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
目的:探讨超声与核磁共振(MRI)在鉴别女性盆腔肿物中的诊断价值。方法:选取2020年1月-2022年12月于宜昌市中心人民医院行手术治疗的65例女性盆腔肿物患者,收集所有患者的临床资料,内容包括术前超声及MRI检查结果、术后病理资料等。结果...目的:探讨超声与核磁共振(MRI)在鉴别女性盆腔肿物中的诊断价值。方法:选取2020年1月-2022年12月于宜昌市中心人民医院行手术治疗的65例女性盆腔肿物患者,收集所有患者的临床资料,内容包括术前超声及MRI检查结果、术后病理资料等。结果:在盆腔肿物的定位诊断中,MRI检查的准确率高于超声(95.38%vs 83.08%,P<0.05),其中腹膜内肿物MRI定位符合率97.92%,超声定位符合率为93.75%;腹膜后肿物MRI定位符合率88.24%,超声定位符合率为52.94%。在盆腔肿物诊断良恶性方面,MRI检查的灵敏度(98.00%vs 92.00%)、特异度(86.67%vs 66.67%)和符合率(95.38%vs 86.15%)均优于超声检查组。良性病变最常见的病理类型为子宫肌瘤、卵巢囊肿及输卵管积液/积脓,恶性病变最常见的病理类型为腹膜后淋巴肿瘤、卵巢恶性肿瘤。本研究发现腹膜内与腹膜后肿物平均直径差异有统计学意义(4.5±1.7 cm vs 7.9±3.4 cm)(P<0.05)。结论:MRI在女性盆腔肿物定位及良恶性鉴别诊断方面均优于超声。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.
文摘目的:探讨超声与核磁共振(MRI)在鉴别女性盆腔肿物中的诊断价值。方法:选取2020年1月-2022年12月于宜昌市中心人民医院行手术治疗的65例女性盆腔肿物患者,收集所有患者的临床资料,内容包括术前超声及MRI检查结果、术后病理资料等。结果:在盆腔肿物的定位诊断中,MRI检查的准确率高于超声(95.38%vs 83.08%,P<0.05),其中腹膜内肿物MRI定位符合率97.92%,超声定位符合率为93.75%;腹膜后肿物MRI定位符合率88.24%,超声定位符合率为52.94%。在盆腔肿物诊断良恶性方面,MRI检查的灵敏度(98.00%vs 92.00%)、特异度(86.67%vs 66.67%)和符合率(95.38%vs 86.15%)均优于超声检查组。良性病变最常见的病理类型为子宫肌瘤、卵巢囊肿及输卵管积液/积脓,恶性病变最常见的病理类型为腹膜后淋巴肿瘤、卵巢恶性肿瘤。本研究发现腹膜内与腹膜后肿物平均直径差异有统计学意义(4.5±1.7 cm vs 7.9±3.4 cm)(P<0.05)。结论:MRI在女性盆腔肿物定位及良恶性鉴别诊断方面均优于超声。
