Cases reported "Endometrial Neoplasms"

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1/9. Endometrial adenocarcinoma with diffused/scattered "intramural" spreads: report of a case and review of the literature.

    A case is reported of endometrial adenocarcinoma of the uterus in an 85-year-old patient with an unusual spreading pattern. On macroscopic examination, only a tiny exophytic tumor was found in the uterine cavity, while microscopic examination demonstrated a scattered (scirrhous) spread of the carcinoma cells throughout the myometrium. The tumor occupied about half of the upper uterine corpus. The intramural spread of the tumor could not be seen at the time of macroscopic examination of the uterine cut surface. The tumor cells were attached closely to the serosal membrane, and metastasis to the left ovary was found. Intraoperative cytology detected malignant cells in the ascites. We present here this unusual type of endometrial carcinoma and review our previous report which dealt with pure "intramural carcinomas of the uterine corpus".
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ranking = 1
keywords = ascites
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2/9. Recurrent ascites and pleural effusions after surgery for early-stage endometrial adenocarcinoma.

    A case of massive postoperative ascites in a woman treated for endometrial cancer is reported. A workup for typical causes of ascites yielded negative results, prompting a more detailed analysis of the patient's condition. hypothyroidism was discovered. After correction of the hypothyroidism, the ascites slowly resolved. Since myxedema is an uncommon cause of ascites, this is usually a diagnosis of exclusion. However, hypothyroidism must be ruled out to prevent unnecessary and possibly inappropriate treatments for ascites.
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ranking = 9
keywords = ascites
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3/9. chylous ascites following treatment for gynecologic malignancies.

    BACKGROUND: chylous ascites is a rare complication following abdominal radiation or para-aortic lymph node dissection in the management of gynecologic malignancies. Treatment options include dietary restriction with addition of medium-chain triglycerides, serial paracenteses, total parenteral nutrition, and somatostatin. Current opinion advocates that surgical exploration and peritoneo-venous shunts be reserved for refractory cases. CASES: Two patients developed chylous ascites, one after completion of surgical staging and chemoradiation for stage IIB squamous carcinoma of the cervix and one following para-aortic lymph node dissection for recurrent malignant mixed mullerian tumor of the endometrium. In both cases resolution of the chylous ascites followed placement of a peritoneo-venous shunt. CONCLUSIONS: chylous ascites should be considered in the differential diagnosis of ascites in patients with gynecologic malignancy treated with radiation or para-aortic lymph node dissection.
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ranking = 9
keywords = ascites
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4/9. Multiparameter flow cytometry in the diagnosis of a gynaecologic double tumor: a case report.

    PURPOSE. An uncommon clinical presentation of metastatic tumor will often lead to additional diagnostic examinations. The patient of the present study was known to have endometrial cancer which was thought to be limited to the endometrium. Three months postoperatively, she developed ascites due to spread of the tumor, which is rarely seen in low-stage endometrial cancer. METHOD. Multiparameter flow cytometry using both cell phenotype information and dna ploidy was performed. RESULTS. Retrospectively, the patient was diagnosed as having a dna-diploid epithelial tumor of the endometrium as well as a dna-aneuploid epithelial tumor in the left fallopian tube. It was shown that 3 months after primary surgery she developed ascites caused by metastatic tumor from the primary fallopian tube cancer. CONCLUSION. The complete diagnosis was made using multiparameter flow cytometry which, at present, is not routinely applied in gynecologic pathology.
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ranking = 2
keywords = ascites
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5/9. Numerical chromosome abnormalities associated with early clinical stages of gynecologic tumors.

    Cytogenetic data are presented for 12 ovarian, three endometrial, and one fallopian tube tumors. In 15 of these, primary tumors were analyzed and in one ascites was studied. All specimens were obtained at the time of diagnostic surgery. trisomy for chromosome 7 was detected in three ovarian and one endometrial tumors. In one case, trisomy 7 was the sole cytogenetic abnormality detected. Three of the four patients with trisomy 7 had early stages of adenocarcinoma. The data suggest that numerical chromosome abnormalities may be common in borderline and in less aggressive gynecologic tumors.
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ranking = 1
keywords = ascites
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6/9. Right atrial and right ventricular obstruction by recurrent stromomyoma.

    A 30-year-old woman had a history of a uterine fibroid 6 years before admission. She had resection of a right atrial mass diagnosed as a leiomyoma 2 years ago and a second cardiac procedure for recurrent tumor 1 year ago. Pathologic examination at that time indicated that the tumor was a low-grade endometrial stromal sarcoma (stromatosis) with features of benign leiomyoma (intravenous leiomyomatosis). This time she was admitted with facial and lower extremity swelling as well as ascites. Transthoracic and transesophageal echocardiography revealed a large tumor entering the heart from the inferior vena cava and filling the right atrium and ventricle. lower extremity ischemia from bilateral compartment syndrome due to severe edema developed, and she underwent successful surgical resection of the tumor that filled the right side of the heart, inferior vena cava, and mesenteric and renal veins.
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ranking = 1
keywords = ascites
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7/9. Chyloperitoneum following treatment for advanced gynecologic malignancies.

    BACKGROUND: Chyloperitoneum is an uncommon complication following retroperitoneal surgery. Blunt abdominal trauma, abdominal surgery, abdominal or pelvic radiation, cirrhosis, lymphoma, tuberculosis, and congenital defects of lacteal formation may also lead to chylous ascites. CASES: Two patients developed chylous ascites after treatment for gynecologic malignancies. One, who also received pelvic and abdominal radiation, developed chylous ascites 11 months after retroperitoneal lymph node dissection for advanced endometrial cancer. She was treated with a diet low in fat and high in medium-chain triglycerides, as well as with intravenous hyperalimentation. She had recurrences of chylous ascites, which responded to paracentesis and intravenous hyperalimentation. The second patient developed chylous ascites 2 months after retroperitoneal lymph node dissection for advanced fallopian tube cancer. She was treated with a medium-chain triglyceride diet, which resulted in resolution of her symptoms. CONCLUSION: Chyloperitoneum is an uncommon complication following treatment for gynecologic malignancies. Our second case is the first reported in which retroperitoneal lymph node dissection for gynecologic malignancy resulted in chyloperitoneum. However, because gynecologic malignancies frequently metastasize to the periaortic lymph nodes, chylous ascites may be an important cause of morbidity following treatment.
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ranking = 251.95498495861
keywords = chyloperitoneum, ascites
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8/9. Hepatic venoocclusive disease as a complication of whole abdominopelvic irradiation and treatment with the transjuglar intrahepatic portosystemic shunt: case report and literature review.

    We report the novel use of the transjugular intrahepatic portosystemic shunt (TIPS) procedure for the treatment of intractable ascites due to hepatic venooclusive disease as a result of whole abdominopelvic radiotherapy. A patient with Stage III endometrioid carcinoma of the endometrium treated with postoperative whole abdominopelvic irradiation developed intractable ascites. Multiple paracenteses and computerized tomography were negative for recurrent carcinoma. liver biopsy demonstrated hepatic venoocclusive disease, a rare complication of therapeutic radiation involving the liver. Successful relief of ascites and its adverse symptomology were achieved with the transjugular intrahepatic portosystemic shunt. Relevant literature regarding the pathogenesis, prognosis, and treatment of radiotherapy-related hepatic venoocclusive disease are reviewed.
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ranking = 3
keywords = ascites
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9/9. Primary lymphoma of the endometrium. A report of two cases diagnosed on cervicovaginal smears.

    BACKGROUND: Primary lymphomas of the endometrium are extremely rare. diagnosis is difficult, especially when the neoplasm is originally evaluated on a cervicovaginal smear. When lymphomas involve the endometrium, the cervix is three times more likely to be the primary site rather than the endometrium. Two of the symptoms of primary lymphoma of the endometrium are abnormal vaginal bleeding and an abdominal or pelvic mass. CASES: Case 1 was a 36-year-old, obese, black female with an abdominal mass and recent onset of ascites. The second case was a 31-year-old, obese, black female with a history of menometrorrhagia. The cytologic findings in both cases revealed an individual cell population, high nuclear/cytoplasmic ratio, small nucleoli and coarsely granular chromatin with some chromatin clearing. Endometrial currettings showed a histologic pattern of malignant non-Hodgkin's lymphoma, diffuse, large cell type. Immunoperoxidase staining was positive for leukocyte common antigen. CONCLUSION: Two cases of lymphoma of the endometrium were diagnosed first by a cervical cytologic smear, supported by a positive body cavity fluid in one case and histology in both. The differential diagnoses included various inflammatory lesions, small cell carcinoma, endometrial stromal sarcoma and granulocytic sarcoma.
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ranking = 1
keywords = ascites
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