Cases reported "Adnexal Diseases"

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1/6. Endometrial carcinoma presenting as hematometra mimicking a large pelvic cyst.

    Large pelvic cysts are commonly seen in gynecologic practice; their heterogeneous origin is reflected in their pleomorphic clinical features. We report the case of a 64-year-old multiparous postmenopausal woman with an unusual manifestation of endometrial adenocarcinoma that presented as hematometra mimicking a large pelvic cyst. In this case, hematometra was well demonstrated by transabdominal sonography, but transvaginal sonography allowed better visualization of the endometrial lining and suggested the correct diagnosis of endometrial cancer. Abnormal vaginal bleeding or hematometra in postmenopausal women should lead to assessment of the endometrial mucosa. Transvaginal sonography can be used to visualize neoplastic lesions in the endometrium when hematometra is detected through transabdominal sonography.
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ranking = 1
keywords = gynecologic
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2/6. Anterior pseudomeningocele evaluated as a pelvic mass.

    OBJECTIVE: The differential diagnosis of pelvic masses is broad, and nongynecologic causes should be considered. RESULTS: A patient with a presumed adnexal mass was diagnosed eventually with an anterior pseudomeningocele.
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ranking = 1
keywords = gynecologic
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3/6. Nabothian cysts stimulating an adnexal mass.

    Nabothian (retention) cysts are common gynecologic findings and rarely of clinical significance. This case report describes the presence of large and numerous Nabothian cysts stimulating an adnexal mass.
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ranking = 1
keywords = gynecologic
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4/6. CT and MR demonstration of nabothian cysts mimicking a cystic adnexal mass.

    The CT and magnetic resonance appearance of prominent nabothian cysts is presented. Although small nabothian cysts are common gynecologic findings, they at times reach 2-4 cm in diameter and may simulate a cystic adnexal mass.
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ranking = 1
keywords = gynecologic
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5/6. Unsuspected adnexal masses in renal transplant recipients.

    Post-transplant sonograms in 74 female recipients less than 40 years old revealed unsuspected adnexal masses in 5 (7 per cent). Sonographically, these masses were difficult to distinguish from other post-transplant fluid collections, such as lymphoceles, urinomas or abscesses and, consequently, led to further diagnostic evaluations in 4 patients. Of the adnexal masses 4 were excised surgically: 2 were hemorrhagic ovarian cysts, 1 was a follicular ovarian cyst and 1 was a paraovarian cyst. A coexisting gynecologic mass should be included in the differential diagnosis of a perinephric mass in female transplant recipients. Pre-transplant sonograms to identify or exclude occult pelvic masses in women may be of benefit in simplifying the postoperative management and minimizing unnecessary diagnostic evaluation.
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ranking = 1
keywords = gynecologic
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6/6. Laparoscopic management of adnexal masses in women with a history of nongynecologic malignancy.

    OBJECTIVE: To describe the safety and efficacy of laparoscopy in the diagnosis and treatment of patients with a history of nongynecologic malignancy presenting with an adnexal mass. methods: A retrospective review of the records of all patients with a history of nongynecologic malignancy who underwent laparoscopy for adnexal masses at our institution in 1992-1994. RESULTS: Thirty-four patients were identified. The mean age was 57.3 years (range 32-85). Twenty-five had breast cancer, three had malignant melanoma, and two had lymphoma; the remaining four had lung, colon, stomach, and pancreatic cancer, respectively. Thirty of the 34 cases (88%) were managed laparoscopically; unilateral or bilateral salpingo-oophorectomy was performed in 22, laparoscopically assisted vaginal hysterectomy in three, ovarian cystectomy in three, and pelvic washings in two. In these cases, the adnexal disease was benign in 24 and metastatic cancer in six. In all the metastatic cases, preoperative ultrasound or computed tomography scan revealed complex and/or solid adnexal masses. Six complications occurred in the 34 cases; two of 25 patients who had D&C had uterine perforation, two patients had subcutaneous hematomas at laparoscopic puncture sites, one had a bowel obstruction, and one developed pneumonia after laparotomy. CONCLUSION: laparoscopy proved to be safe and effective in the initial surgical evaluation of patients with a history of a nongynecologic malignancy presenting with an adnexal mass. Most patients can be spared the added morbidity and convalescence associated with laparotomy. This laparoscopic approach should be considered the initial method of surgical evaluation in this population.
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ranking = 7
keywords = gynecologic
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