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At least 631 records · Page 35Linked to original sources
PubMed2006

Positron emission tomography in the detection and staging of ocular adnexal lymphoproliferative disease.

PURPOSE: To evaluate the role of fluorine 18 deoxyglucose positron emission tomography (FDG PET) in the initial staging of ocular adnexal lymphoma (OAL). DESIGN: Retrospective nonrandomized case series. PARTICIPANTS: Eleven patients with OAL who underwent FDG PET at initial staging. METHODS: Retrospective review of all the clinical and imaging records, including computed tomography (CT) and FDG PET. MAIN OUTCOME MEASURES: The ability of PET studies to detect OAL and distant disease was compared with CT. RESULTS: Eleven patients with OAL who underwent FDG PET at initial staging were retrospectively reviewed having full access to their clinical and imaging data. Fluorine 18 deoxyglucose PET found distant disease in 5 of 6 lymphoma patients with systemic disease; 4 of these patients (66%) were upstaged, changing the clinical management. Orbital lesions were demonstrated in 3 of 11 patients, giving PET a sensitivity of 27% in the orbit and 83% systemically for detection of lymphoma. CONCLUSION: The ability of FDG PET to find systemic extranodal lymphomatous sites not detected with conventional imaging provides valuable information in OAL patients, which may result in important changes in staging and management. The technique does have limitations in detecting OAL compared with conventional imaging, possibly owing to background physiologic activity in the extraocular muscles in the orbit and the small volume of some orbital deposits.

Adult↗
PubMed2005

Ocular adnexal mucosa-associated lymphoid tissue lymphoma treated with radiotherapy.

Forty-two patients with stage IE ocular adnexal mucosa-associated lymphoid tissue (MALT) lymphoma were retrospectively analyzed. Five-year local control and progression-free survival rates were 100 and 77%, respectively. The most common relapsed site was the contralateral orbit. Thirty Gy of local irradiation seemed to be quite effective and safe.

Adult↗
PubMed1996

Postmenopausal adnexal cysts: how clinical management has evolved.

It has been 25 years since the introduction of the palpable postmenopausal ovary syndrome. As diagnostic imaging techniques have improved, small findings imaged in the adnexa were often handled as if they had been palpated. Clinical management was not made on any scientific basis. New endovaginal probes afford a degree of image magnification that is as if we are doing ultrasonography through a low-power microscope ("sonomicroscopy"). More recent additions of CA 125 measurement, color flow Doppler, and advanced endoscopic surgical techniques have come into the picture. This report attempts to describe an approach to postmenopausal cystic adnexal masses that synthesizes available information and techniques. It is designed to prevent unnecessary surgery and to prevent undue anxiety but not to miss or, at the least, unduly delay the diagnosis of ovarian cancer when it is, in fact, present.

Adnexa Uteri↗
PubMed1990

Ocular adnexal Kaposi's sarcoma in acquired immunodeficiency syndrome.

We examined histopathologically 18 ocular adnexal Kaposi's sarcoma lesions related to acquired immunodeficiency syndrome. These lesions were classified into three types. Type I consisted of thin, dilated vascular channels lined by flat endothelial cells with lumen-containing erythrocytes. Type II featured plump, fusiform, endothelial cells, often with a hyperchromatic nucleus and foci of immature spindle cells and occasional slit vessels. Type III was characterized by large aggregates of densely packed spindle cells with hyperchromatic nuclei, occasional mitotic figures, and abundant slit spaces often containing erythrocytes in between. Clinically, type I and type II tumors were patchy and flat (less than 3 mm in height) and of less than four months' duration. Type III tumors were nodular and elevated (greater than 3 mm in height). We describe the clinical and histopathologic types of Kaposi's sarcoma that may help in diagnosis.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Adnexal infarction after conservative surgical management of torsion of a hyperstimulated ovary.

OBJECTIVE: To report a case of postoperative necrosis after conservative management of torsion of a hyperstimulated ovary. DESIGN: Case report and literature review. SETTING: Tertiary care center. PATIENT: Infertility patient undergoing IVF-ET. INTERVENTIONS: Detorsion followed by unilateral salpingo-oophorectomy 2 days later. MAIN OUTCOME MEASURE: Postoperative course. RESULTS: Postoperative necrosis after detorsion. CONCLUSIONS: Postoperative necrosis is an uncommon but serious complication of conservative surgical management of adnexal torsion.

Adnexa Uteri↗
PubMed1997

Diagnostic formula for the differentiation of adnexal tumors by transvaginal sonography.

OBJECTIVE: To create a strategy for sonographic differentiation of benign and malignant adnexal tumors in premenopausal and postmenopausal patients. METHODS: Multiple sonomorphologic criteria were analyzed prospectively in 754 tumors. Four hundred were found in premenopausal and 354 in postmenopausal women. In a logistic regression model, relevant criteria were selected, and a diagnostic formula for tumor differentiation was derived. RESULTS: There were 165 malignant tumors, of which 37 (9.2%) were found in premenopausal and 128 (36.2%) in postmenopausal women. In both groups, the criteria of solid phase and ascites were the most significant. Further important diagnostic criteria were structure and tumor size in premenopausal women and cyst architecture and tumor surface in postmenopausal women. These results allowed an estimation of the probability of malignancy. Using a cutoff point of 10% for the probability to classify tumors as malignant, the sensitivity and specificity in premenopausal patients were 86.5% and 92.6%, respectively, with an accuracy of 92%. In postmenopausal women, the sensitivity, specificity, and accuracy were 93%, 82.7%, and 86.6%, respectively. Assuming a prevalence as given in the study, the positive and negative predictive values were 54.4% and 98.5% in premenopausal and 75.3% and 95.4% in postmenopausal women. CONCLUSIONS: With four binary criteria, a useful diagnostic formula for tumor differentiation was obtained. However, estimates for sensitivity, specificity, and accuracy may be too optimistic because they were derived from the same data that were already used for model selection.

Adnexa Uteri↗
PubMed1998

Endometrial cancer, cervical cancer, and the adnexal mass.

Cancers of the endometrium, cervix, and ovaries account for nearly 25,000 annual deaths among women in the United States. In recent years, better understanding of the causes and risk factors associated with gynecologic malignancies has contributed to more effective screening and early diagnosis. Abnormal uterine bleeding, a palpable adnexal mass, or vague abdominal complaints in women older than 40 can be signs of cancer. Regular pelvic examination, combined with appropriate use of the Papanicolaou's smear, endometrial biopsy, transvaginal sonography, and other tests, is recommended.

Aftercare↗
PubMed1985

Cutaneous T-cell lymphoma presenting as a rapidly enlarging ocular adnexal tumor.

A 63-year-old man, in good health previously, developed swelling and erythema of the right upper eyelid which progressed to involve both eyelids and surrounding tissues. After one month, he had a 9.0 x 9.0 x 3.5 cm mass despite two attempts at incisional drainage and treatment with antibiotics. Multiple asymptomatic erythematosus nodules (2-3 cm in diameter) developed on his back, trunk, and arms four weeks after onset of the eyelid erythema and swelling. Biopsies of two upper back papules and the eyelid disclosed cutaneous T-cell lymphoma, a lymphoproliferative malignancy of thymus derived lymphocytes originating in the skin. Systemic chemotherapy resulted in a marked decrease in the ocular adnexal mass but lymphomatous meningitis and quadriplegia developed. The patient died four months later; an autopsy was not performed. This case demonstrates that cutaneous T-cell lymphoma may rarely have its initial manifestation as a rapidly enlarging eyelid tumor.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1997

Cytogenetic and fluorescence in situ hybridization analyses of a microcystic adnexal carcinoma with del(6)(q23q25).

Cytogenetic analysis of a case of microcystic adnexal carcinoma (MAC) revealed three unrelated clones with the karyotypes: 46,XX,del(6)(q23q25)[17]/46,XX,1 approximately 2dmin[4]/46,XX,t(1;3) (p10;q10)[2]. Analysis of the 6q- by fluorescence in situ hybridization (FISH) showed that it had resulted from a long arm deletion. The finding of a clonal 6q deletion as the sole karyotypic change in a MAC is of special interest because we previously have identified 6q deletions in different types of malignant salivary gland tumors. This observation, together with the histopathologic similarities between salivary gland tumors and sweat gland tumors, further emphasize the histogenetic relationships between these tumor types.

Carcinoma, Skin Appendage↗
PubMed1985

Histologic diagnosis of benign adnexal skin tumors. An algorithmic approach.

Adnexal lesions have traditionally been classified according to their histogenesis. Frequently this approach is not particularly helpful in the initial evaluation of these lesions. A diagnostic algoithm based on morphologic characteristics alone provides a more orderly and logical approach to their diagnosis.

Adenoma↗
PubMed1999

Microcystic adnexal carcinoma: collaborative series review and update.

BACKGROUND: Microcystic adnexal carcinoma (MAC) is a malignant appendageal tumor first described in 1982. It can be clinically and histologically confused with other malignant and benign cutaneous neoplasms, leading to inadequate initial treatment. This neoplasm is locally aggressive and deeply infiltrating, characterized by high morbidity and frequent recurrence. Mohs micrographic surgery has been used to conserve tissue and improve the likelihood for cure. OBJECTIVE: We report our experience using Mohs micrographic surgery for the treatment of MAC and compare with earlier reports in the literature. In addition, we review the epidemiology, clinical and histologic characteristics, and optimal treatment of this rare neoplasm. We also describe a 15-year-old white male patient with MAC on the scalp occurring only 7 years after radiation exposure. METHODS: The medical records of 11 patients with MAC who were treated by Mohs micrographic surgery were reviewed at both departments, and follow-up data were obtained. RESULTS: In all patients treated with Mohs micrographic surgery, there were no recurrences after a mean follow-up of 5 years. CONCLUSION: Mohs technique enables the detection of clinically unrecognizable tumor spread and perineural invasion often encountered with MAC. Aggressive initial treatment by microscopically controlled excision appears to offer the greatest likelihood of cure for this neoplasm, while providing conservation of normal tissue. In addition, we describe the second youngest patient with MAC and readdress the issue of previous radiotherapy as an important predisposing factor.

Adolescent↗
PubMed1999

Female adnexal tumour of probable Wolffian origin in a 23-year-old woman.

This report describes a case of female adnexal tumour of probable Wolffian origin in a 23-year-old woman. This is the youngest patient so far described in association with this tumour. Following surgical management 11 years ago, there was neither recurrence nor metastasis and the patient gave birth to three children.

Adult↗
PubMedDate not supplied

Comparison of resistive index versus pulsatility index in assessing the benign etiology of adnexal masses.

Retrospective analysis of pelvic sonograms with colorguided spectral Doppler evaluation of 189 adnexal masses yielded four malignancies, 20 benign neoplasms, 32 cysts, and 14 endometriomas. Fifty-eight masses were presumed benign on additional imaging. Pulsatility index (PI) < 1.0 was seen in 70% neoplasms, 63% benign cysts and 50% endometriomas. Thirteen percent of benign cysts and no neoplasms had resistive index (RI) < 0.4. Fifty percent malignancies had PI < 1.0. None had RI < 0.4. Both thresholds lack sufficient sensitivity and specificity for distinguishing benign and malignant lesions.

Adolescent↗
PubMed2001

Elevated serum CA 125 and adnexal mass mimicking ovarian carcinoma in a patient with tuberculous peritonitis.

A 49 year old woman presented with weight loss, diffuse abdominal pain and distension, low grade fever, massive ascites, and an increased serum CA 125 value. Computed tomography of the abdomen and pelvis and ultrasonography of the pelvis were suggestive of ovarian carcinoma. Exploratory laparotomy revealed massive ascites; diffuse peritoneal studding of numerous 1- to 2-mm implants in the bowel, omentum and abdominal wall; a cystic adnexal mass; and indurated head of the pancreas. Histopathological examination of several implants showed multiple epitheloid granulomata with rare central necrosis. The patient responded well to antituberculous therapy.

Journal Article↗
PubMed2003

Laparoscopic approach to an uncommon adnexal neoplasm associated with infertility: serous cystadenofibroma of the fallopian tube.

A rare case of serous cystadenofibroma of the fallopian tube was discovered during evaluation for in vitro fertilization-embryo transfer. Bilateral tubal occlusion was noted on hysterosalpingogram, and a right adnexal cyst, initially thought to be of ovarian origin, was identified by office transvaginal sonography. Laparoscopy revealed a 5.5-cm, fluid-filled mass involving the distal aspect of the right fallopian tube. Both ovaries and uterine exterior appeared grossly normal. The cyst was decompressed and removed intact without incident through a 5-mm laparoscopic cannula. The mass showed histologic features consistent with benign serous cystadenofibroma. The patient had an uncomplicated postoperative convalescence and continued to do well 3 months after surgery.

Adnexa Uteri↗
PubMed1998

Conservative therapy of adnexal torsion employing color Doppler sonography.

STUDY OBJECTIVE: To ascertain if color Doppler sonography (CDS) can detect viability of adnexa in torsion. DESIGN: Concurrent, nonrandomized study (Canadian Task Force classification II-2). SETTING: Tertiary medical care center in a university hospital. PATIENTS: Twenty-seven women suspected of having torsion of the ovary in which a benign tumor was present. INTERVENTIONS: Color Doppler sonography of the ovarian pedicle suggested torsion. Laparoscopy or laparotomy was performed in 19 patients and confirmed the diagnosis. MEASUREMENTS AND MAIN RESULTS: We identified a twisted vascular pedicle of the ovarian tumor by CDS in 24 (88%) of 27 women. Pedicle arterial and venous blood flow was observed in 10 women; pathology specimens revealed normal tissue, edema with congestion, or early hemorrhage. In all nine in whom only arterial blood flow or no blood flow was observed, pathology revealed hemorrhagic necrosis. In five women with arterial and venous blood flow the tumor was managed conservatively, either by detorsion or cystectomy, after which no embolism or tumor recurrence was seen at follow-up ultrasonography. Normal follicular development and ovulation occurred in these patients. CONCLUSION: For women of childbearing age in whom torsion of benign adnexal tumors is suspected, CDS should be performed to confirm the diagnosis and ascertain whether or not pedicle arterial and venous blood flow is present. If such blood flow is detected, the adnexa is considered to be viable and detorsion or cystectomy may be performed, thus preserving the ovary. It is recommended that further studies with a larger group be undertaken to provide a basis for statistical analysis.

Abdomen, Acute↗
PubMed1995

A tumour derived from Ebner's glands: microcystic adnexal carcinoma of the tongue.

Microcystic adnexal carcinoma (MAC) is known as an infiltrating but non-metastasizing tumour of the skin, that derives from sweat glands or follicular epithelium. We report on a rare case of MAC of the tongue. The patient had noticed the tumour for two years with slowly increasing dysphagia but no other symptoms of an oropharynx carcinoma. Histological and immunohistochemical analyses showed a similarity between the tumour derived from Ebner's glands of the tongue and MAC of the sweat glands.

Aged↗
PubMed2000

The histologic value of adnexal (eccrine gland and follicle) infiltration in mycosis fungoides.

BACKGROUND: To verify the incidence and the possible diagnostic use of detecting adnexotropism in mycosis fungoides (MF). METHODS: We reviewed the frequency and the intensity of the eccrine and follicular infiltration in 104 biopsy specimens from indisputable cases of MF and in a control group of 20 biopsy specimens of spongiotic dermatitis. Syringohyperplasia and follicular mucinosis were also evaluated. RESULTS: A prominent eccrine infiltration was noted in 32 of 104 specimens (30%). Marked acrosyringial and ductal eccrine hyperplasia was present in 5 specimens (5%). In 13 of the 32 specimens with prominent eccrine infiltration (40%), epidermotropism was slight or less evident than syringotropism. Follicular structures were visible in 59 specimens and significantly infiltrated in 57%. Follicular mucinosis was found in 5 (8.4%). In the control group of spongiotic dermatitis, a significant eccrine and follicular infiltration was found only in case (5%). CONCLUSIONS: Adnexal (eccrine gland and follicle) infiltration may be a useful diagnostic tool in MF, particularly in those in which epidermotropism is slight.

Eccrine Glands↗