in aspirated samples from three patients with serous cystadenoma and one with serous cystadenofibroma. Masses from the five patients with follicle cysts and cystic follicles contained numerous granulosa cells. Ciliated cells or ciliated cytoplasmic fragments were found in all aspirated samples except those from patients with follicle cysts, cystic follicles or endometriosis. In two patients, one with endometriosis and one with serious cystadenoma, the epithelial cells were atypical, with a high nuclear/cytoplasmic ratio, hyperchromasia, nuclear molding and large nucleoli. These results could be misinterpreted as indicating malignancy. In summary, the vast majority of aspirated samples (91%) contained benign cells. However, caution should be exercised in the interpretation of possibly misleading cytologic findings in patients with endometriosis or cystadenoma.

Adenofibroma↗
PubMed1997

[Operative laparoscopy and the adnexal cystic mass: where to set the limit?].

OBJECTIVE: To study the importance and the consequences of several managements options for adnexal cystic masses suspicious at ultrasound and/or at laparoscopy. MATERIAL AND METHODS: The importance of this question was evaluated by studying the correlation between the ultrasonographic appearance, the macroscopic diagnosis and the pathologic diagnosis in a series of 1098 patients operated over a 14-year period. The laparotomy rates obtained with the managements proposed were calculated by adding the laparotomies which would be performed because of the suspicious appearance to the laparotomies effectively performed in the department when treating the non suspicious masses. RESULTS: 32 of the 323 suspicious cases at ultrasound were malignant. The negative predictive value of the laparoscopic diagnosis of malignancy was 100%. Depending on the management used, the incidence of laparotomy could have varied from 6.1% to 31.3% between 1987 and 1991, and from 12.9% to 41.9% between 1992 and 1993. These results were related to preoperative selection. CONCLUSION: Using a simple management which includes diagnostic laparoscopy for masses suspicious at ultrasound and laparotomy for masses suspicious at laparoscopy, 80.1% of the patients would be treated by laparoscopic. This management seems reasonable until the long term results of large series about the laparoscopic treatment of ovarian cancer become available.

Adnexal Diseases↗
PubMed1997

[Adnexal torsion during pregnancy. Diagnostic and therapeutic problems in Burkina Faso].

The authors report a case of adnexal torsion during early pregnancy. Because of a late diagnosis they had to practise an unilateral adnexectomy with a conservative medical treatment of the pregnancy. They recommend an early surgical treatment, that will save the adnexa and permit a normal evolution of the pregnancy. In a young patient, the loss of an ovary may be a tragic event.

Adnexal Diseases↗
PubMed1997

[The laparoscopic approach to the polycystic liver and adnexal cysts].

Having re-examined the nosographic data acquired on the subject of hepatic polycystosis and uterine adnexal cysts, the authors report the results of their experience. On the basis of the evaluation of these results (no laparotomic conversion, no postoperative complications, reduced hospital stay), which are comparable to those reported in the literature, the authors conclude that the modern technology may be used to advantage in all cases where laparoscopic surgery is not difficult, does not require numerous tests and does not entail a high risk of complications.

Adnexal Diseases↗
PubMed1986

Microcystic adnexal carcinoma. Immunohistologic observations suggesting dual (pilar and eccrine) differentiation.

Microcystic adnexal carcinoma (MAC) is a locally aggressive neoplasm that has recently been recognized as a clinicopathologic entity. Its histologic appearance includes both pilar and eccrine differentiation. We initially treated two patients with MAC of the cheek and of the nasolabial fold, respectively; by microscopically controlled excision because of the contiguous growth of the tumors. Despite the benign histologic appearance, there was deep and extensive infiltration of the subcutaneous tissue. Both patients responded favorably to initial treatment with microscopically controlled excision. In addition, immunoperoxidase staining for carcinoembryonic antigen supported the dual differentiation of this unusual neoplasm. We speculate that previous radiotherapy may be an important predisposing factor in the pathogenesis of MAC.

Biopsy↗
PubMed1990

Microcystic adnexal carcinoma. An immunohistochemical comparison with other cutaneous appendage tumors.

Since its initial description, microcystic adnexal carcinoma (MAC) of the skin has been controversial. In particular, it features keratin production of the type seen in some pilar neoplasms , and has been thought to pursue partial follicular differentiation. Diagnostically, MAC may be difficult to separate from desmoplastic trichoepithelioma (DTE) in superficial biopsy specimens. We studied 12 MACs, 22 malignant eccrine acrospiromas, 7 sudoriferous syringometaplasias, 6 syringomas, 5 DTEs, and 40 other benign pilar neoplasms immunohistochemically. Paraffin sections and antibodies to "hard" (pilar) keratins. epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA), Leu-M1, and S100 protein were employed. The MACs exhibited reactivity for hard keratin subclasses AE 13 and AE 14, EMA, CEA, and Leu-M1. Desmoplastic trichoepitheliomas expressed positivity for AE 14, EMA, and Leu-M1 focally, but lacked the other specified markers. Syringomas and malignant acrospiromas displayed EMA, CEA, and AE 14 reactivity, and 5 syringometaplastic lesions were AE 14-reactive. Benign pilar tumors aside from DTEs were reactive only for AE 13, AE 14, or both. These data indicate that MAC exhibits an immunophenotype that is a "hybrid" of those seen in pure sweat glandular and follicular neoplasms, and suggest that it may indeed show combined pilar and sudoriferous differentiation. Based on these results, it also appears that immunohistochemical analysis may be useful in the diagnostic separation of MAC and DTE.

Adenoma, Sweat Gland↗
PubMed1978

Conjunctival adnexal cysts and dermoids.

Of 128 cysts diagnosed clinically and pathologically as epidermoids and dermoids, 12 lesions were discovered that were lined by nonkeratinizing squamous epithelium with variable numbers of admixed goblet cells. Five lesions did not contain any adnexal structures in their walls and were designated as simple conjunctival cysts; seven lesions additionally displayed appendages in their walls and were diagnosed as conjunctival dermoids. Clinically, this group of 12 cysts differed from classic epidermoids and dermoids by their overwhelming superomedial location and absence of associated osseous defects. It is proposed that these nonkeratinizing cysts represent sequestrations of conjunctival-type epithelium, analogous to the displacements of keratinizing surface epidermis that are most commonly responsible for the production of classic epidermoids and dermoids. It is possible to confuse conjunctival cysts and dermoids with mucoceles.

Adolescent↗
PubMed1982

Ocular adnexal lymphoid tumors. Correlative ultrastructural and immunologic marker studies.

Twenty-two ocular adnexal lymphoid infiltrates were analyzed by electron microscopy as well as immunologically and cytochemically. Five reactive polyclonal lesions were found to be preponderantly composed of small mature lymphocytes (presumably T cells) with clumped nuclear chromatin, sparse cytoplasmic organelles, and numerous monoribosomes. In 11 monoclonal B-cell lesions, both the 1-micrometer plastic sections examined by light microscopy and the electron micrographs disclosed immature cells, with more dispersed nuclear chromatin, prominent nucleoli, abundant cytoplasmic polyribosomes, and increased numbers of mitochondria and strands of endoplasmic reticulum particularly in plasmacytoid lesions). The remaining six monoclonal B-cell lesions were composed of comparatively well-differentiated cells requiring electron microscopy to show somewhat more prominent nucleoli, slightly less dense clumping of the nuclear chromatin, increased numbers of mitochondria and short segments of rough-surfaced endoplasmic reticulum, and monoribosomes rather than polyribosomes. The importance of distinguishing this group of well-differentiated monoclonal lesions from the less well-differentiated ones was underscored by the results of the follow-up examinations, in that no evidence of extraorbital disease has been discovered in the former group, while a 50% incidence occurred in the latter.

Adolescent↗
PubMed1987

Ocular and adnexal complications of unilateral orbital advancement for plagiocephaly.

Strabismus, ptosis, lateral canthal dystopia, nasolacrimal obstruction, and cranial nerve palsy were noted preoperatively in 32%, 21%, 14%, 12%, and 9% of 34 patients, respectively, undergoing ophthalmologic evaluation prior to unilateral orbital advancement for plagiocephaly. Thirty-two percent of the patients had normal preoperative ocular and adnexal examination results. Ptosis, strabismus, and amblyopia were frequently acquired postoperative abnormalities in 29%, 18%, and 18% of the patients, respectively. Forty-four percent of the patients had no new abnormalities following craniofacial surgery.

Child↗
PubMed1992

Surgical management of advanced ocular adnexal amyloidosis.

Ocular adnexal amyloidosis is characterized by amyloid deposition within the deep connective tissue layers of the eyelids, conjunctiva, and anterior orbit. Management of advanced cases has traditionally been unsatisfactory, with either no surgery offered because of fear of hemorrhage or an en bloc resection performed of the entire involved area. We present two cases of advanced periorbital amyloidosis successfully managed by preserving the anatomic planes of the eyelids and meticulously debulking the deposits with a spooned curette. Lax eyelid tendons and aponeuroses were simultaneously repaired, and no sacrifice of eyelid tissues was necessary. One patient remained asymptomatic for 2 years after surgery before developing early reaccumulation in the lower eyelids. The other patient required additional eyelid debulking and ptosis revision 8 months after surgery, but was in stable condition at follow-up 2 years after surgery. This technique offers safe, easily repeatable, nondestructive treatment for advanced periocular amyloidosis.

Amyloidosis↗
PubMed1976

Female adnexal tumor of probable Wolffian origin: evidence of a low grade malignancy.

A broad ligament tumor with the histologic features of a female adnexal tumor of probable Wolffian origin, as described by Kariminejad and Scully, is reported. Although previous cases were thought to be benign, in the present case, hepatic metastasis occurred 6 years after resection of the primary. Cytologic features by light microscopy were more anaplastic than in the original cases. Ultrastructural findings were not specific for any normal adult or fetal mesonephric tissue previously studied by electron microscopy.

Adenocarcinoma↗
PubMed2003

Clinicopathologic analysis of ocular adnexal lymphomas: extranodal marginal zone b-cell lymphoma constitutes the vast majority of ocular lymphomas among Koreans and affects younger patients.

The majority of ocular adnexal lymphomas (OAL) are primary marginal zone B-cell lymphomas (MALT lymphomas). The present study correlated the clinicopathological variables with the histologic subtypes by World Health Organization (WHO) classification with emphasis on MALT lymphomas in OALs of Koreans. There were 68 cases (31 males and 37 females), with a mean age of 45.9 years (range 7-89 years). Histologically, 61 MALT-type, 2 diffuse large B-cell (DLBCL), 2 mantle cell type (MCL), 1 anaplastic large-cell (ALCL), and 2 NK/T-cell lymphomas (NK/T-L) were counted among them. Fifty-seven were primary cases (P-OAL), and 11 were secondary cases (S-OAL). Nearly all P-OALs were MALT lymphomas (n = 56, 98%), with an exception of 1 MCL. Eleven S-OALs included 5 MALT type, 2 DLBCL, 1 ALCL, 1 MCL, and 2 NK/T-L. All MALT lymphoma patients were alive (n = 59) except for 2 after a mean duration of follow-up of 27.6 months (range: 0-108 months): one died of an unrelated cause and one died of recurrence. One non-MALT type P-OAL was alive with no evidence of disease (42 months). Of the 11 S-OAL, 4 had marrow involvement and 5 had progression or relapse outside the orbit. Compared with the other subtypes, MALT lymphoma was more likely to present with local disease (P = 0.001), achieve complete remission (CR) (0.022), and be alive at last follow-up (0.197), and less likely to experience recurrence (P = 0.06). In conclusion, OALs in Koreans are characterized by a preponderance of primary lymphomas over systemic lymphomas, striking predominance of MALT type lymphomas, and young age of occurrence. Histologic subtype by WHO classification has a significant correlation with the final outcome, with the most favorable outcome associated with OALs of the MALT type.

Adolescent↗
PubMedDate not supplied

Echogenic adnexal masses associated with first-trimester pregnancy: sonographic appearance and clinical significance.

In a retrospective survey of a large obstetrical ultrasound experience, 10 echogenic adnexal masses in nine patients with a coexistent intrauterine pregnancy were detected and analyzed. Definitive follow-up data available for seven of the nine patients disclosed three ovarian teratomas, two hemorrhagic corpus luteum cysts, one endometrioma, one inflammatory mass, and one colonic pseudomass. In one additional patient, an echogenic ectopic pregnancy with an intrauterine pseudogestational sac simulated the above entities. Conservative management with follow-up sonography is generally indicated for echogenic masses coexistent with first-trimester intrauterine pregnancies.

Adnexa Uteri↗
PubMed1984

Cutaneous adnexal squamous carcinoma.

A 46-year-old woman developed a squamous carcinoma of the skin that was treated with surgical excision followed by irradiation. The excised tumor showed no epidermal involvement; therefore, it was diagnosed as metastatic squamous carcinoma. However, a 4-year disease-free follow-up indicates that it represents a primary skin tumor. Since the exact histogenesis is unclear, this tumor is tentatively designated "cutaneous adnexal squamous carcinoma."

Carcinoma, Squamous Cell↗