1/15. A case of Currarino triad with familial sacral bony deformities.We describe a male patient presenting with Currarino triad: a recto-urethral fistula, sacral bony deformity, and a presacral teratoma. Clinical screening of his family revealed three additional cases with incomplete forms of this association. Cytogenetic findings in the patient and his mother were normal. This case suggests that the occurrence of an anorectal malformation together with a sacral bony deformity should raise a physician's index of suspicion for associated presacral tumors, and that screening of the patient's family members with sacral radiographs is necessary.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/15. Ovarian teratoma with diffused peritoneal reactions mimicking advanced ovarian malignancy.BACKGROUND: Benign cystic teratomas are one of the most common benign ovarian neoplasms. Although its rupture is rare, once occurred it can cause complications such as granulomatous peritonitis, mimicking metastatic ovarian malignancy. CASE: A 39-year-old woman, Para 0-0-0-0, presented to the hospital with rapid abdominal distention for 3 months. Her physical examination and ultrasonographic findings led to a diagnosis of advanced stage ovarian carcinoma. An exploratory laparotomy was performed and the operative impression was that of stage III ovarian carcinoma. Total hysterectomy with bilateral salpingo-oophorectomy and surgical staging were done. The postoperative pathology revealed a benign cystic teratoma of right ovary with chronic granulomatous peritonitis. She was well at discharge and at her 1-year follow-up. CONCLUSION: Although ruptured a benign cystic teratoma is rare, it can cause granulomatous peritonitis, the clinical findings of which mimic advanced stage ovarian carcinoma. This warrants physicians to be aware of and intraoperative frozen section should be used, its correct management will provide a good outcome with less complication.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/15. Rare case of carcinoid tumor arising within teratoma in kidney.Not all enhancing lesions in the kidney are renal cell carcinoma. We report a rare case of a carcinoid tumor arising within a teratoma of the kidney in an asymptomatic female patient. Carcinoid tumors and teratomas involving the kidneys are rare. The two entities existing simultaneously in the same kidney are exceptionally unique. Still, the radiographic characteristics of these lesions have been previously described and should be familiar to practicing physicians.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/15. A salutary tale of mistaken identity in testicular cancer.This case report illustrates the importance of not relying on imaging alone. A 26-year-old patient underwent an orchidectomy for mature teratoma; however, as he had abdominal lymphadenopathy, he was treated with 2 cycles of chemotherapy followed by retroperitoneal lymph node dissection. The abdominal histology revealed mature teratoma and he remained on intense surveillance. Three years later, computerized tomography (CT) indicated he had lung lesions and left hilar lymphadenopathy and, despite normal tumor markers, he was thought to have relapsed. He was treated with 2 cycles of second-line chemotherapy but there was no change in the lung lesions. He underwent a CT-guided biopsy which diagnosed sarcoidosis. He was kept under observation by the respiratory physicians and remains well. sarcoidosis is commonly associated with lymphoma among other malignancies. In the Mayo series, they concluded there was a strong association between sarcoidosis and teratoma but cautioned against a causal relationship as both diseases are rare and found in the same age group. This case report reminds us to always consider the differential diagnoses, particularly if the imaging does not fit the rest of the clinical picture, and when in doubt obtain histology prior to treatment.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/15. Acute pulmonary embolism following laparoscopic ovariectomy: a case report.Laparoscopic surgery is usually considered to be less invasive when compared to traditional laparotomy, and is regarded as a relatively low-risk procedure for postoperative complications because of the reduced surgical stress and earlier mobilization. However, we describe a 47-year-old woman who presented with acute respiratory distress, drowsy consciousness, and circulatory collapse shortly after gynecologic laparoscopic ovariectomy for removing an ovarian teratoma at a local hospital. After resuscitation, the patient was transferred to our emergency department. Immediate bedside electrocardiographic and echocardiographic examination results led to acute pulmonary embolism being quickly diagnosed. The patient received subsequent intensive care with smooth course. Although pulmonary embolism is rare after laparoscopic surgery, early detection and quick treatment are important in the management of this life-threatening complication and offer good prognosis. The risk of pulmonary embolism after gynecologic laparoscopic surgery remains unclear. Therefore, the decision to provide prophylaxis is up to the individual physician, and should take into consideration the patient's individual risk factors and comorbidities.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/15. Misdiagnoses in obstetric and gynecologic ultrasound examinations: causes and possible solutions.Two small series of cases documenting ultrasound misdiagnoses are presented. The first concerns obstetric ultrasound misdiagnoses originating in the private offices of physicians. The second concerns gynecologic ultrasound misdiagnoses originating in a level II medical center. A dichotomy exists in the use of diagnostic ultrasound examination in the practice of obstetrics and gynecology. The dichotomy is a serious defect in our specialty that needs urgent addressing. The institutional problem can be partially resolved by furnishing the sonographer with the referred patient's history and physical findings. The problem of the ultrasound machine in the office of a private physician is much more complex. It may require government intervention and strict licensing measures for resolution.- - - - - - - - - - ranking = 2keywords = physician (Clic here for more details about this article) |
7/15. Testicular cancer in a 13-year-old adolescent.A 13-year-old adolescent with cancer of the testicle is presented. The fact that he was aware of this mass and did not seek medical care stresses the need of physicians to carefully examine the male genitalia and to teach self-examination.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
8/15. Development of agoraphobia after surviving cancer.We present a case conference on a 32-year-old accountant who developed embryonal carcinoma of the testis, two months after the birth of a son with a missing leg. His cancer was successfully treated with surgery and chemotherapy. After 5 years, when he was told that he need not be closely followed by his physicians anymore because he had been cured of cancer, he developed agoraphobia with panic attacks. This interfered with his occupational and social adjustment. His phobia was treated successfully with pharmacotherapy, behavior therapy, and psychotherapy. We explore the psychologic impact of cancer, the activation of separation anxiety and aggressive impulses after its successful treatment, the crippling nature of his agoraphobia, and the ingredients of his successful response to treatment.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
9/15. Congenital anorectal malformations. Harbingers of sacrococcygeal teratomas.Since 1973, seven infants treated at the University of florida, Gainesville, for congenital anorectal anomalies have been found to have concomitant sacrococcygeal teratomas. As anorectal anomalies occur in approximately one in every 5,000 live births and sacrococcygeal teratomas are noted in one in every 40,000 live births, this presentation would suggest a prevalence that precludes a random association. The presence of significant anorectal strictures in these patients resulted in a delay in the diagnosis of the presacral teratomas. As the frequency of malignant change in sacrococcygeal teratomas has been documented to increase proportionately with age, early diagnosis and excision of these lesions is essential. Our experience with these children suggests that the presence of congenital anorectal malformations in infancy should raise the physician's index of suspicion for associated sacrococcygeal teratomas.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
10/15. Curability of cancer in children.The case records of 173 patients treated for cancer during childhood, free of disease at least 5 years later and free of disease in 1967 were reviewed. There were 84 boys and 89 girls. Tumor types were lymphomas, including one acute leukemia, sarcomas of the bone and soft parts, Wilms' tumor, neuroblastoma and carcinomas. Among the long survivors there were clusters in the less than 1-year age group and more than twelve years. Although many of the children were well adjusted in later life, others developed emotional problems. Cancer detection in a well child population for the tumors characteristically seen in the different age groups is the responsibility of the parents and physicians rendering health supervision to the children.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
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