1/108. Unusual appearance of thromboembolism on perfusion lung imaging.A 46-year-old woman with advanced ovarian carcinoma had progressive dyspnea and was evaluated with ventilation and perfusion lung imaging. A characteristic pattern of multiple branching perfusion defects of a segmental nature on the perfusion scan suggested tumor microembolism and lymphangitic carcinomatosis. However, in this case, this pattern was associated with pulmonary thromboembolism and was documented by the post mortem examination. Pulmonary thromboembolism should be included among the differential diagnoses in a patient with clinical symptoms and a perfusion scan that reveals multiple branching perfusion defects.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
2/108. Metastatic ovarian neuroblastoma: a case report.Ovarian metastasis of childhood tumors is rare despite their aggressive nature. The childhood tumor that spreads to the ovary most frequently is the neuroblastoma. The clinical features and frequent bilaterality of ovarian metastatic tumors are helpful diagnostic features in many cases, but when the ovarian tumor is the presenting manifestation of the disease, differentiation from various primary ovarian tumors may be difficult. In this paper, a rare case of metastatic ovarian neuroblastoma is reported.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
3/108. Cystic struma ovarii: a rare presentation of an infrequent tumor.CONTEXT: struma ovarii, a rare neoplasm, is a monophyletic teratoma composed of thyroid tissue. It is generally considered to account for less than 5% of mature teratomas. CASE REPORT: A diagnosis of struma ovarii may be the source of many diagnostic problems. It may be cystic and microscopic examination may only reveal a few typical thyroid follicles, resulting in confusion with other cystic ovarian tumors. Extensive sampling should be undertaken and immunohistochemistry may be decisive in establishing the thyroid nature of the epithelial lining. The authors report two cases of cystic struma ovarii, and discuss diagnostic criteria and the limitations of frozen biopsies in these tumors.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
4/108. Laparoscopic cystectomy of a twisted, benign, ovarian teratoma in the first trimester of pregnancy.Adnexal torsion is an unusual, but serious complication in pregnancy. The treatment is surgical, but this may increase the risk of pregnancy loss in the first trimester. The use of laparoscopic surgery, which is less invasive than traditional laparotomy, has been limited by diagnostic and technical difficulties including determination of ovarian tumor nature and spillage of cyst contents intraoperatively. A 25-year-old woman in her 11th week of pregnancy had acute severe left lower-abdominal pain, which was diagnosed as left ovarian teratoma with torsion. She underwent emergency laparoscopic surgery with unwinding of the twisted fallopian tube and ovary and cystectomy of the teratoma. The patient subsequently delivered a full-term baby, without complications. Accurate ultrasound and cytologic diagnoses along with copious intraoperative warm, normal saline irrigation were likely contributing factors to the successful outcome of this case.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
5/108. yolk sac tumor of the ovary: radiologic-pathologic correlation in four cases.We report the radiologic and pathologic features of yolk sac tumor (endodermal sinus tumor) of the ovary in four patients. yolk sac tumors were shown as well-enhancing solid tumors on both CT and MR studies and were associated with prominent signal voids on MRI. A hypervascular nature was confirmed on microscopic studies. Areas of hemorrhage were another common characteristic. These imaging findings seem to have an important implication for the diagnosis of this tumor.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
6/108. Conservative treatment of recurrent ovarian fibromas in a young patient affected by Gorlin syndrome.The case of recurrent bilateral ovarian fibromas occurring in a 22 year old Italian girl affected by Gorlin syndrome is reported. Ovarian fibromas occur in 75% of female patients with Gorlin syndrome and their recurrence has rarely been reported in the literature. Management is guided by the benign nature of the lesion and consists of surgical removal of the fibroma. Preservation of the normal ovarian tissue is recommended even though there is risk of recurrence of the fibroma.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
7/108. The role of chemotherapy and prophylactic bilateral oophorectomy in a case of colorectal adenocarcinoma with ovarian metastases.A 66-year-old female presented with a large abdominal mass and accompanying systemic complaints of abdominal pain, constipation. and fever. On exploratory laparotomy, the mass was found to be a moderately differentiated adenocarcinoma of the sigmoid colon with metastasis to the left ovary. A primary colorectal carcinoma that has metastasized to the ovaries can be difficult to distinguish clinically from an advanced primary ovarian tumor. histology and tumor markers are currently the most useful tools available in making an accurate diagnosis. If the nature of the primary tumor is uncertain and the initial response to chemotherapy is poor, the patient's prognosis will also he poor. Though controversy exists regarding the role of prophylactic bilateral oophorectomy during resection for primary colorectal cancer, later confusion can be avoided by performing this procedure when the colorectal carcinoma is first diagnosed. However the possibility of a concurrent primary ovarian tumor must not be overlooked.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
8/108. risk in numbers--difficulties in the transformation of genetic knowledge from research to people--the case of hereditary cancer.Difficulties in communicating diagnostic information are exacerbated when the 'diagnosis' is a 'genetic risk' for cancer. The risk estimation demanded in this situation differs from other types of probability estimations. Observations of participants in 45 consultation sessions between physicians and potential patients were conducted at a clinic for hereditary cancer to explore the communication of genetic information. Thirty-three sessions were audiotaped, transcribed verbatim and analyzed, along with notes from the other sessions. A dominant theme was found to be numerical discussion of risk. Further analysis resulted in the description of problems for practitioners in the process of translating scientific knowledge into clinical management. Problems in providing information include unclear aims of the consultation sessions, mixing various types of background information and probabilities, recognizing how low the predictive values are, and difficulties in communicating the relationship between probability and conclusions. Problems in communicating information about the genetic risk for cancer are of at least two types: dilemmas arising from uncertainties implicit in the nature of the information itself and difficulties in communicating information in a manner that those concerned can interpret. These issues need clarification, so that information with far-reaching consequences can be made as clear and comprehensible as possible for those involved.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
9/108. Immunohistochemical localization of aromatase and apoptosis-associated proteins in ovarian serous cystadenocarcinoma arising from ovarian endometriosis.An immunohistochemical study was made of a case of serous cystadenocarcinoma that had been shown to have arisen from ovarian endometriosis. aromatase cytochrome P450 (P450arom), an enzyme responsible for estrogen biosynthesis, was localized in the epithelial linings of the endometriosis and faintly in the transitional part, whereas it was not expressed in the carcinoma tissue. In contrast, estrogen receptors, progesterone receptors, and apoptosis-associated proteins, Fas, Fas ligand, and Bax were expressed in both endometriosis and carcinoma tissues of the tumor, whereas Bcl-2 was not expressed in either tissue of the tumor. It was suggested that the undifferentiated shift of the histologic grade might result in the loss of P450arom and that the malignant transformation was not caused by an altered balance of apoptosis-associated proteins. Accumulation of these studies may lead to a better understanding of the nature of malignant transformation of ovarian endometriosis.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
10/108. Potential clinical utility of CA-125 in responsive but persistent large-volume ovarian cancer following platinum-based chemotherapy.BACKGROUND: Despite the demonstrated clinical utility of the serum ca-125 antigen level in ovarian cancer, controversy exists regarding interpretation of "discordant" results between changes in this tumor marker and measurable disease masses. CASE: A patient with ovarian cancer cared for in the Gynecologic Cancer Program of the Cleveland Clinic Foundation receiving second-line single-agent carboplatin for recurrent disease demonstrated a major response in serum CA-125, but minimal shrinkage of a large painful abdominal mass. A laparotomy was performed both to define the nature of this mass and to attempt to relieve symptoms. The mass was found to be a large "inflamed pseudotumor with central necrosis." No viable tumors cells were found. CONCLUSION: This case represents an excellent example of the remarkably complex biology of malignant disease and suggests how evaluation of changes in CA-125 in women with ovarian cancer may be utilized in individual patients to develop optimal management plans.- - - - - - - - - - ranking = 1keywords = nature (Clic here for more details about this article) |
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