1/9. Internal hemorrhage caused by a twisted malignant ovarian dysgerminoma: ultrasonographic findings of a rare case and review of the literature.PURPOSE: Ovarian cancer presents as an acute abdomen very rarely. The purpose of the study is the description of a right ovarian malignant dysgerminoma presenting as an abdominal emergency. CASE: A 16-year-old white female presented with acute abdominal pain in the right iliac fossa. On physical examination the abdomen was acute and a mass in the right lower abdomen was palpated. The patient was sexually active and bimanual gynecological examination revealed the presence of a large lobulated solid tumor in the position of the right adnexa. Ultrasound examination showed the presence of a large, multilobulated, heterogeneous, predominantly solid pelvic mass. color flow imaging showed intratumoral flow signals. The uterus and the left ovary had normal size and echo-texture. Fluid was found in the cul-de-sac and in Morisson's space. An immediate exploratory laparotomy exposed the presence of a twisted right ovarian mass and intraperitoneal hemorrhage. A superficial tumoral vessel actively bleeding was seen. Peritoneal fluid was obtained for cytology. The intra-abdominal hemorrhage ceased when the ovarian pedicle was clamped. The patient underwent right salpingo-oophorectomy and biopsy of the omentum. Pathologic analysis revealed a malignant dysgerminoma of the right ovary, expanding to the mesosalpinx. Cytology was positive for malignancy. Postoperative CT scan of the upper and lower abdomen was negative. The patient was assigned to FIGO Stage IIC and referred for platinum-based chemotherapy. CONCLUSION: Ovarian malignant dysgerminoma may present as an acute abdomen because of torsion, passive blood congestion, rupture of superficial tumoral vessels and subsequent intra-abdominal hemorrhage. Ovarian dysgerminoma should be part of the differential diagnosis in a young woman with acute surgical abdomen and a solid heterogeneous pelvic mass detected by ultrasonographic scan.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/9. Ovarian dysgerminoma and acute abdomen.BACKGROUND: Ovarian dysgerminoma cases are very rarely presented together with acute abdomen. The purpose of this study is to present dysgerminoma ovarii with abdominal pain in lower right abdominal part after abdominal trauma as an abdominal emergency. patients AND methods: Our 12-year old female patient was admitted to our hospital after traffic accident with abdominal trauma. On physical examination the abdomen was acute and the mass in lower abdomen was palpated. Ultrasound and CT examinations showed the presence of large, multilobulated and predominantly solid pelvic mass. Fluid was found in the lower part of pelvis. Immediate exploratory laparotomy was performed. It exposed a superficial actively bleeding tumour vessel. We stopped the bleeding and did a biopsy of the tumour because it was too big for surgical treatment. CONCLUSION: Ovarian dysgerminoma should be part of the differential diagnosis in female children with acute surgical abdomen when a solid mass is detected by ultrasonographic scan (Fig. 4, Ref. 11).- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
3/9. Post-irradiation vasculopathy of intracranial major arteries in children--report of two cases.We report two rare cases of post-irradiation vasculopathy of intracranial major arteries in children. A 13-year-old girl suffered from transient right hemiparesis 1 year after irradiation for suprasellar germinoma. Left carotid angiograms revealed marked stenoses of the intracranial internal carotid, middle cerebral, and anterior cerebral arteries, which were previously normal, and moyamoya vessels. A 2.5-year-old girl underwent internal irradiation with 198Au colloid for cystic craniopharyngioma. At the age of 10 years, she suddenly became unconscious after vomiting. Computed tomographic scans showed a right frontal intracerebral hematoma. Right carotid angiograms disclosed complete obstruction of the intracranial internal carotid, middle cerebral, and anterior cerebral arteries and moyamoya vessels, previously not present. The danger of radiation therapy causing occlusive vasculopathy in small and major cerebral arteries in children is emphasized. To prevent permanent ischemic neurological deficits, vasculopathy should be treated either medically or surgically as early as possible.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/9. Dispermic chimera associated with dysgerminoma.A 12-year-old female patient (Miss E.Y.) suffering from abdominal tumor was proved to be a dispermic or generalized chimera. Ninety-two percent of her red cells were group A1, the first locus of phosphoglucomutase (PGM1) 1A, 6-phosphogluconate dehydrogenase (PGD) AC and 8% of them were group B, PGM1 1A-2A, PGD A. Ninety cells out of one hundred and ten cultured lymphocytes were normal 46 XY and 20 cells were normal 46 XX. She secreted B and H substances at normal secretor range and a small amount of A substance in her saliva. The A-transferase level found in her serum was about 40% of those of group A1 individuals. The B-transferase level was in the normal range. Her hairs had B antigen and PGM1 phenotype of their root cells was 1A-2A. The cells of hair root were X chromatin-positive and Y body-negative. Her nails had lesser A antigen and potent B antigen. Major epithelial cells (approximately 75%) of her buccal mucosa expressed B antigen and minor cells expressed A antigen. The proportion of the X chromatin-positive buccal cells (15%) was lower than those in normal females (20-25%) and that of Y body-positive buccal cells (10%) was higher than those in normal females (0-3%). The surgically resected abdominal tumor was her right uterine adnexa with malignant transformation, the histological diagnosis of which was dysgerminoma. The tumor cell nest and the epithelial cells of ductal structure expressed A antigen, whereas the endothelial cells of blood vessels expressed B antigen. These findings showed that the proband's body cells arose from the two cell lines, one carrying A1 gene had normal 46 XY male karyotype and another carrying B gene had normal 46 XX female karyotype, and suggested that her right gonad which was contributed by the former cell line had a malignancy in the presence of y chromosome.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
5/9. Multiple fusiform intracranial aneurysms following curative radiation therapy for suprasellar germinoma. Case report.A 17-year-old girl died from the rupture of a large fusiform aneurysm of the terminal internal carotid artery. autopsy revealed three other fusiform aneurysms originating from major cerebral arteries clearly within the ports of previously administered telecobalt radiation therapy. Five years prior to her death, a suprasellar germinoma was partially removed and the area was treated by radiation therapy via three ports. The original arteriograms showed a normal vascular tree. Repeat arteriograms, 3 years and 8 months before her death, demonstrated the aneurysms. The development of aneurysms following radiation damage of the arteries has been reported previously, but not in intracranial vessels.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
6/9. Treatment of sequential bilateral germ cell tumors of the testis following interval retroperitoneal lymph node dissection.Modification in lymphatic drainage following retroperitoneal lymph node dissection, such as a collateral circulation or lymph node and lymphatic vessel regeneration, was observed in 2 patients in whom a second tumor developed in the remaining testicle. Such alterations of the lymphatic system are difficult to evaluate for the possible presence of metastatic disease. The presence of extensive collateral circulation rules out lymph node dissection or radiation therapy as an appropriate treatment in these patients. A short course of systemic chemotherapy, regardless of the histological type of the second malignancy, seems to be the safest adjunctive treatment in such cases.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
7/9. Pure gonadal dysgenesis with microscopic ovarian streak and gonadoblastoma.A phenotypic female with an XY karyotype and no grossly demonstrable streak gonads is described. She had a microscopic focus of gonadoblastoma developing in a 3 X 2 mm area in the region of the ovarian vessels. The case stresses the importance of a careful search of the pelvic cavity in phenotypic females with a 46, XY karyotype.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
8/9. Radiooncological management of very advanced extragonadal seminomas.Five case histories involving extragonadal type-I Dixon-Moore seminomas are described, each having a large retroperitoneal tumor growth with, variously, lymph node or lung metastases, growth into or around organs, blood vessels and muscles, etc. The large tumor masses could be completely resected in some cases only. In three cases, post-operative combined radio- and chemotherapy have left the patients tumor-free for several years; in two cases radiotherapy given along resulted in a full remission. In one case, the undescended testis, in another, the fibrous tissue in an atrophic testicle of a patient evincing Turner's syndrome were shown not to contain primary tumor. The excellent therapeutic results confirm the correctness of the combined surgical, radiotherapeutic and chemotherapeutic treatment; it appears that correct timing of the various therapies is of prime importance.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |
9/9. Intravascular gas within an ovarian tumor: a CT sign of ovarian torsion.A case of twisted ovarian tumor with intravascular gas is presented, and the mechanism of the gas formation is discussed. On the basis of the probable mechanism of gas formation observed in dead fetuses, the gas seen in the present case is considered to have been oxygen released from trapped oxyhemoglobin within the tumor vessels. "Intravascular gas" within an ovarian tumor, although extremely rare, is diagnostic of ovarian torsion.- - - - - - - - - - ranking = 0.5keywords = vessel (Clic here for more details about this article) |