Background. Inflammatory pseudotumor (IPT) of the cervix uteri has been reported in only one patient. Here, we present a case of cervical IPT with bilateral parametrial involvement causing hydroureteronephrosis. Case....Background. Inflammatory pseudotumor (IPT) of the cervix uteri has been reported in only one patient. Here, we present a case of cervical IPT with bilateral parametrial involvement causing hydroureteronephrosis. Case. A 48- year- old, gravida 2, para 1, woman was referred for evaluation of lower abdominal pain and right-sided hydroureteronephrosis. On speculum and colposcopic examinations, the cervix appeared normal. Computed tomo-graphy scan revealed a 5 cm × 4cm mass in the cervix invading both parametria. At laparotomy, the cervix was globally enlarged and both parametria were infiltrated by a tumor of rubbery consistency. After freeing both ureters, the cervix was removed with bilateral parametria and 2- cm vaginal cuff. Histologically, the tumor was characterized by proliferation of fibroblast-like spindle cells and diffuse infiltration of plasma cells and lymphocytes. Immunohistochemical staining showed that the lymphocytes were polyclonal. Immunostaining for smooth muscle actin was negative. The tumor was thus identified as inflammatory pseudotumor. Cervical stroma, bilateral parametria, and subepithelial tissues of the vagina were involved with tumor. However, invasion was not identified in the epithelia of the cervix and vagina or surgical margins of the resected specimen. Postoperative course was uneventful. There is no evidence of recurrent disease 8 months following surgery. Conclusion. The case we present is the second reported case of cervical IPT. It is unique in showing locally aggressive behavior. Surgical resection appears to be the treatment of choice for IPT.展开更多
Background. We present the first case of an ovarian dysgerminoma complicated by pseudo- Meigs’ syndrome. Furthermore, this is the fourth reported case of ovarian dysgerminoma with functioning ovarian stroma resulting...Background. We present the first case of an ovarian dysgerminoma complicated by pseudo- Meigs’ syndrome. Furthermore, this is the fourth reported case of ovarian dysgerminoma with functioning ovarian stroma resulting elevated androgen levels preoperatively. Case. A 25- year- old white female was referred to our department for abdominal swelling and a rapidly enlarging abdominal mass. Chest X- ray showed massive right pleural effusion. Abdominopelvic CT scan showed a left adnexal solid mass and ascites. Preoperative abnormally elevated hormone levels were as follows: free testosterone 7.7 pg/mL, androstenodione 13.6 ng/mL, and cortisol 29.4 μ g/dL. Left salpingo- oophorectomy and wedge resection of the right ovary were performed. Final histopathological investigation of the left ovary was dysgerminoma associated with stromal luteinization. Conclusion. Dysgerminoma should be considered in the differential diagnosis in a young patient with a pelvic mass, ascites, and pleural effusion and preoperative counseling should be directed accordingly. In addition, dysgerminomas may be accompanied by ovarian stromal luteinization and steroid hormone production, which occasionally result in chemical or clinical hyperandrogenism.展开更多
文摘Background. Inflammatory pseudotumor (IPT) of the cervix uteri has been reported in only one patient. Here, we present a case of cervical IPT with bilateral parametrial involvement causing hydroureteronephrosis. Case. A 48- year- old, gravida 2, para 1, woman was referred for evaluation of lower abdominal pain and right-sided hydroureteronephrosis. On speculum and colposcopic examinations, the cervix appeared normal. Computed tomo-graphy scan revealed a 5 cm × 4cm mass in the cervix invading both parametria. At laparotomy, the cervix was globally enlarged and both parametria were infiltrated by a tumor of rubbery consistency. After freeing both ureters, the cervix was removed with bilateral parametria and 2- cm vaginal cuff. Histologically, the tumor was characterized by proliferation of fibroblast-like spindle cells and diffuse infiltration of plasma cells and lymphocytes. Immunohistochemical staining showed that the lymphocytes were polyclonal. Immunostaining for smooth muscle actin was negative. The tumor was thus identified as inflammatory pseudotumor. Cervical stroma, bilateral parametria, and subepithelial tissues of the vagina were involved with tumor. However, invasion was not identified in the epithelia of the cervix and vagina or surgical margins of the resected specimen. Postoperative course was uneventful. There is no evidence of recurrent disease 8 months following surgery. Conclusion. The case we present is the second reported case of cervical IPT. It is unique in showing locally aggressive behavior. Surgical resection appears to be the treatment of choice for IPT.
文摘Background. We present the first case of an ovarian dysgerminoma complicated by pseudo- Meigs’ syndrome. Furthermore, this is the fourth reported case of ovarian dysgerminoma with functioning ovarian stroma resulting elevated androgen levels preoperatively. Case. A 25- year- old white female was referred to our department for abdominal swelling and a rapidly enlarging abdominal mass. Chest X- ray showed massive right pleural effusion. Abdominopelvic CT scan showed a left adnexal solid mass and ascites. Preoperative abnormally elevated hormone levels were as follows: free testosterone 7.7 pg/mL, androstenodione 13.6 ng/mL, and cortisol 29.4 μ g/dL. Left salpingo- oophorectomy and wedge resection of the right ovary were performed. Final histopathological investigation of the left ovary was dysgerminoma associated with stromal luteinization. Conclusion. Dysgerminoma should be considered in the differential diagnosis in a young patient with a pelvic mass, ascites, and pleural effusion and preoperative counseling should be directed accordingly. In addition, dysgerminomas may be accompanied by ovarian stromal luteinization and steroid hormone production, which occasionally result in chemical or clinical hyperandrogenism.
