Intestinal duplication is an uncommon congenital abnormality, with potential life-threatening complications, usually manifesting in childhood. Due to its non-specific clinical presentation as well as its resemblance t...Intestinal duplication is an uncommon congenital abnormality, with potential life-threatening complications, usually manifesting in childhood. Due to its non-specific clinical presentation as well as its resemblance to other abdominal processes at imaging, the differential diagnosis may be very difficult. This case report describes a young female adult accessed twice to our Emergency Department with recurrent pain in the right iliac fossa and a clinical picture of abdominal pain and bowel obstruction, who was finally diagnosed with complicated duplication cyst, then resected. The diagnostic tools performed show the simple duplication cyst at the beginning, in the ileocecal region, with the characteristic “gut signature” at Ultrasound and its subsequent inflammatory changing at Computed Tomography, which led to the right diagnostic hypothesis, confirmed by histopathology. An early diagnosis of this condition is needed to undertake the correct surgical approach.展开更多
Klinefelter syndrome （KS） is a hypergonadotropic hypogonadism characterized by a 47, XXY karyotype. The risk of testicular cancer in KS is of interest in relation to theories about testicular cancer etiology general...Klinefelter syndrome （KS） is a hypergonadotropic hypogonadism characterized by a 47, XXY karyotype. The risk of testicular cancer in KS is of interest in relation to theories about testicular cancer etiology generally; nevertheless it seems to be low. We evaluated the need for imaging and serum tumor markers for testicular cancer screening in KS. Participants were 40 consecutive KSpatients, enrolled from December 2009 to January 2013. Lactate dehydrogenase （LDH）, alpha-fetoprotein （AFP）, and beta-human chorionic gonadotrophin subunit （^-HCG） serum levels assays and testicular ultrasound （US） with color Doppler, were carried out at study entry, after 6 months and every year for 3 years. Abdominal magnetic resonance （MR） was performed in KS when testicular US showed micro-calcifications, testicular nodules and cysts. Nearly 62% of the KS had regular testicular echotexture, 37.5% showed an irregular echotexture and 17.5% had micro-calcifications and cysts. Eighty seven percent of KS had a regular vascular pattern, 12.5% varicocele, 12.5% nodules 〈1 cm, but none had nodules 〉1 cm. MR ruled out the diagnosis of cancer in all KS with testicular micro calcifications, nodules and cysts. No significant variations in LDH, AFP, and ^-HCG levels and in US pattern have been detected during follow-up. We compared serum tumor markers and US pattern between KS with and without cryptorchidism and no statistical differences were found. We did not find testicular cancer in KS, and testicular US, tumor markers and MR were, in selected cases, useful tools for correctly discriminating benign from malignant lesions.展开更多
文摘Intestinal duplication is an uncommon congenital abnormality, with potential life-threatening complications, usually manifesting in childhood. Due to its non-specific clinical presentation as well as its resemblance to other abdominal processes at imaging, the differential diagnosis may be very difficult. This case report describes a young female adult accessed twice to our Emergency Department with recurrent pain in the right iliac fossa and a clinical picture of abdominal pain and bowel obstruction, who was finally diagnosed with complicated duplication cyst, then resected. The diagnostic tools performed show the simple duplication cyst at the beginning, in the ileocecal region, with the characteristic “gut signature” at Ultrasound and its subsequent inflammatory changing at Computed Tomography, which led to the right diagnostic hypothesis, confirmed by histopathology. An early diagnosis of this condition is needed to undertake the correct surgical approach.
文摘Klinefelter syndrome （KS） is a hypergonadotropic hypogonadism characterized by a 47, XXY karyotype. The risk of testicular cancer in KS is of interest in relation to theories about testicular cancer etiology generally; nevertheless it seems to be low. We evaluated the need for imaging and serum tumor markers for testicular cancer screening in KS. Participants were 40 consecutive KSpatients, enrolled from December 2009 to January 2013. Lactate dehydrogenase （LDH）, alpha-fetoprotein （AFP）, and beta-human chorionic gonadotrophin subunit （^-HCG） serum levels assays and testicular ultrasound （US） with color Doppler, were carried out at study entry, after 6 months and every year for 3 years. Abdominal magnetic resonance （MR） was performed in KS when testicular US showed micro-calcifications, testicular nodules and cysts. Nearly 62% of the KS had regular testicular echotexture, 37.5% showed an irregular echotexture and 17.5% had micro-calcifications and cysts. Eighty seven percent of KS had a regular vascular pattern, 12.5% varicocele, 12.5% nodules 〈1 cm, but none had nodules 〉1 cm. MR ruled out the diagnosis of cancer in all KS with testicular micro calcifications, nodules and cysts. No significant variations in LDH, AFP, and ^-HCG levels and in US pattern have been detected during follow-up. We compared serum tumor markers and US pattern between KS with and without cryptorchidism and no statistical differences were found. We did not find testicular cancer in KS, and testicular US, tumor markers and MR were, in selected cases, useful tools for correctly discriminating benign from malignant lesions.
