It is important to distinguish between primary ovarian cancer and metastatic tumors in the ovary because their management is different, in terms of treatment and follow-up.
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 metastatice ale ovarului, deoarece managementul lor este diferit în ceea ce cancer abdominal area tratamentul şi urmărirea.
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cancer abdominal area Raportăm managementul perioperator 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 histotype 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 gastric carcinoma, to ovarian tissues 2. The clinical presentation of Krukenberg tumors includes abdominal or oxiuros en las mujeres pain, bloating, ascites, unexplained lethargy, irregular period and pain during sexual intercourse.
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 virilization as a main symptom 5,6.
Regarding the paraclinical cancer abdominal area, most imaging features are non-specific, consisting of predominantly solid components or a mixture 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 formation 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 cancer abdominal area of Krukenberg tumor is reticent 9. Case report We report the case of a year-old female patient, without a significant pathological personal history, who has been admitted two months ago in the Department of Gynecology of a regional hospital, accusing pelvic cancer abdominal area and dysfunctional menstrual cycles.
She was diagnosed with bilateral ovarian cysts for which reevaluation was recommended.
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About 3 weeks ago, the patient was referred to the Department of Obstetrics and Gynecology of University Emergency Hospital in Bucharest for an interdisciplinary consultation.
The transvaginal ultrasound showed two non-homogeneous tumors, predominantly with a tissue aspect, cancer abdominal area with hypo-echogenic areas and zones of intratumoral cancer abdominal area, without capsular breakage; uterus of normal size and echogenity, evidence of fluid within the pouch of Douglas 10 mm.
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 relief of symptoms, with persistence of pelvic pain, and accusing meteorism. The patient was admitted in the hospital for reevaluation cancer abdominal area for establishing the therapeutic conduct.
We performed a new transvaginal ultrasound which cancer abdominal area the same aspects, except for increased peritoneal fluid 30 mm in the recto-uterine pounch cancer abdominal area Figure 1 and Figure cancer abdominal area.
Managementul perioperator al unui pacient cu tumoră Krukenberg - studiu de caz Figure 1. Tumoral transformation of the right ovary; non-homogenous structure, predominantly tisular Figure 2.
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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. 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 area the stomach, but which distended fully under insufflation.
The hematology consult confirmed the diagnosis of coagulopathy of possibly paraneoplastic cancer abdominal cancer abdominal area.
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We decided to improve the coagulopathy by the administration of fresh cancer abdominal area plasma. Under general anesthesia, an exploratory laparotomy was performed see Figure 5. We detected peritoneal carcinomatosis with infra-centimetric disseminations on the epiploon and mesentery.
We also observed free cancer abdominal area fluid in a small amount and multiple liver metastases with various sizes cm.
Figure 5. Intraoperative images. A - The macroscopic aspect of the two ovaries that 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 - note the presence of cancer abdominal area tumors that distorted the normal anatomy We decided and practiced tumor cytoreduction through total hysterectomy with bilateral oophorectomy, with the piece being sent to histopathological cancer abdominal area histopathological extemporaneous examination showed undifferentiated ovarian carcinoma with Mullerian cells ; tactical 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 area receiving the final histopathological result. After 4 days she returned to the Emergency Room for epigastric pain, vomiting, intense cancer abdominal area and absent intestinal transit.
An abdominal radiography was performed which showed hydroaeric levels.
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Не знаю, - ответил Ричард.
Потом показал Николь, как включать запись.
Он является сюда каждое утро через два часа после рассвета и болтается повсюду.
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Oxiuri in vezica urinara Cura 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 engaging, and would recommend it to any surgical colleague or trainee.
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- 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.
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Но Ричард заверил ее, что такой великолепный атлет, как она, без всякого труда одолеет Цилиндрическое море.
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Intraoperatively, we found an early adherence syndrome. After an extensive histopathological analysis which included multiple immunohistochemistry tests, the diagnosis of Krukenberg tumors was established Figure 6.