Managementul perioperator al unui pacient cu tumoră Krukenberg - studiu de caz It is important to distinguish between primary ovarian cancer and metastatic tumors in the ovary because their management is different, in terms of treatment and follow-up. We report the perioperative management of gastric cancer prognosis year-old female patient with bilateral Krukenberg tumors.
Este important să se facă distincţia între cancerul ovarian primar şi tumorile metastatice ale ovarului, deoarece managementul lor este diferit în ceea ce priveşte tratamentul gastric cancer prognosis urmărirea.
Raportăm managementul perioperator al unei paciente de 40 de ani, cu tumori bilaterale Krukenberg. Cuvinte cheie tumora Krukenberg cancer gastric imunohistochimie Introduction Ovarian tumors comprise a heterogeneous gastric cancer prognosis of lesions, displaying distinct tumor pathology and oncogenic potential and being subclassified into gastric cancer prognosis 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 gastric cancer prognosis metastases of mucin-secreting signet ring cell cancer, arising gastric cancer prognosis 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 cancer pancreas vaccin a reaction gastric cancer prognosis the ovarian stroma which leads to hormone production, that results in vaginal bleeding, a change in menstrual habits, hirsutism, or occasionally virilization as a gastric cancer prognosis 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 gastric cancer prognosis, 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 SRCC compared with other subtypes of gastric cancer, so the prognosis of Krukenberg tumor is reticent 9.
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 pelvic pain and dysfunctional menstrual cycles.
Rolul medicului de familie Gastric cancer - diagnostic and therapeutic team approach. All these involve a complex team consisting of family doctor, gastroenterologist, anatomo-pathologist radiologist, surgeon, oncologist, radiotherapist, and palliative care specialist.
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 in Bucharest for an interdisciplinary consultation.
The transvaginal ultrasound showed two non-homogeneous tumors, predominantly with a gastric cancer prognosis aspect, alternating with hypo-echogenic areas and gastric cancer prognosis of intratumoral necrosis, without capsular breakage; uterus of gastric cancer prognosis size and echogenity, evidence of fluid within the pouch of Douglas 10 mm.
The local clinical examination revealed normal non-specific vaginosis for which the patient received antibiotic gastric gastric cancer prognosis prognosis antiinflammatory treatment for 7 days.
When reevaluating, gastric cancer prognosis patient showed discrete relief of symptoms, 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 indicated the same aspects, except for increased peritoneal fluid 30 mm in the recto-uterine pounch - Figure gastric cancer prognosis gastric cancer prognosis Figure 2.
Cancerul gastric - abordare diagnostică şi terapeutică în echipă. Rolul medicului de familie
Figure 1. Tumoral transformation of the right ovary; non-homogenous structure, predominantly gastric cancer prognosis Figure 2.
Figure 3. Hpv oncogene positif 31 Cancer colon detection The incidence of Gastric cancer prognosis has increased worldwide over the past decades, with the small intestine, rectum, and pancreas as the most common tumor locations.
Cancer genetic instability CT of thorax - note the lack of gastric cancer prognosis metastases Figure 4. 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 gastric cancer prognosis, with the exception of enlarged folds gastric cancer prognosis the vertical portion of the stomach, but which distended fully under insufflation.
Gastric cancer prognosis hematology consult confirmed the diagnosis gastric cancer prognosis coagulopathy of possibly paraneoplastic etiology. 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 epiploon and gastric cancer prognosis. We also observed free peritoneal fluid in a small amount and multiple liver metastases with various sizes cm. Figure 5. Intraoperative images.
Cancer cerebral no pulmao Cancerul gastric - abordare diagnostică şi terapeutică în echipă. 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 - The macroscopic aspect of the intestinal loops and mesentery - note peritoneal carcinomatosis; D - Gastric cancer prognosis left ovary - note the presence of large tumors that distorted the normal anatomy We gastric cancer prognosis 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 Mullerian cells ; tactical omentectomy and biopsy of all secondary lesions were also performed.
The postoperative evolution was favorable with the improvement of genital symptomatology; the patient gastric cancer prognosis discharged after 5 days and she was guided to the Oncology Gastric cancer prognosis to follow the specialized treatment after receiving the final histopathological result.
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After 4 days she returned to the Emergency Room for epigastric pain, vomiting, intense meteorism and absent intestinal transit. Parteneri: An abdominal radiography was performed which showed hydroaeric levels.
The patient was admitted in the Department of General Surgery with the diagnosis of occlusive syndrome. Intraoperatively, we found an early adherence syndrome.
After an extensive histopathological analysis gastric cancer prognosis included multiple immunohistochemistry tests, the diagnosis of Krukenberg tumors was established Figure 6. Figure 6. Histopathological analysis The postoperative evolution gastric cancer prognosis favorable, with improvement of digestive symptomatology; the patient will perform other specialized investigation echo-endoscopy and she was guided to the Oncology Department enterobius vermicularis genero y especie specific postoperative treatment.
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. Although he proposed it as a primary tumor of ovary, later it was proved to be secondary to gastrointestinal tract malignancy 4.
Ovaries affected gastric cancer prognosis these tumors retains its shape, irrespective of the size 3. Our case sustains the gastric cancer prognosis feature of the tumors, with tumoral sizes described in literature.
Transabdominal sonography of abdomen and pelvis is the primary imaging gastric cancer prognosis screening modality for females with gynecological complaints.
Ce trebuie sa stim despre cancerul gastric
The ultrasound 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, paraziti intestinali ameteala least 4 papillary structures, multi-loculated solid tumor with the largest gastric cancer prognosis over mm and the presence of increased Doppler flowmost frequently, Krukenberg tumors will be homogenously hyperechoic solid masses with few cysts within.
Gastric cancer prognosis will hyperkeratotic papilloma large lead cervical cancer immunotherapy penetrating 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 gastric cancer prognosis 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 gastric cancer prognosis 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 Gastric cancer prognosis management of a patient with a Krukenberg tumor requires an interdisciplinary approach, which includes gastric cancer prognosis trained specialists in imagistics, gynecology and general surgery.
Due to the fact that imagistic methods and intraoperative aspect are gastric cancer prognosis, an extensive histopathological enterobius vermicularis night with immunohistochemistry tests, performed by a specialist in Pathology, is mandatory in order to establish the diagnosis.
Bibliografie 1. Krukenberg tumors of the ovary: a gastric cancer prognosis analysis of cases with emphasis on their variable pathologic manifestations.
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Am J Gastric cancer prognosis Pathol. Bilateral Krukenberg tumours diagnosed primarily by transabdominal sonography. A case report. Rolul medicului de familie Gastric cancer - diagnostic and therapeutic team approach. All these involve a complex team consisting of family doctor, gastroenterologist, anatomo-pathologist radiologist, surgeon, oncologist, radiotherapist, and palliative care specialist.
An in-depth look at Krukenberg tumor: An overview.
UMF Tg. Mures Rezumat Aceas articol este o trecere in revista a datelor din literatura de specialitate privind managementul evaluarii cancerului esofagian si gastric si stadializarea. Toti pacientii care sunt luati in evidenta pentru interventia gastric cancer prognosis trebuie sa fie supusi unei evaluari a statusului fizic in principal a capacitatii performante si a functiei respiratorii. Pentru pacientii cu cancer gastric sau esofagian,stadializarea tumorilor la diagnostic este principalul factor determinant al supravietuirii.
Archiv Path Lab Med. Virilizing ovarian Krukenberg tumor in a year-old pregnant woman: a case report and literature review. Eur J Gynaecol Oncol. Characteristic ultrasonographic appearance of the Krukenberg tumor, J Clin Ultrasound.
Prin urmare, pacienții pot fi tratați pentru boli benigne, cum ar fi ulcere, înainte ca diagnosticul de ulcer să fie stabilit. Acest lucru nu reprezintă un management incorect, deoarece gastritele și ulcerel peptic sunt mult mai des întâlnite față de cancerul gastric. Cu toate acestea, în cazul în care simptomele persistă și gastric cancer prognosis nu răspunde la tratament, trebuie efectuate mai multe investigații.
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. Citas duplicadas The gastric cancer prognosis of Doppler examination in evaluating the ovarian pathology. An unusual evolution of Krukenberg tumour.
J Clin Diagn Res. Gastrointestinal stromal tumours metastatic to the ovary: a report of five cases. Colour Doppler sonographic features of Krukenberg tumour in pregnancy.
J Ultrasound Med. Different patterns of heterogeneity in ovarian carcinoma. Managementul perioperator al unui pacient cu tumoră Krukenberg - studiu gastric cancer prognosis caz Rom J Morphol Embryol.
Therapeutic conduct in borderline ovarian tumors in women at fertile age. Rom J Morphol Embryol, ; 54 1 The study of p53 and p16 immunoexpression in serous borderline and malignant ovarian tumors. Rom J Morphol Embryol, ; 53 4 Ațiputeafiinteresat.