2.Adrenal tumours in pregnancy: diagnostic challenge and management dilemma.
Jessie Wai Leng PHOON ; Devendra KANALINGAM ; Hong Liang CHUA
Singapore medical journal 2013;54(7):e141-5
Adrenal gland tumours in pregnancy are very rare occurrences and have highly variable clinical presentations. The timely diagnosis of adrenal tumours in pregnancy is extremely important, as failure to do so may lead to fatality. As there is limited published literature on adrenal tumours in pregnancy and no consensus on its management, the management of such patients with regard to medical and surgical treatments, as well as timing of delivery, must therefore be individualised and carried out with multidisciplinary expertise. We present two cases of adrenal tumours in pregnancy, both with favourable outcomes and variable gestations. Our first and second cases discuss a large phaeochromocytoma and a cortisol-secreting adrenal cortical adenoma in pregnancy, respectively.
Adrenal Gland Neoplasms
;
diagnosis
;
surgery
;
Adrenalectomy
;
Adult
;
Biomarkers
;
blood
;
urine
;
Diagnosis, Differential
;
Female
;
Humans
;
Laparoscopy
;
Magnetic Resonance Imaging
;
Pheochromocytoma
;
diagnosis
;
surgery
;
Pregnancy
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Pregnancy Complications, Neoplastic
;
diagnosis
3.Giant nasal septalhaemangioma in pregnancy: one case report.
Dawei ZHANG ; Haihai GAO ; Renjie CHEN
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2015;29(9):851-852
A pregnant lady in her third trimester presented with a rapidly growing right-sided nasal mass associated with epistaxis and nasal obstruction for six months. Examination showed a non tender, protruding mass completely occluding her right nostril. Wide surgical excision was done under anaesthesia. Histopathology revealed capillary haemangioma. In a gravid patient with a rapidly growing intranasal lesion, capillary haemangioma should be considered as a differential diagnosis.
Diagnosis, Differential
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Epistaxis
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Female
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Hemangioma, Capillary
;
diagnosis
;
pathology
;
Humans
;
Nasal Cavity
;
physiopathology
;
Nasal Obstruction
;
pathology
;
Nose Neoplasms
;
diagnosis
;
pathology
;
Pregnancy
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Pregnancy Complications, Neoplastic
;
diagnosis
;
pathology
4.MR Imaging of Pregnancy Luteoma: a Case Report and Correlation with the Clinical Features.
Hung Wen KAO ; Ching Jiunn WU ; Kuo Teng CHUNG ; Sheng Ru WANG ; Cheng Yu CHEN
Korean Journal of Radiology 2005;6(1):44-46
We report here on a 26-year-old pregnant female who developed hirsutism and virilization during her third trimester along with a significantly elevated serum testosterone level. Abdominal US and MR imaging studies were performed, and they showed unique imaging features that may suggest the diagnosis of pregnancy luteoma in the clinical context. After the delivery, the serum testosterone level continued to decrease, and it returned to normal three weeks postpartum. The follow-up imaging findings were closely correlated with the clinical presentation.
Adult
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Contrast Media
;
Diagnosis, Differential
;
Female
;
Gadolinium DTPA/diagnostic use
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Hirsutism/etiology
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Humans
;
Luteoma/complications/*diagnosis
;
Magnetic Resonance Imaging
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Ovarian Neoplasms/complications/*diagnosis
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Pregnancy
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Pregnancy Complications, Neoplastic/*diagnosis
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Pregnancy Outcome
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Ultrasonography, Prenatal
;
Virilism/etiology
5.Pheochromocytoma complicated with cardiomyopathy after delivery--a case report and literature review.
Hyun Joong KIM ; Duk Kyung KIM ; Sang Chul LEE ; Soon Ha YANG ; Jung Hyun YANG ; Won Ro LEE
The Korean Journal of Internal Medicine 1998;13(2):117-122
Pheochromocytoma in pregnancy is very rare but it is associated with very high maternal and fetal mortality. Therefore, it is important to include pheochromocytoma in the differential diagnosis of hypertension associated with pregnancy. It is difficult to make a diagnosis of pheochromocytoma in pregnancy before delivery. The characteristic symptoms of pheochromocytoma could be initiated during delivery because the process of delivery, general anesthesia, fetal movement, induce acute surge of catecholamine release, which could also induce cardiomyopathy. Early diagnosis and intensive care can affect the prognosis of cardiomyopathy induced by pheochromocytoma. Proper management with alpha-blockade, beta-blockade and angiotension converting enzyme inhibitor could acutely reverse the course of cardiomyopathy.
Adrenal Gland Neoplasms/surgery
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Adrenal Gland Neoplasms/diagnosis*
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Adrenal Gland Neoplasms/complications
;
Adult
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Cardiovascular Agents/therapeutic use
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Disease-Free Survival
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Echocardiography
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Electrocardiography
;
Female
;
Human
;
Myocardial Diseases/ultrasonography
;
Myocardial Diseases/etiology*
;
Myocardial Diseases/drug therapy
;
Pheochromocytoma/surgery
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Pheochromocytoma/diagnosis*
;
Pheochromocytoma/complications
;
Pregnancy
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Pregnancy Complications, Cardiovascular/etiology*
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Pregnancy Complications, Neoplastic/surgery
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Pregnancy Complications, Neoplastic/diagnosis*
;
Pregnancy Outcome*
;
Puerperium
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Tomography, X-Ray Computed
;
Substances: Cardiovascular Agents
6.Clinical analysis of cervical screening in 2329 pregnant women.
Ying WANG ; Yanhong YU ; Lin XIAO ; Xianjun MI ; Lihua FU ; Yanyan LUO
Journal of Southern Medical University 2014;34(9):1355-1358
OBJECTIVETo study the cytopathologic characteristics of cervical diseases in pregnant women and the outcomes of the postpartum women to provide evidence for prevention and treatment of cervical cancer.
METHODSThis study was conducted among 2329 pregnant women undergoing routine gestational examinations between September, 2012 and September, 2013. The women with abnormal cytological findings by Thin-prep cytology test (TCT) were followed up and colposcopy and cervical biopsy were performed. The TCT results of these women were compared with those of 32 491 non-pregnant women in Zhongshan Cervical Cancer Mass Screening Program.
RESULTSOf the 2329 pregnant women, a total of 97 patients had abnormal TCT results (4.16%). Cervical biopsy were performed for 14 patients (14.43%), and 8 (57.14%) of them had evidence of cervical intraepithelial neoplasia (CIN) or cancer on biopsy. In the 32491 non-pregnant women in the mass screening program, 1383 (4.26%) women had abnormal TCT results and cervical biopsy were performed for 248 patients (17.93%), among whom 148 (59.68%) had evidence of CIN or cancer on biopsy. The rate of high-grade squamous intraepithelial lesion (HSIL) was significantly higher in non-pregnant women than in pregnant women (P=0.033), but the total rate of cytological abnormalities were comparable between them (P=0.911). The patients with CIN had regular examinations during pregnancy and postpartum follow-up showed no invasive carcinoma.
CONCLUSIONPregnancy is not a risk factor to accelerate the progress of cervical lesions, and most of the cervical lesions are relieved or show no progression in the postpartum women, suggesting the feasibility of follow-up during pregnancy and postpartum reevaluation for patients with CIN in pregnancy.
Biopsy ; Cervical Intraepithelial Neoplasia ; diagnosis ; Colposcopy ; Cytodiagnosis ; Female ; Humans ; Mass Screening ; Postpartum Period ; Pregnancy ; Pregnancy Complications, Neoplastic ; diagnosis ; Uterine Cervical Neoplasms ; diagnosis
7.Challenges in the management of a rare case of extensive retroperitoneal haemangioma in a pregnant woman.
Shu-Qi TAN ; Jason Shau Khng LIM ; Yin Ru TAN ; Hak Koon TAN
Singapore medical journal 2014;55(11):e177-9
Haemangioma of the retroperitoneal space is a rare benign capillary malformation, which can grow significantly in pregnancy due to the multiple associated cardiovascular changes. We herein describe the case of a pregnant woman with an extensive right retroperitoneal haemangioma extending from the level of the renal hilum, across the lateral anterior abdominal wall and into the thigh. We also highlight the challenges faced in the management of the patient's delivery process. To the best of our knowledge, this is the first case of such nature and severity described in the English literature.
Adult
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Cesarean Section
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Female
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Gestational Age
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Hemangioma
;
diagnosis
;
surgery
;
Humans
;
Magnetic Resonance Imaging
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Pregnancy
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Pregnancy Complications, Neoplastic
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Retroperitoneal Neoplasms
;
diagnosis
;
surgery
8.Clinicopathologic study of 25 cases of placental chorioangioma.
Aichun WANG ; Yaqi MA ; Yun WANG ; Yingnan WANG ; Junling XIE ; Li WANG ; Jing YUAN ; Yiqun GU ; Aijun LIU ; E-mail: ALIU301@126.COM.
Chinese Journal of Pathology 2015;44(8):600-602
OBJECTIVETo investigate the clinicopathological characteristics, diagnostic criteria and differential diagnosis of placental chorioangioma.
METHODSTwenty-five cases of placental chorioangioma were analyzed for their clinical data, histomorphology and immumohisto chemical staining. Relevant literature was reviewed.
RESULTSThe average age of the 25 patients was 29 years. Fourteen patients had full-term pregnancy, 10 had preterm labor, and 1 had intrauterine fetal death. Nineteen patients had pregnancy complications. The tumors presented as red or dusty pink nodules with clear borders. The tumor size ranged from 1 to 16 cm. Microscopically, the tumors possessed abundant capillaries or cavernous blood spaces lined by hyperplastic endothelial cells. These cells were positive for CD34 and Ki-67 index < 10%.
CONCLUSIONSPlacental chorioangioma is a rare benign tumor of the placenta, and is associated with various pregnancy complications. Misdiagnosis of cell-rich type tumor should be avoided.
Adult ; Diagnosis, Differential ; Endothelial Cells ; pathology ; Female ; Fetal Death ; Hemangioma ; pathology ; Humans ; Infant, Newborn ; Placenta ; pathology ; Placenta Diseases ; pathology ; Pregnancy ; Pregnancy Complications, Neoplastic ; pathology ; Stillbirth
9.Ovarian Cancer during Pregnancy: Clinical and Pregnancy Outcome.
Yong Soon KWON ; Jung Eun MOK ; Kyung Taek LIM ; In Ho LEE ; Tae Jin KIM ; Ki Heon LEE ; Jae Uk SHIM
Journal of Korean Medical Science 2010;25(2):230-234
The aim of this study is to evaluate the clinical feature and pregnancy outcome in patients with ovarian cancer diagnosed during pregnancy. We retrospectively analyzed the medical records of 27 patients diagnosed with ovarian cancer during pregnancy at Cheil General Hospital & Women's Healthcare Center from January 1996 to December 2006. Mean age of the patients was 29.1 yr (range 23-40), and a mean follow-up period was 57 months (range 7-112 months). Of 27 patients, 15 (55.5%) had borderline malignancies, 7 (25.9%) had epithelial malignancies and 5 (18.6%) had germ cell tumors. A total of 26 patients received a conservative surgery preserving pregnancy. The mean time for surgical intervention during pregnancy was 20 weeks of gestational age. Of the 27 patients, 26 had full term delivery of a healthy baby without any congenital malformation. Only one patient with epithelial ovarian cancer had a relapse at 19 months after the first conservative operation with adjuvant chemotherapy. There were few data for managing patients with ovarian cancer diagnosed during pregnancy. This study results could help establish a guideline for management of ovarian malignancy complicating pregnancy.
Adult
;
Female
;
Gestational Age
;
Humans
;
Neoplasms, Germ Cell and Embryonal/*diagnosis/pathology/secondary
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Neoplasms, Glandular and Epithelial/*diagnosis/pathology/secondary
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Ovarian Neoplasms/*diagnosis/pathology/surgery
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Pregnancy
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Pregnancy Complications, Neoplastic/*diagnosis/pathology/surgery
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*Pregnancy Outcome
;
Retrospective Studies
;
Term Birth
10.A Case of the Hepatocellular Carcinoma during the Pregnancy and Metastasis to the Left Atrium.
Soon Woo NAM ; Jong Tae BAEK ; Sang Bum KANG ; Dong Soo LEE ; Jin Il KIM ; Se Hyun CHO ; Soo Heon PARK ; Joon Yeol HAN ; Byung Min AHN ; Jae Kwang KIM ; Kyu Won CHUNG
The Korean Journal of Hepatology 2005;11(4):381-385
A 28-year-old female with a pregnant state of 29th gestational week was admitted because of nausea and vomiting. MRI showed a huge hepatocellular carcinoma. At the 36th gestational week, a normal delivery was done. Surgery of hepatocellular carcinoma was done at 20 days after delivery. After 22 months from the operation, pulmonary metastasis was found and resection of lung mass was done. About 3 years after resection, a low attenuating nodule was detected in the left atrial chamber of heart. We report a case of hepatocellular carcinoma with metastatic lesions to lung and heart in a pregnant woman.
Adult
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Carcinoma, Hepatocellular/diagnosis/*secondary/surgery
;
Female
;
Heart Atria
;
Heart Neoplasms/diagnosis/*secondary
;
Humans
;
Infant, Newborn
;
Liver Neoplasms/diagnosis/*pathology/surgery
;
Lung Neoplasms/diagnosis/secondary
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Pregnancy
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*Pregnancy Complications, Neoplastic/diagnosis