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Adnexal Mass (adnexal + mass)
Selected AbstractsDoppler studies of the ovarian venous blood flow in the diagnosis of adnexal torsionJOURNAL OF CLINICAL ULTRASOUND, Issue 8 2009Khatib Nizar MD Abstract Purpose. To evaluate the role of ovarian Doppler studies in diagnosing adnexal torsion. Methods. We included in that study all patients who had an adnexal mass with clinical symptoms of intermittent lower abdominal pain and were hospitalized for at least 48 hours of observation. Our protocol included: measurements of the size of the adnexal mass, presence or absence of ovarian edema, presence or absence of adnexal vascularity, presence or absence of ovarian artery flow, presence or absence of ovarian venous flow, pattern of ovarian venous flow. The ovarian artery and vein were sampled just above and lateral to the adnexa. Sensitivity, specificity, and positive and negative predictive values in the diagnosis of adnexal torsion were calculated for each of the gray-scale and Doppler sonographic (US) findings. Results. One hundred and ninety-nine patients presented with adnexal mass and intermittent lower abdominal pain. Sensitivity and specificity of tissue edema, absence of intra-ovarian vascularity, absence of arterial flow, and absence or abnormal venous flow in the diagnosis of adnexal torsion were: 21% and 100%, 52% and 91%, 76% and 99%, and 100% and 97%, respectively. All patients with adnexal torsion had absent flow or abnormal flow pattern in the ovarian vein. In 13 patients, the only abnormality was absent or abnormal ovarian venous flow with normal gray-scale US appearance and normal arterial blood flow. Of these 13 patients, 8 (62%) had adnexal torsion or subtorsion. Conclusion. Abnormal ovarian venous flow may be the only abnormal US sign observed during the early stage of adnexal torsion. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound 2009 [source] Virilization in pregnancy due to a borderline mucinous ovarian tumorJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 3 2007Selvan Pather Abstract Virilization in pregnancy due to borderline mucinous ovarian tumors is very rare. A case of a 28-year-old patient who was noted at 28 weeks' gestation to have marked virilization with raised serum androgens, ascites and a large complex right adnexal mass is presented. Delivery was carried out by cesarean section and at surgery a large tumor was noted in the right ovary. Histology revealed a borderline mucinous ovarian tumor with stromal luteinization, but there was no evidence of stromal invasion. Serum androgens returned to normal levels following surgery and the maternal virilization had resolved at the 6-week postnatal visit. Stromal changes in borderline mucinous ovarian tumors may result in virilization due to androgen production; surgical removal is associated with an excellent clinical outcome. [source] Primary omental ectopic pregnancyJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 3 2004Wai Chung Wong Abstract Omental ectopic pregnancy is a rare form of ectopic pregnancy. Presented here is a case primary omental ectopic pregnancy according to Studdiford's criteria. This patient presented with epigastric pain and anemia without vaginal bleeding, lower abdominal or pelvic pain. Pregnancy status was confirmed after admission. Transvaginal ultrasound examination revealed intrauterine contraceptive device in situ and a large amount of free peritoneal fluid, but no intrauterine sac or adnexal mass. Laparoscopy was performed but pelvic pathology did not account for the 2500 mL of haemoperitoneum. Laparotomy was carried out and partial omentectomy was performed. [source] Multiple extragenital adenomatoid tumors in the mesocolon and omentum,APMIS, Issue 11 2008CHI-JU YEH Adenomatoid tumors are benign mesothelial neoplasms most commonly found in the male and female genital tracts. Extragenital adenomatoid tumors are rare, most of them being solitary tumors. To our knowledge, only one case of multiple extragenital adenomatoid tumors, involving the liver and peritoneum, has been reported to date. Here we report another case of multiple extragenital adenomatoid tumors involving the mesocolon and omentum. A 47-year-old woman presented with a delayed menstrual period. Ultrasonography revealed a left adnexal mass, and surgical resection was attempted at a local hospital. The patient was transferred to our hospital without resection due to the intraoperative finding of multiple peritoneal tumors. At our hospital, an 8.0×7.5×6.0 cm tumor at the mesocolon of the sigmoid colon and three omental nodules measuring up to 2.5×2.0×1.7 cm were resected. Grossly, they were well circumscribed, gray-tan and elastic with small cystic spaces. Microscopically, they were composed of tubules and anastomosing channels lined by flattened or cuboidal cells with bland nuclei. Immunohistochemically, the tumor cells were positive for pan-cytokeratin AE1/AE3, vimentin, cytokeratin 5/6 and calretinin. The postoperative course was uneventful, and the patient was well 10 months after the operation. Despite their rarity, adenomatoid tumors should be included in the differential diagnosis of multiple intra-abdominal tumors. [source] Laparoscopic management of recurrent rupture of an adnexal mass in the second trimester of pregnancy: A case reportASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 1 2010S Hayasaka Abstract We present the case of a patient who developed an acute abdomen after recurrent rupture of an ovarian cyst in the first trimester of pregnancy. After the third rupture and recurrence of the cyst, we performed laparoscopic ovarian cystectomy at 13 weeks of gestation. She went on to deliver a healthy neonate via elective cesarean section at 38 weeks of gestation. To our knowledge, this is the first report of a recurrent rupturing ovarian cyst during pregnancy. Our patient's case suggests that idiopathic recurrent rupture of an ovarian cyst can occur during early pregnancy. Careful follow-up and timely surgical intervention for recurrent rupture of an ovarian cyst are needed in order to reduce the risk of pregnancy loss. [source] Laparoscopic management of primary hepatic pregnancyAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2010Pui-See CHIN A 30-year-old woman presented with epigastric pain with elevated serum human chorionic gonadotropin level (hCG), absence of intrauterine gestational sac and absence of an abnormal adnexal mass on pelvic ultrasonography. Laparoscopy revealed a ruptured hepatic ectopic pregnancy. This was removed by laparoscopic suctioning and haemostasis secured with Surgicel® FribrillaÔ Absorbable Hemostat. Intramuscular methotrexate was administered post-operatively. Patient recovered uneventfully and serum hCG returned to normal. [source] Adnexectomy for benign pathology at vaginal hysterectomy without laparoscopic assistanceBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 12 2002Shirish S. Sheth Of 166 consecutive women with a benign adnexal mass scheduled for vaginal hysterectomy with adnexectomy, the operation was successful in 158 (95%). Preoperatively, attempts were made to ascertain that adnexal mass was benign and either freely mobile or with only slightly restricted mobility. Laparotomy was required in eight women, in five for adhesions and in three for malignancy detected during the operation. No woman required laparoscopic-assisted surgery. The 158 women who had successful vaginal hysterectomy with adnexectomy were compared with 100 similar women who had a laparotomy performed by same single operator. The vaginal group had a lower morbidity, speedier recovery and shorter hospital stay. [source] Preoperative evaluation and triage of women with suspicious adnexal masses using risk of malignancy indexJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 1 2009Christopher A. Enakpene Abstract Aims:, To test the accuracy of risk of malignancy index (RMI) in preoperative prediction of malignancy and treatment of adnexal masses. Methods:, A total of 302 women with ultrasound diagnosed adnexal masses, and serum measurement of cancer-associated antigen CA-125 levels, were studied. They all had surgical exploration between October 2001 and September 2005 at the Friedrich-Alexander University Women's Hospital, Erlangen, Germany. The RMI was based on menopausal status, ultrasound morphology of adnexal masses and absolute level of serum CA-125. A cut-off of 250 was chosen as the threshold for determining the type of surgical operations (laparotomy versus laparoscopy) and the skill of the surgeons (gynecological oncologist versus general gynecologist). The data obtained were analyzed for baseline characteristics using ,2 test and analysis of variance (ANOVA). P < 0.05 were statistically significant. The various testing methods were evaluated for sensitivity, specificity, positive and negative predictive values. Results:, The best individual performance was found in RMI at a cut-off of 250 with a sensitivity of 88.2%, specificity of 74.3%, positive predictive value of 71.3% and negative predictive value of 90%. When RMI was used to triage patient treatment, 81.5% of patients who had laparoscopy had histological diagnosis of benign ovarian tumor and 7.5% had malignant tumor. In contrast, 74.4% of patients who had laparotomy had histological diagnosis of malignant ovarian tumor and 16% had benign tumor. Conclusion:, Risk of malignant index is a reliable, cheap, readily available and cost-effective method of preoperative discrimination of benign from malignant adnexal masses. It is also helpful in triaging patients to different treatment groups. [source] Management and outcomes of adnexal masses during pregnancy: A 6-year experienceJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 4 2008Osman Balci Abstract Aim:, To demonstrate adnexal masses detected during gestations in a 6-year period. Methods:, A retrospective study of pregnancy with adnexal masses requiring surgery over a 6-year period at the Selcuk University Hospital, a tertiary referral center, between June 2000 and June 2006. Results:, We detected 36 pregnancies with adnexal masses. The mean age of the patients was 26.6 years (range, 18,42). The mean gestational age at which adnexal masses were detected was 17 weeks (range, 5,36), and the mean gestational age at the time of surgery was 24 weeks (range, 6,41). Postoperative pathology results of the patients were functional ovarian cysts in 14 cases (41.1%), endometrioma in eight cases (23.5%), dermoid cyst in six cases (17.6%), serous cystadenoma in two cases (5.8%), mucinous cystadenoma in one case (2.9%), para-ovarian cyst in one case (2.9%), and borderline serous tumor in two cases (5.8%). Two patients operated on during the second trimester developed preterm birth risk (5.8%). Miscarriage occurred in only one patient (2.9%). Conclusion:, In this report, we demonstrate a high rate of surgical intervention of adnexal masses at pregnancy which is secondary to the fact that our center works as a tertiary referral center. Most masses at pregnancies were benign in character and our malignity rate was low. We detected an acceptable complication rate due to surgery in pregnant women. [source] Laparoscopy in the treatment of ovarian tumours of low malignant potentialAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 6 2007Andreas OBERMAIR Abstract Laparoscopy is increasingly used by gynaecologists for the investigation of adnexal masses. Uncertainty exists whether ovarian tumours of low malignant potential can effectively be treated by laparoscopy, whether staging bears a benefit for all patients, whether port-site metastases are a problem and how long patients need to be followed up after surgery. This review summarises the evidence to address these important questions. [source] | ||||||||||