Ultrasonography Evaluation of Pelvic Masses

Chu, Linda C.; Coquia, Stephanie; Hamper, Ulrike M.

doi:10.1016/j.rcl.2014.07.003

Cited by 12 publications

(10 citation statements)

References 57 publications

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“…The characterization of neovascularization includes thin walls, a small lumen, absents of muscle layer, and compression of peripheral blood vessels. Therefore, peripheral blood vessels are distorted and even the normal blood vessel distribution is destructed, resulting in abnormal hemodynamics ( 13 ). In general, these auxiliary examinations, especially HFUS combined with CEUS, are of great significance for detecting benign and malignant tumors.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Dermoscopic, High-Frequency Ultrasound, Contrast-Enhanced Ultrasound Appearances and Special Treatment of a Patient With Syringoid Eccrine Carcinoma on the Chest

et al. 2021

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This article aims to explain the use of a variety of noninvasive of minimally invasive examinations to obtain reliable diagnostic clues. The choice of treatment methods and repair techniques for wound defects are also critical in terms of the prognosis. Here, we describe the case of a 53-year-old male patient who visited our dermatology clinic due to a red plaque on the inner side of his left nipple without any symptoms for more than 30 years. He was given dermoscopy, high-frequency ultrasound (HFUS), Color Doppler flow imaging (CDFI), and contrast-enhanced ultrasound (CEUS) examinations. Currently, there are no literatures on these auxiliary examinations for this disease. Dermoscopy revealed that there were abundant blood vessels on the periphery of the skin lesion with obvious dilation. HFUS revealed an inhomegeneous hypoechoic solid mass in the dermis with clear borders and irregular shape. CDFI indicated that there are abundant blood flow signals in the periphery and central of the tumor. CEUS showed a mixed inhomogeneous, grid-like high-enhancement pattern. Based on the above auxiliary findings, the possibility of malignant lesion was suspected. Therefore, the patient was given a pathological examination, which showed that many luminal structures of the dermis layer were embedded in the hyperplastic fibrous tissue. The atypical cells were not obvious but showed an infiltrating growth pattern. Immunohistochemistry showed positive reaction for cytokeratin 7 (CK7), epithelial membrane antigen (EMA), and carcinoembryonic antigen (CEA) and a weak positive results was obtained for S-100. There was also a negative result for CK20, gross cystic disease fluid protein 15 (GCDFP-15), and P63. As a result, the patient was diagnosed with “syringoid eccrine carcinoma.” The treatment was surgical excision. Mohs microsurgery was combined with the looped, broad, and deep-buried suturing technique (LBD tension-reduced suturing technique). This technique directly sutures the wound instead of carrying out traditional skin grafting or flap transfer. The postoperative follow-up results were satisfactory as no obvious keloid formed on the wound during the follow-ups. In conclusion, ultrasound is greatly advantageous in tumor morphology and hemodynamics. It orients the therapeutic management and assesses the therapeutic efficacy and the tumoral prognosis. In surgical treatments, a less-traumatic operation should be selected to reduce the patient’s pain.

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Section: Discussionmentioning

confidence: 99%

Case Report: Dermoscopic, High-Frequency Ultrasound, Contrast-Enhanced Ultrasound Appearances and Special Treatment of a Patient With Syringoid Eccrine Carcinoma on the Chest

et al. 2021

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“…[ 13 ] Since mucinous tumors are usually large in size, manifest as multicystic lesions, and contain characteristic internal components such as septations with low-level internal echoes, discrimination between benign and malignant pathology is difficult with sonographic findings alone. [ 14 ] Brenner tumors often appear as a solid mass with internal echoes and are generally similar to fibroma and uterine leiomyoma, and borderline or malignant ovarian tumors contain mixed cystic components and need to be discriminated from other malignant ovarian masses. [ 15 ] Absence of arterial flow in the twisted ovarian pedicle was identified in color Doppler test performed to differentiate ovarian torsion.…”

Section: Discussionmentioning

confidence: 99%

“…[ 15 ] Absence of arterial flow in the twisted ovarian pedicle was identified in color Doppler test performed to differentiate ovarian torsion. [ 14 ] However, despite blood flow to the ovaries in color Doppler ultrasound, the likelihood of torsion cannot be completely excluded. [ 16 ]…”

Section: Discussionmentioning

confidence: 99%

Ovarian torsion of mixed epithelial tumor misdiagnosed as a malignancy in postmenopausal woman

Jeon

Ryu²,

Seo³

et al. 2017

Medicine

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Rationale:Adnexal torsion is 1 of the most common emergency gynecological disease. It is more often diagnosed in reproductive age, but rarely in postmenopausal women. The clinical symptoms of adnexal torsion are nonspecific in postmenopausal women. Epithelial ovarian tumors are common in adults, and the risk of malignancy increases with age, especially after menopause. So, it is difficult to diagnose adnexal torsion precisely compared with reproductive women, and most cases of adnexal torsion with postmenopausal women are diagnosed as a malignancy preoperatively. We report a case of ovarian torsion with mixed epithelial tumor misdiagnosed as a malignancy in postmenopausal woman.Patient concerns:A 65-year-old woman presented lower left abdominal pain, and there was slight abdominal distension, but no tenderness or rebound tenderness on abdominal palpation.Diagnoses:Radiologic assessments showed a huge multiseptated cystic mass with solid portion in the left ovary, and malignancy was suspected. The test for serum tumor markers revealed normal levels of cancer antigen 125 (CA-125).Interventions:The patient underwent a laparotomy and there was torsion of the left ovary. We conducted frozen biopsy of left ovary for confirming malignancy before performing staging surgery.Outcomes:The result of a frozen section biopsy confirmed a borderline Brenner tumor associated with a benign mucinous tumor. Subsequently, total hysterectomy and right salpingo-oophorectomy were performed. The operation was completed without addition proceduresLessons:Ovarian torsion is benign in most cases and malignancy is rare. Although very rare, ovarian torsion can occur in postmenopausal women, and it should be taken into consideration that the possibility of malignancy is low in postmenopausal women with normal CA-125 levels. Instead of performing staging surgery, it appears to be appropriate to carry out surgery based on the result of intraoperative frozen section biopsy so that we were able to avoid unnecessary surgical procedures.

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“…It has the advantage of being inexpensive, widely available and offers superior tissue characterization compared with computed tomography. Many pelvic masses have characteristic sonographic appearances that allow for confident diagnosis and management . Nevertheless, despite the recent development of the 3‐D ultrasound, with and without power Doppler , the misinterpretation of images is not uncommon.…”

Section: Introductionmentioning

confidence: 99%

“…Many pelvic masses have characteristic sonographic appearances that allow for confident diagnosis and management. 1 Nevertheless, despite the recent development of the 3-D ultrasound, with and without power Doppler, the misinterpretation of images is not uncommon. In fact, a bladder diverticulum can occasionally appear as a complex pelvic mass, not clearly connected to the bladder.…”

Section: Introductionmentioning

confidence: 99%

Occasional finding of giant bladder diverticulum that simulated an ovarian cyst: A case report and literature review

Braga

Serati

Vitelli

et al. 2016

J of Obstet and Gynaecol

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We present a case of a preoperatively unrecognized giant bladder diverticulum in a 63-year-old postmenopausal woman. We carried out preoperative ultrasonographic evaluation and suspected an ovarian cyst. We performed two transvaginal ultrasonography scans before surgery, asking the patient to totally empty her bladder. Consequently, we decided to subject the patient to laparoscopic cyst removal. However, during surgery, the presumed ovarian cyst was not found and a bladder diverticulum was suspected. To confirm our hypothesis, we filled the bladder with saline until the reappearance of giant swelling and we recognized a bladder diverticulum. This case shows that diagnosis based on imaging alone can reveal unpleasant pitfalls. It is important to integrate clinical information, and to consider other possible investigations in order to reduce the chances of a misdiagnosis.

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Ultrasonography Evaluation of Pelvic Masses

Cited by 12 publications

References 57 publications

Case Report: Dermoscopic, High-Frequency Ultrasound, Contrast-Enhanced Ultrasound Appearances and Special Treatment of a Patient With Syringoid Eccrine Carcinoma on the Chest

Case Report: Dermoscopic, High-Frequency Ultrasound, Contrast-Enhanced Ultrasound Appearances and Special Treatment of a Patient With Syringoid Eccrine Carcinoma on the Chest

Ovarian torsion of mixed epithelial tumor misdiagnosed as a malignancy in postmenopausal woman

Occasional finding of giant bladder diverticulum that simulated an ovarian cyst: A case report and literature review

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