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
Background: Cardiac masses are not rare findings;they can be primary or secondary. The differential diagnosis may need surgical intervention in most cases. Case summary: A 42-year female presented with complaints of d...Background: Cardiac masses are not rare findings;they can be primary or secondary. The differential diagnosis may need surgical intervention in most cases. Case summary: A 42-year female presented with complaints of dyspnea, palpitations, ventricular premature beats, attacks of non-sustained ventricular tachycardia. Echocardiography revealed a myocardial septal mass on both sides in the right and left ventricles. The decision to operate was taken and the masses were removed. It was proved by histopathologic examination to be metastatic from her skin melanoma. Clinically, arrhythmias subsided. Conclusion: The decision of surgery proved unavoidable. Early diagnosis by surgical intervention is important for effective treatment.展开更多
BACKGROUND Paragonimiasis is a food-borne parasitic infection caused by lung flukes of the genus Paragonimus. Although the most common site of infection is the pleuropulmonary area, the parasite can also reach other p...BACKGROUND Paragonimiasis is a food-borne parasitic infection caused by lung flukes of the genus Paragonimus. Although the most common site of infection is the pleuropulmonary area, the parasite can also reach other parts of the body on its journey from the intestines to the lungs, ending up in locations such as the brain,abdomen, skin, and subcutaneous tissues. Ectopic paragonimiasis is difficult to diagnose due to the rarity of this disease.CASE SUMMARY Here, we report a rare case of simultaneous breast and pulmonary paragonimiasis in a woman presenting painless breast mass and lung nodule with a history of eating raw trout. To confirm the diagnosis, serologic testing and tissue confirmation of the breast mass were performed. The patient was treated with surgical resection of the mass and praziquantel medication.CONCLUSION Ectopic paragonimiasis is difficult to diagnose due to the rarity of this disease.Thus, thorough history-taking and clinical suspicion of parasitic infection are important.展开更多
BACKGROUND Monoclonal immunoglobulin can cause renal damage,with a wide spectrum of pathological changes and clinical manifestations without hematological evidence of malignancy.These disorders can be missed,especiall...BACKGROUND Monoclonal immunoglobulin can cause renal damage,with a wide spectrum of pathological changes and clinical manifestations without hematological evidence of malignancy.These disorders can be missed,especially when combined with other kidney diseases.CASE SUMMARY A 61-year-old woman presented with moderate proteinuria with normal renal function.She was diagnosed with IgA nephropathy combined with monoclonal gammopathy of undetermined significance after the first renal biopsy.Although having received immunosuppressive treatment for 3 years,the patient developed nephrotic syndrome.Repeated renal biopsy and laser microdissection/mass spectrometry analysis confirmed heavy chain amyloidosis.After nine cycles of bortezomib,cyclophosphamide and dexamethasone,she achieved very good partial hematological and kidney responses.CONCLUSION Renal injury should be monitored closely in monoclonal gammopathy patients without obvious hematological malignancy,especially in patients with other preexisting renal diseases.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.
文摘Background: Cardiac masses are not rare findings;they can be primary or secondary. The differential diagnosis may need surgical intervention in most cases. Case summary: A 42-year female presented with complaints of dyspnea, palpitations, ventricular premature beats, attacks of non-sustained ventricular tachycardia. Echocardiography revealed a myocardial septal mass on both sides in the right and left ventricles. The decision to operate was taken and the masses were removed. It was proved by histopathologic examination to be metastatic from her skin melanoma. Clinically, arrhythmias subsided. Conclusion: The decision of surgery proved unavoidable. Early diagnosis by surgical intervention is important for effective treatment.
文摘BACKGROUND Paragonimiasis is a food-borne parasitic infection caused by lung flukes of the genus Paragonimus. Although the most common site of infection is the pleuropulmonary area, the parasite can also reach other parts of the body on its journey from the intestines to the lungs, ending up in locations such as the brain,abdomen, skin, and subcutaneous tissues. Ectopic paragonimiasis is difficult to diagnose due to the rarity of this disease.CASE SUMMARY Here, we report a rare case of simultaneous breast and pulmonary paragonimiasis in a woman presenting painless breast mass and lung nodule with a history of eating raw trout. To confirm the diagnosis, serologic testing and tissue confirmation of the breast mass were performed. The patient was treated with surgical resection of the mass and praziquantel medication.CONCLUSION Ectopic paragonimiasis is difficult to diagnose due to the rarity of this disease.Thus, thorough history-taking and clinical suspicion of parasitic infection are important.
文摘BACKGROUND Monoclonal immunoglobulin can cause renal damage,with a wide spectrum of pathological changes and clinical manifestations without hematological evidence of malignancy.These disorders can be missed,especially when combined with other kidney diseases.CASE SUMMARY A 61-year-old woman presented with moderate proteinuria with normal renal function.She was diagnosed with IgA nephropathy combined with monoclonal gammopathy of undetermined significance after the first renal biopsy.Although having received immunosuppressive treatment for 3 years,the patient developed nephrotic syndrome.Repeated renal biopsy and laser microdissection/mass spectrometry analysis confirmed heavy chain amyloidosis.After nine cycles of bortezomib,cyclophosphamide and dexamethasone,she achieved very good partial hematological and kidney responses.CONCLUSION Renal injury should be monitored closely in monoclonal gammopathy patients without obvious hematological malignancy,especially in patients with other preexisting renal diseases.
