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Sciatic schwannomas (SSs) are extremely rare, and most are benign. Herein, we report a case of giant SSs in a woman who presented with abdominal pain. Because of the pain pattern and auxiliary examination findings, the patient was initially diagnosed with an ovarian cystadenoma. Magnetic resonance imaging (MRI) revealed an intrapelvic tumor. Histopathological examination confirmed that the mass was a benign intrapelvic schwannoma. Two days after complete tumor resection, the patients experience impaired mobility of the right lower limb. The tumor was 7 × 5.5 × 5 cm3 in size and in contact with the sacrum. The patient was followed up for up to 2 years. No evidence of recurrence was observed in the MRI scan. Severe damages to the sciatic nerve during surgery resulted in permanent neurological deficits. Hence, we also discuss the diagnostic tools and treatments for intrapelvic SSs, as well as the importance of careful radiological examination and multidisciplinary collaboration.

Autoamputation of the ovary is a rare occurrence of uncertain aetiology with only a few cases reported in literature. It usually develops following ovarian torsion or torsion of a dermoid cyst with subsequent necrosis of the pedicle and autoamputation. We present the case of a 42 year-old woman was admitted for a laparoscopic removal of a right ovarian cyst. The ultrasound showed a right ovarian cystic mass suggestive of a cystadenoma, and another heterogeneous small echogenic cyst of the left ovary. During laparoscopy, excessive bleeding from the ovarian cortex complicated the cyst stripping and, considering the age of the patient and the emerging technical difficulty of the procedure, a total adnexectomy for the right ovary was performed. While exploring the small cyst on the left ovary, a dermoid cyst was found in the Douglas pouch. This finding could be interpreted as an autoamputation of the adnexa due to an asymptomatic torsion of a previous ovarian cyst arising from the left ovary. Medical errors could occur due to lack of knowledge, expertise, as well as lack of training and surgical skills, but also due to an unfortunate association of very rare confounding factors. Even in the hands of experts, following the basic rules of surgery remains a milestone in teaching and preventing surgical complications.

The article describes a clinical case of drug resistant miliary tuberculosis in an immunocompetent woman with a multifetal pregnancy after in vitro fertilization (IVF). Difficulties in diagnosing miliary tuberculosis were due to the late detection of the initial focus of infection, that was endometrial tuberculosis, which generalized after IVF. The rare association of isthmic nodose salpingitis and a borderline ovarian tumor (serous ovarian cystadenoma) was a factor complicating the detection of tuberculosis.Conclusion: In an IVF program with bilateral fallopian tube occlusion, tuberculosis should be considered as a possible cause of this pathology. Endometrial tuberculosis is associated with a risk of repeated implantation failure and generalization of the disease.

BACKGROUND Pelvic washing specimens are relatively common and are submitted for patients undergoing gynecologic surgery to evaluate them for metastatic or occult disease. Psammoma bodies are a relatively uncommon finding in these specimens. To date, large-scale studies of their cytologic-histologic correlates and thus clinical significance have been limited. METHODS A 10-year retrospective search for all pelvic washing specimens was performed, and all cases were reviewed for the presence of psammoma bodies. The findings for the corresponding surgical pathology specimens were then catalogued. RESULTS Psammoma bodies were present in 138 cases (3.6% of 3840 total pelvic washings). More than half of the cases (n = 73 [53%]) were associated with benign processes, including mesothelial hyperplasia (n = 44), endosalpingiosis (n = 11), endometriosis (n = 11), and ovarian cystadenoma/cystadenofibroma (n = 7). Nineteen cases (14%) were associated with serous borderline tumors. Malignancies were noted in a third of the cases (n = 46 [33%]) and were most frequently low-grade serous adenocarcinomas (n = 15), high-grade serous adenocarcinomas (n = 11), or endometrioid endometrial carcinomas (n = 8). Patients found to have benign processes (median age, 50 years) or borderline disease (median age, 56 years) were significantly younger than patients with malignancies (median age, 65 years; P

El cistoadenoma seroso de ovario es un tipo de tumor derivado del epitelio celómico superficial. Se denominan quistes ováricos gigantes aquellas que miden más de 10 cm de diámetro o que se extienden por encima del ombligo. En la literatura, algunos casos de quistes ováricos gigantes se han mencionado esporádicamente, especialmente en pacientes posmenopáusicas. Los tumores serosos son comúnmente benignos en 70-80%, 5–10% tiene límite potencial maligno, y 20-25% son malignos. Solo el 10-20% de los casos son bilaterales. Ocurren en adultas de todas las edades, con edades medias reportadas de 40 a 60 años. Se reporta el caso de una mujer posmenopáusica de 79 años con un quiste ovárico izquierdo gigante que mide 14x11x7.5 cm y 794 g de peso conteniendo líquido seroso. Acude a consulta por presentar dolor pélvico tipo cólico irradiada a región lumbar desde hace 4 meses, con antecedente de hipertensión arterial crónica. Teniendo en cuenta la edad y el estado de la menopausia, se le realiza laparotomía para quistectomía izquierda sin ninguna complicación significativa. En el examen histopatológico, el quiste se confirmó como cistoadenoma seroso benigno del ovario. Tuvo evolución posoperatoria favorable.

Ovarian cystadenomas may present in a functional manner. Biochemical workup of seemingly benign ovarian lesions should be considered in the appropriate clinical context.

Mixed epithelial and stromal tumor (MEST) of the kidney is a rare tumor composed of epithelial and stromal cells. Steroid hormones seem to have a role in genesis and evolution of MESTs family, considering the marked female predominance, common history of long-term estrogen replacement, the frequent expression of estrogen (ER) and progesterone (PR) receptors in tumor mesenchymal component. We report the case of a 37-year-old woman admitted to the Department of Surgery because of abdominal pain. She had taken oral estrogen-progestin therapy for 4 years until the age of 35 for dysmenorrhea. During an abdominal ultrasound (US) was identified a left ovarian cyst, 60 mm x 20 mm, suggestive of simple cyst. Then a US repeated after 12 months showed the enlargement of the ovarian cyst (76 mm × 53 mm x 78 mm) and the appearance of a new exophytic cystic-solid mass of 120 mm in the lower pole of the left kidney. The patient underwent laparoscopic left partial nephrectomy and left ovariectomy. Histopathological examination and immunohistochemical analysis was consistent with a MEST of the kidney and a primary serous cystadenoma of the ovary. We report the second case in the literature of a MEST of the kidney along with a primary serous ovarian cystadenoma. We emphasize the hypothesis of the correlation between MESTs and hormonal milieu and the importance of clinical evaluation prior to the administration of any hormone therapy.

Yingying Sun,1,* Xuan Wang,1,* Hexin Wen,2 Bo Zhu,1,3 Lan Yu1,3 1Department of Pathology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, People’s Republic of China; 2Department of Gastrointestinal Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu, People’s Republic of China; 3Bengbu Medical College, Anhui Key Laboratory of Infection and Immunology, Bengbu, People’s Republic of China*These authors contributed equally to this workCorrespondence: Lan YuDepartment of Pathology, The First Affiliated Hospital of Bengbu Medical University, 287, Changhuai Road, Bengbu, Anhui Province, People’s Republic of ChinaTel +86-18555520163Email yulan790210@163.comPurpose: Recurrence and metastasis are the most common causes of high mortality rates in patients with serous ovarian cancer (SOC). Non-structural maintenance of chromosomes (non-SMC) condensin I complex subunit H (NCAPH) is a newly identified essential oncoprotein whose function in SOC pathogenesis has not been reported yet. Angiogenic factor with G patch and FHA domains 1 (AGGF1) is an effective promoter of angiogenesis in humans, leading to cancer cell infiltration and progression. Forkhead box C2 (FOXC2) plays a pivotal role in epithelial-to-mesenchymal transition (EMT). The present study analyzed the correlations among the expressions of these three proteins and their relationships with the clinicopathological characteristics and survival of patients with SOC.Patients and Methods: The expressions of NCAPH, AGGF1, and FOXC2 were detected by the immunohistochemical examination of 153 SOC tissue samples and 30 serous ovarian cystadenoma tissue samples. Clinicopathologic and follow-up data of the patients were collected.Results: The expressions of NCAPH, AGGF1, and FOXC2 were remarkably higher in the SOC tissue samples than in the serous ovarian cystadenoma tissue samples. The protein expressions were positively correlated with the histological tumor grade, the International Federation of Gynecology and Obstetrics (FIGO) stage, lymph node metastasis, and intraperitoneal implantation, but were negatively correlated with the overall survival (OS). Moreover, multivariate analysis showed that the NCAPH, AGGF1, and FOXC2 expressions, FIGO stage, and histological tumor grade were independent adverse prognostic factors for OS in patients with SOC.Conclusion: The results of this study show that the expressions of NCAPH, AGGF1, and FOXC2 are promising biomarkers and possible therapeutic targets in patients with SOC.Keywords: serous ovarian cancer, NCAPH, AGGF1, FOXC2, cancer prognosis

Patient: Female, 72 Final Diagnosis: Benign ovarian mucinous cystadenoma Symptoms: Difficulty breathing and ambulation • heartburn • reflux • early satiety • nausea Medication: — Clinical Procedure: Total abdominal hysterectomy along with bilateral salpingo-oophorectomy Specialty: Obstetrics and Gynecology Objective: Rare disease Background: Mucinous cystadenoma is a benign cystic ovarian tumor arising from the surface epithelium of the ovary; it usually presents with vague, unspecific abdominal symptoms. If not detected early, they have the potential to grow to a substantial size and can present with huge abdominal distention leading to various compression symptoms. Mucinous cystadenomas most commonly occur in the third to sixth decades of life, and rarely occur in extremes of age. The reported incidence of giant ovarian cystadenoma in postmenopausal women is low or relatively unknown due to widespread use of ultrasound and other radiological imaging modalities these days. Here, we report a case of giant mucinous cystadenoma in a 72-year-old postmenopausal woman with multiple comorbidities. Case Report: We present the case of a 72-year-old postmenopausal high-risk patient who presented with a huge abdominal distention which started gradually 1 year before. Abdominopelvic ultrasound showed a left giant multiloculated abdominal cyst. An intact 27-kg ovarian cyst was removed, and a total abdominal hysterectomy (TAH) along with bilateral salpingo-oophorectomy (BSO) was performed. The final histopathological report showed a benign ovarian mucinous cystadenoma. Conclusions: Mucinous cystadenoma is a benign neoplastic disease that can reach a massive size. They are rare in the post-menopausal age group, but when they do occur, they pose a diagnostic and therapeutic challenge. This case report highlights the importance of early detection and management of adnexal masses in postmenopausal high-risk patients to decrease preoperative and postoperative complications and improve quality of life.

An ovarian mucinous cystadenoma is a common benign tumour of the ovary that tends to reach very large sizes. Although traditional morcellation in the abdominal cavity is largely avoided in gynaecologic surgery, several authors have proposed other systems and techniques for the removal of large masses without resorting to laparotomy. We proposed an extremely minimally invasive technique to remove a large mass with a very low suspicion of malignancy, and created a video demonstration of the procedure. In this short film we illustrate our novel technique using only 2 laparoscopic ports, which maximizes both cosmesis and speed of recovery. The technique is not a completely closed system, therefore the potential for spreading an undiagnosed malignancy still exists. Accordingly, the authors do not suggest this technique for masses with a high potential for malignancy. However, in properly consented patients where there is very little suspicion for malignancy, our technique may be a reasonable option to promote fast recovery and provide excellent cosmesis.

Endometrial adenocarcinomas arising in a complete septate uterus with cervical and vaginal duplication are rare. Here, we report a case of stage III endometrioid endometrial adenocarcinoma arising in a complete septate uterus with a double cervix and vagina coupled with a left serous ovarian cystadenoma in a 35-year-old-female patient. The patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy and was addressed to the oncologist for adjuvant radio-chemotherapy. We highlight the symptoms, diagnosis, and therapeutic management, and compare them to the recent literature.

Objective: To construct and validate a combined Nomogram model based on radiomic and semantic features to preoperatively classify serous and mucinous pathological types in patients with ovarian cystadenoma. Methods: A total of 103 patients with pathology-confirmed ovarian cystadenoma who underwent CT examination were collected from two institutions. All cases divided into training cohort (N = 73) and external validation cohort (N = 30). The CT semantic features were identified by two abdominal radiologists. The preprocessed initial CT images were used for CT radiomic features extraction. The LASSO regression were applied to identify optimal radiomic features and construct the Radscore. A Nomogram model was constructed combining the Radscore and the optimal semantic feature. The model performance was evaluated by ROC analysis, calibration curve and decision curve analysis (DCA). Result: Five optimal features were ultimately selected and contributed to the Radscore construction. Unilocular/multilocular identification was significant difference from semantic features. The Nomogram model showed a better performance in both training cohort (AUC = 0.94, 95%CI 0.86-0.98) and external validation cohort (AUC = 0.92, 95%CI 0.76-0.98). The calibration curve and DCA analysis indicated a better accuracy of the Nomogram model for classification than either Radscore or the loculus alone. Conclusion: The Nomogram model combined radiomic and semantic features could be used as imaging biomarker for classification of serous and mucinous types of ovarian cystadenomas.

Specific microRNAs (miRNAs) are packaged in exosomes that regulate processes in tumor development and progression. The current study focuses on the influence of exosomal miRNAs in the pathogenesis of epithelial ovarian cancer (EOC). MiRNA profiles were determined in exosomes from plasma of 106 EOC patients, eight ovarian cystadenoma patients, and 29 healthy women by TaqMan real-time PCR-based miRNA array cards containing 48 different miRNAs. In cell culture experiments, the impact of miR-200b and miR-320 was determined on proliferation and apoptosis of ovarian cancer cell lines. We report that miR-21 (P = 0.0001), miR-100 (P = 0.034), miR-200b (P = 0.008), and miR-320 (P = 0.034) are significantly enriched, whereas miR-16 (P = 0.009), miR-93 (P = 0.014), miR-126 (P = 0.012), and miR-223 (P = 0.029) are underrepresented in exosomes from plasma of EOC patients as compared to those of healthy women. The levels of exosomal miR-23a (P = 0.009, 0.008) and miR-92a (P = 009, 0.034) were lower in ovarian cystadenoma patients than in EOC patients and healthy women, respectively. The exosomal levels of miR-200b correlated with the tumor marker CA125 (P = 0.002) and patient overall survival (P = 0.019). MiR-200b influenced cell proliferation (P = 0.0001) and apoptosis (P < 0.008). Our findings reveal specific exosomal miRNA patterns in EOC and ovarian cystadenoma patients, which are indicative of a role of these miRNAs in the pathogenesis of EOC.

A 61-year-old Caucasian female presented for surgical resection of a 80-kg ovarian cystadenoma. Symptoms included bilateral pedal oedema, a grossly distended abdomen with abdominal venous collaterals secondary to inferior vena cava compression, and intermittent syncope secondary to compression of

We are conducting a prospective study trying to determine, in both sexes, the frequency of appearance of ectopic Leydig cells, their preferred location, their relationship with nerve structures and the possible causes of their appearance. We have studied 86 cases that were removed according to different clinical indications for pathological study: uterine leyomiomas (n = 12), ovarian cystadenoma (n = 4), endometrial hyperplasia (n = 8), endometrial carcinoma (n = 12), cervical carcinoma (n = 4), seminoma (n = 4), fallopian tube ligatures (n = 24), vasectomies (n = 8), nonspecific orchiepididymitis (n = 2), and unknown (n = 8). We have observed ectopic Leydig cells in 13/86 cases (15.11%), 9/72 in the female samples (12.50%) and 4/14 in male samples (28.57%). The most frequent location was the mesosalpinx (4 of 13: 30.76%). These high figures lead us to believe that the ectopia of Leydig cells is not really a pathologic entity, but a finding related to specific functions yet to be determined.

A case of large benign serous cystadenoma in 68 year post hysterectomy woman presented with distension and pain in abdomen. Ultrasonography was suggestive of large multinucleated multiseptic cystic lesion extending from right adnexa up to right hypochondriac and epigastric region measuring 28 cm ×20 cm may be a complex ovarian cyst. Computed tomography (CT) showed 25.9 cm×15cm×23cm multiloculated cyst with multiple internal septations suggestive of ovarian neoplasm such as serious cystadenoma. Exploratory laparotomy with right ovarian cystectomy was done. Mass of 32 cm×25cm×15 cm size of weight 6.2kg was removed and send for frozen section which suggestive of benign serous cystadenoma.

Collision tumors represent a coexistence of two adjacent but histologically distinct tumors without histologic admixture in an organ. Ovarian fibroma is the most common benign stromal tumor. Serous tumors of the ovary are the most common of epithelial tumors. However, a collision between them is a rare pathology mimicking a malignant tumor. We report a 63-year-old woman with sparse postmenopausal bleeding. Ultrasound examination of organs in a small pelvis rounded right ovary formation with hypo and hyperdense sections. Paraclinical: CA125 slightly increased. Histological: collision between two benign ovarian tumors imitating carcinoma.

Mucinous ovarian cystadenoma is a benign tumor, which accounts for 15% of all ovarian tumors and when diagnosed, 80% are benign, 10% limitrophe, and 10% malignant. It is a cyst that arises from the ovary surface epithelium, presenting multilocular features with a plain surface. It is more common between 30- and 50-years old persons and clinical signs differ from other ovarian pathologies because they present rapid growth, reach large dimensions, and evolve with peritoneal pseudomyxoma, causing a significant increase in abdominal volume. Imaging methods such as ultrasonography and computed tomography, as well as the tumor markers CA-125 and CEA, are fundamental for its elucidation and therapeutic planning. We report a case of giant mucinous cystadenoma of the left ovary in a 61-year-old patient admitted to the emergency room.

Giant ovarian cystadenoma is a rare and often late presentation. The mass effect of such tumors can lead to profound respiratory and cardiovascular compromise, predominately through inferior vena cava compression, but also restriction of normal lung function through transdiaphragmatic mass effect and, as is seen in this case, cardiac tamponade. In this article, the authors outline an expedited program of preoperative optimization and a choreographed physiological assessment strategy to functionally assess the hemodynamic consequences of a giant ovarian mucinous neoplasm, thereby informing the safe conduct of anesthesia and surgery.

A female in her thirties fell face down in her room. She was motionless when her sister found her. She was transported to the hospital by ambulance and was in a state of cardiopulmonary arrest on admission. She did not respond to resuscitation. Her abdomen had started to swell 3years before her death. An autopsy was performed to clarify the decedent's cause of death. She was 172cm tall and weighed 146kg. Her maximum abdominal girth was 172.1cm. A subcutaneous hemorrhage measuring 4.5cm in diameter was observed in the epigastric region. The abdominal cavity contained brownish ascites (54.1L). The left ovary was markedly swollen, and the combined weight of the uterus and right ovary was more than 13.0kg. A left ovarian tumor consisting of serous and mucinous cysts was detected. There were no metastatic lesions in the peritoneum or other organs. She might have suffered circulatory disturbance caused by the ascites and ovarian tumor. Moreover, being in a prone position would have resulted in an increase in intra-abdominal pressure, further exacerbating her circulatory problems. Therefore, her cause of death was considered to be circulatory failure caused by significant ascites and a large ovarian tumor.

WOS: 000402089000024, PubMed ID: 28285211, INTRODUCTION: Ectopic adrenal tissue is a very rare entity in adult females, especially in the ovary, and is generally diagnosed incidentally during surgery. Although it can present at various sites during childhood, it becomes atrophic by adulthood due to normally functioning adrenal glands. Patients are predominantly asymptomatic; however, in some cases endocrine symptoms such as hypertension and fasciotruncal obesity due to hormonal activity can be seen or neoplastic transformation can appear. PRESENTATION OF CASE: A 65-year-old patient with progressive pelvic pain and postmenopausal vaginal bleeding was evaluated by transvaginal ultrasound, which revealed bilateral adnexal masses measuring 5 cm in size and a normal uterus with an increased endometrial thickness of 7 mm. Initially the endometrial sampling result was reported as benign. The patient underwent abdominal hysterectomy and bilateral salpingo-oophorectomy and the pathological diagnosis was again benign, with serous ovarian cystadenoma being found in both ovaries. The pathologist also reported incidental ectopic adrenal tissue on the wall of the left ovarian cystadenoma. DISCUSSION: Ectopic adrenal tissue is infrequent in female genital organs especially at older ages. Only a few cases of ovarian ectopic adrenal tissue have been reported. To the best of our knowledge the present case is the fourth report in the English literature, and is of additional importance given the patient's age. CONCLUSION: Ectopic adrenal tissues are generally asymptomatic and revealed incidentally during surgery; however some cases have demonstrated the risk of neoplastic transformation. Therefore, surgeons must be aware of this rare entity that bears the risk of malignancy, and should surgically remove all suspicious lesions. (C) 2017 The Author(s). Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.

Adenomatoid tumor of the ovary is rare, and so are collision tumors in this location. The most common histological combination of ovarian collision tumors is the coexistence of mature cystic teratoma with ovarian cystadenoma or cystadenocarcinoma. Presented herein is a rare case of ovarian adenomatoid tumor found incidentally and coexisting with mature cystic teratoma. A 44-year-old woman presented with a one-year history of intermittent right-sided pelvic pain. Ultrasound evaluation revealed a heterogeneous cystic mass in the right ovary, and a clinical diagnosis of teratoma was made. The patient subsequently underwent a right salpingo-oophorectomy. Pathological examination revealed a mature cystic teratoma and coexistent adenomatoid tumor. The two tumors were separate and no transitional features were recognized histologically. To our knowledge, no previous report of coexistence of these two tumors has been reported. Both tumors are benign and completely excised; therefore no adverse consequences are expected.

The purpose of the present study was to assess the association of regulatory T cells (Tregs; CD4+ FOXP3+) and helper T lymphocytes (Th17) releasing interleukin (IL)-21 and IL-22, with the Risk of Ovarian Malignancy Algorithm (ROMA). Similar association was made with two additional tumour markers, human epididymis protein 4 (HE4) and carbohydrate antigen 125 (CA125) from patients serum. The presence of Tregs and Th17 was determined both in the peripheral blood and in the tissue of epithelial ovarian tumors. Mononuclear cells obtained from patient's peripheral blood (PBMCs) and from ovarian tissue were isolated by density gradient centrifugation. As a control group patients who had undergone surgery for infertility without ovarian pathology were selected. The percentage of Tregs and Th17 releasing IL-21 or IL-22 cells from both peripheral blood and tumor tissue was measured by flow cytometry. No differences in demographic parameters like body mass index, age, or gravidity were observed among the studied groups. However, an increased concentration of marker HE4 and value of ROMA was identified in individuals with ovarian cancer when compared with women with cystadenomas. Furthermore, a negative correlation between the ROMA value in the serum and Tregs from the peripheral blood of patients with cystadenoma ovarian tumors was detected. The presented work documents, for the first time, the negative association between peripheral blood Tregs and ROMA evaluation based on the tumour markers present in the serum of women with ovarian cystadenoma. Such an effect might result from the negative impact of Tregs on the inflammation process and on tumorigenesis caused by the persistent inflammation.

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Benign cystic ovarian tumors are frequent in teenagers and young adults due to hormonal imbalance and thanks to the existence of advanced imaging and early diagnosis methods, these tumors are promptly treated (conservative treatment – hormonal treatment). Occasionally, these tumors reach vast dimensions due to some patient’s negligence and only go to the doctor’s office when the tumor becomes visible to the naked eye. Surgical treatment for benign cystic ovarian tumors is laparoscopic because of the short recovery period and also because of a lower risk of developing postoperative eventration. We present the case of a 20-years-old patient, with history of right gigantic ovarian cystic tumor (~22 cm cranio-caudal diameter) diagnosed in another medical department (with the use of ultrasound, CT, MRI), presented for admission accusing pollakiuria and abdominal distension. Biohumoral testing had no significant alterations, tumor markers (CA 125 and HE4) and ROMA score within the normal range, suggesting the benign character of the tumor, alongside the CT and MRI results. We operated laparoscopic, using Hasson technique to puncture the cyst. The excision of the tumor was difficult (it was adherent to the uterus, the large ligament, parietal pelvic peritoneum and uterine wall). Postoperative evolution was favorable, histopathological examination showed the tumor was an ovarian serous cystadenoma. Conclusion is that periodic ob-gyn consultation and quick medical care in case of genital or abdominal symptoms occurrence could improve the chances of partial or total preservation of the said ovary and better chances of using laparoscopic approach in young patients.

Se presenta el caso de un cistoadenoma seroso de ovario poco común en nuestro medio por sus dimensiones y peso, extirpado en el Servicio de Obstetricia y Ginecología del Hospital Félix Torrealva Gutiérrez, EsSalud de Ica. Paciente de 47 años, analfabeta, obrera, natural de Abancay, con historia de infertilidad primaria, cuadro de distensión y dolor abdominal por ocho años. Con el diagnóstico de tumor gigante de ovario, es sometida a cirugía. Alta en buenas condiciones. COntrol prosterior sin complicaciones.

Pelvic tumors in adolescent females are very uncommon. While the most common presentation is pelvic discomfort, we report the case of a 14-year-old female presenting with menorrhagia which is an unusual initial complaint for a large pelvic tumor. Adolescent females who present with heavy menstrual bleeding initially undergo assessment to rule out a bleeding disorder. In this case, careful history and physical examination helped in making a quick diagnosis and management. Ultrasound of abdomen showed a huge cystic mass due to serous cystadenoma of the ovary.

Background: Giant ovarian tumors are now rarely encountered, because of the wide availability of medical care, and most cases are benign. Case: A rare case of a giant ovarian cystadenoma in a 41-year-old woman, with such severe abdominal distension that she could not walk, is reported. Her abdominal girth was 141 cm. The patient was 151 cm tall and weighed 92.6 kg. Computed tomography (CT) showed a large, multilocular, cystic tumor that occupied the whole abdomen. The preoperative diagnosis was malignant ovarian tumor or ovarian cystadenoma. Results: On laparotomy, gradual intraoperative drainage of the tumor was first performed over 2 hours, and then total hysterectomy with bilateral salpingo-oophorectomy was performed successfully. Pathologic findings confirmed that the tumor was a mucinous cystadenoma. Conclusions: There is a lack of evidence on how to manage such giant tumors in the perioperative period; however, in the present case, intraoperative drainage and tumor resection were safely per...

Epithelial ovarian tumors are common in adult women, but rare in children. Especially mucinous ovarian cystadenoma is extremely rare, with only 16 cases in premenarchal girls reported to date. We present a case of 12-year-old premenarchal girl with symptoms of lower abdominal distension. CT showed a large multilocular tumor spreading throughout the entire abdominal cavity from the right upper quadrant to the pelvic cavity. The tumor was brought out little by little with aspiration of the fluid contents with a small incision. The tumor was found to originate from the left ovary, and oophorectomy was performed. The tumor measured 26 × 18 cm and weighed 5860 g. Histological diagnosis was mucinous ovarian cystadenoma with borderline malignancy. No evidence of recurrence had been seen as of 2 years postoperatively. In the review of premenarchal mucinous borderline ovarian cystadenoma, all cases were stage I and underwent salpingo-oophorectomy or oophorectomy. Those patients were alive without recurrence. Al-though mucinous borderline ovarian cystadenoma was characterized as malignancy, premenarchal cases showed favorable outcomes and salpingo-oohprectomy or oophorectomy appears appropriate.

Deciduosis is a term referred to foci of ectopic decidualized stromal cells thought to be due to a form of “stromal mullerianosis”. The changes are commonly observed in association with pregnancy and are sometimes secondary to exogenous progesterone administration. Deciduosis of various sites have been reported, some of which include the peritoneal surfaces of pelvic and abdominal structures. Deciduosis is usually an incidental finding at caesarean section and runs an asymptomatic benign course, though some articles have reported rarer cases associated with potentially fatal haemoperitoneum, dystocia, and even symptoms mimicking acute bowel obstruction. Although not always clinically significant, deciduosis can prove a difficult diagnostic dilemma clinically and on histopathology as a result of its pseudomalignant morphological appearance.

Women with congenital adrenal hyperplasia (CAH) caused by steroid 21-hydroxylase deficiency show reduced fertility, especially with the salt-wasting form. A 27-year-old pregnant woman with this disease underwent laparotomy and oophorectomy to remove a multilocular ovarian tumor at 14 weeks of pregnancy. This proved to be a mucinous cystadenoma. Toward the third trimester, she presented with marked elevations of 17α-hydroxyprogesterone and plasma renin activity. Careful management of endocrine and body fluid homeostasis allowed her to give birth to a healthy female infant with normal external genitalia. This case illustrates endocrinological parameters during pregnancy in a woman with classical salt-wasting CAH.

Peptidylarginine deiminase type 4 (PADI4) converts arginine residues into citrulline. The current study focused on the expression of PADI4 in various subtypes of ovary cancers, and this study investigated the effects of estrogen on PADI4 expression in SKOV-3 cells that originated from ovary tumors. We utilized immunohistochemistry, real-time PCR and western blotting to analyze the expression of PADI4 in the tumor tissues and in the cell line that were cultured with estrodial-17β. PADI4 was detected in serious cystadenocarcinoma (n=39, positivity=100%), clear cell cancer (n=7, positivity= 100%), mucinous cystadenocarcinoma (n=6, positivity=100%), dysgerminoma (n=6, positivity=100%), squamous cell tumor (n=6, positivity=100%), sibnet-ring cell carcinoma (n=6, positivity=100%), endodermal sinus tumor (n=6, positivity=100%), germ cell tumors (n=6, positivity=100%) and immature teratoma (n=6, positivity=100%). However, PADI4 was either not detected or detected at low levels in granulosa cell tumor (n=6), malignant thecoma (n=6), ovarian cystadenoma (n=5) and normal ovarian tissue (n=11). For serious cystadenocarcinoma, all of the samples with high PADI4 expression belonged to the T1 and T2 stages of pTMN, whereas all of the samples that exhibited weak or moderate PADI4 expression belonged to the T3 and T4 stages. PADI4 was evenly distributed in the cytoplasm of tumor cells of serious cystadenocarcinoma that were classified as being grade II and III by histopathological scoring. However, PADI4 showed granular cellular distribution in the tumor tissues that were isolated from grade I cystadenocarcinoma. In addition, the PADI4 level was positively related with the ages of the patients that presented with serious adenocarcinoma (p=0.029). Real-time PCR and western blot analyses confirmed that PADI4 was expressed at higher levels in ovarian adenocarcinoma (n=8) compared to ovarian cystadenoma (n=5) (p< 0.05). The study also detected an increased level of PADI4 in SKOV-3 cells that were incubated with estrodial-17β in the range of 10(-12) to 10(-4)M. The results suggest an important role for PADI4 in the tumorigenesis of ovary cancers that are under the regulation of estrogen.

The number of ovarian cystadenoma of low potential malignancy (abbreviation: LPM) was 31 (5.7%) among common epithelial tumors [benign cystadenoma = 400 (74.0%), carcinoma = 110 (20.3%)]. Their mean ages, bilaterlity, frequency of ascites and nulligravidity were situated intermediately between those of benign cystadenoma and carcinoma. Abdominal tumor, distention, pain and metromenorrhagia were the main symptoms, although gastrointestinal complaints were rare in LPM cystadenoma. With LPM cystadenoma, 19 (61.3%) patients were at stage I, 7 (22.6%) at stage II and 5 (16.1%) at stage III, but with carcinoma, 44 (40.0%) were at stage III-IV [33 (30.0%) at stage I, and 31 (28.2%) at stage II]. The 5-year actuarial survival rate was 90% for LPM cystadenoma, but 43% for carcinoma. These results suggest that the clinical and biological features as well as the histological definition of LPM cystadenoma are situated intermediately between those of benign cystadenoma and carcinoma.

We describe the perioperative management of a patient requiring removal of a 56.7-kg ovarian cystadenoma, highlighting our techniques in managing the changes in the patient's respiratory, vascular, renal, and gastrointestinal systems due to the large mass. An appreciation of the unique physiologic and anatomical changes in patients with large abdominal masses allows for appropriate precautions in the perioperative period.

Cell cultures of ovarian cystadenomas transfected with SV40 large T antigen are not immortal because they invariably reach a phenomenon called crisis, which is triggered in part by telomere attrition. Recovery from crisis may be an integral component of the malignant transformation process. We reported earlier that such ovarian cystadenoma cell cultures undergo severe changes in DNA ploidy as they approach crisis and that such changes are an important determinant of crisis independent of telomere attrition. Here, we show that in sharp contrast to these benign ovarian tumours, the DNA content of ovarian tumours of low malignant potential (LMP) was remarkably stable as they approached crisis, suggesting that telomere attrition was the main determinant of this mortality checkpoint. Lack of a ploidy-based crisis was not due to loss of expression of a functional SV40 large T antigen protein. We conclude that ovarian LMP tumours are characterised by increased numerical chromosomal stability compared to cystadenomas. This might account for the fact that most LMP tumours are diploid or near diploid in vivo. This fundamental difference in chromosomal stability between ovarian cystadenomas and LMP tumours also suggests potential differences in predisposition to progression to malignancy between these two ovarian tumour subtypes.

Osteopontin (OPN), as a malignant transformation related protein phosphorylation was firstly completed the extraction by Senger in 1979. With the progress of research on osteopontin (OPN), people found out that there was little amount in the normal tissues that was showed with low expression, however, in a variety of malignant tumors, the amount of OPN was over expressed. In this paper, it takes the structure and function of osteopontin as the breakthrough point, exploring the expression and the function of osteopontin (OPN) in ovarian cancer. Introduction Ovarian cancer is one of the common malignant tumors of the female reproductive organs, the incidence rate is inferior to cervical cancer and carcinoma of endometrium, which can rank the third place among the tumors, because there are no symptoms in the early clinical stage of ovarian cancer, and the founded tumors by carrying on operation of laparotomy confined to only 30% of the ovaries.When it was founded, most of them had the diffusion and transferred. Therefore, the mortality rate of ovarian cancer accounted for the first place among all types of gynecological tumors. Osteopontin (OPN) is a kind of secretory calcium binding protein phosphorylated glycoprotein, OPN is associated with gastric cancer, nasopharyngeal carcinoma, lung cancer, while relationship with ovarian cancer was rarely reported in China. The Structure of Osteopontin Osteopontin (OPN) as a malignant transformation of the phosphorylation of protein extraction was earliest extracted by Senger in 1979. In1987 under the control of protein kinase C, it was cloned as a tumor promoter induced genes. Compared with nontransformed cells, it can have high expression in many transformed cells, which also can have the over-expression in many tumors. The human beings' OPN gene is located in 4q13, which is composed of seven exons and six introns. OPN is not only an adhesive protein, but also is a cytokine, which is a kind of secretory calcium binding phosphorylated glycoprotein with multiple functions, and its relative molecular mass is 41500kd. The Ser residue of this acidic protein can be phosphorylated, which can carry with negative charge, at the same time, it is lack of two level structure that can be extended. Encoding the sequence of the single gene is highly conserved in vertebrates, which can be the same with many extracellular matrix proteins, with cell adhesion sequence, namely, the sequence of (Arg-Gly-Asp, RGD). Therefore, it can have regulation on the transcription of the malignant cells. The Function of Osteopontin OPN has many biological functions, which can play roles that may be not exactly the same in different tissues. In the bone matrix, OPN is mainly involved in the resorption and formation of bone; in the tissue of inflammation, it mainly through the effect of cell signal to have transduction, so as to promote the adhesion and migration of inflammatory cells. Xie and other people use antisense gene therapy model to show that OPN can promote the aggregation of macrophage. In addition, as for the aspect of the damages of organs, OPN can play the role of being protective agent, it can increase the tolerance ability of cells to the acute ischemia; 4th International Conference on Mechatronics, Materials, Chemistry and Computer Engineering (ICMMCCE 2015) © 2015. The authors Published by Atlantis Press 1967 restrain the biological synthesis of nitric oxide synthase and nitric oxide; enhance the cell tolerance to hypoxia; reduce the period of cell apoptosis. Parathyroid hormone, vitamin D, calcium, phosphate and so on can promote the expression of OPN both in vitro and vivo; at the same time, estrogen, the inhibitors of angiotensin converting enzyme, angiotensin prime II receptor as well as antagonistic agents can inhibit the expression of OPN. Osteopontin receptor family can be including integrin receptor and CD44 receptor. And the one that can be combined with C terminus belongs to the CD44 family, among them, the combination of OPN-CD44v6 can be carried out by amino acid polycondensation, and the expression of CD44v6 can be the necessary condition for the invasion of tumors. The Expression and Function of Osteopontin in Ovarian Cancer There is a thrombin interaction site in OPN molecule, which can carry out the hydrolization of OPN, after the hydrolysis of OPN molecule and the adhesion of cells will be decreased, Xuan and other people believed that the shear of thrombin on OPN may be a kind of natural physiological regulation of body with functions. In addition, the structure of OPN also can be including a signal peptide sequence, from 7 to 10, a consecutive ASP sequence, and the combined site of calcium, the binding domains of heparin, as well as other multiple functional domains. The unique and complex molecular structure of OPN can make it play a very important role in the promotion of the development process of tumors. OPN can promote the growth and proliferation of tumor cells, inducing the formation of neovascularization, which also can enhance tumor cells to have adhesion and migration through a variety of ways, so as to participate in the invasion and metastasis of tumors. A large number of studies have showed that OPN had close relationship with the occurrence, development, metastasis and prognosis of a lot of malignant tumors. As for the expression of OPN in ovarian cancer, there are some studies both at home and abroad. Kim and other staff studied the expression of OPN in normal ovarian tissues, ovarian borderline tumors and malignant ovarian tumor tissue by adopting the immunohistochemical method. The results showed that there was no expression of OPN in normal ovarian tissues, however, the expression positive rate in malignant ovarian tissue was significantly higher than that of the positive rate in borderline tumors, which was statistically significant not only in the occurrence of ovarian cancer, but also in the process of development with its great significance. Rosen and other researching staff found out that there was no expression of OPN in the normal ovarian cells, but in ovarian cystadenoma, borderline ovarian tumor and serous ovarian cancer, the expression of them was increased gradually, which also can indicate that there is a close relationship between the occurrence and development of ovarian cancer with OPN.

Background Benign ovarian neoplasms originating from epithelial tissue are common tumors in adult women. However, they are rarely seen in the pediatric population, especially in the first decade of life. Case We report a case of a 6-year-old, premenarchal girl, previously healthy, with frequent micturition lasting 3 days prior to the first examination, without discomfort or pain. Laboratory analyses of blood and urine showed no abnormalities. Repeated ultrasonographic examinations revealed bilateral, cystic, rapidly growing ovarian masses. Cysts were surgically removed, with preservation of normal ovarian tissue, and histopathologic findings showed a serous cystadenoma of both ovaries.

BACKGROUND Psammoma bodies (PBs) are encountered only rarely in body cavity fluids (BCF). Although to the authors' knowledge their presence in certain neoplasms (e.g., those of the thyroid, ovary, lung, brain, etc.) is established, their significance in BCF has not been well defined. METHODS Diagnoses concerning 3335 BCF samples were reviewed from the cytopathology files for the presence of PBs over an 8-year period. Cytologic preparations included cytospin preparations and Millipore filters stained with the Papanicolaou stain. Clinicopathologic correlation was performed on any subsequent surgical studies. RESULTS Of the 3335 BCF samples studies (2444 pleural samples, 688 peritoneal samples, and 203 pericardial samples), PBs were noted in 123 cases (3.7%). Of these 123 cases, 112 were the peritoneal fluid (91%), 10 were the pleural fluid (8.1%), and 1 was in the pericardial fluid (0.81%). All 11 cases of pleural and pericardial effusions with PBs were malignant (carcinomas of the thyroid, lung, and ovary) compared with 62 of 112 peritoneal fluid samples (55.4%) (carcinoma of the ovary and uterus and mesothelioma). Nine of the remaining 50 cases of cytologically benign peritoneal fluids with PBs detected on follow-up tissue biopsy demonstrated peritoneal metastases from ovarian or endometrial carcinoma. Therefore, 41 of 112 cases of peritoneal fluid with PBs remained benign even after clinical follow-up and/or tissue biopsy (36.6%) and demonstrated ovarian cystadenoma/cystadenofibroma, papillary mesothelial hyperplasia, endosalpingiosis, endometriosis, and other miscellaneous benign diagnoses. CONCLUSIONS PBs in BCF is a rare finding. Although in the authors' experience their presence in pleural and pericardial effusions signifies carcinomatous involvement, in the current study, peritoneal fluids with PBs were found to be benign in a significant number of cases (36.6%). In the latter scenario and in the absence of an obvious malignancy, attempts should be made to rule out the above-mentioned benign lesions. Cancer (Cancer Cytopathol) 2004. © 2004 American Cancer Society.

he specific preoperative diagnosis of a pelvic mass can be challenging despite the excellent anatomic detail provided by sonographic imaging of the female pelvis. There is a wide spectrum of possible differential diagnoses of a complex pelvic mass, including benign ovarian cysts, ovarian carcinoma, hydrosalpinx, tubo-ovarian abscess, gastrointestinal conditions (e.g., inflammatory bowel disease, mucocele, and abscess), peritoneal causes (e.g., pseudocyst, malignancy, and tuberculous peritonitis), lymphoma, and mesothelioma. This report describes a case of tuberculous peritonitis in a young woman with a large pelvic mass and sonographic features mimicking those of an ovarian cystadenoma.

The antigens encoded by the major histocompability complex (HLA-DR) are cell glycoproteins that play a fundamental role in the regulation of the immune response. The prognosis of ovarian cancer is dependent on the histological type and on the clinical stage at diagnosis. Our study reports the value of HLA-DR antigen as a prognostic marker of ovarian serous adenocarcinoma. We studied 31 cases of serous ovarian cystadenoma, 12 cases of serous ovarian borderline cystadenoma, and 39 cases of well-differentiated cystadenocarcinoma for HLA-DR monoclonal antigen. We also studied the T helper marker (CD4) in the tumor stroma of the relevant cases, given that it is now known that the dependence of immune responsiveness on the class II antigens reflects the central role of these molecules in presenting antigen to T helper cells. HLA-DR was expressed in 20 of 31 cystadenomas (64.5%), 4 of 12 borderline tumors (33.3%), and in 10 of 39 invasive carcinomas (25.6%). CD4 was expressed in 9 of 31 cystadenomas (29%), 5 of 12 borderline tumors (42%), and in 26 of 39 invasive carcinomas (67%). There was a statistically significant difference for the two examined antigens in cystadenomas ( p

A potential tetrasaccharide ligand for E-selectin, (Na(+-)O(3)SO-3)Galbeta-(1--4)[Fucalpha-(1--3)]Glcbeta-(1--6)Gal, an analogue of the ovarian cystadenoma glycoprotein tetrasaccharide fragment, was synthesized in a highly practical way.

In adolescent Ovarian cysts are an extremely common gynaecological problem. Majority of ovarian cysts are benign with few cases being malignant. Ovarian serous cystadenomas are rare in children. A 14-year-old presented with severe abdominal pain and abdominal distention. She underwent emergency laparotomy and surgical removal, the mass was found to be torsion of ovarian serous cystadenoma-fibroma on histology. In conclusions, germ cell tumours the most important causes for the giant ovarian masses in children. Epithelial tumours should not be forgotten in the differential diagnosis.

We report on an exceedingly rare case of cutaneous and uterine leiomyomatosis in a 58-year-old Caucasian woman associated with ovarian cystadenoma and complete deletion of the fumarate hydratase gene. All patients and their family members with verified mutation have to be regularly screened for associated neoplasms, in particular papillary renal cell carcinoma (HLRCC, hereditary leiomyomatosis and renal cell cancer).

A 59-yr-old, captive female African elephant (Loxodonta africana) died of a cardiovascular collapse. Necropsy revealed bilateral replacement of the ovarian tissue by multiple cystic formations of up to 10 cm in diameter. The cysts were thin walled and filled with clear watery fluid. Smaller solid masses with an irregular surface projected from the wall of a few of the cysts. Histologically, the cystic structures were characterized by a single layer of well-differentiated cuboidal epithelial cells resting on a basement membrane. Occasionally the cysts contained nodular proliferations of single-layered, well-differentiated cuboidal epithelial cells forming anastomosing tubules and occasional papillary projections. The ovarian neoplasia was diagnosed as a bilateral multilocular serous ovarian cystadenoma. The nulliparous status and the advanced age may have contributed to the ovarian pathology.