1/14. Huge omental cyst mimicking ascites.An unusual case of omental cyst is described. A 4-year-old child presenting as abdominal distension of short duration, clinically diagnosed as ascites, was subsequently proved to be giant omental cyst. The case is reported because of its unique presentation.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/14. Giant omental cyst simulating ascites in a Nigerian child: case report and critique of clinical parameters and investigative modalities.We report our experience of managing an 18-month-old boy in whom a giant omental cyst of 4.6 kg, which constituted 42% of his pre-operative weight, masqueraded as massive ascites. Pre-operative diagnosis and early surgical intervention were facilitated by inter-disciplinary collaboration, ultrasonography and radiological contrast studies. The differential diagnoses and treatment options of omental and mesenteric cysts are discussed. The importance of ultrasonography as an initial imaging tool for arriving at the correct diagnosis in a child with ascites of obscure aetiology is emphasized.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/14. Peritoneal tuberculosis with negative polymerase chain reaction results: report of two cases.Peritoneal tuberculosis is rarely observed in European countries. We report on peritoneal tuberculosis in two female immigrants from somalia and Columbia who presented with diffuse abdominal pain, fever, weight loss and exudative, lymphocytic ascites. Laboratory investigations showed an increase in c-reactive protein and carcinoma antigen 125 serum levels. Nodular peritoneal lesions and adhesions were detected by ultrasound and computed tomography. In both patients, peritoneal biopsy from laparoscopy revealed epitheloid granulomas with central necrosis and multinucleate giant cells. microscopy and PCR analysis were, however, negative for mycobacterium tuberculosis in both patients. Despite repeated testing, ascites culture became positive for M. tuberculosis in only one patient. Shortly after starting antituberculous drug treatment, both patients improved, ascitic fluid disappeared and c-reactive protein and carcinoma antigen 125 serum levels returned to normal. Even in Western countries, peritoneal tuberculosis should be considered in any febrile patient with abdominal signs and symptoms, particularly if ascites is present. Empirical antituberculous treatment is justified in patients with clinical and histological features highly suggestive of peritoneal tuberculosis, even in cases with negative results from microscopy, culture and PCR analysis.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/14. Giant bilateral ovarian cysts in an adolescent masked by obesity and mimicking ascites: a case report.ovarian cysts are a common pathology after the 4th decade of life. We can find either smaller functional, non-neoplastic ones (belonging to the follicular and luteinic varieties) or larger tumoral cysts, which, however, are usually benign. These may be of the serous or mucinous type and can sometimes reach really large sizes. Reports of giant ovarian manifestations were more frequent a few decades ago. Prior to the advent of modern radiological, ultrasonographic, tomographic and magnetic resonance imaging techniques, diagnosis was often difficult. Nevertheless, even today, in some cases (as a result of pronounced obesity, for example, associated perhaps with diagnostic negligence), cases of giant ovarian cysts may still be encountered. We report the case of a (previously obese) 19-year-old female, admitted to our hospital for presumed ascites, identified and ultrasonographically misdiagnosed by her gynaecologist. The patient was, in fact, suffering from giant serous cystoadenomas in both ovaries.- - - - - - - - - - ranking = 3keywords = giant (Clic here for more details about this article) |
5/14. Giant cell hepatocellular carcinoma.A terminal case of giant cell hepatocellular carcinoma, subsequent to hepatitis b-associated macronodular cirrhosis is presented, illustrated and discussed. The uncommon finding of malignant ascites, in itself atypical of hepatocellular carcinoma, with an almost exclusive content of giant cells as the cellular component, was a feature of this unusual variant of hepatocellular carcinoma.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
6/14. Multicentric giant lymph node hyperplasia with ascites and double cancers, an autopsy case.A 70-year-old man, diagnosed to have multicentric giant lymph node hyperplasia (MGLNH) of the plasma cell type by postmortem examination, had double cancers of the thyroid and kidney, as well as a large amount of ascites and persistent serositis. Serum immunoelectrophoresis showed monoclonal IgG (lambda). Using the paired immunofluorescent technique, monoclonal plasma cell proliferation was observed on the section of a lymph node. The cause of the ascites was speculated to be the combined influence of peritonitis, renal dysfunction and obstruction of abdominal lymphatic ducts. Occurrence of double cancers and persistent peritonitis suggest the long-standing faulty immune regulation in MGLNH.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
7/14. ascitic fluid cytologic features of a malignant mixed mesodermal tumor of the ovary.A case of malignant mixed mesodermal tumor of the ovary in a postmenopausal patient presenting with abdominal distension is reported. Cytologic examination of smears of the ascitic fluid showed the presence of adenocarcinomatous and sarcomatous cells (with some of the latter being giant cells) plus numerous unidentifiable cells that bore some resemblance to either mesothelial cells or macrophages. Electron microscopic studies showed a clear differentiation of the adenocarcinomatous and sarcomatous cells from positively identified mesothelial cells and macrophages also present in the ascitic specimen, indicating that the unidentified cells in fact originated in the adenocarcinoma (endometrioid carcinoma), chondrosarcoma and unclassified sarcoma found in the surgical specimen. The differential diagnostic cytomorphologic and electron microscopic features are described in detail.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/14. "Pseudo-ascites" associated with giant ovarian cysts and elevated cystic fluid amylase.Two patients with massive ovarian cysts that mimicked ascites on physical examination, ultrasonography, and abdominal plain film are reported. Elevated cyst amylase in both patients, and in one, elevated serum amylase, further confused the diagnosis. Massive ovarian cysts should be considered in the differential diagnosis of presumed ascites in female patients, particularly in the setting of elevated serum or "ascitic" fluid amylase.- - - - - - - - - - ranking = 4keywords = giant (Clic here for more details about this article) |
9/14. Congenital hepatic fibrosis--unusual presentations.Two children with congenital hepatic fibrosis presented atypically: one with prolonged fever and hepatomegaly associated with a giant intrahepatic biliary cyst and a second with ascites at an early age despite normal serum albumin concentrations.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
10/14. Giant ovarian cyst mimicking ascites.A 60-year-old female patient presented to our clinic with complaints of abdominal distention. The rapid accumulation of fluid was originally thought to be ascites, based on ultrasonographic examination. The cause, however, was ultimately determined to be a borderline malignant giant ovarian cyst. Several processes can mimick ascites: bladder distention or diverticulum, hydronephrosis, pancreatic pseudocysts, and large uterine or ovarian tumors. For this reason, clinicians must consider processes other than ascites in the differential diagnosis of large abdominal fluid accumulation.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
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