1/60. Giant abdominopelvic epithelioid angiomyolipoma associated with tuberous sclerosis: report of a case.tuberous sclerosis is a hereditary autosomal-dominant disease characterized by hamartomas that can develop in any organ. We report herein the case of a 34-year-old female with tuberous sclerosis and a huge abdominopelvic mass that started growing quickly 2 years after its diagnosis. The patient had undergone several previous operations for hydrocephalus and cerebral tubers, and a nephrectomy for right renal angiomyolipoma. On admission, she was in poor general health with renal failure, severe anemia, and weight loss. A laparotomy revealed that the tumor occupied the pelvis, the lower and part of the upper abdomen, and was hypervascularized, with an extremely irregular surface covered in nodules, vegetations, and areas of hemorrhagic necrosis. The development of the mass and the impossibility of recognizing the internal genital organs led us to assume that the formation had originated from these. Frozen-section examination indicated an undifferentiated tumor that had not been completely resected. Her postoperative course was complicated by bronchopneumonia and progressive renal failure. The patient died 10 days after surgery due to cardiorespiratory failure. A histological diagnosis of epithelioid angiomyolipoma was confirmed. Although it is presently impossible to determine whether angiomyolipoma with predominant epithelioid cells is more aggressive than typical angiomyolipoma, it definitively demonstrated local aggressive behavior in this patient.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
2/60. Successful treatment of recurrent pelvic desmoid tumour with tamoxifen: case report.The case report of a young woman with recurrent pelvic desmoid tumour successfully treated with tamoxifen is described. The desmoid tumour recurred within 6 months after the initial exploratory laparotomy. tamoxifen therapy led to complete relief of ascites within 2 months and complete tumour regression by the end of the fourth month, and the patient has remained stable for 6 years. Without sacrificing pelvic organs or major vessels and preserving reproductive ability, tamoxifen should be considered as the first drug of choice in such a recurrent condition.- - - - - - - - - - ranking = 0.5keywords = organ (Clic here for more details about this article) |
3/60. Massive abdominal and pelvic myxoma in Carney's syndrome.This report describes a massive abdominal and pelvic myxoma in a patient with Carney's syndrome. A 38 year old woman presented with abdominal distension and a palpable mass, and at operation a large pelvic and abdominal tumour was identified and resected. The surgical specimen consisted of a lobulated mass, which on cut section had a uniform gelatinous consistency. The mass surrounded both ovaries, the appendix, and the upper part of the uterus, but macroscopically did not appear to involve these organs. Histological examination showed plump stellate and spindle shaped cells set in an abundant myxoid stroma, in keeping with a myxoma. Immunohistochemical staining revealed positivity of tumour cells for vimentin, but no reactivity to desmin, alpha-smooth muscle actin, S-100 protein, CD34, or AE1/AE3. This is the first documented case of massive adominal and pelvic myxoma in a patient with Carney's syndrome. Clinicians and pathologists should be aware that myxomas in Carney's syndrome can rarely involve unusual sites other than the skin and heart.- - - - - - - - - - ranking = 0.5keywords = organ (Clic here for more details about this article) |
4/60. Giant ancient schwannoma of the pelvis.A 43-year-old man with a large ancient schwannoma of the pelvis, presenting with varicose veins, is reported. Ancient schwannoma (neurilemmoma) is a benign tumour of nerve sheath origin characterised histologically by features of severe degeneration and which rarely can grow to a large size. Malignant transformation, though reported, is extremely rare.- - - - - - - - - - ranking = 0.59268612445719keywords = nerve (Clic here for more details about this article) |
5/60. Hemangiomatosis presenting as meralgia paresthetica.The authors present a 15-year-boy with meralgia paresthetica caused by the recurrence of a diffuse congenital hemangiomatosis in the pelvic region. Relief of the patient's symptoms was achieved by neurolysis of the lateral femoral cutaneous nerve in the thigh and partial excision of the tumor. To our knowledge, hemangiomatosis has never been suggested as a cause of meralgia paresthetica.- - - - - - - - - - ranking = 0.59268612445719keywords = nerve (Clic here for more details about this article) |
6/60. Pedicle myocutaneous flaps for reconstruction following total pelvic exenteration of intrapelvic recurrent rectal cancer: report of a case.A vast metastatic tumor mass of recurrent rectal carcinoma in the intrapelvic organs is commonly considered unsuitable for total pelvic exenteration (TPE); first, because it is unlikely that it would improve the prognosis and health-related quality of life of the patient, and second, because of the difficulties involved in this surgical technique. However, by using a plastic surgery technique involving reconstruction by filling the pelvic dead space with pedicle myocutaneous flaps (PMF), primary wound closure and extensive resection of the perineum can be achieved, whereby postoperative metastasis may be prevented. We report herein the case of a 71-year-old man found to have local recurrence in the perineum with extensive invasion of the soft tissue as well as adjacent organs, 20 months after abdominal perineal resection for rectal carcinoma. TPE with extensive resection of the perineal soft tissue was performed, followed by perineal reconstruction and packing of the pelvic dead space with PMF, mainly constructed from the gracilis and sartorius muscles of both femurs. His postoperative course was uneventful and he has remained free of local recurrence and symptomatic perineal complaints for 1 year. In this report, we examine the effectiveness of using the gracilis muscle for PMF in intrapelvic and perineal reconstruction after TPE.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
7/60. Pelvic neurilemmoma.A case of a 37-year-old man admitted to our Department of internal medicine for medical evaluation of hypertension is reported. The patient had a 4-year history of oscillating hypertension prior to admission, however, with no major subjective complaints, except for pollakisuria. Clinical and biochemical assessment revealed no damage to target organs. Laboratory parameters showed normal values, except for hyperlipidemia. On routine ultrasonography of the pelvis confirmed a pelvic tumor of uncertain etiology, with no abdominal lymph node enlargement. No signs of metastasis were found. The patient was transferred to the Department of Surgery, where the tumor was removed in toto. Histopathologic analysis of the tumor, 11 x 8 x 8 cm in size, composed of cellular and mixoid areas with traces of collagenous connective tissue, necrosis, and tiny calcifications with scattered palisading nuclei and Verocay bodies, pointed to the diagnosis of a benign tumor, i.e. neurilemmoma. Postoperatively, the patient's subjective state was excellent, with normal blood pressure values, and without pollakisuria. A very large space-occupying lesion was responsible for compression of the neighboring organs, especially urinary bladder, resulting in pollakisuria. To our knowledge, pelvic localization of neurilemmoma, particularly a large one, is rare.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
8/60. ultrasonography: an aid in the diagnosis of masses in pediatric patients.Ultrasound was used to evaluate 100 pediatric patients suspected of having a mass. This technique was found to be useful in several ways: (1) differentiation of cystic, solid, and complex masses, which is not usually possible with routine roentgenographic evaluation; (2) delineation of free fluid collections from those that are loculated or contained within masses; (3) measurement of the size of both normal and abnormal structures; and (4) confirmation of the abnormal position or absence of organs. Ultrasound was used as a supplement to routine clinical and radiologic studies.- - - - - - - - - - ranking = 0.5keywords = organ (Clic here for more details about this article) |
9/60. Primary large cell neuroendocrine carcinoma of the presacral region.A 7 cm diameter presacral tumour, not related to the intrapelvic organs, was found in a 51 year old woman. The needle biopsy showed a poorly differentiated large cell carcinoma. The patient died of urosepsis after chemotherapy. Postmortem examination revealed no other primary or metastatic tumour. Histological examination of the presacral tumour showed a large cell carcinoma with a trabecular pattern and strong immunoreactivity for neuroendocrine markers. The tumour was finally classified as a primary large cell neuroendocrine carcinoma of the presacral region.- - - - - - - - - - ranking = 0.5keywords = organ (Clic here for more details about this article) |
10/60. Treatment of giant ancient pelvic schwannoma.A 32-year-old patient presented with urinary retention and chronic constipation. Computerized tomography and magnetic resonance imaging showed a 10 x 11cm encapsulated tumor with cystic areas lying ventral to the sacrum. There was no evidence of invasion of bladder or rectum. At laparotomy, a 10 x 11 cm mass was found in the left pelvis. Final pathology revealed an ancient schwannoma. In most large series, 80% to 90% of the primary retroperitoneal tumors are malignant. Retroperitoneal schwannomas can be benign or malignant, roughly half of the reported cases showed malignancy. Benign schwannomas may arise along the course of any myelinated nerve, with the acoustic neuroma being the most frequent site. Immunostaining showed a strong expression of S-100 protein. The staining for this protein is helpful for differentiation of a benign schwannoma from a malignant peripheral nerve sheath tumor and from other benign spindle cell tumors. The treatment of choice for benign schwannomas is complete excision. recurrence or persistence seems to be associated with incomplete resection, which occurred in 10% of the reported cases. After surgery, the patient had normal erection, normal micturition, and normal defecation but no symptoms of motor and sensory disturbances.- - - - - - - - - - ranking = 1.1853722489144keywords = nerve (Clic here for more details about this article) |
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