Gynecology & obstetrics case reports最新文献

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Decompression of hematocolpos caused by acquired obstruction in patient with prior radiation therapy for vaginal cancer. 阴道癌放疗后获得性梗阻所致结肠血液病的减压。

Gynecology & obstetrics case reports

Pub Date : 2021-01-01 Epub Date: 2021-10-21

Adam D Elwood, Eugenia Girda

Background: This report is intended to present a unique patient with acquired vaginal obstruction due to prior radiation therapy and subsequent development of hematocolpos. We present a method of surgical decompression for the hematocolpos as well as this patient's follow-up and prevention of re-epithelialization.

Case: One patient was recruited and consented for this case study. Pre-operative evaluation, including examination and imaging, intra-operative findings, and post-operative evaluation were reported in this study. After surgical evaluation and drainage of hematocolpos via incision and drainage, a foley balloon was placed to prevent re-epithelialization. Intra-operative fluid cultures yielded no growth. At her follow-up appointment, the foley balloon was removed and the vaginal canal was intact without agglutination or re-accumulation of hematocolpos.

Conclusions: This is a unique case of acquired obstruction from radiation therapy causing significant symptomatic hematocolpos. We offer a minimally invasive approach for decompression, evaluation of malignancy, and prevention of re-obstruction. Her post-operative appointment showed resolution of symptoms and patent vaginal canal. Long-term outcomes are still required, including monitoring for malignant recurrence, re-obstruction and stenosis, and sexual health. If re-epithelialization occurs, more definitive therapy will be required, including excision of the vaginal septum or hysterectomy.

背景:本报告旨在介绍一个独特的患者获得性阴道梗阻，由于先前的放疗和随后的发展血性结肠。我们提出了一种手术减压的方法，以及该患者的随访和预防再上皮化。病例:一名患者被招募并同意参加本病例研究。本研究报告了术前评估，包括检查和成像，术中发现和术后评估。在手术评估和通过切口和引流引流结肠后，放置一个foley球囊以防止再上皮化。术中液体培养未见生长。在她的随访预约中，切除了foley球囊，阴道管完好无损，没有凝集或再积血。结论:这是一个独特的病例获得性梗阻放射治疗引起显著症状性血肠。我们提供微创入路减压，评估恶性肿瘤，预防再阻塞。术后就诊显示症状消退，阴道通畅。仍然需要长期结果，包括监测恶性复发、再梗阻和狭窄以及性健康。如果发生再上皮化，则需要更明确的治疗，包括切除阴道间隔或子宫切除术。

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Malignant Struma Ovarii Requiring Emergency Surgery for Acute Abdomen: A Case Report and Literature Review 急腹症需要紧急手术的恶性卵巢瘤:1例报告及文献复习

Gynecology & obstetrics case reports

Pub Date : 2020-01-01 DOI: 10.36648/2471-8165.6.1.86

I. Murakami, Kyoko Tanaka, D. Aoki

Malignant struma ovarii is an extremely rare tumor, accounting for ≤0.1% of all mature cystic teratomas and 0.01% of all ovarian tumors. We herein describe a case involving a patient who underwent emergency surgery for suspected torsion of a mature cystic teratoma that was later diagnosed as malignant struma ovarii. A 23-year-old woman was brought to our hospital with the main complaint of acute lower abdominal pain. Computed tomography revealed a 10-cm-diameter right ovarian tumor with findings suggestive of a mature cystic teratoma. Based on the computed tomography and clinical findings, torsion of the ovarian tumor was suspected; therefore, emergency laparoscopic-assisted surgery was performed. On histopathological examination, the tumor was composed of cells with clear basophilic cytoplasm and a round nucleus. The cells were organized in thyroid follicle-like structures or funicular and solid honeycomb structures, and they exhibited slight nuclear atypia, proliferation, and vascular invasion. The tumor was diagnosed as malignant struma ovarii, and additional surgical resection of the right adnexa with partial omentectomy by laparotomy was performed on a later date. No malignant cells were found in the subsequently resected tissues, and cytologic examination of the ascitic fluid was negative. Because no residual tumor was found, the patient was followed up at the outpatient clinic without additional treatment. No signs of recurrence had been detected at the time of this writing. We herein present this case along with a literature review.

卵巢恶性瘤是一种极为罕见的肿瘤，占所有成熟囊性畸胎瘤的≤0.1%，占卵巢肿瘤的0.01%。我们在此描述一个病例，患者因怀疑成熟囊性畸胎瘤扭转而接受紧急手术，后来被诊断为卵巢恶性肿瘤。一名23岁女性以急性下腹痛主诉来到我院。计算机断层扫描显示一个直径10厘米的右卵巢肿瘤，显示成熟的囊性畸胎瘤。结合ct及临床表现，怀疑卵巢肿瘤扭转;因此，急诊腹腔镜辅助手术。组织病理学检查，肿瘤由嗜碱性细胞质清晰、细胞核圆形的细胞组成。细胞呈甲状腺滤泡样结构或索状和实心蜂窝状结构，表现出轻微的核异型性、增殖和血管浸润。肿瘤被诊断为卵巢恶性瘤，随后行右附件切除及部分网膜剖腹切除术。随后切除的组织中未发现恶性细胞，腹水细胞学检查为阴性。由于未发现肿瘤残留，患者在门诊随访，未接受额外治疗。在撰写本文时，没有发现复发的迹象。我们在此提出这个病例，并进行文献回顾。

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