Background: Lipoleiomyomas are uncommon benign neoplasms composed of various mixtures of long intersecting bundles of bland smooth-muscle cells and mature adipocytes. These neoplasms are predominantly located in uteri and commonly occur in asymptomatic perimenopausal and postmenopausal women. Although radiologic examination is important for preoperative diagnosis and discerning the exact location of a lipoleiomyoma, the final pathologic examination confirms this diagnosis. This case of lipoleiomyoma of the uterus in a premenopausal woman is reported because because of this patient's rare presentation. Case: A 40-year-old, gravida 3, para 3, premenopausal woman presented with pain in her abdomen and dyspepsia for 45 days. Contrast-enhanced computed tomography scan results were suggestive of a possible mitotic etiology of ovarian origin. An exploratory laparotomy was performed and the neoplasm was examined histologically. Results: During the operation, the mass was found to be a large subserosal cervical fibroid growth, but the patient had healthy ovaries. The histopathology was distinctive and typical of a lipoleiomyoma. Conclusions: It is important to differentiate a lipoleiomyoma from an ovarian neoplasm that requires surgical excision. ( J GYNECOL SURG 30:24)
Background: Ovarian immature teratoma (IMT) with gliomatosis peritonei (GP) is a rare condition. IMT of the ovary represents 1% of all ovarian cancers. The majority of these are 5-31 cm in diameter. This article describes a case of a giant IMT (22.8 kg) in a girl with GP, which is an extremely rare presentation. Case: A 15-year-old girl presented with abdominal distension and pain of insidious onset. On clinical examination, a huge abdominal mass was found. Contrast-enhanced computed tomography (CECT) showed a large solid cystic abdominopelvic mass with multiple areas of calcified foci and fat density, likely to be malignant, and of ovarian origin. Serum alpha-fetoprotein (AFP), CA-125, and CA-15.3 were 1805 international units (IU)/mL, 1475 IU/mL, and 69.6 IU/mL, respectively. Left salpingo-oophorectomy with omentectomy was performed and samples were sent for histopathologic examination. Results: Microscopically, the ovary revealed IMT grade I, and the omentum showed an implant of mature glial tissue (GP). The patient had no complications at her 6-month follow-up. Conclusions: This is the first reported case of IMT of such massive size, with GP. This case demonstrates that IMT can grow to an enormous size (weighing >20 kg) and should be considered whenever gross abdominal distension is seen in young women. With peritoneal implants suspected to be of a teratomatous nature, thorough and extensive sampling is essential to exclude the presence of immature elements that may imply a poor prognosis and require aggressive therapy. ( J GYNECOL SURG 30:222)
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