The objective of this study was to analyze the clinical benefit of histopathologic analysis of appendectomy specimens from patients with an initial diagnosis of acute appendicitis. We retrospectively analyzed the demographic and histopathologic data of 1255 patients (712 males, 543 females; age range, 17-85 years) who underwent appendectomy to treat an initial diagnosis of acute appendicitis. Patients who underwent incidental appendectomy during other surgeries were excluded from the study. Histopathologic findings of the appendectomy specimens were used to confirm the initial diagnosis. Ninety-four percent of the appendectomy specimens were positive for appendicitis. Of those, 880 were phlegmonous appendicitis, 148 were gangrenous appendicitis with perforation, and the remaining 88 showed unusual histopathologic findings. In the 88 specimens with unusual pathology, fibrous obliteration was observed in 57 specimens, carcinoid tumor in 11, Encheliophis vermicularis parasite infection in 8, granulatomous inflammation in 6, appendiceal endometriosis in 2, and 1 specimen each showed mucocele, eosinophilic infiltration, Taenia saginata parasite infection, and appendicular diverticulitis. All carcinoid tumors were located in the distal appendix. Six of the 11 carcinoid tumors were defined by histopathology as involving tubular cells, and the other 5 as involving enterochromaffin cells. Six patients had muscularis propria invasion, 2 patients had submucosa invasion, 2 patients had mesoappendix invasion, and 1 patient had serosal
Endometriosis is defined as the presence of ectopic endometrial tissue outside the lining of the uterine cavity. It occurs most commonly in pelvic sites such as ovaries, cul-de-sac, and fallopian tubes but also can be found associated with the lungs, bowel, ureter, brain, and abdominal wall. Abdominal wall endometriosis, also known as scar endometriosis, is extremely rare and mainly occurs at surgical scar sites. Although many cases of scar endometriosis have been reported after a cesarean section, some cases of scar endometriosis have been reported after an episiotomy, hysterectomy, appendectomy, and laparoscopic trocar port tracts. To our knowledge, 14 case reports related to trocar site endometriosis have been published in the English language literature to date. Herein, we present the case of a 20-year-old woman (who had been previously operated on for left ovarian endometrioma 1.5 years ago by laparoscopy) with the complaint of a painful mass at the periumbilical trocar site with cyclic pattern. Consequently, although rare, if a painful mass in the surgical scar, such as the trocar site, is found in women of reproductive age with a history of pelvic or obstetric surgery, the physician should consider endometriosis.
Squamous cell carcinoma (SCC) of the renal pelvis is a rare neoplasm and is usually associated with long standing renal stone disease. This tumor is aggressive in nature and usually has a poor prognosis. We report a case who presented with sudden significant weight loss. During the radiologic investigation, a renal mass and staghorn calculi were detected in the right kidney. The patient subsequently underwent right radical nephrectomy. Pathological diagnosis was SCC of renal pelvis with extensive infiltration in to the renal parenchyma. The radiologic imaging features and histopathologic findings of this rare tumor are discussed in this report.
Appendiceal endometriosis is an unusual histopathological finding. A preoperative diagnosis is difficult, but this condition should be considered when women of childbearing age present with clinical symptoms of acute appendicitis.
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