Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Metachronous papillary serous carcinoma of the peritoneum (PSCP) after endometrial carcinoma (EC) is an extremely rare condition. Only three patients have been reported in the English literature. We present the fourth patient who had a more aggressive and fatal clinical course. A 79-year-old multiparous woman complained of progressive abdominal pain and distension after 5 years, subsequent to total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometrioid type EC. Serum CA-125 level being followed routinely rose above 500 IU/mL. Abdominal and pelvic computed tomography demonstrated ascites, omental thickening, and nodularity. Paracentesis showed malignant cells resembling papillary adenocarcinoma. Omentectomy and bilateral pelvic lymphadenectomy were performed as cytoreductive surgery. The histologic slides of the totally sampled ovaries obtained from the first operation were reexamined and the corresponding paraffin blocks were re-sectioned but no tumor was detected. The microscopic appearance of the tumor in the omentum differed from that of the previous EC. Immunohistochemically, while the tumor showed reactivity for low and high molecular weight cytokeratin (CK) cocktail, epithelial membrane antigen, CK7, CA-125, and Ber-EP4, the immunostains for calretinin, monoclonal carcinoembryonic antigen, and CK20 were negative. On the basis of these results and the criteria proposed by the Gynecologic Oncology Group, the tumor was diagnosed as metachronous PSCP developed after EC, which corresponded to stage IIIC according to FIGO criteria for ovarian carcinoma. The patient received two cycles of carboplatin and paclitaxel and died 2 months after the cytoreductive surgery.
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PMID:The development of papillary serous carcinoma of the peritoneum subsequent to endometrial carcinoma: a case report and review of the literature. 1798 45

We report the case of a 62-year-old woman who presented with a 2-week history of fever, abdominal pain and ascites. Her serum CA-125 level was very high (1070 U/ml), that in addition to clinical finding and ultrasonography suggested genital malignancy. Unexpectedly, the diagnosis of pelvic-peritoneal tuberculosis was reached by hystopathology after abdominal hysterectomy with bilateral adnexectomy. Cultures of ascitic fluid taken on admission grew Mycobacterium tuberculosis six weeks later. Serum levels of CA-125 returned to normal during antituberculous drug treatment. This observation should help clinicians to entertain a differential diagnosis of pelvic-peritoneal tuberculosis in patients with ascites and raised CA-125 serum levels, and in some cases to prevent unnecessary laparotomy. Moreover, it indicates that his tumour marker, widely used to monitor patients undergoing treatment for ovarian cancer, may be also used to follow disease activity in non-neoplastic ascitic states, particularly to monitor response to treatment of pelvic-peritoneal tuberculosis.
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PMID:[Active pelvic-peritoneal tuberculosis with ascites and very high CA-125 level--a case report]. 1895 23

A 72-year-old postmenopausal woman presented with dyspepsia, weight loss, abdominal pain, and ascites. Ultrasonography revealed a pelvic mass and evidence of pyometra. Serum CA-125 was raised. Paracentesis revealed lymphocytic exudate but no malignant cells or acid-fast bacilli. However, after drainage of pyometra endometrial curettings revealed epithelioid granuloma with acid-fast bacilli. She had complete recovery with full course of antituberculosis treatment. Thus, pelvic tuberculosis should be considered in the differential diagnosis of ovarian malignancy, which can prevent many unnecessary laparotomies.
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PMID:Pelvic tuberculosis in a postmenopausal woman mimicking ovarian malignancy--a clinical dilemma. 1955 90

Tuberculosis, and specially its extrapulmonary location still causes diagnostic difficulties. In 2007, in Poland 7.3% of newly registered cases of tuberculosis in Poland were located extrapulmonary. Peritoneal tuberculosis is often wrongly diagnosed as an ovarian cancer, it is due to similar symptoms like abdominal pain, abdominopelvic masses, ascites and elevated serum CA-125. Two patients who were admitted to our department with suspicion of ovarian cancer are presented. Subjective symptoms suggested the ovarian cancer, elevated levels of CA-125, chest x-rays without abnormal findings or with minimal fibrotic changes and uncharacteristic results of additional investigations were disclosed. A diagnostic laparoscopy was made to establish the diagnosis. Because of clinical and operative picture suggesting ovarian cancer in both cases resections were performed. The procedure consisted of total abdominal hysterectomy and bilateral salpingo-oophorectomy. Biopsy specimens were taken up and verified histopathologically. The peritoneal tuberculosis was recognized in both cases.
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PMID:[Peritoneal tuberculosis mimicking ovarian cancer--diagnostic difficulties. Two cases reports]. 1972 50

Desmoplastic small round cell tumor (DSRCT) is a rare aggressive tumor primarily involving serosal surfaces in adolescents and young men. Diagnosis is based on specific clinicomorphologic, immunohistochemical, and genetic features. We report here a variant of DSRCT involving the ovaries that mimics the Sertoli-Leydig cell tumor in a 21-year-old woman complaining of abdominal pain. Abdominal ultrasonography and computed tomography showed a right adnexal mass. She had a slightly raised serum CA-125 level. Frozen section examination identified the right ovarian mass as a poorly differentiated Sertoli-Leydig cell tumor. The surgically resected tumor and left ovary and omentum implants found during laparoscopy were diagnosed as DSRCT with Leydig cell hyperplasia. Immunohistochemically, the tumor cells were negative for epithelial markers but were positive for calretinin and inhibin. The patient is still undergoing chemotherapy at 8 months after initial presentation with partial response. This case showed that DSRCT with unusual immunohistochemical profiles and Leydig cells hyperplasia pose a diagnostic challenge. Molecular genetic techniques may help in these cases.
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PMID:Ovarian involvement by desmoplastic small round cell tumor with leydig cell hyperplasia showing an unusual immunophenotype (cytokeratin negative, calretinin and inhibin positive) mimicking poorly differentiated sertoli leydig cell tumor. 1985 Dec 10

Though malignant transformation of endometriosis has been documented, malignancy arising from extragonadal endometriosis is rare. We present the case of a 39-year-old woman with abdominal pain and fullness after menstruation. Evaluation revealed a cul-de-sac mass and CA-125 level of 1048 U/ml. A hysterectomy, bilateral salpingo-oophorectomy, and omentectomy were performed. Endometrioid adenocarcinoma with a clearly defined transition zone from endometriosis to adenocarcinoma was noted histologically. Adjuvant chemotherapy and GnRH agonist treatment was administered. Serum CA-125 level was 1.51 U/ml 19 months after completion of treatment. Patients with endometriosis and elevated CA-125 levels should be managed aggressively and CA-125 levels monitored until they have normalized.
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PMID:Malignant transformation of extragonadal endometriosis: a case report. 1989 17

A phase-I trial to assess the safety and tolerability of human interleukin-12 (IL-12) plasmid (phIL-12) formulated with a synthetic lipopolymer, polyethyleneglycol-polyethyleneimine-cholesterol (PPC), was conducted on women with chemotherapy-resistant recurrent ovarian cancer. A total of 13 patients were enrolled in four dose-escalating cohorts and treated with 0.6, 3, 12 or 24 mg m(-2) of the formulated plasmid once every week for 4 weeks. Administration of phIL-12/PPC was generally safe and well-tolerated. Common side effects included low-grade fever and abdominal pain. Stable disease and reduction in serum CA-125 levels were clinically observed in some patients. Measurable levels of IL-12 plasmid were detectable in PF samples collected throughout the course of phIL-12/PPC treatment. In comparison, serum samples either did not contain detectable amounts of plasmid DNA or contained <1% of the amount found in the corresponding PF samples. Treatment-related increases in IFN-gamma levels were observed in PF but not in serum. These data demonstrate that IL-12 gene delivery with a synthetic delivery system is feasible for ovarian cancer patients.
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PMID:Phase-I clinical trial of IL-12 plasmid/lipopolymer complexes for the treatment of recurrent ovarian cancer. 2003 66

A case of primary adenocarcinoma of the rectovaginal septum (PARVS) is reported with clinical and pathological findings. A 37-year-old Caucasian woman with a history of sterility and small posterior leiomyoma, a few months after a cesarean section, was admitted because of vaginal spotting, abdominal pain and constipation. Her previous history did not reveal exposure to diethylstil bestrol (DES). Pelvic computed tomography showed a heterogeneous pelvic mass in the Douglas pouch, measuring 9 cm in diameter, located in the rectovaginal septum, involving the rectal and vaginal wall. Histological examination of neoplastic tissue revealed solid sheet structures, occasional tubular lumen, extensive necrotic areas and clear cells. The neoplastic elements showed immunoreactivity for Mullerian markers (cytokeratin 7, CA-125 and vimentin). Because, the present case of PARVS cannot be due to DES exposure, the clear appearance of the neoplastic elements could represent only one differentiation of Mullerian rests. Moreover, because no foci of endometriosis were identified in several sections of the neoplasm, uterine and cervical wall, and tissues nearby the neoplasm could represent a rare subtype of PARVS arising in the absence of endometriosis.
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PMID:Primary adenocarcinoma of the rectovaginal septum arising in pregnancy in the absence of endometriosis. 2052 44

Transitional carcinomas are extremely rare in the fallopian tube. A 41-year-old premenopausal lady presented with colicky abdominal pain and was found to have a left-sided pelvic mass on examination. In view of the elevated CA-125 and imaging findings suggestive of ovarian mass, she underwent staging laparotomy. Pathological examination confirmed a primary transitional cell carcinoma of the left fallopian tube. Review of available literature suggested that the primary transitional cell carcinoma is probably less aggressive compared to classical adenocarcinoma of the fallopian tube, and it has to be distinguished from the recently recognized entity, parafallopian tube transitional cell carcinoma.
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PMID:Primary transitional cell carcinoma of the fallopian tube in a premenopausal woman: A case report and review of literature. 2066 6

A 36-year-old man was admitted for persistent abdominal pain and weight loss. He had had significant exposure to asbestos, as he had been active in cleanup after the World Trade Center attack. A CT scan of his abdomen was initially read as peritoneal carcinomatosis without evidence of ascites. Infectious etiology was subsequently ruled out and diagnostic laparoscopy was performed for tissue diagnosis revealing noncaseating granulomas consistent with peritoneal sarcoidosis. Of note, he had an elevated CA-125 level on admission, which is unique in males with peritoneal sarcoidosis.
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PMID:A rare case of peritoneal sarcoidosis in a 36-year-old construction worker. 2149 Aug 71


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