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An improved risk of malignancy index in diagnosis of adnexal mass

Chinese Medical Journal 2012年第3期000卷 533-535页

作者： WANG Li-ming SONG Hao SONG Xiao ZHOU Xiao-bin Department of Obstetrics and Gynecology the Affiliated Hospital of Medical College of Qingdao University Qingdao Shandong 266003 China Qingdao Municipal Hospital Qingdao Shandong 266012 China Medical College of Qingdao University Qingdao Shandong 266028 China

Background With the advent of color Doppler flow imaging （CDFI） and technological development of detection of serum tumor markers,new opportunities are presented to the improved risk of malignancy index （RMI） based on Jacobs＇research for predicting ovarian malignancy in patients with adnexal *** One hundred and eighty women with an adnexal mass admitted for primary laparotomy were *** specific growth factor （TSGF） adjusted ultrasound scores and the results of Doppler blood flow analysis were obtained before the *** on the parameters which had been studied in Jacobs＇ research,TSGF levels and the findings of color Doppler flow imaging,the risk of malignancy model was redesigned using a binary Logistic regression *** diagnostic efficacy of the improved risk of malignancy index （improved RMI） was compared with the Jacobs＇model RMI by receiver operator characteristic （ROC） *** The ROC curve showed a higher sensitivity （Mcnamer＇s test,P 〈0.05） in the discrimination between benign and malignant adnexal masses for the improved RMI than the *** with the RMI,the improved RMI had an advantage in prediction of ovarian germ cell tumors and granular cell tumor （28.57% vs.71.43%,P 〈0.05） and the early stage tumors and borderline tumors （33.33% vs.66.67%,P〈0.05）.Conclusion The predictability of the improved RMI is better than the classic Jacobs＇ model,especially in diagnosis of the ovarian germ cell tumors and granular cell tumor and other early stage adnexal tumors.

关键词： improved risk of malignancy index adnexal mass malignant diagnosis

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Current diagnostic approach to patients with adnexal masses: which tools are relevant in routine praxis?

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Chinese Journal of Cancer Research 2013年第1期25卷 55-62页

作者： Milan M. Terzic Jelena Dotlic Ivana Likic Nebojsa Ladjevic Natasa Brndusic Nebojsa Arsenovic Sanja Maricic Tihomir Mihailovic Sasa Andrijasevic Clinic of Obstetrics and Gynecology Clinical Center of Serbia School of Medicine University of Belgrade Center for anesthesiology and resuscitation Clinical Center of Serbia Department of Cellular Pathology PathLinks Pathology Services Lincoln County Hospital Occupational Health Department General Health Center "Savski Venac" Department of Radiology Ultramedica Clinic American Medical Academy

Objective： The aim of the study was to investigate which anamnestic, laboratory and ultrasound parameters used in routine practice could predict the nature of adnexal mass, thus enabling referral to relevant specialist. Methods： Study involved the women treated for adnexal tumors throughout a period of 2 years. On admission, detailed anamnestic and laboratory data were obtained, expert ultrasound scan was performed, and power Doppler index （PDI）, risk of malignancy index （RMI） and body mass index （BMI） were calculated for all patients. Obtained data were related to histopathological findings, and statistically analyzed. Results： The study included 689 women （112 malignant, 544 benignant, and 33 borderline tumors）. Malignant and borderline tumors were more frequent in postmenopausal women （P=0.000）. Women who had benignant tumors had the lowest BMI （P=0.000）. There were significant （P〈0.05） differences among tumor types regarding erythrocyte sedimentation rate, CA125 and carcinoembryonic antigen （CEA） levels. Among ultrasound findings, larger tumor diameter and ascites were more frequent in malignant tumors （P=0.000）. Women with malignant tumors had highest values of RMI and PDI （P=0.000）. Conclusions： Anamnestic data, ultrasound parameters and laboratory analyses were all found to be good discriminating factors among malignant, benignant and borderline tumors.

关键词： adnexal mass risk of malignancy index power Doppler index tumor markers body mass index

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Low-grade mucinous appendiceal neoplasm mimicking an ovarian lesion: A case report and review of literature

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World Journal of Clinical Cases 2021年第10期9卷 2334-2343页

作者： André Luís Borges Catarina Reis-de-Carvalho Martinha Chorão Helena Pereira Dusan Djokovic Department of Obstetrics and Gynecology Hospital de São Francisco Xavier-Centro Hospitalar Lisboa OcidentalLisbon 1449-005Portugal Faculdade de Ciências da Saúde Universidade da Beira InteriorCovilhã6201-001Portugal Department of Obstetrics Gynecology and Reproductive MedicineHospital de Santa Maria-Centro Hospitalar Universitário Lisboa NorteLisbon 1649-028Portugal Department of Pathology Hospital Egas MonizCentro Hospitalar Lisboa OcidentalLisbon 1349-019Portugal Department of Obstetrics and Gynecology Maternidade Dr.Alfredo da Costa-Centro Hospitalar Universitário de Lisboa CentralLisbon 2890-495Portugal Faculdade de Ciências Médicas Nova Medical SchoolLisbon 1169-056Portugal

BACKGROUND Appendiceal tumors are rare lesions that may not be easily differentiated from primary ovarian lesions preoperatively,despite the use of advanced diagnostic methods by experienced *** SUMMARY A 59-year-old G2P2 woman,with chronic pelvic pain,underwent a pelvic ultrasound that revealed an adnexal mass measuring 58 mm×34 mm×36 mm,with irregular borders,heterogeneous echogenicity,no color Doppler vascularization and without acoustic *** ovarian tissue was visualized in contact with the lesion,and it was impossible to separate the lesion from the ovary by applying pressure with the ultrasound ***,peritoneal metastases or other alterations were not *** the international ovarian tumor analysis ADNEX model,the lesion was classified as a malignant tumor(the risk of malignancy was 27.1%,corresponding to Ovarian-adnexal Reporting Data System category 4).Magnetic resonance imaging confirmed the presence of a right adnexal mass,apparently an ovarian tumor measuring 65 mm×35 mm,without signs of invasive or metastatic *** explorative laparotomy,normal morphology of the internal reproductive organs was noted.A solid mobile lesion involved the entire *** was *** of the abdominal cavity revealed no signs of malignant ***,the appendiceal lesion corresponded to a completely resected low-grade mucinous appendiceal neoplasm(LAMN).CONCLUSION The appropriate treatment and team of specialists who should provide health care to patients with seemingly adnexal lesions depend on the nature(benign vs malignant)and origin(gynecological vs nongynecological)of the ***,gynecologists and other pelvic surgeons should be familiar with the imaging signs of LAMN whose clinical presentation is silent or *** assistance of a consultant specializing in intestinal tumors is important support that gynecological surgeons can receive during the operation

关键词： adnexal mass Appendiceal neoplasm Diagnostic imaging Pelvic neoplasm adnexal diseases Pelvic neoplasm Case report

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Ovarian Pregnancy: A Case Report

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Open Journal of Obstetrics and Gynecology 2021年第11期11卷 1446-1451页

作者： Hadja Maïmouna Barro Daff Brahima Donigolo Aïssatou Mbodji Khalifa Babacar Mansour Fall Youssoupha Touré Moussa Diallo Abdoul Aziz Diouf Alassane Diouf Cheikh Anta Diop University of Dakar Gynecological and Obstetrical Clinic Public Institution Aristide-Le Dantec Hospital Da-kar Senegal Department of Obstetrics and Gynecology University Hospital of Pikine Thiaroye Pikine Senegal

Background: Ovarian pregnancy is a rare entity of ectopic pregnancy, with a prevalence in the literature estimated between 1/2500 to 1/5000 births. The majority of ovarian pregnancies are diagnosed in the 1st trimester due to the noisy symptomatology. However, in small proportions, they may continue into the 2nd or 3rd trimester, making their diagnosis more difficult. Aim: We report a case of ovarian pregnancy in a 26-year-old patient, discovered intraoperatively as a large unruptured ovarian mass. Case report: A 26-year-old woman referred to the maternity ward for management of fetal death in utero at 31 weeks of amenorrhea associated with overlying placenta previa. Ultrasound performed in the department, was in favor of an abdominal pregnancy stopped at 31 SA with a placenta that seemed to adhere to the posterior wall of the uterus, which was empty. A Laparotomy was performed, on exploration, a large right ovarian mass was found, the site of the pregnancy. A right adnexectomy, after adhesiolysis, was performed. The incision of the operative part revealed a macerated female fetus. The clinical evolution was favorable. Conclusion: We report on a case of unruptured ovarian pregnancy, discovered in the 3rd trimester of pregnancy. The ultrasound diagnosis of an ovarian pregnancy beyond the 2nd trimester remains a challenge, the management remains surgical.

关键词： Ectopic Pregnancy Ovarian Pregnancy adnexal mass

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Unicentric Castleman’s Disease Presenting as Retroperitoneal Pelvic Lymph Node in Young Female—Laparoscopic Excision: A Case Report

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Open Journal of Obstetrics and Gynecology 2020年第11期10卷 1590-1608页

作者： Divyesh V. Shukla[divyeshshukla@***] Shilpi D. Shukla Amit Shah Sangita Patel Salome Shukla Isha Hospital Sarabhai Campus Vadodara India

Unicentric Castleman’s disease (UCD) is localized lymphoproliferative disease and has favourable prognosis. Surgery offers complete cure of unicentric Castleman disease. Radiotherapy offers either complete response or variable clinical response and cure in selected patients. The present case report is of a young unmarried obese girl presented with pain in right iliac fossa for 2 months. On pelvic ultrasound and MRI performed for diagnosis only single enlarged right external iliac lymph node was the positive finding. The CT scan guided biopsy was performed and the histopathological finding was lymphoid lesion-reactive lymphoid hyperplasia is favoured over Hodgkin’s lymphoma. Successful laparoscopic complete excisional surgery was performed for this single enlarged external iliac lymph node. The final histopathological report of the lymph node removed was unicentric Castleman’s disease, hyaline vascular type. This is the 16th such reported case of pelvic retroperitoneal UCD of hyaline vascular type treated by surgical excision, and 3rd case treated by Laparoscopic excisional surgery. By now at the time of reporting this case 4 months of follow up has been completed and patient does not have any symptom nor not show any sign of residual disease locally on transabdominal ultrasound examination and whole-body PET CT scan is also normal.

关键词： Laparoscopic Surgery Unicentric Castleman’s Disease adnexal mass

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