Cases reported "Ovarian Neoplasms"

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11/141. Primary appendiceal malignancy mimicking advanced stage ovarian carcinoma: a case series.

    BACKGROUND: Primary appendiceal malignancy metastatic to the ovaries is a rare condition that may mimic late stage ovarian cancer. This condition is rarely diagnosed preoperatively. CASES: Three patients referred to our institution from 1994 to 1999 for presumed late stage ovarian cancer were found to have primary appendiceal adenocarcinoma, adenocarcinoid, and mucinous cystadenocarcinoma metastatic to the ovaries at laparotomy. We describe the clinical course of these patients and review the relevant literature. CONCLUSION: It is important for the gynecologic oncologist to be aware of the clinicopathological features and surgical management of these malignancies, as the incidence, prognosis, and recommended treatment vary with histological subtype.
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keywords = gynecologic
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12/141. Port-site metastasis after laparoscopic surgery for gynecologic cancer. A report of six cases.

    BACKGROUND: Port-site metastasis after laparoscopic surgery for gynecologic cancer is a recognized entity. CASES: Five patients underwent laparoscopic peritoneal biopsies for a stage III (n = 4) or IV (n = 1) ovarian cancer with moderate or poor differentiation. The sixth patient underwent a laparoscopic lymphadenectomy for vaginal carcinoma with bulky metastatic pelvic lymph nodes. CONCLUSION: In order to avoid port-site metastasis, patients with an obviously malignant ovarian tumor and ascites should not be treated with laparoscopy using pneumoperitoneum. If a malignant ovarian tumor is discovered during laparoscopy, the interval between initial surgery and complete cytoreductive surgery (with resection of laparoscopic ports) followed by chemotherapy should be as short as possible. For patients with uterine cancer and bulky nodes, laparoscopic lymphadenectomy should be avoided to avoid trocar implantation metastasis.
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keywords = gynecologic
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13/141. Recurrent ovarian clear cell carcinoma: complete remission after radiation in combination with hyperthermia; a case study and in vitro study.

    Since clear cell carcinoma of the ovary does not respond to conventional platinum-based chemotherapy, the prognosis of recurrent tumors is especially poor. In a 51-year old female who underwent surgery for clear cell carcinoma of the ovary, a solitary metastatic carcinoma developed in the pelvic cavity seven months after the initial surgery. The patient underwent a whole pelvic irradiation at a total dose of 65 Gy combined with hyperthermia. Complete remission was achieved 46 months after treatment. A study using gynecologic carcinoma cell lines showed that the mean 50% growth inhibitory dose of radiation was 1.2 /- 0.4 Gy in several clear cell carcinoma cell lines. The value did not significantly differ from those for serous carcinoma cell lines (2.3 /- 1.2 Gy) and uterine cervical carcinoma cell lines (1.6 /- 0.4 Gy). Currently, no anticancer agents are effective for clear cell carcinoma. radiotherapy combined with hyperthermia may be effective for localized tumors.
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ranking = 1
keywords = gynecologic
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14/141. paraneoplastic cerebellar degeneration as the first manifestation of cancer.

    paraneoplastic cerebellar degeneration (PCD) is a type of paraneoplastic syndrome that primarily affects women with gynecological cancers. patients typically experience pancerebellar symptoms, including gait ataxia, dysarthria, nystagmus, and truncal and appendicular ataxia. We present the case of a 50-year-old woman with PCD and presumed ovarian cancer who initially complained of ataxia and dysarthria. PCD was diagnosed on the basis of her symptoms, diagnostic imaging, and laboratory work. PCD symptoms may precede the diagnosis of malignancy by months or years. early diagnosis and treatment of these syndromes, including rehabilitation, may result in improvements in quality of life for this population of patients.
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ranking = 1
keywords = gynecologic
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15/141. An unusual source of massive intra-abdominal hemorrhage during cardio-pulmonary bypass.

    Intra-abdominal hemorrhage occurring while on cardio-pulmonary bypass (CPB) is a rare and potentially lethal event during coronary artery bypass procedures. We herein report an unusual case in which massive intra-abdominal bleeding during CPB originated from a previously undiagnosed ovarian tumor, leading to acute anemization and hemodynamic instability and requiring emergency gynecologic surgery.
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ranking = 1
keywords = gynecologic
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16/141. Arterial occlusion after surgery for ovarian malignancy. A case report.

    BACKGROUND: Inherent in the risks of pelvic surgery is the postoperative morbidity and mortality associated with the procedure. The gynecologic oncology patient presents further risks for several reasons, including a relative state of hypercoagulability. Anticipation of the problem and early recognition are the keys to decreasing the long-term sequelae of a complication. A well-recognized complication of gynecologic oncology surgery is venous thromboembolism. Advances allow the prophylaxis, recognition and treatment of this problem. Acute arterial occlusion is a much less common but potentially devastating complication. CASE: A woman underwent surgery for ovarian malignancy and developed bilateral arterial occlusion of the lower extremities postoperatively. CONCLUSION: Understanding the various genetic defects that predispose certain individuals to hypercoagulability will help identify patients with a particularly high risk of developing acute arterial occlusive disease.
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ranking = 2
keywords = gynecologic
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17/141. Peritoneal tuberculosis with pelvic abdominal mass, ascites and elevated CA 125 mimicking advanced ovarian carcinoma: a series of 10 cases.

    Ten patients with peritoneal tuberculosis who were operated on for suspected advanced ovarian cancer during a 5-year period were analyzed. These 10 cases constituted 1.4% of the 728 new gynecologic cancer cases diagnosed and treated at our department during the same time period. Data were obtained from patients' files and pathology reports. The mean age of cases was 40.6 /- 6.1 (median 37; range 18-72). ascites was present together with ill-defined nodularities or thickening in the Douglas pouch and/or in the adnexal areas on pelvic examination in all patients but three, who presented with well-demarcated adnexal masses of about 5 cm in diameter. All patients had elevated serum CA 125 levels with a median of 331 U/ml, (40-560 U/ml). Ultrasound and abdominopelvic CT examinations revealed omental and mesenteric thickening in addition to ascites in all patients, cystic ovarian masses or ovarian enlargement in five, and peritoneal implants in two. Abdominal paracentesis performed in the six cases in whom the findings were felt to be most inconclusive for the diagnosis of ovarian cancer revealed clear exudative fluid with benign cells. Mycobacteria could not be demonstrated on direct preparations. tuberculosis was diagnosed at laparotomy in all. patients received antituberculous therapy and serum CA 125 levels returned to normal within 2 months after the beginning of treatment. This case series demonstrates a high rate of misdiagnosis between advanced ovarian cancer and peritoneal tuberculosis. Whereas abdominal paracentesis is useless in ruling out peritoneal tuberculosis, and serum CA 125 levels are not helpful in the differential diagnosis, the latter marker may be useful in the follow-up of patients.
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ranking = 1
keywords = gynecologic
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18/141. Calyceal rupture and perirenal urinoma as a presenting sign of recurrent ovarian cancer.

    BACKGROUND: rupture of the urinary collecting system with peripelvic extravasation of urine is an uncommon pathologic condition usually associated with ureteral obstruction from calculi. CASE: We report a patient with calyceal rupture and peripelvic extravasation of urine secondary to distal ureteral obstruction by recurrent ovarian carcinoma. Diagnosis was established with computed tomography and renal scans. Placement of an indwelling ureteral stent via a nephrostomy resolved the urinoma. CONCLUSION: Gynecologic oncologists should be aware that calyceal rupture is a potential complication of gynecologic malignancy. Causes of perirenal urinary extravasation and approaches to diagnosis and management are reviewed.
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ranking = 1
keywords = gynecologic
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19/141. fibrosarcoma associated with a benign cystic teratoma of the ovary.

    OBJECTIVE: A case of ovarian fibrosarcoma associated with a benign cystic teratoma is described. methods: A 32-year-old patient with an ovarian tumor detected by routine gynecological examination was referred to our hospital. In addition to histopathological examination of the resected tumor, immunohistochemical studies as well as a cytogenetic analysis by comparative genomic hybridization were carried out. RESULTS: The 7-cm-sized tumor consisted of two different components: a fibrosarcoma and a benign cystic teratoma. The teratoma contained elements of all three germ layers and lacked any focus of immature teratoma. A fibrosarcoma was immediately connected to the teratoma. The sarcoma cells showed eight mitoses per 10 high-power fields on average and exhibited immunohistochemical reactivity for vimentin only. cytogenetic analysis of the fibrosarcoma using comparative genomic hybridization revealed imbalances of chromosomes 9, 12, and 16. After a 1-year follow-up, there were no signs of tumor recurrence or systemic disease. CONCLUSION: To the authors' knowledge, this is the second report of an association of ovarian fibrosarcoma and benign cystic teratoma, and the first including a cytogenetic analysis.
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ranking = 1
keywords = gynecologic
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20/141. Reduction in fatal pulmonary embolism and venous thrombosis by perioperative administration of low molecular weight heparin. Gynecological ward retrospective analysis.

    OBJECTIVES: To compare the frequency of deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing gynecological operations without low molecular weight heparin (LMWH) prophylaxis and those receiving such prophylaxis. DESIGN: Retrospective, hospital record-based study. MATERIAL AND methods: About 1785 consecutive patients without LMWH prophylaxis and 1871 ones treated with nadroparin (Fraxiparine) 7500ICU s.c. 2h before the operation and repeated daily for 5-7 days or until the patient was fully mobile. DVT was diagnosed on the basis of clinical symptoms and ultrasound examination, and PE on clinical symptoms, gasometric data, electrocardiography and chest X-ray. RESULTS: Among the patients without prophylaxis, four cases of PE occurred (0.22%), two fatal (0.11%), 13 cases of proximal DVT (0.72%) and 41 distal DVT complications (2.3%). In LMWH, group 3 proximal DVT (0.16%) and 18 distal DVT (0.96%) developed but there were no clinically expressed pulmonary embolism. According to the Fisher's exact test, the difference between the complications in the analyzed groups is significant P<0.05. CONCLUSION: The perioperative applying of LMWH to prevent DVT in the patients operated on gynecologically is effective.
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ranking = 2
keywords = gynecologic
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