BACKGROUND A large cervical cyst with a cervical high-grade squamous intraepithelial lesion arising from the cervical stump is rare.After supracervical hysterectomy,there is a risk of various lesions occurring in the ...BACKGROUND A large cervical cyst with a cervical high-grade squamous intraepithelial lesion arising from the cervical stump is rare.After supracervical hysterectomy,there is a risk of various lesions occurring in the cervical stump.We review the types and characteristics of cervical stump lesions and compare total hysterectomy with subtotal hysterectomy.Gynecologists should choose the most suitable surgical method based on both the patient’s condition and wishes.If the cervix is retained,patients require a close follow-up.CASE SUMMARY A 57-year-old woman was admitted to the Gynecology Department for a large pelvic mass.Her chief complaint was abdominal distention for two months.She had undergone subtotal supracervical hysterectomy for leiomyoma 14 years prior.Abdominal ultrasonography detected a 9.1 cm×8.5 cm×8.4 cm anechoic mass with silvery fluid in the pelvic cavity and high-risk human papilloma virus 53(HPV53)was positive.The admission diagnosis we first considered was a pelvic mass mimicking carcinoma of the cervical stump.We performed a laparotomy and a rapid frozen biopsy was suggestive of a fibrous cyst wall coated with a high squamous intraepithelial lesion.The pelvic mass was removed,and a bilateral adnexectomy was implemented.Final pathology confirmed that the pelvic mass was a large inflammatory cyst with a cervical high-grade squamous intraepithelial lesion.After successful intervention,the patient was discharged one week after surgery and there was no recurrence of the vaginal stump at 43 mo.CONCLUSION When addressing benign uterine diseases,gynecologists should pay adequate attention to retaining the cervix.If the cervix is retained,patients require a close follow-up.展开更多
OBJECTIVE To investigate the value of human epididymis geneproduct 4 (HE4) in differential diagnosis of gynecological pelvictumors.METHODS The level of serum HE4 in 132 women wasdetermined. These women were divided in...OBJECTIVE To investigate the value of human epididymis geneproduct 4 (HE4) in differential diagnosis of gynecological pelvictumors.METHODS The level of serum HE4 in 132 women wasdetermined. These women were divided into three groups, i.e.,46 women with good health being classified as the normal control(NC) group, and based on clinicopathological results, the other 86with pelvic masses being classified into groups of benign (n = 56)and malignant lesions (n = 30), respectively.RESULTS The range of serum HE4 in the NC group was(23.5～46.0) pmol/L, with an average value of (34.1 ± 5.6) pmol/L;the range of serum HE4 in the benign lesion group was (30.1～58.9)pmol/L, with an average value of (39.1 ± 7.2) pmol/L; the range ofserum HE4 in the group of malignancy was (31.2～1430.0) pmol/L,and the average value was (248.7 ± 364.5) pmol/L. The level ofHE4 in the malignant lesion group was significantly higher thanthat in the other 2 groups, with a statistical difference, P < 0.001.The diagnostic index reached maximum (0.847) when the serumHE4 was at 51.6 pmol/L, and the sensitivity and specificity of HE4were 86.7% and 98.0%, respectively. The area under the receiver-operator characteristic curve (ROC) was 0.935 (95% CI 0.832～1.037,P = 0.000). The consistency checking Kappa value of HE4 in thediagnosis of pelvic malignant tumors was 0.867, P = 0.000.CONCLUSION The determination of serum HE4 is a goodindicator in differential diagnosis of benign and malignant ovariantumors.展开更多
Peritoneal loose bodies or “peritoneal mice” are rare well circumscribed benign masses composed of free-floating organized fat necrosis. They are usually asymptomatic and found as “incidentalomas” during Imaging. ...Peritoneal loose bodies or “peritoneal mice” are rare well circumscribed benign masses composed of free-floating organized fat necrosis. They are usually asymptomatic and found as “incidentalomas” during Imaging. Their pathogenesis is not well known. We report a rare case of giant intraperitoneal mice which was clinically misdiagnosed as left seminal vesicle malignancy. A review of the literature is also presented.展开更多
基金Supported by National Natural Science Foundation of China,No.81772790 and No.81602293Postgraduate Innovation Fund of 13th Five-year Comprehensive Investment,Tianjin Medical University,No.YJSCX201812
文摘BACKGROUND A large cervical cyst with a cervical high-grade squamous intraepithelial lesion arising from the cervical stump is rare.After supracervical hysterectomy,there is a risk of various lesions occurring in the cervical stump.We review the types and characteristics of cervical stump lesions and compare total hysterectomy with subtotal hysterectomy.Gynecologists should choose the most suitable surgical method based on both the patient’s condition and wishes.If the cervix is retained,patients require a close follow-up.CASE SUMMARY A 57-year-old woman was admitted to the Gynecology Department for a large pelvic mass.Her chief complaint was abdominal distention for two months.She had undergone subtotal supracervical hysterectomy for leiomyoma 14 years prior.Abdominal ultrasonography detected a 9.1 cm×8.5 cm×8.4 cm anechoic mass with silvery fluid in the pelvic cavity and high-risk human papilloma virus 53(HPV53)was positive.The admission diagnosis we first considered was a pelvic mass mimicking carcinoma of the cervical stump.We performed a laparotomy and a rapid frozen biopsy was suggestive of a fibrous cyst wall coated with a high squamous intraepithelial lesion.The pelvic mass was removed,and a bilateral adnexectomy was implemented.Final pathology confirmed that the pelvic mass was a large inflammatory cyst with a cervical high-grade squamous intraepithelial lesion.After successful intervention,the patient was discharged one week after surgery and there was no recurrence of the vaginal stump at 43 mo.CONCLUSION When addressing benign uterine diseases,gynecologists should pay adequate attention to retaining the cervix.If the cervix is retained,patients require a close follow-up.
基金supported by a grant from Subject of Guiding Plan for Scientific Research and Development of Science and Technology Department,Hebei Province,China(No.072761638).
文摘OBJECTIVE To investigate the value of human epididymis geneproduct 4 (HE4) in differential diagnosis of gynecological pelvictumors.METHODS The level of serum HE4 in 132 women wasdetermined. These women were divided into three groups, i.e.,46 women with good health being classified as the normal control(NC) group, and based on clinicopathological results, the other 86with pelvic masses being classified into groups of benign (n = 56)and malignant lesions (n = 30), respectively.RESULTS The range of serum HE4 in the NC group was(23.5～46.0) pmol/L, with an average value of (34.1 ± 5.6) pmol/L;the range of serum HE4 in the benign lesion group was (30.1～58.9)pmol/L, with an average value of (39.1 ± 7.2) pmol/L; the range ofserum HE4 in the group of malignancy was (31.2～1430.0) pmol/L,and the average value was (248.7 ± 364.5) pmol/L. The level ofHE4 in the malignant lesion group was significantly higher thanthat in the other 2 groups, with a statistical difference, P < 0.001.The diagnostic index reached maximum (0.847) when the serumHE4 was at 51.6 pmol/L, and the sensitivity and specificity of HE4were 86.7% and 98.0%, respectively. The area under the receiver-operator characteristic curve (ROC) was 0.935 (95% CI 0.832～1.037,P = 0.000). The consistency checking Kappa value of HE4 in thediagnosis of pelvic malignant tumors was 0.867, P = 0.000.CONCLUSION The determination of serum HE4 is a goodindicator in differential diagnosis of benign and malignant ovariantumors.
文摘Peritoneal loose bodies or “peritoneal mice” are rare well circumscribed benign masses composed of free-floating organized fat necrosis. They are usually asymptomatic and found as “incidentalomas” during Imaging. Their pathogenesis is not well known. We report a rare case of giant intraperitoneal mice which was clinically misdiagnosed as left seminal vesicle malignancy. A review of the literature is also presented.
