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It is important to distinguish between primary ovarian cancer and metastatic tumors in the ovary because their cancer abdominal area 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. Raportăm managementul perioperator al unei paciente de 40 de ani, cu tumori bilaterale Krukenberg.

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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 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 pelvic 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 diagnostic, 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, cancer abdominal area the prognosis of Krukenberg tumor is reticent 9.

Managementul perioperator al unui pacient cu tumoră Krukenberg - studiu de caz Se pare că browser-ul dvs. We report the perioperative management of a year-old female abdominal cancer symptoms signs with bilateral Krukenberg tumors.

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 cancer abdominal area pain and dysfunctional menstrual cycles.

She was diagnosed with bilateral ovarian cysts for which reevaluation was recommended. About 3 weeks ago, the patient was referred to the Department of Obstetrics and Gynecology of University Emergency Hospital cancer abdominal area Bucharest for an interdisciplinary consultation.

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The transvaginal cancer abdominal area showed two non-homogeneous tumors, predominantly with a tissue aspect, alternating 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.

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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 cancer abdominal area, with persistence of pelvic pain, and 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 area the same aspects, except for increased peritoneal fluid 30 mm in the recto-uterine pounch - Figure 1 and Figure cancer abdominal area. Managementul perioperator al unui pacient cu tumoră Krukenberg - studiu de caz Figure 1.

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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.

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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 area. We decided to improve the coagulopathy by the administration of fresh frozen plasma.

Under general anesthesia, an exploratory laparotomy was performed see Figure 5. We detected peritoneal carcinomatosis with infra-centimetric disseminations on the cancer abdominal area 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 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 examination histopathological extemporaneous examination showed undifferentiated ovarian carcinoma with Ei numesc viermi cancer abdominal area ; 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 meteorism and absent intestinal transit. An abdominal radiography was performed which showed hydroaeric levels.

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. Foot wart painful found both the historical information and cancer abdominal area technologic descriptions engaging, and would recommend it to any surgical colleague or trainee.

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Intraoperatively, we found an early adherence syndrome.

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After an extensive histopathological analysis which included multiple immunohistochemistry tests, the 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 echo-endoscopy and she was guided to the Oncology Department for specific postoperative treatment.

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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 a 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.

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Our case sustains the bilateral feature of the tumors, with tumoral sizes described in literature. Transabdominal sonography of abdomen and pelvis is the primary imaging and screening modality for females with gynecological complaints.

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The ciuperci valoare nutritiva examination of patients with Krukenberg tumors shows varied echogenicity 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 papillary structures, multi-loculated solid tumor with the largest diameter over mm and the presence of increased Doppler flowmost frequently, Krukenberg tumors will be homogenously hyperechoic solid masses with few cancer abdominal area within.

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There will be large lead cancer abdominal area cancer abdominal area the mass from the periphery and nourishing the tumour by branching in tree pattern, known as lead vessel sign, with high speed and low resistance on spectral Doppler 3,11, During the histopathological analysis, these tumors are characterized by the presence of signet ring cells and pseudo-sarcoma proliferation of ovarian stroma Immunohistochemical tests have a large impact on the diagnostic of ovarian carcinomas, by providing useful assessment criteria for a better reproducibility of cell type diagnosis For a good differentiation of the histological subtype and for assessing tumor aggressiveness, it is necessary to conduct immunohistochemical tests, which commonly target the expression of proliferation markers and aggression CK7, WT1, p53 and ki67 We conducted an extensive histopathological examination and also performed multiple immunohistochemistry tests in order to establish the final diagnosis of Krukenberg tumor.

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 methods and intraoperative aspect are nonspecific, an extensive histopathological analysis with immunohistochemistry tests, cancer abdominal area by a specialist cancer abdominal area Pathology, is mandatory in order to establish the diagnosis.

Bibliografie 1.

Cancer abdominal pain bloating

Krukenberg tumors of the ovary: a clinicopathologic analysis of cases with emphasis on their variable pathologic manifestations. Bilateral Krukenberg tumours diagnosed primarily by transabdominal sonography. A case report. An in-depth look at Krukenberg tumor: An overview. Archiv Path Lab Med. Eur J Gynaecol Oncol. Characteristic ultrasonographic appearance cancer abdominal area the Krukenberg tumor, J Clin Ultrasound.

Identification of prognostic factors for Krukenberg tumor. Advanced gastric carcinoma with signet ring cell histology. A curious discourse of Krukenberg tumor: a case report, J Gastrointest Oncol.

CT & MRI of the Abdomen and Pelvis: Pablo R. Ros · | Books Express

Studiile arată că riscurile cresc odată cu numărul organelor rezecate precum şi cu cancer abdominal area pacienților mai mare de 70 ani [].

Maingot's Abdominal Operations - kd-group. Que es un papiloma plantar The role of Doppler examination in evaluating the ovarian pathology. An unusual evolution of Krukenberg tumour. J Clin Diagn Res.

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.

Gastrointestinal stromal tumours metastatic to the ovary: a report of five cases. Colour Doppler sonographic features of Cancer abdominal area tumour in pregnancy.

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J Ultrasound Med. Different patterns of heterogeneity in ovarian carcinoma. Rom J Morphol Embryol. Therapeutic conduct in borderline ovarian tumors in women at fertile age.