BACKGROUND Giant ovarian cysts(≥15 cm in diameter)are rare.The size limit of cysts and the methodology for a safe and successful minimally invasive surgery has not been established.Here we report a case of a large 10...BACKGROUND Giant ovarian cysts(≥15 cm in diameter)are rare.The size limit of cysts and the methodology for a safe and successful minimally invasive surgery has not been established.Here we report a case of a large 10-kg multi-locular ovarian mass,which was successfully laparoscopically removed:Our aim was to innovate the surgical practice in this field by providing a safe,effective,and minimally invasive management method for such complex and rare cases.CASE SUMMARY A 49-year-old nulliparous woman presented with abdominal distension,lasting from six Mo prior to admission;she reported worsening abdominal pain,abdominal swelling,and mild dyspnea.Imaging showed a presumed benign multi-locular(>10 locules)left ovarian cyst that measured about 30 cm in diameter.Based on the IOTA-ADNEX model the mass had a 27.5%risk of being a borderline or malignant tumor.The patient was successfully treated via a direct laparoscopic approach with salpingo-oophorectomy,followed by the external drainage of the cyst.Tumor spillage was successfully avoided during this procedure.The final volume of the drained mucinous content was 8950 L;the cyst wall,extracted through the minilaparotomy,weighed about 1200 g.The pathologic gross examination revealed a 24 cm×15 cm×10 cm mass;the histologic examination diagnosed a mucinous cystoadenoma.To our knowledge,this is the first case of a giant multi-locular ovarian cyst treated with a direct laparoscopy with salpingo-oophorectomy followed by external decompression.CONCLUSION Choosing the appropriate technique and surgeon skill are necessary for a safe and effective minimally-invasive approach of unique cases involving giant ovarian cysts.展开更多
Diffusion weighted imaging(DWI) evolved as a complementary tool to morphologic imaging by offering additional functional information about lesions. Although the technique utilizes movement of water molecules to charac...Diffusion weighted imaging(DWI) evolved as a complementary tool to morphologic imaging by offering additional functional information about lesions. Although the technique utilizes movement of water molecules to characterize biological tissues in terms of their cellularity, there are other factors related to the histological constitution of lesions which can have a significant bearing on DWI. Benign lesions with atypical histology including presence of lymphoid stroma, inherently increased cellularity or abundant extracellular collagen can impede movement of water molecules similar to malignant tissues and thereby, show restricted diffusion. Knowledge of these atypical entities while interpreting DWI in clinical practice can avoid potential misdiagnosis. This review aims to present an imaging spectrum of such benign neck masses which, owing to their distinct histology, can show discordant behavior on DWI.展开更多
<strong>Introduction:</strong> Unilateral nasal mass can be benign or malignant. Very rarely we will find benign salivary gland tumor in nasal cavity. Pleomorphic adenoma is still the most common pathologi...<strong>Introduction:</strong> Unilateral nasal mass can be benign or malignant. Very rarely we will find benign salivary gland tumor in nasal cavity. Pleomorphic adenoma is still the most common pathological variety either in major or minor salivary gland tumors. In the nasal cavity, even though most of the accessory salivary glands are present in the lateral wall of nose, nasal septum remains the most common site of origin. <strong>Case Report:</strong> A 40-year-old female presented with right-sided nasal obstruction and epistaxis. CT scan of Nose and Paranasal sinuses found a lesion involving the anterior third of the right nasal cavity. The patient underwent complete surgical resection of the tumor via an endonasal approach. Histological examination found a mixed cellular component (epithelial and myoepithelial) and mesenchymatous tissue with chondromyxoid stroma, enabling diagnosis of a typical pleomorphic adenoma. <strong>Conclusion:</strong> Pleomorphic adenoma is the most common salivary gland tumor but rare to find in the nasal cavity with only few cases reported in the literature. Although benign, the risk of local recurrence, malignant transformation and metastasis requires close long-term follow-up.展开更多
We aimed to investigate the difference in efficacy of medical treatment of symptomatic benign prostatic hyperplasia （BPH） between normal and obese patients with BPH; obesity was determined by either body mass index ...We aimed to investigate the difference in efficacy of medical treatment of symptomatic benign prostatic hyperplasia （BPH） between normal and obese patients with BPH; obesity was determined by either body mass index （BMI） or waist circumference （WC）. In this 12-week prospective observational study, a total of 175 patients aged ≥40 years with International Prostate Symptom Scores （IPSS） ≥12 points and prostate volume≥20 ml were prospectively enrolled. The patients were divided into two groups according to BMI or WC. Patients received the doxazosin gastrointestinal therapeutic system （GITS） at a dose of 4 mg once per day for 12 weeks. The changes from baseline in the IPSS, maximal urinary flow rate （Qmax）, post-void residual volume, quality of life （QoL） scores and adverse events （AEs） were analysed. Of the 175 enrolled patients, 132 completed the study. Sixty-seven patients had BMI 〉23 kg m-2, and 43 had WC 〉90 cm. Obese patients represented by WC 〉90 cm or BMI≥ 23 kg m-2 had a significantly greater prostate volume compared with non-obese patients at baseline. Total IPSS was significantly higher in the WC 〉90 cm group compared to the WC ≤ 90 cm group. Total I PSS was positively correlated with prostate volume （P=-0.031） and WC （P=0.045）. All groups showed significant improvements in total IPSS and QoL at 12 weeks. However, the improvement of total IPSS was greater in the high-BMI and high-WC groups. The most frequent AE was dizziness （n= 13）, and it was significantly lower in the obese BPH patients. Obesity was associated with increased prostate volume and lower urinary tract symptoms. Alpha-blockers appear to be efficacious for controlling symptoms, especially in obese men.展开更多
BACKGROUND: Although the serum carcinoembryonic antigen (CEA) concentration is the well-known prognostic marker of non-small cell lung cancer (NSCLC), serum CEA concentration has been reported to be affected by smokin...BACKGROUND: Although the serum carcinoembryonic antigen (CEA) concentration is the well-known prognostic marker of non-small cell lung cancer (NSCLC), serum CEA concentration has been reported to be affected by smoking status and body mass index (BMI). There are no previous investigations that examined the relationship between BMI and serum CEA concentration in thoracic disease, including NSCLC. METHODS: Consecutive 384 NSCLC patients and 87 patients with benign thoracic disease were enrolled. The relationship between serum CEA concentration and smoking status and BMI in patients with benign thoracic benign disease and NSCLC was examined. RESULTS: In patients with benign thoracic disease, serum CEA concentration significantly increased with smoking status and Brinkman index. However, serum CEA concentration was not related with BMI. Serum CEA concentration of patients with NSCLC was significantly higher than those with benign disease. In NSCLC patients, the relationship between serum CEA concentration and smoking status was also found. A significant relationship between serum CEA concentration and smoking status was also found in patients with adenocarcinoma which is known to have weaker associations with smoking in carcinogenesis. On the other hand, we failed to find the relationship between serum CEA concentration and BMI in NSCLC patients. CONCLUSION: Serum CEA concentration may be affected by smoking status but not BMI in our Japanese patients with thoracic disease.展开更多
背景寻找良性前列腺增生(benign prostatic hyperplasia,BPH)发生的影响因素有助于对BPH进行早期预防。目的探讨中老年男性体检人群临床指标与前列腺体积的相关性,寻找BPH的关联因素。方法回顾性分析2021年6月—2023年6月某三甲医院体...背景寻找良性前列腺增生(benign prostatic hyperplasia,BPH)发生的影响因素有助于对BPH进行早期预防。目的探讨中老年男性体检人群临床指标与前列腺体积的相关性,寻找BPH的关联因素。方法回顾性分析2021年6月—2023年6月某三甲医院体检中心行健康检查的中老年男性的资料,以前列腺总体积(total prostate volume,TPV)为分组标准,TPV>25 cm3为BPH组,TPV≤25 cm3为健康对照组,采用Spearman相关性分析和多因素Logistic回归分析与TPV相关的因素。结果共纳入6732例45~89岁中老年男性,其中BPH组3972例,健康对照组2760例。与健康对照组相比,BPH组年龄[M(IQR):56(51~60)岁vs 53(49~58)岁,P<0.001]、体质量指数(body mass index,BMI)[M(IQR):26.41(24.64~28.36)kg/m^(2) vs 25.76(24.06~27.80)kg/m^(2),P<0.001]、空腹胰岛素(insulin,INS)[M(IQR):10.67(7.27~15.53)mmol/L vs 10.25(6.90~14.93)mmol/L,P=0.005]、总前列腺特异性抗原(total prostate specific antigen,tPSA)[M(IQR):1.01(0.66~1.63)ng/L vs 0.75(0.51~1.10)ng/L,P<0.001]较高,高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)[M(IQR):1.18(1.00~1.37)mmol/L vs 1.19(1.01~1.40)mmol/L,P=0.004]、游离前列腺特异性抗原(free prostate specific antigen,fPSA)/tPSA[M(IQR):0.31(0.23~0.41)vs 0.32(0.24~0.42),P=0.016]较低。相关性分析显示,TPV与年龄(r=0.24,P<0.001)、tPSA(r=0.33,P<0.001)、fPSA(r=0.36,P<0.001)均呈显著正相关。多因素Logistic回归分析结果显示,随着年龄(OR=1.051,95%CI:1.042~1.060,P<0.001)、BMI(OR=1.095,95%CI:1.076~1.116,P<0.001)和tPSA(OR=1.775,95%CI:1.647~1.913,P<0.001)的增长或升高,BPH的发病风险升高,但高HDL-C男性发生BPH的概率较低(OR=0.790,95%CI:0.665~0.945,P=0.009)。结论tPSA、年龄、BMI、HDL-C与前列腺增生发生有关。展开更多
文摘BACKGROUND Giant ovarian cysts(≥15 cm in diameter)are rare.The size limit of cysts and the methodology for a safe and successful minimally invasive surgery has not been established.Here we report a case of a large 10-kg multi-locular ovarian mass,which was successfully laparoscopically removed:Our aim was to innovate the surgical practice in this field by providing a safe,effective,and minimally invasive management method for such complex and rare cases.CASE SUMMARY A 49-year-old nulliparous woman presented with abdominal distension,lasting from six Mo prior to admission;she reported worsening abdominal pain,abdominal swelling,and mild dyspnea.Imaging showed a presumed benign multi-locular(>10 locules)left ovarian cyst that measured about 30 cm in diameter.Based on the IOTA-ADNEX model the mass had a 27.5%risk of being a borderline or malignant tumor.The patient was successfully treated via a direct laparoscopic approach with salpingo-oophorectomy,followed by the external drainage of the cyst.Tumor spillage was successfully avoided during this procedure.The final volume of the drained mucinous content was 8950 L;the cyst wall,extracted through the minilaparotomy,weighed about 1200 g.The pathologic gross examination revealed a 24 cm×15 cm×10 cm mass;the histologic examination diagnosed a mucinous cystoadenoma.To our knowledge,this is the first case of a giant multi-locular ovarian cyst treated with a direct laparoscopy with salpingo-oophorectomy followed by external decompression.CONCLUSION Choosing the appropriate technique and surgeon skill are necessary for a safe and effective minimally-invasive approach of unique cases involving giant ovarian cysts.
文摘Diffusion weighted imaging(DWI) evolved as a complementary tool to morphologic imaging by offering additional functional information about lesions. Although the technique utilizes movement of water molecules to characterize biological tissues in terms of their cellularity, there are other factors related to the histological constitution of lesions which can have a significant bearing on DWI. Benign lesions with atypical histology including presence of lymphoid stroma, inherently increased cellularity or abundant extracellular collagen can impede movement of water molecules similar to malignant tissues and thereby, show restricted diffusion. Knowledge of these atypical entities while interpreting DWI in clinical practice can avoid potential misdiagnosis. This review aims to present an imaging spectrum of such benign neck masses which, owing to their distinct histology, can show discordant behavior on DWI.
文摘<strong>Introduction:</strong> Unilateral nasal mass can be benign or malignant. Very rarely we will find benign salivary gland tumor in nasal cavity. Pleomorphic adenoma is still the most common pathological variety either in major or minor salivary gland tumors. In the nasal cavity, even though most of the accessory salivary glands are present in the lateral wall of nose, nasal septum remains the most common site of origin. <strong>Case Report:</strong> A 40-year-old female presented with right-sided nasal obstruction and epistaxis. CT scan of Nose and Paranasal sinuses found a lesion involving the anterior third of the right nasal cavity. The patient underwent complete surgical resection of the tumor via an endonasal approach. Histological examination found a mixed cellular component (epithelial and myoepithelial) and mesenchymatous tissue with chondromyxoid stroma, enabling diagnosis of a typical pleomorphic adenoma. <strong>Conclusion:</strong> Pleomorphic adenoma is the most common salivary gland tumor but rare to find in the nasal cavity with only few cases reported in the literature. Although benign, the risk of local recurrence, malignant transformation and metastasis requires close long-term follow-up.
文摘We aimed to investigate the difference in efficacy of medical treatment of symptomatic benign prostatic hyperplasia （BPH） between normal and obese patients with BPH; obesity was determined by either body mass index （BMI） or waist circumference （WC）. In this 12-week prospective observational study, a total of 175 patients aged ≥40 years with International Prostate Symptom Scores （IPSS） ≥12 points and prostate volume≥20 ml were prospectively enrolled. The patients were divided into two groups according to BMI or WC. Patients received the doxazosin gastrointestinal therapeutic system （GITS） at a dose of 4 mg once per day for 12 weeks. The changes from baseline in the IPSS, maximal urinary flow rate （Qmax）, post-void residual volume, quality of life （QoL） scores and adverse events （AEs） were analysed. Of the 175 enrolled patients, 132 completed the study. Sixty-seven patients had BMI 〉23 kg m-2, and 43 had WC 〉90 cm. Obese patients represented by WC 〉90 cm or BMI≥ 23 kg m-2 had a significantly greater prostate volume compared with non-obese patients at baseline. Total IPSS was significantly higher in the WC 〉90 cm group compared to the WC ≤ 90 cm group. Total I PSS was positively correlated with prostate volume （P=-0.031） and WC （P=0.045）. All groups showed significant improvements in total IPSS and QoL at 12 weeks. However, the improvement of total IPSS was greater in the high-BMI and high-WC groups. The most frequent AE was dizziness （n= 13）, and it was significantly lower in the obese BPH patients. Obesity was associated with increased prostate volume and lower urinary tract symptoms. Alpha-blockers appear to be efficacious for controlling symptoms, especially in obese men.
文摘BACKGROUND: Although the serum carcinoembryonic antigen (CEA) concentration is the well-known prognostic marker of non-small cell lung cancer (NSCLC), serum CEA concentration has been reported to be affected by smoking status and body mass index (BMI). There are no previous investigations that examined the relationship between BMI and serum CEA concentration in thoracic disease, including NSCLC. METHODS: Consecutive 384 NSCLC patients and 87 patients with benign thoracic disease were enrolled. The relationship between serum CEA concentration and smoking status and BMI in patients with benign thoracic benign disease and NSCLC was examined. RESULTS: In patients with benign thoracic disease, serum CEA concentration significantly increased with smoking status and Brinkman index. However, serum CEA concentration was not related with BMI. Serum CEA concentration of patients with NSCLC was significantly higher than those with benign disease. In NSCLC patients, the relationship between serum CEA concentration and smoking status was also found. A significant relationship between serum CEA concentration and smoking status was also found in patients with adenocarcinoma which is known to have weaker associations with smoking in carcinogenesis. On the other hand, we failed to find the relationship between serum CEA concentration and BMI in NSCLC patients. CONCLUSION: Serum CEA concentration may be affected by smoking status but not BMI in our Japanese patients with thoracic disease.
文摘背景寻找良性前列腺增生(benign prostatic hyperplasia,BPH)发生的影响因素有助于对BPH进行早期预防。目的探讨中老年男性体检人群临床指标与前列腺体积的相关性,寻找BPH的关联因素。方法回顾性分析2021年6月—2023年6月某三甲医院体检中心行健康检查的中老年男性的资料,以前列腺总体积(total prostate volume,TPV)为分组标准,TPV>25 cm3为BPH组,TPV≤25 cm3为健康对照组,采用Spearman相关性分析和多因素Logistic回归分析与TPV相关的因素。结果共纳入6732例45~89岁中老年男性,其中BPH组3972例,健康对照组2760例。与健康对照组相比,BPH组年龄[M(IQR):56(51~60)岁vs 53(49~58)岁,P<0.001]、体质量指数(body mass index,BMI)[M(IQR):26.41(24.64~28.36)kg/m^(2) vs 25.76(24.06~27.80)kg/m^(2),P<0.001]、空腹胰岛素(insulin,INS)[M(IQR):10.67(7.27~15.53)mmol/L vs 10.25(6.90~14.93)mmol/L,P=0.005]、总前列腺特异性抗原(total prostate specific antigen,tPSA)[M(IQR):1.01(0.66~1.63)ng/L vs 0.75(0.51~1.10)ng/L,P<0.001]较高,高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)[M(IQR):1.18(1.00~1.37)mmol/L vs 1.19(1.01~1.40)mmol/L,P=0.004]、游离前列腺特异性抗原(free prostate specific antigen,fPSA)/tPSA[M(IQR):0.31(0.23~0.41)vs 0.32(0.24~0.42),P=0.016]较低。相关性分析显示,TPV与年龄(r=0.24,P<0.001)、tPSA(r=0.33,P<0.001)、fPSA(r=0.36,P<0.001)均呈显著正相关。多因素Logistic回归分析结果显示,随着年龄(OR=1.051,95%CI:1.042~1.060,P<0.001)、BMI(OR=1.095,95%CI:1.076~1.116,P<0.001)和tPSA(OR=1.775,95%CI:1.647~1.913,P<0.001)的增长或升高,BPH的发病风险升高,但高HDL-C男性发生BPH的概率较低(OR=0.790,95%CI:0.665~0.945,P=0.009)。结论tPSA、年龄、BMI、HDL-C与前列腺增生发生有关。
