Pelvic mass

盆腔肿块
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  • 文章类型: Case Reports
    盆腔肿块通常起源于盆腔,通常与子宫有关。卵巢,或肠道疾病。本报告描述了我院诊断为腹膜后皮样囊肿的盆腔肿块患者的情况。我们对这个案例进行了分析和文献综述,减少误诊风险,加强腹膜后肿块的治疗。
    Pelvic masses frequently originate from the pelvic cavity and are often associated with uterine, ovarian, or intestinal disorders. This report describes the case of a patient with a pelvic mass diagnosed as a retroperitoneal dermoid cyst at our hospital. We analyzed this case and conducted a literature review, to mitigate the risk of misdiagnosis and enhance the treatment of retroperitoneal masses.
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  • 文章类型: Case Reports
    异位肾脏是一种罕见的先天性缺陷,通常无症状,但可以在影像学检查中偶然发现。此外,异位肾脏的形态学特征和实验室特征是非特异性的,这可能会导致误导性的诊断方法,特别是当有其他因素时,如感染,阻塞,或其他异常。一名43岁的女性在左附件区域出现肿块。她有纵隔子宫和先天性尿失禁的病史。超声和MRI显示肿块为起源于卵巢的囊肿。然而,肿块可能来自泌尿系统。为了确认诊断,进行了腹腔镜检查,然后进行病理检查,这证实了单系统异位输尿管异位肾的存在。患者接受了肾输尿管切除术,她的症状成功缓解了,导致良好的预后。此病例报告重点介绍了一例罕见病例,涉及异位肾脏和阴道异位输尿管,最初表现为附件囊肿并引起尿流。该病例强调了对症状相似的女性进行早期识别和准确诊断的重要性。
    An ectopic kidney is a rare congenital defect that is often asymptomatic, but can be incidentally discovered during imaging examinations. Moreover, the morphological characteristics and laboratory features of ectopic kidneys are nonspecific, which may lead to misleading diagnostic approaches, particularly when there are additional factors, such as infection, obstruction, or other anomalies. A 43-year-old female presented with a mass in the left adnexal area. She had septate uterus and a history of congenital urinary incontinence. Ultrasound and MRI findings indicated that the mass was a cyst originating from the ovary. However, it is possible that the lump was derived from the urinary system. To confirm the diagnosis, laparoscopy was performed, followed by pathological examination, which confirmed the presence of an ectopic kidney with a single-system ectopic ureter. The patient underwent nephroureterectomy, and her symptoms successfully resolved, leading to a favorable prognosis. This case report highlights a rare case involving an ectopic kidney with a vaginal ectopic ureter that initially presented as an adnexal cyst and caused urinary dribbling. This case emphasizes the importance of early recognition and accurate diagnosis in women with similar symptoms.
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  • 文章类型: Case Reports
    我们介绍了一例罕见的女性盆腔孤立性纤维瘤,使用单孔腹腔镜检查未成功切除,需要转换为剖腹手术。虽然切除成功,手术方法本可以得到改进。对于大肿瘤,通过灵活选择设备和切口位置,可以获得微创效果。
    We present a rare case of a female pelvic solitary fibrous tumor unsuccessfully resected using single-port laparoscopy, requiring conversion to laparotomy. Although the resection was successful, the surgical approach could have been improved. For large tumors, minimally invasive results are possible with flexible choices of equipment and incision position.
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  • 文章类型: Journal Article
    宫颈癌,子宫内膜癌,卵巢癌是女性最常见的十大癌症之一,尤其是卵巢癌被认为是“沉默的杀手”。因此,早期发现,诊断,和治疗是照顾妇女健康的重要手段。本研究探讨超声造影定量分析在盆腔良恶性肿瘤鉴别诊断中的临床价值。
    对151例盆腔肿块患者行CEUS。随后,使用图像增强特征和肿瘤参数完成定性诊断.对CEUS图像进行了多参数分析,其中包括以下参数:到达时间(AT),达到峰值的时间(TTP)峰值强度(PI),和上升坡度(AS)。此外,在多参数分析中评估了CEUS的定性诊断效率,并将结果与病理结果进行比较。
    恶性组患者年龄较大(P=0.001),病变PI值大于良性组(P<0.01)。同一患者的子宫肌层和病变组织之间的PI差(PId)和AS差(ASd)显示出统计学差异(P<0.01)。此外,Pid和ASd显示最大的受试者工作特征(ROC)曲线和ROC曲线下面积(AUC),敏感性为90.9%和91.7%,特异性为86.4%和72.5%,分别。
    CEUS的定量分析提供了一种新的,更简单,为临床上盆腔良恶性肿块的鉴别诊断提供更准确的方法。与同一患者的其他参数相比,PId和ASd的敏感性和特异性更高。
    UNASSIGNED: Cervical cancer, endometrial cancer, and ovarian cancer are among the top 10 most common cancers in women, with ovarian cancer in particular being considered a \"silent killer\". Therefore, early detection, diagnosis, and treatment constitute important means of care for women\'s health. This study investigated the clinical value of the quantitative analysis of contrast-enhanced ultrasonography (CEUS) in the differential diagnosis of benign and malignant pelvic tumors.
    UNASSIGNED: CEUS was performed on 151 patients with pelvic masses. Subsequently, a qualitative diagnosis was completed using the image enhancement features and tumor parameters. A multiparametric analysis of CEUS images was performed, which included the following parameters: arrival time (AT), time to peak (TTP), peak intensity (PI), and ascent slope (AS). In addition, the qualitative diagnostic efficiency of CEUS was assessed in a multiparametric analysis, and the results were compared with pathological findings.
    UNASSIGNED: The patients in the malignant group were older (P=0.001) and had larger lesion PI values (P<0.01) than those in the benign group. The PI difference (PId) and the AS difference (ASd) showed statistical differences (P<0.01) between the myometrium and lesion tissues in the same patient. Moreover, the PId and ASd showed the largest receiver operating characteristic (ROC) curve and area under the ROC curve (AUC), with sensitivities of 90.9% and 91.7% and specificities of 86.4% and 72.5%, respectively.
    UNASSIGNED: The quantitative analysis of CEUS provides a new, simpler, and more accurate method for the differential diagnosis of benign and malignant pelvic masses in clinical practice. The sensitivities and specificities of PId and ASd were higher compared to other parameters from the same patient.
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  • 文章类型: Case Reports
    宫颈腺癌占宫颈癌总病例的10%-25%。但近年来,腺癌的发病率呈比例和绝对上升。临床上,大多数宫颈腺癌没有症状或出现异常子宫出血或阴道分泌物,类似于鳞状细胞癌。不同的是,宫颈细胞学检查显示宫颈腺癌的假阴性率高,可能导致早期检测失败。这份报告提供了两个都有骨盆肿块的病例,大量腹水是最初的症状,这与卵巢癌的临床症状相似,但最终通过手术标本确诊为宫颈腺癌.关于这种情况的文献报道很少。因此,还进行了文献综述,以提高对表现为盆腔肿块和大量腹水的宫颈腺癌的认识,避免误诊。
    Cervical adenocarcinoma accounts for 10%-25% of total cases of cervical carcinoma. But in recent years, the incidence of adenocarcinoma has risen both proportionally and absolutely. Clinically, most cervical adenocarcinoma show no symptom or present with abnormal uterine bleeding or vaginal discharge, similar to squamous cell carcinoma. What different about it is that cervical cytological testing demonstrates a high false-negative rate of cervical adenocarcinoma, potentially leading to the failure in detecting in early stage. This report presents two cases both with pelvic masses, and massive ascites served as the initial symptom, which is similar to the clinical symptom of ovarian cancer, but ultimately diagnosed with cervical adenocarcinoma through surgical specimens. There are few literature reports on this situation. Hence, a literature review also has been performed to improve the recognition for cervical adenocarcinoma presenting with pelvic masses and massive ascites, and to avoid misdiagnosis.
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  • 文章类型: Review
    背景:剖宫产瘢痕缺损(CSD)表现为囊性缺损,连接先前剖宫产(CS)部位的子宫腔。子宫内膜异位症是指在子宫腔外发现子宫内膜腺体和间质。尚未报道CSD子宫内膜异位囊肿的病例。
    方法:在本文中,我们将在CSD出现子宫内膜异位囊肿的患者,其症状是月经周期延长,没有周期性腹痛的时期,有剖宫产史.妇科超声显示子宫右前方有CSD和混合肿块。大约一个月后,肿瘤由直径4.75cm增长到8.06×6.23×3.66cm。病人最终做了手术,这显示出一个从子宫前壁切口突出的肿块,它通过一个光滑表面的细尖附着在子宫前壁上。术中快速细胞病理学检查提示在平滑肌组织内可见子宫内膜腺体,与子宫内膜异位症相似。随后,患者接受了子宫内膜异位囊肿切除术。最终石蜡病理示:平滑肌伴可见子宫内膜腺体,陈旧性出血,1年随访显示CSD无子宫内膜异位囊肿复发。
    结论:CSD子宫内膜异位症囊肿非常罕见。临床症状可能不太明显,诊断主要依赖于患者的既往手术史和影像学。在CSD的位置发现了骨盆肿块,有或没有月经变化和间歇性腹痛的症状,应在CSD考虑子宫内膜异位囊肿。手术治疗是治疗本病的好选择。需要进一步研究这种情况的病因机制以及为什么肿块在一口中迅速扩大。
    BACKGROUND: Cesarean scar defect (CSD) presents as a cystic defect that connects the uterine cavity at the site of the previous cesarean section (CS). Endometriosis refers to the discovery of endometrial glands and stroma outside the uterine cavity. Cases of endometriosis cysts at CSD have not been reported.
    METHODS: In this article, we will present a patient with an endometriosis cyst at CSD with symptoms of a prolonged menstrual cycle, periods without cyclic abdominal pain, and a history of cesarean delivery. The gynecologic ultrasound showed a CSD and a mixed mass in the right front of the uterus. After about 1 month, the tumor grew from a diameter of 4.75 cm to 8.06 × 6.23 × 3.66 cm. The patient eventually had an operation, which revealed a mass protruding from the incision in the anterior uterine wall, which was attached to the anterior uterine wall by a thin tip with a smooth surface. Intraoperative rapid cytopathology suggested that endometrial glands were seen within the smooth muscle tissue, similar to endometriosis. Subsequently, the patient underwent resection of the endometriotic cyst. Final paraffin pathology showed smooth muscle with visible endometrial glands and old hemorrhage, and a one-year follow-up showed no recurrence of endometriosis cysts at CSD.
    CONCLUSIONS: Endometriosis cysts at CSD are very rare. The clinical symptoms may be less obvious, and the diagnosis relies mainly on the patient\'s previous surgical history and imaging. A finding of a pelvic mass in the location of the CSD, with or without symptoms of menstrual changes and intermittent abdominal pain, should be considered an endometriotic cyst at CSD. Surgical treatment is a good choice for this disease. Further studies are needed regarding the etiological mechanism of this case and why the mass enlarged rapidly in one mouth.
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  • 文章类型: Case Reports
    原发性精囊肿瘤极为罕见。已经报道了几种罕见的原发性精囊肿瘤病理类型,比如腺癌,但是没有关于腺纤维瘤的报告.我们报告了第一例由精囊引起的腺纤维瘤。一个50岁的男人,没有任何其他肿瘤的病史或临床证据,在超声检查中意外发现盆腔肿块。随着质量的增长,病人出现轻度便秘,没有泌尿生殖系统或其他症状。所有实验室检查均正常。骨盆的MRI显示混合密度,尺寸11.7×9.9×8.2cm,界限分明的质量。直肠,膀胱,前列腺和淋巴结正常。我们成功地进行了开放手术并切除了肿块。组织病理学结果证实该肿块为原发性精囊腺纤维瘤。在文学中,我们发现对于双相分化肿瘤,穿刺不足容易降低病理诊断的准确性。因此,精囊肿瘤的术前穿刺活检应进一步研究。
    Primary seminal vesicle tumors are extremely rare. Several rare pathological types of primary seminal vesicle tumors have been reported, such as adenocarcinoma, but there is no report on adenofibroma. We report the first case of adenofibroma arising from the seminal vesicle. A 50-year-old man, with no history or clinical evidence of any other tumors, accidentally found a pelvic mass during an ultrasound examination. As the mass grew, the patient developed mild constipation, without genitourinary or other symptoms. All laboratory examinations were normal. MRI of the pelvis revealed a mixed density, measuring 11.7×9.9×8.2cm, well circumscribed mass. The rectum, bladder, prostate and lymph nodes were normal. We successfully performed the open surgery and removed the mass. Histopathological results confirmed that the mass was a primary seminal vesicle adenofibroma. In literature, we found that for biphasic differentiated tumors, it is easy to reduce the accuracy of pathological diagnosis because of insufficient puncture. Therefore, preoperative puncture biopsy for seminal vesicle tumors should be investigated further.
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