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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a case of a 21 years old woman, pregnant (14.1 weeks of gestation), and with 24 hours of abdominal pain received at the emergency room. During examination we found gravid uterus and a mass in the right inguinal area and flank, independent from uterus, painful and with no uterine activity. We perform an obstetric ultrasound with this results: 13 weeks pregnancy and right adnexal cystic tumor with 15 x 14 cm. Patient undergo to emergency exploratory laparotomy, with previous application of indomethacin end progesterone. During surgery performance we observe a bilateral adnexal masse, right side affecting the complete ovary (salpingactomized), and left side extirpated leaving functional tissue ovary. Three days after, patient leaves the hospital without any complication. Pathology reports a bilateral mature teratoma.
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PMID:[Bilateral mature teratoma and pregnancy: case report]. 1880 May 90

Adenomatoid tumor is a benign, usually small lesion that may be found within the wall of fallopian tubes or beneath the uterine serosa near the uterine cornu. It is often accompanied by smooth muscle hypertrophy that may obscure the adenomatoid tumor. We herein report a very unusual case of infarcted leiomyoadenomatoid tumor of the uterus and ovary in a 24-year-old woman who presented with severe lower abdominal pain and masses in the uterus and right ovary. Pelvic ultrasonography and computed tomography revealed a 5 cm mass in the myometrium and a 4 cm mass in the right ovary. Laparoscopy-assisted transvaginal mass removal was performed under the clinical impression of a uterine leiomyoma and benign ovarian teratoma. On a microscopic examination, prominent fascicles of smooth muscle separated or infiltrated by cuboidal or signet ring-like vacuolated cells, as well as tubular formations lined by flattened mesothelial cells and extensive necrosis were observed in both masses. The microscopic appearance often suggested the possibility of a malignant neoplasm due to irregular pseudoinfiltration with atypical cuboidal cells and the paucity of a typical adenomatoid tumor due to infarction, and the presence of epithelial-appearing cells in the hypertrophic smooth muscle bundles that mimicked an infiltrating carcinoma for a leiomyoma or myometrium. These unemphasized features of leiomyoadenomatoid tumors may potentially lead to more aggressive therapy than warranted if not correctly interpreted, especially for infarcted cases.
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PMID:Multicentric infarcted leiomyoadenomatoid tumor: a case report. 1883 Mar 86

Sclerosing mesenteritis is a rare, benign, and chronic fibrosing inflammation disease with unknown etiology that affects the mesentery of small bowel and colon. The disease has two well-established histological types: the acute or subacute form known as mesenteric panniculitis and the chronic form known as retractile or sclerosing mesenteritis. Because the sclerosing mesenteritis is lack of special clinical manifestation and typical signs, so the patients are very easy to be misdiagnosed. The correct diagnosis of sclerosing mesenteritis depends on pathological examination and exploratory laparotomy. We report a case of sclerosing mesenteritis in a 52-year-old male who presented with chronic abdominal pain and intraabdominal mass. This patient had a long-term and heavy drinking history. He was misdiagnosed as celiac teratoma by CT examination and then underwent an exploratory laparotomy at March 2 2004. A mass, its diameter being about 5 cm, was detected in mesentery of distal ileum. Although a few small intestines tightly adhered on the mass, the involved intestine had no obstruction. The intraoperative biopsy indicated that it was an inflammatory mass. The mass and adhered intestines were removed. He was diagnosed with sclerosing mesenteritis by histopathological examination of paraffin section. After operation, this patient went well and lives without recrudescence at the time we wrote this paper.
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PMID:Sclerosing mesenteritis as a rare cause of abdominal pain and intraabdominal mass: a cases report and review of the literature. 1892 52

Ovarian masses in the pediatric age group are rare, and malignancies are even less common. We reviewed our large single-center experience to determine the rate of malignancy and discuss management. We retrospectively reviewed the cases of ovarian masses in children in our institution over a 10-year period. Demographic and tumor-specific data were reviewed and analyzed, and a Student's unpaired t test was used where appropriate. A total of 49 children and adolescents with ovarian masses were found. The mean age at presentation was 13.3 years. Eight masses were malignant (16%) with malignant teratoma, dysgerminoma, and germ cell tumors found. These patients responded to chemotherapy, but there were three recurrences noted that responded to further therapy. Seventy-four per cent of the benign tumors were teratomas. The most common presentation was abdominal pain in 27 patients (55%) followed by an abdominal mass. Ultrasound and CT scans were the most common imaging studies with a mean mass size of 14.7 cm. A majority of the patients underwent a laparotomy with 12 per cent having a minimally invasive procedure. Only 37 per cent of the operations were performed by the pediatric surgeons. There were no deaths in this series after a follow up of over 6 years. Most ovarian masses in childhood are benign. Malignant lesions have favorable outcomes with chemotherapy, even with recurrent disease. Consideration for laparoscopic procedures should be given for the benign lesions.
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PMID:Management and outcomes of ovarian masses in children and adolescents. 1906 61

A 47-year-old woman who presented with abdominal pain was found to have a 20 cm cystic retroperitoneal mass. Pathology indicated a colonic-type adenocarcinoma arising in a primary retroperitoneal mature cystic teratoma. The adenocarcinoma was predominantly intracystic with focal superficial invasion into the cyst wall but not beyond the teratoma capsule. Immunohistochemistry showed that the adenocarcinoma cells were diffusely positive for cytokeratin 20 (CK20) and caudal-type homeobox transcription factor-2 (CDX2) but negative for CK7, confirming the colonic phenotype. In addition, the adenocarcinoma was seen adjacent to teratomatous colonic-type mucosa with adenomatous change (i.e. adenoma), suggesting that it was probably arising from a colonic-type adenoma within the teratoma. The carcinoma had a higher Ki-67 proliferation index and had a higher percentage of cells stained for p53 than the adjacent adenomatous lesion. To the authors' knowledge this is the first documented case in which a colonic-type adenocarcinoma was seen arising from a precursor lesion (i.e. a colonic-type adenoma in a primary retroperitoneal mature cystic teratoma) and is the second case of intestinal-type adenocarcinoma arising in a primary retroperitoneal mature cystic teratoma.
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PMID:Colonic-type adenocarcinoma arising in a primary retroperitoneal mature cystic teratoma. 1906 55

A case of mature cystic teratoma that contained florid vascular proliferation is reported. The ovarian tumor occurred in a 9-year-old girl; symptoms consisted of vomiting, abdominal pain and a palpable mass. The microscopic findings were mostly typical of a mature cystic teratoma, but also abundant vascular proliferation mimicking hemangioma in association with mature neural tissue was observed. There was a disorganized arrangement of medium- and large-sized spaces lined by cuboidal endothelial cells. Immunohistochemical staining for vascular proliferation showed immunoreactivity for CD31 and smooth muscle actin. Florid vascular proliferation may be seen in association with neural tissue of ovarian teratomas and should not be misdiagnosed as immature teratoma or a vascular neoplasm.
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PMID:Florid vascular proliferation in mature cystic teratoma of the ovary: case report and review of the literature. 1936 67

A 40-year-old man presented with abdominal pain and right scrotal swelling. Physical examination revealed a right testicular tumor and CT scan showed a large retroperitoneal mass. The patient underwent right radical orchiectomy, and pathology showed mixed germ cell tumor. After 1 cycle of chemotherapy, CT scan showed interval enlargement of the retroperitoneal mass. Percutaneous biopsy was consistent with teratoma. The patient refused surgical intervention and was noncompliant with follow-up. Four months after presentation, CT scan showed increasing abdominal lymphadenopathy. The patient received 4 cycles of chemotherapy. He presented 4 months later with massive lymphadenopathy and expired before planned palliative surgery.
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PMID:Growing teratoma syndrome. 1964 98

A sacrococcygeal teratoma (SCT) may be completely concealed within the pelvis and therefore not be visible externally. Symptoms of such an SCT can be very aspecific. We present 4 patients with an intrapelvic SCT. The first patient, a newborn girl, had an antenatally-diagnosed cystic mass in her pelvis, which was a benign SCT. After removal she suffered from neurogenic bladder dysfunction. The second patient was a 2-year-old boy who after two incomplete resections of a benign intrapelvic SCT, developed a malignant SCT. The other 2 patients, 2 girls aged 4 and 15 years, both presented with constipation and abdominal pain and were diagnosed as having an SCT. Early detection and radical excision, including removal of the os coccygis, are necessary to prevent development of malignancy. Long-term functional sequelae can occur after excision.
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PMID:[Internally situated sacrococcygeal teratomas, often invisible but not harmless]. 1985 97

A 37-year-old postpartum woman was presented with abdominal pain supposed to be caused by uterine involution or puerperal endometritis after vaginal delivery. During the pregnancy, she was suspected to have a subserosal myoma by ultrasound examination. The pain was finally revealed to be originated from the chemical peritonitis caused by the rupture of the mature cystic teratoma of the ovary by Kristeller's maneuver performed during vaginal delivery. When a pregnant or puerperal woman complains about abdominal pain, we need to consider the possibility of chemical peritonitis resulting from the rupture of mature cystic teratoma of the ovary.
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PMID:Chemical peritonitis caused by an iatrogenic rupture of mature cystic teratoma of the ovary during labor: a report of a case didactic to all the maternity health care workers. 2045 40

Acute abdominal pain during pregnancy is encountered frequently and the differential diagnosis is extensive. Acute ovarian torsion in a pregnant patient is rare and is difficult to diagnose. Infarction caused by ovarian torsion will result if the twist is not unwound spontaneously or surgically in a timely fashion. The case is described of a 28-year-old primigravida who originally presented to the emergency department with right lower abdominal pain. The patient was ultimately found to have an extremely large cystic teratoma of the right ovary with concomitant torsion. Bedside ultrasonography is a highly accessible tool that can be used in a pregnant woman for screening a mass or ascites. Laparoscopic surgery has now been accepted as a safe modality for definitive diagnosis and therapeutic intervention. Because acute ovarian torsion is not encountered frequently, timely diagnosis is required to prevent mortality and minimise morbidity. It is important to keep ovarian torsion in the differential diagnosis of any pregnant woman with acute abdominal pain. Emergency physicians should be aware of the possibility of acute ovarian torsion in pregnant women and should have a high index of suspicion. Early surgical intervention should be undertaken.
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PMID:Ovarian cystic teratoma torsion in pregnancy. 2081 Apr 65


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