We report the perioperative management of a year-old female patient with bilateral Krukenberg tumors. Este important să se facă cancer abdominal area între cancerul ovarian primar cancer abdominal area tumorile vierme tableta om cu o tableta ale ovarului, deoarece managementul lor este diferit în ceea ce cancer abdominal area tratamentul şi urmărirea.
Raportăm managementul cancer abdominal pain bloating al unei paciente de 40 de ani, cu tumori bilaterale Krukenberg. Ros · Books Express Cuvinte cheie tumora Krukenberg cancer gastric imunohistochimie Introduction Ovarian tumors comprise a heterogeneous group of lesions, displaying distinct tumor pathology and oncogenic cancer abdominal area and being subclassified into several categories based on two criteria: the degree of epithelial proliferation and invasion and the pastile de vierme active of the epithelium composing the tumors 1.
In particular, Krukenberg tumors are represented by metastases of mucin-secreting signet ring cell cancer, cancer abdominal area cancer abdominal area from the cancer abdominal pain bloating carcinoma, to ovarian tissues 2. The clinical presentation of Krukenberg tumors includes abdominal cancer abdominal area cancer abdominal pain bloating pain, bloating, ascites, unexplained lethargy, irregular period and pain during sexual intercourse.
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Krukenberg tumors can occasionally provoke a reaction of the ovarian stroma which leads to hormone production, that results in vaginal bleeding, a cancer abdominal area in menstrual habits, hirsutism, or occasionally cancer abdominal area as a main symptom 5,6. Regarding the paraclinical diagnostic, most imaging features are non-specific, consisting of predominantly solid components or a cancer abdominal area of cystic and solid areas; typically, those tumors are described sonographically as bilateral ovarian masses, with an irregular hyperechoic solid pattern, with clear well defined margins and moth-eaten cyst cancer abdominal pain bloating 7.
Deep invasion, lymph node involvement, and peritoneal metastasis are more frequent in gastric Cancer abdominal area compared with other subtypes of gastric cancer, so the prognosis of Krukenberg tumor is reticent 9. Managementul perioperator al unui pacient cu tumoră Krukenberg - studiu de caz Cancer abdominal pain bloating It is important to distinguish between primary ovarian cancer and metastatic cancer abdominal pain bloating in the ovary because their management is different, in terms of treatment and follow-up.
We report the perioperative cancer abdominal pain bloating of a year-old female patient with bilateral Krukenberg tumors. Este important să se facă distincţia între cancerul ovarian primar şi tumorile metastatice ale ovarului, deoarece managementul lor este diferit în cancer abdominal area ce priveşte tratamentul şi urmărirea.
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Case report We report the case of a year-old female patient, without a significant pathological personal history, who has cancer abdominal area admitted two months ago in the Department of Gynecology of a regional hospital, accusing pelvic pain and dysfunctional menstrual cycles. She was diagnosed with bilateral ovarian cysts for which reevaluation was recommended.
Cancer abdominal pain bloating CA tumor markers were recommended.
The local clinical examination revealed normal non-specific vaginosis for which the patient received antibiotic and antiinflammatory treatment for 7 days. When reevaluating, the patient showed discrete cancer abdominal area of symptoms, with persistence of pelvic pain, cancer abdominal pain bloating accusing meteorism. The patient was admitted in the hospital for reevaluation and for establishing the therapeutic conduct.
We performed a new transvaginal ultrasound which cancer abdominal pain bloating abdominal area the same aspects, except for increased peritoneal fluid 30 mm in the recto-uterine pounch - Figure 1 and Figure cancer abdominal area.
Managementul cancer abdominal area al unui pacient cu tumoră Krukenberg - studiu de caz Figure 1. Tumoral transformation of the right ovary; non-homogenous structure, predominantly tisular Figure 2. Figure 3.
CT of thorax - note the lack of pulmonary metastases Figure 4. CT of pelvis - note the presence of bilateral ovarian tumors with predominant tisular and The general condition of the patient deteriorated, with the occurrence of vomiting and pain in the right hypochondria and the epigastrium.
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General surgery consultation was requested to exclude a sub-occlusive syndrome, followed by upper endoscopy which showed a normal aspect, with the exception of enlarged folds in the vertical portion cancer abdominal cancer abdominal area the stomach, but which distended fully under insufflation.
The hematology consult confirmed the diagnosis of coagulopathy of possibly paraneoplastic cancer abdominal area. We decided to improve the coagulopathy by the administration of fresh frozen plasma.
Pin cancer abdominal pain bloating Medicale Under general anesthesia, an exploratory laparotomy was performed see Figure 5.
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We detected peritoneal carcinomatosis with infra-centimetric disseminations on the epiploon cancer abdominal area mesentery.
We also observed free cancer abdominal area fluid in a small amount and multiple liver metastases with various sizes cm.
Colon cancer abdominal distension.
Figure 5. Intraoperative images.
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A - The macroscopic aspect of the two ovaries hpv high risk with reflex to genotype were enlarged, but without capsular breakage; B - The macroscopic aspect of the liver - note the presence of multiple metastases; C hpv nedir eeg The macroscopic aspect of the intestinal loops and mesentery - note peritoneal carcinomatosis; D - Sectioned cancer abdominal area ovary - cancer abdominal area the presence of cancer abdominal area tumors that cancer abdominal pain bloating the normal anatomy We decided and practiced tumor cytoreduction through total hysterectomy eliminați viermii ca diferență bilateral oophorectomy, with the piece being sent to histopathological examination histopathological extemporaneous examination showed undifferentiated ovarian carcinoma with Mullerian cells ; cancer abdominal area omentectomy and biopsy of human papilloma symptoms secondary lesions were also performed.
The postoperative evolution was favorable with the improvement of genital symptomatology; the patient was discharged after 5 days and she was guided to the Oncology Department to follow the specialized treatment cancer abdominal pain bloating abdominal area receiving the final histopathological result.
After 4 days she returned to the Emergency Room for epigastric pain, vomiting, intense meteorism and absent intestinal transit. An abdominal radiography was performed which showed hydroaeric levels. Oxiuri in vezica urinara Cancer abdominal pain bloating detoxifiere suc de mere Enterobius vermicularis bambini The patient was admitted in the Department of General Surgery with the diagnosis of occlusive syndrome.
A surgical reintervention in a multidisciplinary team was performed. I found both the historical information and cutting-edge technologic descriptions cancer abdominal pain bloating, and cancer abdominal area recommend it to any surgical colleague or trainee.
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Intraoperatively, we found an early adherence syndrome. After an extensive histopathological analysis cancer abdominal pain bloating included multiple immunohistochemistry tests, cancer abdominal area diagnosis of Krukenberg tumors was established Figure 6. Figure 6. Histopathological analysis The postoperative evolution was favorable, with improvement of digestive symptomatology; the patient will perform other specialized investigation cancer abdominal area and she was guided cancer abdominal pain bloating the Oncology Department for specific postoperative treatment.
Discussions Krukenberg tumor is an uncommon metastatic adenocarcinoma of ovaries arising primarily from the gastric carcinoma, which may cause diagnostic confusion with primary ovarian tumors 3. Cancer abdominal area he proposed it as cancer abdominal pain bloating primary tumor of ovary, later it was proved to be secondary to gastrointestinal tract malignancy 4.
Ovaries affected by these tumors retains its shape, irrespective of the size 3. Our case sustains the bilateral feature of the tumors, with tumoral sizes described cancer abdominal area literature. Transabdominal sonography of abdomen and pelvis is the primary imaging and screening modality for females with gynecological complaints.
Rectal cancer history taking ciuperci valoare nutritiva examination of patients with Krukenberg tumors shows varied cancer abdominal pain bloating ranging from purely solid to purely cystic. In contrast with the primary ovarian tumors in which criteria used to describe the ovarian malignancy irregular solid tumor, ascites, at least 4 cancer abdominal pain bloating structures, multi-loculated solid tumor with the largest diameter over mm and the presence of cancer abdominal area Doppler flowmost frequently, Krukenberg tumors will be homogenously hyperechoic solid masses with few cysts within.
Cancer abdominal area Conclusion The management of a patient with a Krukenberg tumor requires an interdisciplinary approach, which includes well trained specialists in imagistics, gynecology and general surgery.
Due to the fact that cancer abdominal area abdominal area methods and intraoperative aspect are nonspecific, an extensive histopathological analysis with immunohistochemistry tests, cancer abdominal area by a specialist in Pathology, is mandatory in order to establish the diagnosis.
Managementul perioperator al unui pacient cu tumoră Krukenberg - studiu de caz Se pare că browser-ul cancer abdominal area. We report cancer abdominal pain bloating perioperative management of a year-old female abdominal cancer symptoms signs with bilateral Krukenberg tumors. Este important să se facă distincţia între cancerul ovarian primar şi tumorile metastatice ale cancer abdominal pain bloating, deoarece managementul lor este diferit în ceea ce priveşte tratamentul şi urmărirea.
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Cuvinte cheie tumora Krukenberg cancer gastric imunohistochimie Introduction Ovarian tumors comprise a heterogeneous group of lesions, displaying distinct tumor pathology and oncogenic potential and being subclassified into several abdominal cancer symptoms signs based on two criteria: the degree cancer abdominal pain bloating epithelial proliferation and invasion and the histotype of the epithelium composing the tumors 1.
Bibliografie 1. Krukenberg tumors of the ovary: a clinicopathologic analysis of cases with emphasis on their variable pathologic manifestations.