Cases reported "Adnexal Diseases"

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11/33. Laparoscopic cystectomy of an ovarian mucinous cystadenoma in a 12-year-old girl: a possible role of operative laparoscopy for a huge benign adnexal mass.

    The case of an obese 12-year-old girl with a huge and mobile pelvic cystic mass is presented. After ultrasonography and determination of tumor markers, a right huge benign adnexal mass was suspected. In order to avoid exploratory laparotomy because severe pain and a large operative scar were expected, an operative laparoscopy was performed. No intra-operative and post-operative complications were observed. With the uneventful recovery, only a one-day hospital stay was needed. Neither residual nor recurrent evidence was suspected after 2-, 6-, 12-, 18- and 24-months follow-up. With proper case selection, good pre-operative counseling and the operation performed under familiarity and good training in laparoscopy, laparoscopic management of a huge suspected benign adnexal mass is technically feasible. The benefits are reducing hospital stay, lowering morbidity, especially less pain and cosmetic acceptance of the operative scar.
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12/33. Laparoscopic management following ultrasonographic-guided drainage in a patient with giant paraovarian cyst.

    BACKGROUND: Giant and paraovarian cysts are unusual masses that are usually treated by laparotomy. The safety of laparoscopic management of benign paraovarian cysts has been demonstrated, but it is believed that the size of benign paraovarian cysts is a limiting factor for laparoscopic surgery. methods: We describe a new technique for the laparoscopic removal of a giant and benign paraovarian cyst in a 40-year-old woman. A paraovarian cystic mass was detected on the right part of her body that extended to the liver. It was confirmed on both ultrasonography and computed tomography scans. After ultrasound-guided aspiration of the cyst, the mass was resected laparoscopically. RESULTS: No complications were noted during or after the surgical procedure. The patient was discharged on postoperative day 2. CONCLUSIONS: Laparoscopic surgery can be safely applied in patients with giant and benign paraovarian cysts.
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13/33. Laparoscopic removal of a large adnexal mass.

    BACKGROUND: Laparoscopic removal of adnexal masses has been facilitated by the use of commercially available retrieval bags. Masses up to 18 cm can be removed using zipper storage bags. Masses with greater diameters have required laparotomy or techniques that do not isolate the mass from the peritoneal cavity. By using larger bags available in the operative suite, even the very large adnexal mass can be isolated from the peritoneal cavity and extracted via laparoscopy. CASE: A 46-year-old nulligravida presented with a 20.9-cm adnexal mass. She underwent laparoscopy and extraction of a dermoid with an improvised retrieval bag without intraperitoneal spillage. CONCLUSION: Very large adnexal masses can be removed laparoscopically without intraperitoneal spillage despite the lack of commercially available bags for this purpose.
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keywords = operative
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14/33. Appendiceal mucocele: a rare differential diagnosis of a cystic right adnexal mass.

    CASE REPORT: We present the case of a 42-year-old woman with an incidental finding of a large right adnexal mass during pelvic ultrasound scan for a spontaneous miscarriage. Ultrasound suggested the mass was ovarian in origin and serum Ca125 was normal. laparotomy, however, revealed normal ovaries with no ovarian pathology. The right adnexal mass was appendiceal in origin and was delivered intact with no spillage. histology confirmed a diagnosis of mucinous cystoadenoma of the appendix. DISCUSSION: Pre-operative diagnosis of this condition is difficult. Various radiological tools including CT scans, MRI, and ultrasound scans have been used with poor results. Pre-operative diagnosis would be useful, as extra measures could be taken to avoid intra-peritoneal rupture during surgery with the consequent development of pseudomyxoma peritonei. For a similar reason, needle aspiration should be avoided. In malignant cases co-existing ovarian neoplasm must be excluded as this will be present in 2-24% of cases. Simple appendicectomy is curative in uncomplicated, unruptured cases. CONCLUSION: Although relatively rare, appendiceal tumours should be considered in women who present to gynaecologists with a right adnexal mass.
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15/33. Mesenteric lymphangioma presenting as adnexal torsion: case report and literature review.

    We report the case of a patient with a mesenteric chylous lymphangioma who presented with acute pelvic symptoms mimicking adnexal torsion. The cyst contents had no specific sonographic or CT characteristics, such as a fluid-fluid level, to aid the preoperative diagnosis; definitive diagnosis was made only upon histopathologic examination of the cyst, which was resected intact.
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ranking = 0.1
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16/33. mucocele of the vermiform appendix with sonographic appearance of an adnexal mass.

    mucocele of the vermiform appendix is caused by mucus retention in its lumen, due to obstruction or hyperproduction. Appendiceal malignancy can be the underlying cause, making accurate preoperative diagnosis imperative. In women, it can sometimes present as an adnexal mass. A rare case of an appendiceal mucocele is presented, mimicking a cystic tumor of the right adnexum, both clinically and ultrasonographically. In addition, serum levels of CA-125 were increased. This is the first case of a mucocele of the appendix simulating an adnexal mass on ultrasound with increased levels of CA-125 to be reported. This clinical entity should be considered in patients presenting on ultrasound with a right-sided adnexal mass as a rare potential diagnosis.
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ranking = 0.1
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17/33. A case of a mature cystic teratoma of the uterosacral ligament successfully treated by laparoscopic surgery.

    An asymptomatic tumor was found in the pelvic cavity of a 49-year-old woman during a routine examination. With a diagnosis of mature cystic teratoma of the right ovary, laparoscopic surgery was performed. The intraoperative finding showed the presence of a cystic tumor firmly attached to the uterosacral ligament in a position distant from the bilateral ovaries. Laparoscopic excision was performed, and the diagnosis of mature cystic teratoma of the uterosacral ligament was made histopathologically. This is the first report in the literature of successful laparoscopic treatment for a mature cystic teratoma of the uterosacral ligament.
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ranking = 0.1
keywords = operative
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18/33. Adnexal torsion in a patient with bichorial twin pregnancy in the 21st week of gestation treated by open laparoscopy: a case report.

    Adnexal torsion is a rare finding during pregnancy. Here we report a patient with bichorial twin pregnancy in the 21st week of gestation with adnexal torsion. She was admitted with acute abdominal pain. Open laparoscopy was performed and the left adnexa was unwinded successfully. The postoperative follow-up was uneventful. Adnexal torsion as differential diagnosis of acute abdomen in pregnancy should be considered seriously to avoid irreversible lesions of the ovary and (salpingo-) oophorectomy.
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ranking = 0.1
keywords = operative
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19/33. Symptomatic internal hernia of the broad ligament: a complication of electrocoagulation therapy of endometriosis.

    A 31-year-old nulligravid woman had had two previous laparoscopies for endometriosis. disease of the right broad ligament was treated by electrocoagulation at the first surgery, but pain persisted despite postoperative danazol therapy. At her second laparoscopy, a large defect of the right broad ligament was noted, but not treated. At her third operation, laparoscopic excision of endometriosis was followed by herniorrhaphy of the right broad ligament through mini-laparotomy. The potential for bowel herniation exists whenever a closed loop is present in the abdominal cavity.
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ranking = 0.1
keywords = operative
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20/33. Primary carcinoma of the broad ligament. Report of four cases and review of the literature.

    The clinical and pathologic features of four new and eight previously reported primary carcinomas of the broad ligament have been reviewed. The patients' ages ranged from 29 to 70 years (average, 46) and the most common clinical presentations were vague lower abdominal pain, a palpable pelvic mass, and an associated disorder such as pelvic endometriosis. The tumors ranged from 4.5 to 13 cm in greatest dimension and were solid, cystic, or mixed. All of them were unilateral. review of the pathologic descriptions and illustrations of the cases in the literature and microscopic review of one reported case revealed that four of the tumors were endometrioid carcinomas, four were clear cell carcinomas, one was probably a mucinous adenocarcinoma, two were papillary adenocarcinomas of undetermined cell type, and one was a serous papillary cystadenoma of borderline malignancy with microinvasion. Three patients were treated by excision of the tumor alone. Seven of them were treated by total abdominal hysterectomy and salpingo-oophorectomy; three patients received postoperative radiation therapy, and one of them also received chemotherapy. Eight patients were free of disease 6 months to 7 years postoperatively, and one patient with distant metastasis (rib) at the time of operation lived for 27 months. In three cases no follow-up data were available. Three of the four patients in current series were found to have pelvic endometriosis at the time of operation. Three of their carcinomas were endometrioid and one was of clear cell type, suggesting the possibility of an origin from endometriotic tissue in the broad ligament.
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ranking = 0.2
keywords = operative
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