BACKGROUND Appendiceal tumors are rare lesions that may not be easily differentiated from primary ovarian lesions preoperatively,despite the use of advanced diagnostic methods by experienced clinicians.CASE SUMMARY A ...BACKGROUND Appendiceal tumors are rare lesions that may not be easily differentiated from primary ovarian lesions preoperatively,despite the use of advanced diagnostic methods by experienced clinicians.CASE SUMMARY A 59-year-old G2P2 woman,with chronic pelvic pain,underwent a pelvic ultrasound that revealed an adnexal mass measuring 58 mm×34 mm×36 mm,with irregular borders,heterogeneous echogenicity,no color Doppler vascularization and without acoustic shadowing.Normal ovarian tissue was visualized in contact with the lesion,and it was impossible to separate the lesion from the ovary by applying pressure with the ultrasound probe.Ascites,peritoneal metastases or other alterations were not observed.With the international ovarian tumor analysis ADNEX model,the lesion was classified as a malignant tumor(the risk of malignancy was 27.1%,corresponding to Ovarian-Adnexal Reporting Data System category 4).Magnetic resonance imaging confirmed the presence of a right adnexal mass,apparently an ovarian tumor measuring 65 mm×35 mm,without signs of invasive or metastatic disease.During explorative laparotomy,normal morphology of the internal reproductive organs was noted.A solid mobile lesion involved the entire appendix.Appendectomy was performed.Inspection of the abdominal cavity revealed no signs of malignant dissemination.Histopathologically,the appendiceal lesion corresponded to a completely resected low-grade mucinous appendiceal neoplasm(LAMN).CONCLUSION The appropriate treatment and team of specialists who should provide health care to patients with seemingly adnexal lesions depend on the nature(benign vs malignant)and origin(gynecological vs nongynecological)of the lesion.Radiologists,gynecologists and other pelvic surgeons should be familiar with the imaging signs of LAMN whose clinical presentation is silent or nonspecific.The assistance of a consultant specializing in intestinal tumors is important support that gynecological surgeons can receive during the operation to offer the patient with intestinal patholo展开更多
2019年12月,巴西肿瘤外科协会(Brazilian Society of Surgical Oncology)针对放、化疗后局部持续或复发宫颈癌(PRCC)患者的补救性盆腔廓清术(PE)治疗,颁布《巴西肿瘤外科协会盆腔廓清术治疗宫颈癌指南》(Guidelines of the Brazilian So...2019年12月,巴西肿瘤外科协会(Brazilian Society of Surgical Oncology)针对放、化疗后局部持续或复发宫颈癌(PRCC)患者的补救性盆腔廓清术(PE)治疗,颁布《巴西肿瘤外科协会盆腔廓清术治疗宫颈癌指南》(Guidelines of the Brazilian Society of Oncologic Surgery for Pelvic Exenteration in the Treatment of Cervical Cancer)(以下简称为《PE指南》)。该指南基于目前文献中可获得最佳证据,对局部PRCC患者进行补救性PE的最佳处理方式提出建议。这是全球首次颁布的关于PE作为局部PRCC患者治疗选择的指南。笔者拟就该指南涉及的局部PRCC患者接受根治性或姑息性PE治疗的适应证、术前评估、术中评估,PE治疗手术入路及技巧、PE手术范围分类,PE患者尿路重建、阴道重建、肠道重建、盆底功能重建,以及PE术后患者随访等内容进行详细解读。展开更多
Aggressive angiomyxoma is rare mesenchymal tumor that most commonly arises in the vulvo-vaginal region, perineum, and pelvis of women. The term aggressively emphasizes the often infiltrative nature of the tumor and it...Aggressive angiomyxoma is rare mesenchymal tumor that most commonly arises in the vulvo-vaginal region, perineum, and pelvis of women. The term aggressively emphasizes the often infiltrative nature of the tumor and its frequent association with local recurrence. Preoperative diagnosis and treatment may be difficult. We report a 55-year-old patient who presented with a pelvic mass with no significant medical history. The radiological assessment showed a pelvic cystic tumor retro and lateral bladder. A surgical excision was performed with a diagnosis of aggressive angiomyxoma pelvis that misdiagnosed as ovarian tumor. The patient received adjuvant radiotherapy after surgery and remains well with no signs of local recurrence at 12 months follow-up. As surgery is the main treatment, preoperative diagnosis and assessment of extent of the tumor for planning surgery can not be overemphasized. The authors discuss this finding through the diagnostic difficulties and the evolution of this entity.展开更多
文摘BACKGROUND Appendiceal tumors are rare lesions that may not be easily differentiated from primary ovarian lesions preoperatively,despite the use of advanced diagnostic methods by experienced clinicians.CASE SUMMARY A 59-year-old G2P2 woman,with chronic pelvic pain,underwent a pelvic ultrasound that revealed an adnexal mass measuring 58 mm×34 mm×36 mm,with irregular borders,heterogeneous echogenicity,no color Doppler vascularization and without acoustic shadowing.Normal ovarian tissue was visualized in contact with the lesion,and it was impossible to separate the lesion from the ovary by applying pressure with the ultrasound probe.Ascites,peritoneal metastases or other alterations were not observed.With the international ovarian tumor analysis ADNEX model,the lesion was classified as a malignant tumor(the risk of malignancy was 27.1%,corresponding to Ovarian-Adnexal Reporting Data System category 4).Magnetic resonance imaging confirmed the presence of a right adnexal mass,apparently an ovarian tumor measuring 65 mm×35 mm,without signs of invasive or metastatic disease.During explorative laparotomy,normal morphology of the internal reproductive organs was noted.A solid mobile lesion involved the entire appendix.Appendectomy was performed.Inspection of the abdominal cavity revealed no signs of malignant dissemination.Histopathologically,the appendiceal lesion corresponded to a completely resected low-grade mucinous appendiceal neoplasm(LAMN).CONCLUSION The appropriate treatment and team of specialists who should provide health care to patients with seemingly adnexal lesions depend on the nature(benign vs malignant)and origin(gynecological vs nongynecological)of the lesion.Radiologists,gynecologists and other pelvic surgeons should be familiar with the imaging signs of LAMN whose clinical presentation is silent or nonspecific.The assistance of a consultant specializing in intestinal tumors is important support that gynecological surgeons can receive during the operation to offer the patient with intestinal patholo
文摘2019年12月,巴西肿瘤外科协会(Brazilian Society of Surgical Oncology)针对放、化疗后局部持续或复发宫颈癌(PRCC)患者的补救性盆腔廓清术(PE)治疗,颁布《巴西肿瘤外科协会盆腔廓清术治疗宫颈癌指南》(Guidelines of the Brazilian Society of Oncologic Surgery for Pelvic Exenteration in the Treatment of Cervical Cancer)(以下简称为《PE指南》)。该指南基于目前文献中可获得最佳证据,对局部PRCC患者进行补救性PE的最佳处理方式提出建议。这是全球首次颁布的关于PE作为局部PRCC患者治疗选择的指南。笔者拟就该指南涉及的局部PRCC患者接受根治性或姑息性PE治疗的适应证、术前评估、术中评估,PE治疗手术入路及技巧、PE手术范围分类,PE患者尿路重建、阴道重建、肠道重建、盆底功能重建,以及PE术后患者随访等内容进行详细解读。
文摘Aggressive angiomyxoma is rare mesenchymal tumor that most commonly arises in the vulvo-vaginal region, perineum, and pelvis of women. The term aggressively emphasizes the often infiltrative nature of the tumor and its frequent association with local recurrence. Preoperative diagnosis and treatment may be difficult. We report a 55-year-old patient who presented with a pelvic mass with no significant medical history. The radiological assessment showed a pelvic cystic tumor retro and lateral bladder. A surgical excision was performed with a diagnosis of aggressive angiomyxoma pelvis that misdiagnosed as ovarian tumor. The patient received adjuvant radiotherapy after surgery and remains well with no signs of local recurrence at 12 months follow-up. As surgery is the main treatment, preoperative diagnosis and assessment of extent of the tumor for planning surgery can not be overemphasized. The authors discuss this finding through the diagnostic difficulties and the evolution of this entity.
