Sensation Of Mass Research Articles

Uterine Tumor Resembling Ovarian Sex-Cord Tumor (UTROSCT): A Rare Polyphenotypic Neoplasm.

Uterine tumor resembling ovarian sex-cord tumor (UTROSCT) is a rare form of uterine mesenchymal neoplasm. Although UTROSCT generally exhibits benign behavior with a favorable prognosis, this neoplasm is nevertheless classified as being of uncertain malignant potential, given its low rate of recurrence and the fact that it rarely produces metastases (e.g., in the lymph nodes, epiploic appendix, omentum, small bowel, subcutaneous tissue, lungs). Its histogenesis is also uncertain. Typically, UTROSCT occurs in peri-menopausal or menopausal women, but it can sometimes be observed in young women. Usually, this neoplasm can be found in the uterine corpus as a nodular intramural lesion, while it is less frequently submucosal, subserosal, or polypoid/intracavitary. UTROSCT can cause abnormal bleeding, pelvic pain, enlarged uterus, and mass sensation, but sometimes it is found purely by chance. This neoplasm can be considered polyphenotypic on morphological, immunohistochemical, and genetic analyses. Generally, upon microscopic examination, UTROSCT shows a predominant pattern of the cords, nests, and trabeculae typical of sex-cord tumors of the ovary, while immunohistochemically it is characterized by a coexpression of epithelial, smooth muscle, and sex-cord markers. The aim of this review is to report clinical and pathological data and genetic alterations to establish their impact on the prognosis and management of patients affected by this rare entity.

Jaboulay's versus harmonic scalpel hydrocelectomy: prospective randomized controlled study.

Surgical procedures for vaginal hydroceles have been varied with the aims of preventing recurrence, hematoma and edema formation and providing a better cosmetic outcome. The Jaboulay's procedure remains a preferred procedure owing to its simplicity and good long term outcome. However, sac eversion during the procedure leads to scrotal edema and mass sensation due to remnant sac in cases of large or secondary hydrocele sacs. Sac excision in these cases may provide better outcomes by removing the excess tissue. We aimed to compare the postoperative outcome after Jaboulay's procedure and harmonic scalpel excision of the sac in terms of scrotal edema, hematoma formation and the final cosmetic appearance. 72 adult patients with vaginal hydrocele were randomized into two groups, who underwent harmonic scalpel sac excision and Jaboulay's procedure respectively, performed by a single surgeon. Preoperatively, patient demographics were noted. Postoperatively, data was recorded on the 1st day, 3rd day & 10th day about postoperative complications, and outcomes. Satisfaction on final cosmetic outcome was compared between the groups at the 3rd month. Post operative edema and sensation of mass in the scrotum were more (but not significant) in the Jaboulay's procedure group. Seroma and wound infection rates were similar in both groups. Patient satisfaction on cosmesis was better in the sac excision group. Hydrocelectomy with excision of the sac using a harmonic scalpel results in a lower incidence of postoperative oedema and better patient satisfaction in terms of cosmetic outcome compared to Jaboulay's procedure in the treatment of adult hydroceles.

Neurofibromatosis Type 1-Associated Multiple Malignant Peripheral Nerve Sheet Tumors: A Case Report and Literature Review

Background: Neurofibromatosis type 1 (NF-1) is a genetic disorder characterized by café-au-lait macules, freckling, Lisch nodules, and neurofibromas. NF-1 patients have a special predisposition to tumorigenesis due to genetic mutations, affecting the tumor regulator systems. Malignant Peripheral Nerve Sheet Tumor (MPNST) is a highly aggressive soft tissue tumor that is usually associated with NF-1. Case presentation: A 32-year-old woman was presented complaining of weakness, severe fatigue, weight loss, peripheral paresthesia, progressive generalized myalgia, bone pain, and a mass sensation in her right thigh since three months ago. She was a known case of NF-1 since childhood. After clinical and radiological evaluation, multiple masses were detected in the retroperitoneal cavity adjacent to the left kidney, uterus, and right thigh. Finally, the patient was planned for surgical excision of two masses with subsequent chemotherapy. Both excised masses were confirmed as MPNSTs by histopathological examination. Conclusion: Regarding the predisposition of NF-1 patients to tumorigenesis and the high prevalence of peripheral nerve tumors among these patients, any masses changing their character should raise suspicion for malignancy. One of the serious malignant lesions is MPNST. The primary treatment plan for these malignant lesions is surgical excision with subsequent chemotherapy or radiotherapy based on individual characteristics.

V12-09 FEMALE URETHRAL LEIOMYOMA RESECTION AND JUGAL GRAFT URETHROPLASTY: STEPWISE VIDEO

You have accessJournal of UrologyCME1 Apr 2023V12-09 FEMALE URETHRAL LEIOMYOMA RESECTION AND JUGAL GRAFT URETHROPLASTY: STEPWISE VIDEO Bruno Di Domenico, Arthur Degani Ottaiano, Fabio Franco Oliveira Junior, Natália Dalsenter Avilez, Joao Marcos Ibrahim de Oliveira, Jefferson Douglas Camargo Moreira, André Canettieri Rubez, Caio De Oliveira, Gabriel Chahade Sibanto Simoes, Lucas Mira Gon, and Cassio Luis Zanettini Riccetto Bruno Di DomenicoBruno Di Domenico More articles by this author , Arthur Degani OttaianoArthur Degani Ottaiano More articles by this author , Fabio Franco Oliveira JuniorFabio Franco Oliveira Junior More articles by this author , Natália Dalsenter AvilezNatália Dalsenter Avilez More articles by this author , Joao Marcos Ibrahim de OliveiraJoao Marcos Ibrahim de Oliveira More articles by this author , Jefferson Douglas Camargo MoreiraJefferson Douglas Camargo Moreira More articles by this author , André Canettieri RubezAndré Canettieri Rubez More articles by this author , Caio De OliveiraCaio De Oliveira More articles by this author , Gabriel Chahade Sibanto SimoesGabriel Chahade Sibanto Simoes More articles by this author , Lucas Mira GonLucas Mira Gon More articles by this author , and Cassio Luis Zanettini RiccettoCassio Luis Zanettini Riccetto More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003347.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Leiomyoma is a benign tumor that originates from smooth muscle cells. Despite being the most common benign tumor in women, it is exceptionally uncommon in the urethra, with approximately 150 reported cases. The peak incidence is in the third and fourth decades. The symptoms are location and size related, usually affecting the proximal urethra with a mean diameter of 3.7 cm. The main signs and symptoms are mass sensation in the urethra, dyspareunia, irritative and obstructive urinary tract symptoms, hematuria, and acute urinary retention. Imaging tests such as ultrasound and magnetic resonance imaging (MRI) help diagnose and adequate surgical planning. Complete resection helps avoid recurrence, which may require urethral resection and reconstruction. METHODS: A 25-year-old patient with moderate intellectual disability reported vaginal bleeding for 15 days, despite using medroxyprogesterone acetate. Progressive growth of a perineal mass, incomplete bladder emptying sensation and straining were present for one year. She denied hematuria. There was a fixed and painless solid mass of 4×3 cm on the anterior vaginal introitus, with minor bleeding at the mobilization. MRI showed a solid and heterogeneous mass, measuring 4.4×3.2×2.4 cm and no defined cleavage plane with the urethra or anterior vaginal wall. A surgical intervention was proposed. Under general anesthesia, with the patient in the lithotomy position, a U-shape supra-meatal incision was made. Total en-bloc resection of the mass was performed, with an unsuccessful attempt at urethral preservation. The proximal margin was sent to frozen section biopsy with negative result to determine where to stop ressection. Jugal graft urethroplasty was performed using 5-0 polydioxanone. The pubourethral ligament was reconstructed with vycril 2-0. Closure of the vaginal mucosa was made with 2-0 vycril. RESULTS: An anatomopathological study revealed complete resection of leiomyoma. Patient was discharged on the first postoperative and had the Folley catheter removed after 3 weeks. At a four-month follow-up, there were no complications or recurrence of urinary symptoms. CONCLUSIONS: Urethral leiomyoma is a rare pathology, and there is no established protocol for its treatment. The challenge is resecting the lesion entirely while preserving the structures. It is crucial to reconstruct the urethra and connective tissue support to maintain adequate urinary function. Although it may prolong operation time, jugal graft urethroplasty is a feasible option for large leiomyomas. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1067 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Bruno Di Domenico More articles by this author Arthur Degani Ottaiano More articles by this author Fabio Franco Oliveira Junior More articles by this author Natália Dalsenter Avilez More articles by this author Joao Marcos Ibrahim de Oliveira More articles by this author Jefferson Douglas Camargo Moreira More articles by this author André Canettieri Rubez More articles by this author Caio De Oliveira More articles by this author Gabriel Chahade Sibanto Simoes More articles by this author Lucas Mira Gon More articles by this author Cassio Luis Zanettini Riccetto More articles by this author Expand All Advertisement PDF downloadLoading ...

Periurethral and Anterior Vaginal Wall Masses: Etiology, Presentation, and Treatment Outcomes.

To describe the etiology and presenting symptoms of periurethral and anterior vaginal wall masses in a large series of patients in an academic institution. A retrospective chart review of 126 patients presenting and undergoing treatment for periurethral and anterior vaginal wall masses between November 2001 and July 2021 was completed. Clinicopathologic data were extracted. Ethics approval was obtained. The primary objective of this study was to determine the etiology of these masses; secondary objectives included determining the rates of presenting symptoms, complications, resolution of stress urinary incontinence (SUI), and de novo SUI. The median age of patients was 42 years. The most common etiology was urethral diverticula (39.7%), followed by Skene gland cysts or abscesses (30.2%). The rate of malignancy was 1.6%, and the rate of infection was 21.4%. The most common presenting symptoms were sensation of mass (78.6%), dyspareunia (52.4%), and discharge (46.0%). The rate of surgical complications was 9.5%. Three patients had recurrence on follow-up, but there were no recurrent urethral diverticula after excision. The rate of de novo SUI was 5.6%. The rate of resolution of SUI was 67.6%, and all patients who had slings reported resolution of SUI. Urethral diverticula and Skene gland cysts or abscesses accounted for 70% of periurethral and anterior vaginal wall masses in this series. Treatment by complete excision is usually successful.

Mass simulation in VR using vibrotactile feedback and a co-located physically-based virtual hand

Virtual reality allows for highly immersive simulated experiences and interaction with virtual objects. However, virtual objects do not have real masses. Providing the sense of mass for virtual objects using un-grounded haptic interfaces has proven to be a complicated task in virtual reality. This paper proposes using a physically-based virtual hand with improved co-location and a complementary vibrotactile effect on the index fingertip to give the sensation of mass to objects in virtual reality. The vibrotactile feedback is proportional to the balanced forces acting on the virtual object and is modulated based on the object’s velocity. For evaluating this method, we set an experiment in a virtual environment where participants wear a VR headset and attempt to pick up and move different virtual objects using a virtual physically-based hand while a voice-coil actuator attached to their index fingertip provides the vibrotactile feedback. Our experiments indicate that the virtual hand and our vibration effect give the ability to discriminate and perceive the mass of virtual objects.

Diagnosis dan Penatalaksanaan Karsinoma Tonsil

AbstractTonsilar carcinoma is the most common squamous cell carcinoma of the tonsils that presents as ulcerated lesions on a necrotic basis. These tumors often appear at an advanced stage and often metastasize to the lymph nodes. In recent years, head and neck malignancies due to HPV infection have increased. Other causes of carcinoma of the tonsils are smoking and alcohol abuse. The overall incidence of tonsillar carcinoma increase in the younger population, and this may be associated with an increase of human papilloma virus infection. Tonsil carcinoma varies in clinical history. In the early stages, tonsilar carcinoma are asymptomatic, but at an advanced stages patients might have complaint of a persistent sore throat, unilateral otalgia, or a sensation of mass in the throat, bleeding from the mouth, fetor oris with trismus as a sign of a local invasion. The diagnosis of tonsilar carcinoma made based on history, physical examination, clinical symptoms, and supporting examinations such as of CT scan, MRI and tumor tissue biopsy. Management of tonsilar carcinoma for stage I-II and stage III (T1-2, N1) are local and regional radiotherapy to achieve a good effect. Radiotherapy is the main treatment modality in early-stage of tonsillar carcinoma. concomitant chemotherapy and radiation therapy are the standard treatment for advanced tonsillar carcinoma currently. chemotherapy can be given before radiotherapy or as neoadjuvant, given after radiotherapy or as adjuvant, or given concurrently with radiotherapy.

Giant hamartomatous polyp of the uterine cervix with heterologous mesenchymal tissue in a child: a case report\xa0

BackgroundPolyps of the uterine cervix are one of the most common benign hyperplastic lesions occurring in the female genital tract that usually arise from the endocervical canal and are believed to be the result of reactive changes due to long-standing chronic inflammation, multiparty, and foreign bodies. Cervical polyps are usually small in size (less than 4 cm) that are commonly found in adult women; however, a few cases of giant polyps and the rare occurrence of these lesions in children have also been reported. Heterotopias and malignant transformation in cervical polyps are considered to be very rare.Case presentationWe present the case of a 10-year-old Afghan girl with a giant pedunculated mass protruding out of the uterine cervix that was accompanied by abdominal pain and mass sensation. The mass was completely excised by surgical intervention and the specimen was submitted for histopathological evaluation. Upon gross and microscopic examination, the characteristic findings of a hamartomatous polyp with heterologous mesenchymal tissue in the form of mature cartilage were seen. To the best of our knowledge, this is the first case of a giant (17.5 cm) hamartomatous polyp of the uterine cervix in this age group.ConclusionGiant hamartomatous cervical polyps rarely occur in patients below 10 years of age. The majority of these lesions are benign; however, a few cases with malignant transformation are also reported, which demands elaborate investigations into the etiopathogenesis and nature of the lesions.

Relationship Between rhTSH Administration and Thyroid Cancer Progression: A Case Report

Abstract Introduction: The relationship between the administration of recombinant TSH (rhTSH) and the progression of thyroid cancer has been described in some case reports (1). There are scant data suggesting that rhTSH acts as a growth factor that stimulates metastatic tumor expansion. Case Report: A 55 year old male patient who 3 years ago reported an evident mass at cervical level. The ultrasound documented a large thyroid mass with an endothoracic component. The FNA reported BETHESDA IV, suspicious for follicular neoplasia. Extension studies showed lytic left parietal bone lesion and liver metastatic compromise. The pathology of the total thyroidectomy showed a follicular carcinoma with a micronodular pattern and capsular invasion, of 19x9x7 cm, vascular and esophageal involvement T4BN0M1. He was sent to radioiodine therapy with 100 MCI with previous suspension of LT4 (Preablative TGL> 300 ng / ml (<50 ng / ml) Abs-TGL 2 IU / ml (<2 IU / ml) TSH 31.3 mIU / L (0.37-4.7 mIU / L) and body scan documenting uptake of the radiotracer at the left parietal, the anterior costal grating, and liver. A second dose of iodine was applied, with 150 MCI after stimulation with thyrotropin (Preablative TGL> 300 ng / ml, Abs-TGL 1.76 IU / ml, TSH 83 mIU / L) Immediately after the administration of rhTSH, the patient described the appearance of alopecic plaques on the scalp, sensation of mass at the right upper quadrant of the abdomen and bone pain in the right rib cage and at the right hip, which progressively worsened the following days until they were incapacitating. The scan report showed a new uptake in dorsal vertebrae, the MRI showed new bone injury at the innominate bone, as well as increase in the sum of its maximum dimensions by 22%, indicative of progression. The cerebral angio-MRI showed hypervascularized metastasis at the left parietal level. Bone scintigraphy documented foci of hyper uptake in both parietals, manubrium and sternal body, 5-8 right anterior costal arches, right scapula, both humeral heads, vertebral bodies T3-T5-T7L4, right acetabulum, left proximal femur and the entire length of the right femur. The clinical and imaging worsening of the bone lesions after the application of rhTSH was striking, for this reason radiotherapy and embolization of the liver lesion was performed. The patient was not a candidate for neurosurgical management due to the vascular component of the cranial lesions. Conclusion: rhTSH is a very well-tolerated method that avoids symptoms associated with severe hypothyroidism. However, it has been associated with neoplastic progression. This is one of the few cases documented in the literature where there is a direct association between the administration of rhTSH and the progression of bone metastases.

Tuberculosis ileocecal: A propósito de un caso

La tuberculosis es una enfermedad de importancia en la salud pública a nivel mundial, con una alta incidencia a nivel del territorio colombiano. Principalmente, afecta el parénquima pulmonar; sin embargo, en un porcentaje elevado de casos se diagnostica en su forma extrapulmonar y el tracto gastrointestinal es uno de los sitios más frecuentes. Así mismo, la región ileocecal y el íleon terminal son las regiones con más predilección por la bacteria Mycobaterium tuberculosis. Las manifestaciones en esta rara presentación de la enfermedad están dadas por dolor abdominal y sensación de masa principalmente, lesiones ulcerosas en la mucosa intestinal y hallazgos histológicos correspondientes a granulomas caseificantes de gran tamaño y de morfología confluente, que se diferencian de otras entidades como la enfermedad de Crohn. La búsqueda de la enfermedad dentro del tracto gastrointestinal se realiza con ayuda de métodos invasivos como la colonoscopia y de ayudas diagnósticas de laboratorio como cultivos, tinciones o reacción en cadena de la polimerasa (PCR). Dada la complejidad en el diagnóstico de esta forma de tuberculosis, el conocimiento y la manera en que se aborda un paciente con un cuadro sugestivo de esta enfermedad son factores importantes para establecer el manejo terapéutico oportuno. Se comparte un caso inusual de tuberculosis ileocecal como manifestación de síndrome febril prolongado con desenlace fatal.

Endometriosis de la pared abdominal: estudio descriptivo de una serie de 21 casos

Introducción. La endometriosis de la pared abdominal se define como la presencia de tejido endometrial en cualquiera de las capas que componen la pared abdominal. Su incidencia es baja y se caracteriza por un diagnóstico tardío.
 Materiales y métodos. Se trata de un estudio descriptivo y ambiespectivo entre 2010 y 2014 en pacientes con endometriosis de la pared abdominal, cuyo análisis patológico fue realizado en un centro de ayudas diagnósticas de Medellín. Se identificaron las variables histopatológicas del reporte, y la información clínica mediante una entrevista telefónica suministrada por la paciente. Se analizaron los datos con medidas descriptivas de resumen.
 Resultados. Participaron 21 de 65 pacientes con diagnóstico de endometriosis de la pared abdominal. La media de edad al momento del diagnóstico fue de 35,3 años (desviación estándar, DE=8), el 71,4 % tenía el antecedente de cesárea y, el 38,1 %, el de endometriosis pélvica. El 95,2 % de las pacientes manifestaron dolor, de las cuales el 50 % lo percibió como constante con agudización cíclica y, el 40 %, como cíclico; además, el 90,5 % manifestó sensación de masa. La mediana del tiempo desde la aparición de la lesión hasta el diagnóstico, fue de 24 meses (RIQ=6-60). Solo en cuatro pacientes se hizo el diagnóstico prequirúrgico. El tratamiento fue quirúrgico en todas las pacientes y ocho (38,1 %) presentaron recidiva.
 Conclusiones. La endometriosis de la pared abdominal usualmente se manifiesta como masas dolorosas asociadas con cicatrices quirúrgicas previas, generalmente de origen ginecológico y los síntomas empeoran con la menstruación. Es usual que su diagnóstico sea tardío y pocas veces se hace antes del estudio histopatológico. El tratamiento de elección es la resección quirúrgica, aunque no es despreciable el porcentaje de recidivas.

Pregnancy-associated Breast Cancer: A Review of Imaging Modalities

Context: The most common cancer and cause of cancer-related death in pregnant and breastfeeding patients is breast cancer. In the world, the incidence of pregnancy-associated breast cancer (P.A.B.C) is increasing, which is due to the fact that women delay their pregnancy up to the middle ages. According to the definition of P.A.B.C, a pregnancy-associated breast cancer is a case of breast cancer that occurs during pregnancy or up to 1 year after delivery. The aim of this paper is to review the clinical findings and novel imaging methods and findings, which help to diagnose pregnancy-associated breast cancer early. Evidence Acquisition: We reviewed the papers with subjects of PABC and imaging modalities in PABC by searching the medical and health databases such as PubMed, Google Scholar, as well as clinical trials. Results: The most frequent manifestation is a painless mass sensation. The most prevalent pathology of PABC is high-grade ductal carcinoma. The first diagnostic tool and most sensitive modality of imaging in this disease is ultrasound. Mammography during pregnancy and lactation is a safe method, which performs in symptomatic patients or in patients with positive ultrasound findings. MRI is not recommended during pregnancy, but it is completely harmless in breastfeeding patients and it is usually used as the complementary modality. Conclusions: Timely diagnosis of PABC requires complete knowledge of clinical symptoms and accurate interpreting of the images in different diagnostic modalities including mammography, ultrasound, and MRI. It should be noted that delay in diagnosis of PABC is the most common cause of low survival rate and bad prognosis. © 2018, Author(s).

THE COMPARISON BETWEEN PRESENTING SYMPTOMS OF OVARIAN CANCER AND OTHER ABDOMINAL - PELVIC CANCERS

Introduction : Diagnostic delays of ovarian cancer, has been attributed to the lack of a reliable and cost-effective screening test and presumption that ovarian cancer is symptomatic in the early stages. To investigate presenting symptoms of ovarian cancer and compare with symptoms of other abdominal-pelvic cancers Methods : We reviewed the medical records of all women with abdominal-pelvic cancers between March, 2003 and March, 2005 in Shiraz medical centers to compare, presenting symptoms of ovarian cancer and other abdominal-pelvic cancers. Results : Of 168 women with a diagnosis of abdominal-pelvic cancers, ovarian cancer was diagnosed for 22 women. (Stage I: 0, Stage II: 2, Stage III: 10, Stage IV: 7 and 3 patients without staging.) The mean age of patients with ovarian cancer was 51/6.The sensation of abdominal mass was more common in women with ovarian cancer than other abdominalpelvic cancers (P=0.00l). Constipation was documented in the patients with colon cancer more than women with ovarian cancer (P=0.012), whereas urinary symptoms were more common in patients with ovarian cancer (P=0.004).Although the women with bladder cancer complained from urinary problems more than who had ovarian cancer (P=0.00l), but defecation problems and abdominal pain were more detected in patients with ovarian cancer (p=0.05). Conclusion : The most common cases of ovarian cancer present in the end stage that usually have poor prognosis. It can be associated to both patient and healthcare factors. This cancer is associated with many symptoms, but few symptoms are related to reproductive system. Sensation of abdominal mass, abdominal pain and urinary and defecation problems are the symptoms that can be associated with this cancer. Key words : Presenting Symptoms, Ovarian Cancer, and Abdominal-Pelvic Cancers.

The role of 18 F-FDG PET/CT in Better Follow up in Patient with Hodgkin Lymphoma: A Case Report

PET/CT scans have recently become the gold standard in determining the extent of HL, with a specificity and sensitivity that is superior to that of CT scans alone. Herein, we survey relationship between PET/CT with follow up in Hodgkin disorder. On November 14, 2016, for 36 years old man with complaint of mass sensation with radicalular neck pain, sonography in the axillary right region was done and in report multiple lymph nodes with cortical thickening and hilar obliteration. In complementary IHC that was done in other center CD 10, Ki67, CD 5, CD 21 and CD 23 were negative and CD 68, Pax5, CD 3 were positive. Low dose CT images (30 mAs and 120 KV) without contrast were obtained for attenuation correction and anatomical localization purposes showed Hodgkin's lymphoma with initial staging (metabolically active conglomerated nodal disease in the left axillary region accompanied by a suspicious focal involvement of the spleen PET/CT images can be a very useful guide for a doctor and, in part, to exclude a patient and his/her family from psychological feedback in order to get the right decision.

Sensitivity and specificity of clinical findings for the diagnosis of pelvic congestion syndrome in women with chronic pelvic pain.

Background Pelvic congestion syndrome is among the causes of pelvic pain. One of the diagnostic tools is pelvic venography using Beard's criteria, which are 91% sensitive and 80% specific for this syndrome. Objective To assess the diagnostic performance of the clinical findings in women diagnosed with pelvic congestion syndrome coming to a Level III institution. Methods Descriptive retrospective study in women with chronic pelvic pain taken to transuterine pelvic venography at the Advanced Gynecological Laparoscopy and Pelvic Pain Unit of Clinica Comfamiliar, between August 2008 and December 2011, analyzing social, demographic, and clinical variables. Results A total of 132 patients with a mean age of 33.9 years. Dysmenorrhea, ovarian points, and vulvar varices have a sensitivity greater than 80%, and the presence of leukorrhea, vaginal mass sensation, the finding of an abdominal mass, abdominal trigger points, and positive pinprick test have a specificity greater than 80% when compared with venography. Conclusion This study may be considered as the first to evaluate the diagnostic performance of the clinical findings associated with pelvic congestion syndrome in a sample of the Colombian population. In the future, these findings may be used to create a clinical score for the diagnosis of this condition.

5-Year data analysis of patients following abdominal wall endometrioma surgery.

BackgroundEndometriosis is a disorder in which an ectopic endometrial tissue grows outside the uterine cavity. The ectopic endometrium embedded in the subcutaneous fatty layer and the muscles of abdominal wall is called as abdominal wall endometriosis (AWE). AWE is a rare condition; however, it is usually known to develop along with previous surgical scars. Caesarean section and hysterectomy are considered to be commonly associated with the development of AWE.MethodsWe evaluated the data of the patients who underwent AWE surgery between March 2009 and March 2014.ResultsThe mean age of the patients was 32.5 years. We found a previous history of caesarean section in all of the patients. The most frequent symptoms of the patients were abdominal mass sensation and abdominal pain. Invasion of endometriosis to fat layer, fascia, muscular layer, and peritoneum was recorded. Three masses were located within the scar regions.ConclusionsWe can conclude that there is a high prevalence of caesarean sections among the women with AWE.

Peritoneal Tuberculosis: An Uncommon Disease Calling for Close Scrutiny

Introduction: Tuberculosis (TB) is a disease with diverse clinical manifestations. It typically attacks the lungs (pulmonary); however, it may also affect other parts of the body (extrapulmonary) with or most commonly without lung involvement. Notable extrapulmonary infection sites include pleura, central nervous system, lymphatic system, genitourinary system, bones and joints, and abdomen. Abdominal TB is one of the most prevalent forms of extrapulmonary presentations of this variable disease. Given the patients with abdominal complaints especially in developing countries, where the disease is endemic, it should be kept in mind that abdominal TB has numerous differential diagnoses. Case Presentation: Our case is a 46 year-old female with left upper abdominal pain and mass sensation, with no associated signs or symptoms, but negative family history of TB and carcinoma. The patient underwent several diagnostic procedures so that the ultimate cause for her abdominal pain would be discovered among various existing differential diagnoses. Discussion: Peritoneal TB, although not very common, is still the important cause of not only abdominal symptoms but also female infertility. The need to pay more accurate attention to peritoneal TB in endemic areas, especially in young patients considered to have peritoneal carcinomatosis, seems very important.

Thyroid Lymphoma

The purpose of this study was to correlate the clinicoradiologic and pathologic features of thyroid lymphoma and to identify the most useful diagnostic method for thyroid lymphoma as the first line. Our study population included 16 patients with a diagnosis of thyroid lymphoma by fine-needle aspiration, core biopsy, or surgery from 1995 to 2010. We retrospectively reviewed imaging and medical records. Sonographic findings were correlated with histopathologic results. Of the 16 patients, primary lymphomas were found in 13 and secondary in 3. The mean ages of the patients with primary and secondary lymphomas were 60.8 and 42.7 years, respectively. Most patients with primary lymphomas had symptoms of rapid neck swelling or a mass sensation. All primary lymphomas revealed non-Hodgkin B-cell lymphoma, and secondary lymphomas included a B-cell origin in 2 and a T-cell origin in 1. On sonography, 10 (77%) of 13 primary lymphomas showed diffuse heterogeneous hypoechoic parenchyma with intervening echogenic septa-like structures, whereas all secondary lymphomas showed markedly hypoechoic nodules. Markedly hypoechoic parenchyma was correlated with lymphoepithelial lesions and neoplastic cells, whereas the intervening echogenic septa-like structures were consistent with fibrosis on pathologic examination. The exact diagnosis of thyroid lymphoma was possible with core biopsy in all 9 cases (100%) but with fine-needle aspiration in only 3 of 10 (30%), which included 7 under sonographic guidance and 3 under palpation (P = .0030). Diffuse hypoechoic parenchyma with intervening echogenic septa on sonography under the impression of a primary thyroid lymphoma, particularly in the setting of a rapidly enlarging mass, should prompt core biopsy rather than fine-needle aspiration.

A Hemorrhoid by Any Other Name

A 92-year-old man with dementia presented with perianal discomfort and fecal incontinence of 1 week duration. He denied pain, pruritus, bleeding, or sensation of a mass. Physical examination was notable for a raised verrucous mass (0.75 cm) extending from the dentate line distally for 7 cm, circumferentially covering 75% of the anal margin. Punch biopsy specimens were obtained for diagnosis. Histology revealed intraepithelial cells with prominent nucleoli and abundant clear cytoplasm. Surgical options were explained to the patient, but given his decline in function and overall poor life expectancy, radiation therapy was offered. He successfully completed a regimen of 44 Gy in 11 fractions. On follow-up examination, no appreciable perianal mass was observed; the patient denied anal discomfort, pain, bleeding, or symptoms of obstruction. Perianal Paget disease is uncommon, with fewer than 300 cases reported in the literature.1,2 Classically described as involving the breast, Paget disease has been shown to affect areas containing apocrine glands, including the perianal region, vulva, penis, scrotum, thighs, buttocks, and axilla.2 Perianal Paget disease typically presents in the sixth decade of life with pruritus ani, bleeding, excoriation, pain with defecation, anal pain, or mass sensation.2 Lesions are characterized as slightly raised, erythematous, and well-demarcated.3 Treatment is predominantly surgical, consisting of local excision, wide local excision with skin grafting or flap reconstruction, or in severe cases abdominoperineal resection.4,5 Radiation therapy can be offered in select patients with good outcome.

Acometimento orbitário na doença de Rosai-Dorfman

A doenca de Rosai-Dorfman (DRD) ou histiocitose sinusal com linfadenopatia macica e uma entidade clinica idiopatica, rara e benigna, caracterizada pela proliferacao histiocitaria com linfofagocitose. Geralmente se apresenta com linfoadenomegalia cervical, no entanto pode haver acometimento extranodal, sendo a regiao orbitaria um dos locais de possivel acometimento. Na maioria dos casos e uma doenca autolimitada com melhora espontânea, entretanto pode ser necessaria exerese cirurgica da lesao ou tratamento com corticosteroides e radioterapia.Neste trabalho, relatamos o caso de um paciente masculino de 29 anos, com queixa de tumoracao em palpebra inferior direita por 6 meses e historia de acometimento sinusal previo pela doenca de Rosai Dorfmann. Ao exame oftalmologico apresentava proptose de olho direito e aumento de volume de palpebra inferior direita. O exame de tomografia computadorizada de orbitas evidenciou lesao solida extraconal em orbita direita. Apos a exerese da lesao houve melhora importante do quadro clinico. O exame histopatologico associado a imuno-histoquimica confirmou o envolvimento orbitario na DRD. Revisamos tambem o quadro clinico, diagnostico diferencial e tratamento desta afeccao.