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1/12. Metastasis from small cell carcinoma of the lung producing acute appendicitis.

    A case of acute gangrenous appendicitis with perforation caused by metastatic small cell carcinoma of the lung in a 65 year old man is reported. The manifestation of appendicitis occurred more than 4 years after the diagnosis of the bronchogenic carcinoma. With longer survival of patients with disseminated tumors it is probable that new manifestations of those malignancies will be discovered. Acute appendicitis due to metastasis from a distant neoplasm should be considered in the differential diagnosis of right lower abdominal pain in the oncology patient.
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ranking = 1
keywords = neoplasm
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2/12. adult Wilms' tumor presenting as acute abdomen with elevated serum lactate dehydrogenase-4 and -5 isoenzymes: case report.

    Wilms' tumor, an embryonic neoplasm, is the most frequent renal tumor in childhood but is rare in adults. The prognosis of adult Wilms' tumor is worse than pediatric Wilms' tumor. The preoperative diagnosis of adult Wilms' tumor is extremely difficult to make because diagnostic imaging techniques, such as intravenous pyelography, computed tomography, ultrasound, renal angiography, and nuclear magnetic resonance imaging, only confirm the presence of a renal mass. diagnosis usually depends on histological characteristics, such as the presence of blastemic, epithelial, and mesenchymal components. A 27-year-old female presented with acute abdomen and with elevated serum lactate dehydrogenase (LDH) at 212 U/l (normal range: 47-140), and 2 of 5 LDH isoenzymes, namely LDH-4 at 13.6% (normal range: 6.8%-10.2%) and LDH-5 at 20% (normal range: 6.5%-9.7%). In this patient, stage I Wilms' tumor was managed by radical nephrectomy. The levels of LDH returned to its normal range. In conclusion, in cases of acute abdomen with a renal mass in young adults, the possibility of Wilms' tumor should be considered. serum LDH and its isoenzymes, LDH-4 and LDH-5, could be used as tumor markers for either differential diagnosis or monitoring the response of treatment.
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ranking = 1
keywords = neoplasm
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3/12. pseudomyxoma peritonei.

    pseudomyxoma peritonei is a relatively rare and poorly understood condition in which mucus accumulates within the peritoneal cavity. The presence of cells in the mucin, either inflammatory or neoplastic, distinguishes it from simple acellular mucus ascites caused by mucinous spillage. There is widespread seeding of the peritoneal and omental surfaces with a heavy cancerous glaze. This is principally a complication of borderline or malignant neoplasm of the ovary and/or appendix. This paper describes two cases of previously healthy women who both presented with an acute abdomen, and were diagnosed postoperatively with pseudomyxoma peritonei. In addition, literature on the clinical presentation, diagnostic procedures, and treatment options has been briefly reviewed.
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ranking = 1
keywords = neoplasm
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4/12. Adnexal torsion presenting as an acute abdomen in a patient with bilateral cystic teratoma of the ovary.

    Benign cystic teratomas are the most common ovarian neoplasms in women. Teratomas are usually benign, unilateral, and most often found in young and premenopausal women. Most are 5 cm to 10 cm in diameter when diagnosed, and on sectioning, they usually contain thick sebaceous material, tangled hair, and various dermal structures. One of the major complications seen in cystic teratoma is torsion, a partial or complete twisting of the ovarian suspensary pedicle causing severe pain, nausea, and tissue necrosis. The patient described had bilateral cystic teratomas, one uncommonly large and torsed, causing an acute abdomen. Discussion includes the diagnosis, operative management, and postoperative findings.
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ranking = 1
keywords = neoplasm
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5/12. Spontaneous rupture of a dissection of the left ovarian artery.

    A 53-year-old female was suddenly hospitalized with acute left lateral abdominal pain. There was no history of trauma to the abdomen. She had received no abdominal operation. X-ray showed a soft tissue shadow in the left flank which displaced the bowel shadows medially. Plain abdominal CT showed a left retroperitoneal hematoma. Dynamic abdominal CT showed an outflow of medium from a blood vessel in the hematoma. At laparotomy, the source of bleeding was found to be the left ovarian artery. The ovarian artery was dilated and meandered remarkably. The ovarian artery and vein were ligated proximally and left adenectomy was performed. The patient made an uneventful recovery. Histological examination suggested a spontaneous rupture of a dissection of the left ovarian artery.
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ranking = 0.011473112597786
keywords = soft
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6/12. Acute abdomen due to torsion of a pelvic wandering spleen.

    wandering spleen is a rare entity characterized by incomplete fixation of the spleen by lienorenal and gastrosplenic ligaments. wandering spleen can migrate to the lower abdomen or pelvis, and can be either congenital or acquired. It is most commonly found in women of reproductive age, and may be misdiagnosed as an abdominal or adnexal mass. It is usually asymptomatic, but may present with acute, chronic, or intermittent abdominal pain. Here, we report a case of torsion of a huge congenital pelvic wandering spleen and microscopic isolated pancreatic tissue (disconnected from the pancreas) with impending splenic rupture in a 23-year-old female patient. Progressively severe chronic or intermittent torsion of the vascular pedicle of the wandering spleen caused progressive intermittent lower abdominal pain. The patient underwent splenectomy with resection of the long pedicle and the postoperative course was uneventful. The pathognomonic computerized tomography features of this case, including absence of the spleen in the left upper quadrant and the presence of a whirl-like structure running down to the central portion of the distally located large soft-tissue mass and with a notched- (hilar-) like contour, are also described.
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ranking = 0.011473112597786
keywords = soft
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7/12. Small intestinal angiosarcoma leading to perforation and acute abdomen: a case report and review of the literature.

    A 76-year-old man presented to the emergency room with abdominal pain and fatigue. The patient had a history of gastrointestinal bleeding. An abdominal computed tomographic scan showed collections of free air in the abdomen with obstruction of the distal small intestine and multiple masses in the liver. laparotomy revealed a widespread malignant neoplasm in the abdomen, with multiple tumor nodules in the ileal wall, mesentery, and liver. The ileal wall was perforated within the area of one of the tumors. Pathologic examination of the lesion showed a neoplasm composed of solid sheets of spindle and undifferentiated cells, forming interlacing delicate vascular channels with atypical endothelial cells. The tumor cells were positive for the endothelial marker CD31, whereas reactivity for a broad panel of epithelial and other endothelial markers was negative. This case demonstrates that although angiosarcomas of the gastrointestinal tract are rare, they should be considered in cases of intestinal perforation or severe bleeding, especially in the elderly. A broad panel of immunochemical markers might be necessary to establish the pathologic diagnosis.
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ranking = 2
keywords = neoplasm
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8/12. Haemangiopericytoma of greater omentum. A rare cause of acute abdominal pain.

    Haemangiopericytoma (HPT) is a rare neoplasm that can occur in any part of the human body. In this report, we describe the case of a patient with sudden severe upper abdominal pain caused by primary HPT in the greater omentum.
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ranking = 1
keywords = neoplasm
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9/12. A case of group B streptococcal pyomyositis.

    The group B streptococcus is an opportunistic pathogen that causes a variety of serious infections including bacteremias, puerperal sepsis, and neonatal meningitis. Group B streptococcal infections of muscle are rare. We report here an unusual case of group B streptococcal pyomyositis. pyomyositis arises predominantly from infections caused by staphylococcus aureus and, occasionally, streptococcus pyogenes. Because of the rarity of pyomyositis in temperate climates, the common lack of localizing signs or symptoms, and the frequently negative blood cultures, considerable delay often precedes the diagnosis of pyomyositis; in fact, the infection has been initially misdiagnosed as muscle hematoma, cellulitis, thrombophlebitis, osteomyelitis, or neoplasm. diagnosis may be greatly aided by radiologic techniques that can demonstrate the sites of muscle enlargement and the presence of fluid collections. The response to antibiotics is usually rapid, but resolution of the infection may require aspiration of deeply situated muscle abscesses. This report describes a diabetic patient with an unusual presentation of pyomyositis that mimicked an acute abdomen.
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ranking = 1
keywords = neoplasm
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10/12. Acute abdominal conditions in mesenteric lymphangioma.

    Mesenteric lymphangiomas are rare benign tumors that occur in the abdominal cavity attached to the mesentery of the small or large bowel. They are no longer believed to be neoplasms, but may be a result of congenital failure of the original lymphaticovenous system. I have reported four cases of mesenteric lymphangioma causing an acute abdominal condition. Segmental resection of the intestine and the cystic mass was done in all patients, and all recovered uneventfully. There were no postoperative complications or recurrences.
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ranking = 1
keywords = neoplasm
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