Inguinal endometriosis: a case report and review of the literature

Inguinal endometriosis is a relatively rare clinical condition, accounting for 1% of extra-uterine locations. Owing to the particular anatomical area affected, the diagnosis in the asymptomatic forms proves difficult. Imaging fails to yield a reliable diagnosis, which is only possible on the basis of histological findings. Rare cases of neoplastic transformation have been reported. The case described here may be emblematic in terms of the migratory pathogenesis of the lesion. Endometriosis is seldom of interest to the general surgeon, since it is generally an exclusively gynaecological condition. Atypical locations, however, do fall within the domain of general surgery, which is what prompted us to review the relevant literature.     

Umbilical endometriosis: report of a case and review of the literature

The authors present a clinical of umbilical endometriosis in a young woman. This patient never underwent any operation or diagnostic abdominal procedures. The case is very interesting because of problems concerning differential diagnosis with other umbilical and periumbilical diseases and pathogenetic theories. In this study the authors suggest a hypothesis to explain the localization of ectopic endometrium in this site. We review the literature, with some comments on therapeutic options; finally we compare the medical and the surgical approach and we suggest an advisable therapy.     

Ureteral endometriosis: a case report and a review of the Japanese literature

A 42-year-old woman was referred to our hospital because of abdominal fullness and a large abdominal mass. Computed tomography (CT) demonstrated bilateral ovarian tumors, uterine myoma and left hydronephrosis. On excretory urography the left kidney was not visualized and retrograde pyelography (RP) revealed left hydronephrosis and a filling defect in the left lower ureter. Based on the diagnoses of endometriosis of bilateral ovaries, uterine myoma and a left ureteral tumor, abdominal total hysterectomy, right salpingo-oophorectomy and partial ureterectomy were performed. Pathologically, in the uterus, both leiomyoma and adenomyosis, and endometriosis of the right ovary and ureter were diagnosed. Medication with buserelin acetate was started.     

Scar endometriosis: A case report and review of the literature

We report a case of a 32‐year‐old woman presenting with scar endometriosis 2 years after a lower segment caesarean section. The epidemiology, pathogenesis, diagnosis, investigations and treatment of the condition are discussed. Endometriosis is a common gynaecological condition; scar endometriosis is a rare subtype and usually arises after a surgical incision. The diagnosis should be considered for abdominal wall masses in women. Herein, we review the literature regarding the occurrence of endometriosis in surgical scars.     

Adenomyoma of the cervix: report of a case and review of the literature

Adenomyoma of the cervix is a rare benign neoplasm, one of a group of benign endocervical lesions that may histologically be confused with an aggressive cervical carcinoma, adenoma malignum. We recently encountered a case that distorted the cervix and pushed it under the pubic symphysis. We present this case, review the literature of this rare lesion, and discuss the differential diagnosis of this group of endocervical lesions.     

Primary cervical amyloidoma: a case report and review of the literature

Background context

Primary solitary amyloidosis or amyloidoma is a disease process characterized by the focal deposition of amyloid in the absence of a plasma cell dyscrasia with normal serum protein measurements. Solitary amyloidomas affecting the vertebrae are very uncommon but typically affect the thoracic spine. Primary cervical amyloidosis is an exceedingly rare entity with exceptionally good prognosis, but requires diligence of the treating physician to establish the diagnosis and implement the appropriate surgical intervention.

Purpose

This study aimed to present a rare case of primary cervical amyloidosis with long-term follow-up and review the clinical presentation, characteristic imaging findings, diagnostic pathology, differential diagnosis, treatment algorithm, and prognosis of the disease entity. This case demonstrates the progressive resorption of the amyloidoma over time after surgical stabilization. Previous reported cases of primary cervical amyloidosis will also be reviewed.

Study design

This study is a report and review of the literature.

Methods

A 77-year-old woman presented with a several-week history of gradual progressive weakness in her upper and lower extremities. Computed tomography and magnetic resonance imaging demonstrated a retro-odontoid nonenhancing soft-tissue mass, with erosive bony changes and severe mass effect on the upper cervical cord. The patient was taken to the operating room for decompression and posterior spinal stabilization.

Results

Intraoperative tissue specimens demonstrated amyloidosis and extensive systemic workup did not reveal any inflammatory processes, systemic amyloidosis, or plasma cell dyscrasia. Postoperatively, the patient regained full strength and ambulatory status. The patient remains asymptomatic at a 2-year follow-up. A postoperative follow-up magnetic resonance imaging demonstrated complete resorption of the residual amyloidoma.

Conclusions

Primary solitary amyloidosis is a rare form of amyloidosis that is important to differentiate given its excellent prognosis with surgical management. Treatment should include surgical decompression and spinal stabilization. This is the first case report to clinically and radiographically demonstrate the progressive resorption of a primary amyloidoma over time after surgical stabilization in the upper cervical spine. It is imperative that surgeons encountering such lesions maintain a high suspicion for this rare disease entity and advise their pathologists accordingly to establish the correct diagnosis.     

Mixed type ureteral endometriosis : a case report and a review of the Japanese literature

Ureteral endometriosis is a rare but important clinical problem that requires early detection and treatment. The urinary tract is affected in approximately 2% of women with endometriosis. Even though the bladder is the most frequent urinary tract organ affected in these patients,the ureter is also affected in 10-40% of the cases, thus requiring immediate clinical attention. The majority of endometrial lesions is typically located in the lower segment of the ureter and is often difficult to differentiate between endometriosis and malignancy. Ureteral endmetriosis should be considered for women with hydronephrosis. In this report we present one clinical case of mixed-type ureteral endometriosis. A 37-year-old woman was referred to our hospital due to left hydronephrosis. Contrast-enhanced CT scan confirmed left hydronephrosis and also showed a solid mass at the left lower ureter. Retrograde pyelography revealed stenosis of the left lower ureter and Renogram revealed severely impaired renal function. Laparoscopic nephroureterectomy was performed. Pathologically, mixed-type endometriosis of the left ureter was diagnosed.     

颈椎术后视力丧失1例报告并文献复习

在脊柱外科手术中,术后视力丧失(PVL)是一种极为罕见但常导致灾难性后果的并发症.PVL最早由Slocum等[1]于1948年提出,主要表现为术后视力、视野的丧失.据国外文献[2]报道,在非眼科手术中,PVL的发生率仅为0.0008％ ～ 0.0030％,但在脊柱手术中达0.2％.然而,许多脊柱外科医师对这一并发症仍较...     

Dysphagia and cervical osteophytosis: case report and review of the literature

Dysphagia with anterior osteophytosis of the cervical bone is a more and more reported affection, especially after the age of 60. However it remains a rare event. The cause to effect relationship between these two entities should be documented by a complete assessment. Surgical treatment is reserved for patients whose medical treatment has failed. We describe an original case of cervical bone osteophytosis which was diagnosed during an acute and febrile aphagia and review the literature about its assessment and treatment.     

Spontaneous cervical epidural hematoma: case report and literature review

BACKGROUND: Spontaneously occurring epidural hematomas for which no etiology is identified are rare phenomenon. These are often neurosurgical emergencies; therefore, prompt diagnosis and treatment are paramount. Because of the rarity of this condition, we have illustrated in this recent case its presentation, evaluation and management. METHODS: A 63-year-old male presented to our emergency room with right-sided hemiparesis and contralateral hypesthesia, consistent with a C5 Brown-Séquard syndrome. An initial evaluation for cerebral infarction was unremarkable, including a negative brain magnetic resonance image. Further imaging revealed a cervical epidural hematoma of unknown etiology. RESULTS: The patient underwent emergent laminectomy for decompression and evacuation of the hematoma within 24 hours of his presentation to the emergency room. The patient's symptoms improved remarkably after surgery and a 4-month follow-up imaging evaluation revealed no recurrence of his hematoma. CONCLUSION: This report highlights the various presentations, evaluation, and management options for this rare diagnosis. It emphasizes the necessity of prompt diagnosis for possible emergent intervention.     

Sigmoid endometriosis and a diagnostic dilemma - A case report and literature review

Introduction

Intestinal endometriosis is often an infrequently considered diagnosis in female of childbearing age by general surgeon. There is a delay in diagnosis because of constellation of symptoms and lack of specific diagnostic modalities. Patients suffer from intestinal endometriosis for many years before they are diagnosed. Often, such patients are labelled with irritable bowel syndrome. Intestinal endometriosis has a diagnostic time delay of 8–11 years due to its non-specific clinical features and multi-system involvement.

Presentation of Case

Our patient was a 32 years old Caucasian female who was referred to us with features of intestinal obstruction. Despite repeated clinical assessments and use of different diagnostic modalities the diagnosis was still inconclusive even after 21 days of her first presentation to primary care physician. She had an exploratory laparotomy, sigmoid colectomy, and Hartmann''s procedure with a temporary colostomy with us. Histopathology confirmed endometriosis and also showed melanosis coli. She was referred to the gynaecological team for review and follow up.

Discussion

Intestinal endometriosis should be considered as a differential diagnosis in female patients of childbearing age group presenting with non-specific gastrointestinal signs and symptoms. Our patient manifested intestinal endometriosis and melanosis coli on histopathology suggesting symptoms of long duration.

Conclusion

Bowel endometriosis is a less considered and often ignored differential diagnosis in acute and chronic abdomen. This condition has considerable effect on patient''s health both physically and psychologically.Abbreviations: bpm, beats per minutes; CA-125, tumour marker for ovarian carcinoma; cm, centimetre; COCPs, combined oral contraceptive pills; CRP, C-reactive protein, an inflammatory marker; CT scan, computerised tomographic scan; e.g., an abbreviation for the Latin phrase exempli gratia. When you mean “for example,” use e.g.; g, gram; g/dl, gram per decilitre; GnRH, gonadotropic releasing hormone; L, litre; mg, milligram; MRI, magnetic resonance imaging; NSAIDs, non steroidal anti-inflammatory drugs; WBC, white blood cell; %, percentage     

Isolated cervical metastasis of breast cancer: a case report and literature review

Metastasis of distant malignancies to the cervix is a rare event. Patients usually present with abnormal bleeding, pain, and dyspareunia. A smaller number of patients are asymptomatic, and their tumors can be diagnosed early by Pap smears. We present 56-year-old woman with a history of intraductal breast cancer that presented with vaginal bleeding. Colposcopic pathology and fractional curettage revealed a lesion similar to her primary breast cancer. She underwent an extensive workup and hysterectomy that revealed no other lesions. Currently, she is alive and well. Cervical metastasis should be considered in women with a history of breast cancer who present with vaginal bleeding. Aggressive treatment of isolated cervical metastasis from breast cancer is warranted in appropriate patients.     

Abnormal cervical smear in hereditary mucoepithelial dysplasia: a case report

Hereditary mucoepithelial dysplasia is a disorder that involves the mucosa, skin, hair, eyes, and lungs. It is an autosomal dominant condition, although sporadic cases have been reported. The syndrome is caused by an abnormality in desmosomes and gap junctions. We report a case of abnormal cervical smear in an affected individual. Vaginal, oral, and urinary cytological smears show a lack of epithelial cell maturation, large paranuclear cytoplasmic vacuoles, and cytoplasmic strand-shaped inclusions. Abnormal Pap cervical tests have been reported in affected individuals. It has been found that a misinterpretation of abnormal from a cervical smear may lead to an unnecessary hysterectomy. We believe this disorder should be brought to the attention of colposcopists because misinterpreted abnormal cervical Pap tests can lead to unnecessary treatment in such affected individuals.     

Acute small bowel obstruction due to ileal endometriosis: a case report and literature review

A young women presented with non-resolving acute small bowel obstruction and was found to have a stricture in the distal ileum at laparotomy. Histologically this was due to endometriosis. Resection of the involved segment gave excellent results.     

Appendiceal diverticulitis,a rare relevant pathology: Presentation of a case report and review of the literature

IntroductionAppendiceal diverticulitis is a rare pathology that mimics acute appendicitis. Appendiceal diverticula are classified into congenital and acquired with difference in incidence and pathogenesis. Appendiceal diverticulitis is often overlooked because of mildness of symptomatology with increasing risk of complications, such as perforation. Appendiceal diverticula are often associated to higher risk of neoplasm especially carcinoid tumors and mucinous adenomas.Presentation of caseA 40-year-old caucasic male presented into Emergency Room with right lower quadrant pain associated with vomit, abdominal tenderness, fever and moderate leukocytosis (11.93 × 10; neutrophils 78.5%). Acute appendicitis was suspected and a surgical approach was chosen with a McBurney access. The removed specimen (Figs. 1 and 2) was 11 cm long with multiple hyperaemic and oedematous diverticular protrusions. The postoperative course was regular. Discharging was on 4th postoperative day in optimal clinical conditions. The histological examination (Fig. 3) showed acute inflammation of appendiceal pseudodiverticula with acute peridiverticulitis and abscess.DiscussionCurrently, appendiceal diverticulitis is often overlooked with high risk of complications, above all perforation. Attention should be kept during the surgical procedure and the patholological examination in order to identify any associated neoplasm.ConclusionAppendiceal diverticulitis should be considered in adult male patients with right lower quadrant pain or tenderness. Accurate appendectomy should be performed in order to permit an appropriate pathological examination and possible associate neoplasm should always be searched through. Prophylactic appendectomy should be performed in case of incidental finding of appendiceal diverticula in asymptomatic patients in order to avoid the high perforation risk.     

Pleural fluid accumulation due to intra-abdominal endometriosis: a case report and review of the literature.

A case is presented of massive ascites and right sided pleural effusion caused by endometriosis. The final diagnosis was not made for a considerable time. Massive ascites and a right sided pleural effusion caused by endometriosis is rare, with fewer than 10 reports in the literature worldwide. Physicians should be aware of this potentially tentially treatable cause, having excluded other possibilities such as malignancy and tuberculosis.