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Query: UMLS:C0030794 (pelvic pain)
4,056 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The case described here reports on an extremely unusual complication of induced abortion: the rupture of a benign cystic teratoma with spillage of its contents within the walled-off area of the pelvic cavity, and with subsequent infection culminating in a large pelvic abscess. The patient in question was admitted to the hospital for severe pelvic pain. After colpotomy was performed, a large amount of pus was drained out, and the patient was put on antibiotics. A subsequent laparotomy showed a dermatoid cyst on the right ovary, and it was surgically removed. No further complications were observed.
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PMID:Pelvic abscess and perforation of the sigmoid colon by a segment of benign cystic teratoma: an unusual complication of induced abortion. 67 5

A series of 289 patients who were diagnosed with 342 benign ovarian tumors (BOT) at laparotomy have been reviewed. Mean age was 36.7 years (S.D. +/- 13.9), mean parity was 1.5 (S.D. +/- 1.6); 236 (81.7%) patients had a single unilateral ovarian tumor; 29 (10%) patients had bilateral ovarian tumors. Benign cyst teratoma was diagnosed in 89 (26%) tumors, and it was the most frequent histological type. In eight patients (2.8%) the post-operative pathologic report was compatible with malignancy, despite the lack of suspicion at laparotomy. Mean maximal diameter of BOT was 9.1 cm, and almost 60% of the mucinous cystoadenomas were larger than 16 cm. Benign cyst teratoma and serous cytoadenoma had a medium size, about 6-10 cm. Lower abdominal-pelvic pain was the symptom most frequently reported by patients with BOT. Calcifications were most frequently seen in benign cyst teratoma. Tumors of 11-15 cm in size were the tumors most frequently torsioned. Twenty four (8.3%) patients had their surgical operation done during pregnancy; benign cyst teratoma was the tumor most frequently associated with pregnancy.
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PMID:Clinical and pathologic evaluation of 342 benign ovarian tumors. 615 93

A case of massive intracranial immature teratoma in a female stillborn is reported. She was the product of the second pregnancy of a 25-year-old healthy woman. The pregnancy was unremarkable until the 25th week of gestation when the mother noticed a rapid enlargement of her abdomen and intense pelvic pain. Because of the pain, a cesarean section was indicated, and a stillborn weighing 2750g with macrocephaly was delivered. The cranial contents weighed 1350g and showed a huge tumoral mass with only a rim of normal brain. A histologic diagnosis of immature teratoma was made. Massive intracranial teratomas are rare tumors and their occurrence in intrauterine life is even rarer. Their histogenesis is unknown, and there is no explanation for their continuous growth during embryogenesis. A prenatal diagnosis of this rare condition can be made by ultrasound, computed tomography, or magnetic resonance imaging.
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PMID:Massive intracranial immature teratoma. Report of a case with polyhidramnios and intense pelvic pain. 898 92

Adnexal masses diagnosed in a gravid woman sometimes must be surgically evaluated and treated during the pregnancy. A laparoscopic approach may have several advantages over laparotomy, but only one case of laparoscopic adnexal surgery during pregnancy has been previously reported. Two pregnant patients with acute pelvic pain and adnexal masses were treated by operative laparoscopy. One patient had a large benign cystic teratoma and the other had torsion of the fallopian tube secondary to a paratubal cyst. Cystectomies were performed in both women, and in the second patient the tube was reduced and conserved. It appears that with proper care of surgical technique and caution to exclude malignancy, laparoscopy may be performed successfully to remove adnexal masses during the second trimester of pregnancy.
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PMID:Laparoscopic adnexal surgery during pregnancy. 905 May 40

Adnexal masses diagnosed in a gravid woman sometimes must be surgically evaluated and treated during the pregnancy. A laparoscopic surgical approach may have several advantages over laparotomy, but only one case of laparoscopic adnexal surgery during pregnancy has been previously reported. Two pregnant patients with acute pelvic pain and adnexal masses were surgically treated via operative laparoscopy. One patient had a large benign cystic teratoma and one had torsion of the fallopian tube secondary to a paratubal cyst. Cystectomies were performed in both cases and in the second case the tube was reduced and conserved. It appears that with proper surgical technique and caution to exclude malignancy, laparoscopy may be successfully used to remove adnexal masses during the second trimester of pregnancy.
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PMID:Laparoscopic Surgery During Pregnancy 907 91

Nonsmall cell neuroendocrine carcinoma (NSCNEC) of the ovary is a rare and aggressive tumor commonly associated with other surface epithelial and germ cell neoplasms. In this study, we present the clinicopathologic and immunohistochemical features of 11 such cases seen at The University of Texas M.D. Anderson Cancer Center in a 16-year period (1990 to 2005). Patients ranged in age from 22 to 63 years (mean 46.7). The most common presentation was abdominal/pelvic pain (6 cases), followed by ascites (2 cases), pelvic mass, vaginal bleeding, and abdominal bloating (1 case each). Tumors were mostly unilateral, cystic, or solid/cystic and ranged in size from 5 to 26 cm (mean 16.2). In 8 cases, NSCNEC was associated with other epithelial neoplasms, including mucinous neoplasms of low malignant potential, mucinous carcinoma, endometrioid carcinoma, mixed endometrioid and mucinous carcinoma, and a high-grade carcinoma, not otherwise specified. In 2 cases, the tumor was associated with a mature cystic teratoma; one of them also containing an invasive moderately differentiated adenocarcinoma. A single case was associated with a benign ovarian cyst. The latter case had a dermoid cyst in the contralateral ovary. NSCNEC represented anywhere from 10% to 90% of the ovarian tumor. Microscopically, the neuroendocrine component was usually composed of large and/or intermediate oval to round cells. In 2 cases, the intermediate cells were intermixed with small cells. Three cases had also spindle cells. The neoplastic cells were mostly arranged in a solid pattern, nests, or trabeculae. All tumors had a brisk mitotic activity. Immunoperoxidase studies for keratin cocktail, cytokeratin (CK) 7, CK20, CAM 5.2, chromogranin A, synaptophysin, NSE, CD56, and c-kit were performed and the cases stained as follows: keratin cocktail 6/6, CK7 4/5, CK20 3/5, CAM 5.2 3/3, chromogranin A 8/11, synaptophysin 9/9, NSE 1/1, CD56 4/8, and c-kit 5/7. According to the International Federation of Gynecology and Obstetrics staging system, 4 cases were stage I tumors, 3 cases were stage III tumors, and 4 cases were stage IV tumors. Seven patients were treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy followed by chemotherapy. One patient had a bilateral salpingo-oophorectomy with omentectomy and appendectomy followed by chemotherapy; 1 patient had a total abdominal hysterectomy with right salpingo-oophorectomy followed by chemotherapy; one had a bilateral salpingo-oophorectomy followed by chemotherapy, and one had a right salpingo-oophorectomy with appendectomy followed by chemotherapy. Five patients died of disease at 2, 3, 9, 20, and 36 months. One patient is alive with disease at 8 months and 5 are alive without evidence of disease at 11, 28, 37, 66, and 68 months. Four of 5 patients who died of disease had either stage III or IV tumors and 3 of 5 patients who are alive without evidence of disease have stage I tumors. In summary, ovarian NSCNEC is an aggressive tumor with a tendency to present at advanced stage and cause death within a mean of 17 months after diagnosis; however, some patients, particularly those with stage I disease and/or those who have received platinum-based therapy, may have a more favorable prognosis.
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PMID:Ovarian nonsmall cell neuroendocrine carcinoma: a clinicopathologic and immunohistochemical study of 11 cases. 1746 Apr 63

An ovary with a mature cystic teratoma which was autoamputated into the cul-de-sac and confirmed by laparoscopy is described. A 24-year-old woman with a history of chronic pelvic pain for 5 years presented with left abdominal pain. Magnetic resonance imaging revealed a left ovarian mass of 5 cm in diameter. The pain was relieved spontaneously after a few weeks. Laparoscopy was performed 5 months later. The mass was identified in the cul-de-sac partly enveloped in the omentum without any ligamentous or direct connection with the pelvic organs. There was no left ovary in its proper anatomical location. Histopathologic study revealed a mature cystic teratoma with viable ovarian tissue. These findings suggested autoamputation of the ovary either by inflammation or torsion, which is one of the mechanisms for the formation of an ectopic ovary.
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PMID:Ectopic ovary: a case of autoamputated ovary with mature cystic teratoma into the cul-de-sac. 1757 69

Presacral and retrorectal space tumors are relatively rare lesions, the location of which can result in the onset of symptoms that are not well-defined. Retrorectal teratomas are resected to alleviate these symptoms and to rule out malignancy. Complete resection by one of the open abdominal or sacral approaches was traditionally advocated as the best treatment for either a benign or malignant presacral and retrorectal tumor. A 15-year-old girl had chronic, progressively worsening dull pelvic pain and was given the diagnosis of a retrorectal tumor during her first gynecologic examination. Computed tomography of the pelvis showed an encapsulated presacral and retrorectal tumor measuring 10x8.5x8 cm. The retrorectal teratoma was removed by laparoscopy. No complication was observed interoperation. In addition, no sensory or motoric dysfunction of the bladder or rectum was observed postoperatively. Laparoscopy can be used to surgically remove presacral teratomas.
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PMID:Laparoscopic resection of presacral teratomas. 1872 80

Brucellosis which is a systemic infection, is seen endemically in Turkey. Although there a lot of complications related to brucellosis, soft tissue involvement is rare. In this case report a patient with mature cystic teratoma and a Brucella related obturatory abscess, was presented. A 21-year-old female patient with bilateral pelvic pain was admitted to the hospital with complaints of weakness, backache and ab- dominal swelling. Pelvic examination revealed bilateral adnexial sensitive masses. There were no history of systemic complaints or other organ involvement. The patient had no history of contact with infected animals, intramuscular injections or consumption of non-pasteurized foods. A mass of 56 x 63 mm with regular margins and hyperechogenic segments at the left side was detected at ultrasonographic examination. Left ovarian cystectomy and mass excision at the left side were performed during laparotomy. Histopathological examination of the mass revealed chronic granulomatous inflammation characterized by central necrosis, histiocyte and lymphocyte infiltration and formation of giant cells, compatible with brucellosis. Brucella melitensis was isolated from the capsule of pelvic mass on the fifth day of culture in BacT/ALERT Selectlink (Organon Teknika, U.S.A.) system. Brucella Wright agglutination titer which was 1:80 at the admittance, rose to 1:2560 at the sixth week of the follow-up. The patient was treated successfully with the excision of the abscess and 6 weeks course of oral doxycycline and rifampicin. Brucellosis should be considered in the differential diagnosis of pelvic pain and obturatory abscess, especially in endemic areas for brucellosis.
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PMID:[Obturatory abscess and pelvic pain caused by Brucella melitensis]. 1962 21

In childhood mature cystic teratomas are the most common type of ovarian germ cell tumors. Tumors of neuroepithelial origin are extremely rare in mature teratomas. To the authors' knowledge, this is the first case report oligodendroglioma arising in a mature cystic ovarian teratoma in children. A 13-year-old girl presented with a history of pelvic pain for 2 months. An ultrasound examination showed a monolateral multicystic, calcific ovarian mass, measuring approximately 6 x 5 cm, arising in the left over and adnexia, suggesting a teratoma. An exploratorative laparotomy and ooferectomy were performed. On histopatological examination, various samples from cystic areas had mature tissues from all 3 germ cell layers, including skin, bone, bronchial structures, and cerebellum. Sections from solid areas showed uniform population of monotonous, rounded cells with indistinct cytoplasm and having perinuclear halo (fried-egg appearance) on a fibrillary, neuropilic background. Microcalcifications as calcospherites were noted in the stroma. Based on the typical morphological features, the cased was diagnosed as mature cystic teratoma with low-grade oligodendroglioma. To the authors' knowledge, there are a few reports in the literature of an oligodendroglioma arising in an ovarian teratoma in adults and this presented patient is the first case in childhood.
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PMID:Oligodendroglioma arising in a mature cystic ovarian teratoma in a child. 2086 58


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