Ocena kliniczno-patologiczna 194 pacjentek z potworniakiem jajnika: 7-letnie doświadczenie jednego ośrodka

Objectives: To evaluate patients diagnosed with teratoma over a period of seven years with regard to their general characteristics and treatment methods. Material and Methods: A total of 194 patients histologically diagnosed with ovarian teratoma (mature or immature) in the years 2005-2012 at the Ege University Gynecology and Obstetrics Department were evaluated. Results: Average patient age was 34.3 ± 2.16 years. Of these, 169 (86.3%) were premenopausal and 27 (13.7%) postmenopausal; average cyst diameter, measured during the surgery, was 6.9 ± 0.63 cm. While the teratoma had been an asymptomatic finding in 148 (75.5%) patients, 48 (24.5%) were symptomatic. In 107 patients (54.5%) a laparotomy and in 89 (45.5%) a laparoscopy were performed. The presence of torsion was observed during surgery in 9 (4.5%) patients. The 49 (55%) patients who underwent laparoscopic cystectomy experienced a rupture during the intervention, with no cases of clinical chemical peritonitis following the surgery. Conclusion: Caution must be exercised with regard to possible cyst rupture in elderly patients and those with large dermoids; an laparoscopic approach may be reserved for younger patients. In case a rupture occurs during the operation, abundant peritoneal lavage is indicated; in order to limit risks during the controlled excision of the cyst an Endobag should be used if possible.Cel: Ocena pacjentek z rozpoznanym potworniakiem w odniesieniu do charakterystyki ogólnej i metod leczenia. Materiał i metoda: Grupę badaną stanowiło 194 pacjentki z potwierdzonym histologicznie potworniakiem (dojrzałym lub niedojrzałym) w latach 2005-2012 w Ege University w Klinice Ginekologii i Położnictwa. Wyniki: Średnia wieku pacjentek wynosiła 34.3±2.16 lat. Pacjentek w wieku przedmenopauzalnym było 169 (86.3%) a w pomenopauzalnym 27 (13.7%); średni rozmiar guza zmierzony w trakcie operacji wynosił 6.9 ±0.63cm. U większości pacjentek 148 (75.5%) guz nie dawał objawów, natomiast w 48 (24.5%) przypadkach wystąpiły objawy. U 107 (54.5%) pacjentek wykonano laparotomię a u 89 (45.5%) laparoskopię. Skręcenie guza obserwowano w trakcie operacji u 9 kobiet (4.5%). Spośród pacjentek, które przeszły laparoskopowe usunięcie torbieli, u 49 (55%) guz pękł podczas operacji, jednak nie obserwowano chemicznego zapalenia otrzewnej po operacji. Wnioski: Należy zachować szczególną ostrożność w związku z możliwym pęknięciem torbieli u starszych pacjentek oraz w przypadkach dużych guzów. Techniki laparoskopowe należy zarezerwować dla młodszych pacjentek. Należy wykonać płukanie otrzewnej jeśli w czasie operacji dojdzie do pęknięcia torbieli. Aby zmniejszyć ryzyko pęknięcia w trakcie usuwania torbieli wskazane jest użycie endobagu

Kombinacja wewnątrzczaszkowej przezierności i ultrasonografii 3D w diagnostyce wad cewy nerwowej w pierwszym trymestrze ciąży: opis przypadku i przegląd literatury

Neural tube defects are congenital defects of the central nervous system caused by lack of neural tube closure. First trimester screening for aneuploidy has become widespread in the recent years. Fetal intracranial translucency (IT) can be easily observed in normal fetuses in the mid-sagittal plane. The absence of IT should be an important factor taken into consideration in the early diagnosis of open spinal defects. 3D ultrasonography is especially useful in cases of spinal anomalies where the visualization of the fetal structure is insufficient due to fetal position. We present a combination of intracranial translucency and 3D sonography used in the first trimester diagnosis of a neural tube defect case.Wady cewy nerwowej są wrodzonymi defektami centralnego układu nerwowego spowodowanymi brakiem zamknięcia cewy nerwowej. Badania skriningowe w pierwszym trymestrze w kierunku aneuploidii stały się w ostatnich latach bardzo rozpowszechnione. Płodowa przezierność wewnątrzczaszkowa może być oceniona w prawidłowych płodach w płaszczyźnie pośrodkowej. Brak przezierności wewnątrzczaszkowej (IT) powinien być istotnym czynnikiem ryzyka branym pod uwagę we wczesnej diagnostyce otwartych wad cewy nerwowej. Ultrasonografia 3D jest szczególnie przydatna w przypadkach gdy uwidocznienie struktur płodu jest niewystarczające z uwagi na pozycję płodu. Przedstawiamy kombinację przezierności wewnątrzczaszkowej i ultrasonografii 3D w diagnostyce wad cewy nerwowej w pierwszym trymetrze ciąży

The role of the serum inflammatory markers for predicting the tubo-ovarian abscess in acute pelvic inflammatory disease: a single-center 5-year experience

WOS: 000314761000017PubMed ID: 23104053To compare patients with tubo ovarian abscess (TOA) and non-TOA acute pelvic inflammatory disease (PID) and to determinate admitted day laboratory cut-off values for the TOA. Files of inpatients admitted to our clinic with the diagnoses of PID and/or TOA between the years of 2006 and 2011. Laboratory and culture results were obtained from the database of hospital. A total of 73 patients diagnosed with PID and/or TOA were evaluated. Patients who were diagnosed with TOA and PID by physical and sonographic examination were assigned to group 1 and group 2, respectively. Both groups were compared in terms of laboratory, clinical, and epidemiological parameters. Of 73 patients admitted with the diagnosis of PID, 44 (60.3 %) were found to have TOA, and 29 (39.7 %) were not found. Mean age of patients was determined as 41.4 +/- A 7.7 in group 1 and as 35.1 +/- A 6.8 in group 2. Abscess was detected more frequently in patients with low socio-cultural level, and this was found to be statistically significant. The diameter of abscess was found to be a parts per thousand yen5 cm in 39 (88.6 %) patients and 19.5 mm/1/2 h and CRP > 11.5 mg/L were the best predictors of TOA. The high level of CRP and ESR was associated with longer duration of hospitalization and disease severity, and these levels were statistically significantly associated with TOA size of a parts per thousand yen5 cm

Large mucinous neoplasm of the appendix mimicking adnexal mass in a postmenopausal woman

INTRODUCTION: Appendiceal tumors are rare, late-diagnosed neoplasms that may not be differentiated from adnexal masses even by advanced imaging methods and other diagnostic procedures. They may be asymptomatic and remain undiagnosed until surgery. PRESENTATION OF CASE: We report a case of 81-year-old postmenopausal woman presented with abdominal pain. A magnetic resonance imaging revealed right adnexal mass. Laparotomy was performed and detected a 12 cm × 9 cm mucinous tumoral mass arising in the appendix. An appendectomy and a right hemicolectomy with ileo-transverse anastomosis were performed. Histopathological examination was revealed appendiceal mucinous neoplasm with low malignancy potential. DISCUSSION: Gastrointestinal tumors such as appendiceal tumors can mimicking adnexal mass. Therefore, appendiceal tumor kept in mind in a patient with diagnosed adnexal mass, especially patient had non-specific clinical symptoms, laboratory and radiologic findings. CONCLUSION: Gastrointestinal tumors such as appendiceal tumors kept in mind in a patient with diagnosed adnexal mass

Gastrointestinal stromal tumor and leiomyoma of the ileum mimicking adnexal mass: A report of two cases

WOS: 000351642900012PubMed ID: 25698273Adnexal masses are formations seen in women of all ages; they most often include cystic elements. Medical history, physical examination, different imaging methods, and tumor marker determinations must be used together for preoperative evaluation of an adnexal mass. Both benign and malignant tumors of the small intestine are more rarely encountered than malignant tumors of other gastrointestinal system components; although advanced imaging methods and other diagnostic techniques are used, they do not always allow these tumors to be differentiated from adnexal masses. We report here on two cases operated on with the preliminary diagnosis of an adnexal mass, in which the presence of a gastrointestinal stromal tumor and a leiomyoma of the ileum, respectively, was established