Mesovarian hemangioma presenting as massive ascites, pelvic mass, and elevated CA125

Abstract.   Abu J, Brown L, Ireland D, Sizeland E. Mesovarian hemangioma presenting as massive ascites, pelvic mass, and elevated CA125. Int J Gynecol Cancer 2006; 16(Suppl. 1): 412–414.
We present the case of a 48-year-old woman with pelvic mass, ascites, and an elevated CA125 mimicking advanced-stage ovarian cancer. She underwent laparotomy, drainage of ascites, total abdominal hysterectomy, bilateral salpingo-oophorectomy, and infracolic omentectomy. Histology confirmed this to be mesovarian hemangioma, a benign condition.     

Diaphragmatic hernia presenting in utero as a unilateral hydrothorax

A right-sided diaphragmatic hernia presented as a fetal hydrothorax. The fluid-filled hernial sac enveloped the lung and presumably prevented serious compression effects. The implications of fetal thoracic anomalies are discussed.     

Ovarian capillary hemangioma presenting as an adnexal mass with massive ascites and elevated CA-125

OBJECTIVE: Ovarian hemangiomas are very rare with the majority being cavernous hemangiomas. We report a case of a capillary ovarian hemangioma. METHODS: A case report of a woman with a capillary ovarian hemangioma with massive ascites and an elevated CA-125 is presented. RESULTS: A 39-year-old woman presented with an enlarged ovary containing two ovarian cysts. Her CA-125 was elevated to 872 U/ml. On surgical exploration, she had 1500 cc of clear yellow ascitic fluid and a 7.9 x 6.5 x 4.5 cm left ovarian mass. Frozen section revealed marked stromal edema with luteinized cells and no evidence of malignancy. Histologically, the tumor was a cellular capillary hemangioma with an anastomosing vascular pattern. CONCLUSIONS: This is the first case, reported in the literature, of an ovarian capillary hemangioma presenting with an elevated CA-125 and massive ascites.     

Ovarian hemangioma presenting as pseudo-Meigs' syndrome with elevated CA125

We report the first case of ovarian hemangioma presenting as pseudo-Meigs' syndrome with elevated CA125. Abdominopelvic computed tomography (CT) assumed ovarian carcinoma. Chest CT revealed pleural effusion. Intraoperative frozen-section examination of the right ovary showed benign hemangioma. After operation, chest radiograph and ultrasonography showed no pleural effusion or ascites.     

Ovarian capillary hemangioma presenting as pseudo-Meigs' syndrome: a case report

We report a case of pseudo-Meigs' syndrome, consisting of bilateral ovarian hemangiomas, hydrothorax, ascites, and an elevated CA 125 level, which was resolved after laparoscopic bilateral salpingo-oophorectomy.     

Infarcted ectopic spleen presenting as retroperitoneal mass

Wandering or ectopic spleen is an exceptionally rare condition. Because of the abnormally long pedicle, an ectopic spleen is prone to torsion and infarction. Patients can present with abdominal pain or an acute abdomen. The incidence is over a wide age range, but it occurs with a female predominance in the third to fifth decades. We present a case in a 26-year-old female of an infarcted ectopic spleen, initially thought to be a retroperitoneal mass on computed tomography scan, but found at surgery in the lower abdomen. The minimally invasive gynecologic surgeon needs to be aware of this entity, which may rarely be encountered.     

Pelvic mass presenting as meralgia paresthetica.

A 40-year-old woman presented to her gynecologist with an apparent unilateral neuropathy of the lateral cutaneous femoral nerve of the thigh (meralgia paresthetica). On examination, the sensory disturbance extended outside the usual distribution of the lateral femoral cutaneous nerve, suggesting a more proximal lumbar plexus involvement. She was subsequently found to have uterine fibroid disease. At the time of surgery a large posteriorly situated uterine mass was noted to compress the superior portion of the lumbar plexus. Following surgery, she has been symptom-free.     

A case of partial trisomy 4p syndrome presenting as severe hydronephrosis in utero

We describe the phenotypic features in a newborn infant with an unbalanced translocation 46,XY, der(22) inv(4) (p14p16.1) t(4;22) (p15.1;q13.31)pat. The phenotype was consistent with partial trisomy 4p syndrome. Severe bilateral hydronephrosis was diagnosed at a 31 week prenatal ultrasound scan. Both the patient phenotype and the partial trisomy are unusual, the latter due to the complex nature of the chromosomal rearrangement.     

In utero therapy for fetal thoracic abnormalities

Fetal thoracic lung anomalies are rare. The specific diagnosis can be made by utilizing ultrasound, magnetic resonance imaging (MRI), and Doppler studies. Perinatal surveillance is required for large lesions and mediastinal shift regardless of the pathological diagnosis. These can cause physiological changes in the cardiovascular system with resulting hydrops. In utero therapies are variable but with no large randomized trials to compare risks and benefits. In most cases of fetal lung lesions, continued observation with postnatal therapy is the outcome. When fetal hydrops is present or impending, in utero fetal therapy is required to try to reverse that pathological course associated with fetal or neonatal death. Maternal morbidity is increased with the development of MIRROR syndrome following the presence of long-standing fetal hydrops and possible surgical procedures.     

Pericardial cystic mass with fetal tachycardia

A pericardial cystic mass is a rare congenital anomaly and may be mistaken for other pericardial and pleural masses. A 31-year-old pregnant woman at 38 weeks of gestation presented with fetal pericardial cyst and fetal tachycardia, which were confirmed by transthoracal echocardiography after delivery. Tachycardia did not persist after delivery. The case is being followed up without any clinical problems at the pediatric cardiology clinic.     

Practolol peritonitis presenting as a pelvic mass.

A case of sclerosing fibro-peritonitis occurring as a result of practolol therapy is presented. This may occur months after cessation of the practolol because of other side effects and may present to the gynaecologists as a pelvic mass.     

Benign cystic lymphangioma presenting as a pelvic mass

We report a case of a 48-year-old woman with a complaint of chronic pelvic pain with a pelvic mass not related with uterus or adnexes. Preoperative ultrasonography or contrast enhanced computed tomography did not give accurate information on the origin of tumor. At laparotomy a cystic, retroperitoneal mass was totally resected without rupture. Final histopathological examination revealed that cystic spaces with abundant lymphocytes suggesting lymphangioma. No recurrence was detected in the follow up 6 months after total resection. As a result cystic lymphangioma should be considered as a rare cause of pelvic mass in women.     

Endometrial carcinoma presenting as a large inguinal mass

Patients with endometrial cancer usually present with vaginal bleeding. A case of endometrial cancer presenting as an asymptomatic, large, inguinal mass is reported. This unusual clinical picture and its management are discussed.     

Uterine adenofibroma presenting as a cystic adnexal mass

Uterine adenofibroma is a form of mixed mesodermal tumor in which both the epithelial and stromal components are benign. Almost all previously reported cases have been confined to the endometrium or endocervical mucosa. Our patient presented with a cystic adnexal mass and had a hysterectomy. Correspondence to: O. Gemer     

Gastrointestinal stromal tumor presenting as a pelvic mass

Gastrointestinal stromal tumors (GISTs) are c-kit-positive tumors that may arise anywhere in the tubular gastrointestinal tract. Around 5% of the cases arise elsewhere in the abdominal cavity. Tumors originating in the omentum and mesentery have been reported.A 31-year-old woman presented with pelvic pain, a palpable pelvic mass, and elevated CA-125. Imaging showed innumerable pelvic and abdominal masses. Histopathology showed a GIST that was positive for c-kit and vimentin and negative for desmin and smooth muscle actin. The patient was started on imatinib mesylate. Six months after diagnosis the tumor has remained stable.GI stromal tumors (GIST) may initially present as pelvic mass with elevated CA-125. Imatinib mesylate is the current mainstay therapy for GISTs after surgery.