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1/114. Ovarian carcinoma, endometrial carcinoma, and pregnancy.

    A 31-year-old G1 P0 patient with a history of infertility presented with light spotting and cramping at the end of her first trimester. An ultrasonogram at 19 weeks gestation revealed an intrauterine gestation of 21 weeks, a large leiomyoma, and a 8.9 x 6.8 cm complex left ovarian mass. At 35 weeks gestation she had an emergency cesarean section and left salpingo-oophorectomy due to a presumed ruptured ovarian mass. The ovarian mass was diagnosed as a serous cystadenocarcinoma. An exploratory laparotomy with a total abdominal hysterectomy, a right salpingo-oophorectomy, omental biopsy, and periaortic node sampling at 9 weeks postpartum revealed a diagnosis of stage IC ovarian serous cystadenocarcinoma and a stage IA secretory endometrial adenocarcinoma. Adjunctive 32P therapy was successfully administered and at this time the patient has had no recurrence.
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ranking = 1
keywords = complex
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2/114. prenatal diagnosis of congenital neuroblastoma. Analysis of 4 cases and review of the literature.

    OBJECTIVE: Advances in prenatal diagnostics during the last 10 years have enabled the examiner to detect even rare fetal disorders such as fetal tumours. Congenital neuroblastoma is the most frequent solid neoplasm in infancy, with a retroperitoneal cystic or solid mass being a sonographic sign of the conditions. methods: We present 4 cases of neuroblastoma showing suspicious prenatal ultrasound findings. The investigation comprises detection during pregnancy, typical sonographic signs, as well as the postnatal outcome. In addition, a review of the literature is undertaken with a focus on prenatal sonographic signs of congenital neuroblastomas. RESULTS: In all 4 cases, a cystic tumour was detected during the 3rd trimester of pregnancy by means of B-mode sonography. One boy died of disseminated metastases at the age of 26 months. The other 3 survived after surgery and have remained healthy. CONCLUSIONS: The detection of a cystic suprarenal mass is suspicious of a congenital neuroblastoma. The delivery should take place at a perinatal centre.
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ranking = 107.64989963362
keywords = neoplasm
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3/114. Desmoid tumor of the larynx complicating pregnancy: a case report.

    Desmoid tumors are locally invasive fibrous neoplasms that arise from musculoaponeurotic structures. We report the first case of a desmoid tumor of the larynx complicating pregnancy. At 21 weeks' gestation fiberoptic and indirect otolaryngologic examination of the patient's larynx revealed a submucosal tumor involving the left true vocal cord, ventricle of the larynx, and false vocal cord. Histopathologic examination revealed areas of extensive fibrosis intermixed with degenerated vocal cord skeletal muscle. Despite a subtotal excisional biopsy, growth of the desmoid tumor continued during pregnancy. Endoscopic evaluation 9 weeks post partum revealed complete regression of the tumor.
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ranking = 107.64989963362
keywords = neoplasm
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4/114. Borderline ovarian tumors complicating pregnancy: a case report.

    Although the majority of ovarian tumors complicating pregnancy are benign, they still pose a challenge because of the difficulty in differentiating between benign and malignant tumors during pregnancy. To our knowledge, the value of color Doppler ultrasound in the diagnosis of borderline malignant tumors complicating pregnancy remains unclear. We present the case of a 29-year-old pregnant woman with an ovarian tumor of low malignant potential. Preoperative ultrasound revealed a well-encapsulated cystic complex on the left ovary measuring 16 x 18 x 12 cm with an internally smooth surface, multiple septa ranging from 2 to 4 mm in thickness and a small solid component 2 cm in diameter, with a resistance index of 0.42. The differential diagnosis preoperatively was a borderline tumor. The patient underwent a left oophorectomy at 18 weeks of gestation. Frozen pathology indicated a mucinous cystadenocarcinoma of low malignant potential. A thorough surgical staging was completed. The final pathology confirmed mucinous cystadenocarcinoma of low malignant potential, stage IA. Postoperatively, the patient had an uneventful course and did not receive any adjuvant therapy. She delivered a normal male fetus weighing 3,450 g at 38 weeks of gestation. We conclude that color Doppler ultrasound is helpful for the preoperative diagnosis of borderline tumors of the ovaries but its usefulness for making an accurate diagnosis may require further evaluation.
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5/114. trisomy 12 in juvenile granulosa cell tumor of the ovary during pregnancy. A report of two cases.

    BACKGROUND: Granulosa cell tumors constitute only 5% of ovarian neoplasms, and their coexistence with pregnancy is extremely rare. Juvenile granulosa cell tumor has a good prognosis if it is confined to the ovary, but this type behaves more aggressively than the adult type at advanced stages. CASES: We report on successful completion of two singleton pregnancies and deliveries of normal infants in two young women with juvenile granulosa cell tumor diagnosed and treated during pregnancy. This tumor has rarely been described in association with pregnancy. The presence of trisomy 12 as a single chromosomal abnormality was detected in these two tumors. Both tumors were localized strictly to the ovary, so conservative surgery was applied and proved sufficient to remove all tumor tissue. Follow-up showed no signs of recurrence 18 and 53 months after the interventions. CONCLUSION: These cases support the contention that trisomy 12 is a nonrandom chromosome abnormality in juvenile granulosa cell tumors and that pregnancy may affect nuclear stability in this tumor.
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ranking = 107.64989963362
keywords = neoplasm
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6/114. Transabdominal application of transvaginal transducer enhancing depiction of mature cystic teratoma at 34 weeks' gestation.

    We present an unusual case in which a 36-year-old patient was referred for consultation due to increasing upper left abdominal pain at 35 weeks' gestation. Transabdominal ultrasonography disclosed an appropriate-for-gestational-age singleton, vertex-presenting fetus with normal anatomy. An unclear, complex, semisolid, semicystic mass was noted in the upper right abdomen. Due to the close proximity of the adnexal mass to the patient's abdominal wall, a high-frequency transvaginal transducer was applied transabdominally. Unlike the unclear images generated at conventional transabdominal ultrasonography, this application depicted a discrete mass with multiple characteristics consisting of calcifications, hair and fatty tissue, considered diagnostic of a mature cystic ovarian teratoma. The patient delivered spontaneously at 39 weeks' gestation. At 6 weeks' postpartum an elective laparotomy left ovarian cystectomy was performed and a mature cystic teratoma confirmed by pathology examination.
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ranking = 1
keywords = complex
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7/114. colon cancer in pregnancy: report of a case and review of the literature.

    Most colon cancer cases occur in patients over 50 years of age, although about 3% of colorectal cancer patients are younger than 40. During pregnancy the incidence of this neoplasm is estimated to be 0.002%. To date only 32 cases of colonic cancer arising above the peritoneal reflection during pregnancy have been described in the literature. We report another such case, stressing the need for constant alertness on the part of physicians in the presence of abdominal pain and/or distension, a palpable abdominal mass, rectal bleeding and/or weight loss during pregnancy. In fact, the reportedly poorer prognosis of this cancer in pregnant patients is mainly due to the fact that the initial symptoms of the malignancy are usually attributed by the patient, but also by physicians, to normal pregnancy.
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ranking = 107.64989963362
keywords = neoplasm
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8/114. Giant-sized condyloma of the breast with focal acantholytic changes.

    BACKGROUND: A healthy 26-year-old pregnant woman presented with a 6.0-cm exophytic mass in her left inframammary fold. The lesion was surgically excised. methods: Histopathologic sections of the skin lesion were reviewed in hematoxylin and eosin-stained slides. Additional sections were studied by an in situ hybridization method for human papillomavirus dna (HPV) types 6 and 11. RESULTS: The histopathologic examination demonstrated a benign exophytic, verrucous and papillary epidermal proliferation with features of condyloma acuminatum. Reactivity to HPV dna types 6 and 11 was demonstrated by in situ hybridization method. The epidermis adjacent to, and focally within, the neoplasm showed multiple areas of suprabasilar and intraepidermal acantholysis without dyskeratosis. CONCLUSIONS: Condylomas related to HPV 6 and 11 may be found in extragenital locations including conjunctiva, oral and nasal mucosa. To our knowledge, however, the extragenital condylomas described in the literature have not included the giant-sized variant. We describe an example of a benign, giant-sized condyloma acuminatum of the breast with nearby acantholytic alterations similar to Hailey-Hailey disease.
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ranking = 107.64989963362
keywords = neoplasm
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9/114. Prenatal magnetic resonance imaging assisting in differentiating between large degenerating intramural leiomyoma and complex adnexal mass during pregnancy.

    We present an unusual case in which a 36-year-old patient was referred due to increasing upper left quadrant abdominal pain and a possible left adnexal mass at 22 weeks' gestation. ultrasonography demonstrated a multiseptated cystic mass, with solid components measuring 12 cm in diameter. A thin sonolucency was thought to separate the mass from the uterus and thus the mass was considered consistent with an adnexal mass, possibly a mucinous cystadenoma. A large degenerating leiomyoma could not be ruled out with certainty and magnetic resonance (MR) imaging was performed which depicted a thin band of myometrium encompassing the complex mass and was therefore diagnostic of a degenerating uterine leiomyoma. We discuss the contribution of MR imaging in the noninvasive diagnosis of undetermined solid pelvic masses visualized ultrasonographically.
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ranking = 5
keywords = complex
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10/114. Adenocarcinoid tumor of the ovary diagnosed during pregnancy. A case report.

    BACKGROUND: Adenocarcinoid tumors are uncommon neoplasms with dual morphology, showing components of a neuroendocrine tumor with carcinoid features and an adenocarcinomatous component composed of glands lined with mucin-containing cells, some of which are goblet type. CASE: A 36-year-old woman had a left adnexal mass found during the second week of pregnancy. Sonography showed it to be increasing in size and eventually to become associated with pelvic pain. During the 20th week of gestation, an exploratory laparotomy was performed, and the left ovary and fallopian tube were excised. A diagnosis of adenocarcinoma was rendered by intraoperative frozen section. A staging procedure was then performed that included removal of the contralateral adenexa, pelvic lymph node sampling, peritoneal biopsies and partial omentectomy. The vermiform appendix and gastrointestinal tract appeared unremarkable. The patient was discharged. Permanent sections of the left ovary revealed an adenocarcinoid tumor. CONCLUSION: While reports detail ovarian metastases of adenocarcinoid neoplasms from primary appendiceal and other gastrointestinal sites, this case, in the setting of a normal appendix and negative workup for an extraovarian origin, is the fourth documented one of a primary ovarian adenocarcinoid tumor and first diagnosed during pregnancy.
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ranking = 215.29979926725
keywords = neoplasm
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