Pseudo-Meigs syndrome is defined as the secondary accumulation of ascites and hydrothorax associated with pelvic tumor other than benign ovarian tumor such as fibroma, which classically resolve upon surgical removal of the tumor. Here we report a case of pseudo-Meigs syndrome caused by a giant uterine leiomyoma, which was initially suspected to be ovarian cancer. A 37-year old nulliparous woman presented with a 5-month history of abdominal distension and anorexia. Abdominal ultrasonography revealed the presence of a giant cystic lesion and solid mass in the peritoneal cavity along with a massive ascites. Chest X-ray images showed a small pleural effusion on the right side. Because general physicians suspected ovarian cancer and peritonitis carcinomatosis, the patient was referred to our hospital. Although the CA125 serum level was elevated (up to 331.8 U/ml), magnetic resonance imaging (MRI) showed the presence a giant sub-serosal uterine leiomyoma with cystic 2 degeneration, with dimensions 27×15×13 cm. A small dermoid cyst was also detected in the right ovary. The ascites was surgically removed and the patient underwent myomectomy and ovarian cystectomy. We concluded that the patient presented a degenerated leiomyoma with no pathological evidence of malignancy. And because the symptoms of the patient disappeared postoperatively and her CA125 serum levels returned to normal without recurrence of ascites, the patient was diagnosed with pseudo-Meigs syndrome.
Clear cell carcinoma (CCC) of the uterine cervix is rare, and its etiology is unclear, except for reports of prenatal diethylstilbestrol (DES) exposure. In this case report of a 78-year-old postmenopausal Japanese woman with pelvic endometriosis, cervical CCC presented as a deep interstitial tumor, strongly suggesting the patient suffered from cervical endometriosis for a long time. A cystic lesion without solid components was detected in the uterine cervix. Although the patient had regular gynecological examinations every 6 months, she presented 5 years later with a complaint of watery vaginal discharge. Ultrasonography and magnetic resonance imaging (MRI) detected a uterine cervical cystic mass with a solid component. Although no malignancy was confirmed preoperatively, surgery was performed under a high suspicion of cervical cancer. Intraoperative pathology revealed CCC in a solid tumor, so debulking surgery, including lymphadenectomy, was done. Endometrial tissue was found adjacent to the tumor, strongly suggesting the tumor arose from cervical endometriosis. Because endometriosis in ectopic sites carries a risk of carcinogenesis, as is the case in ovarian endometriosis, it may be recommended that a cervical cystic lesion with pelvic endometriosis should be followed up regularly for the early detection of uterine cancer.
BackgroundUterine rupture is a major cause of postpartum hemorrhage (PPH) that requires surgery. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is also helpful for PPH. However, the effectiveness of REBOA in PPH with cardiac arrest is unknown.Case PresentationA 40‐year‐old woman developed hemorrhagic shock due to uterine rupture after an induced delivery. She developed cardiac arrest, but was rescued by cardiopulmonary resuscitation (CPR), REBOA, a hysterectomy, and pelvic gauze packing. The hemodynamics were too unstable to move to the operating room. Then we initiated the CPR assisted with REBOA and decided to activate massive transfusion and perform laparotomy in the emergency room. She was finally discharged home without neurological sequelae.ConclusionOur damage control strategy, including REBOA‐assisted CPR, contributed to saving the life of a patient with a life‐threatening PPH.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.