Incidental adnexal masses considered indeterminate for malignancy are commonly observed on ultrasonography. Multiparametric MRI is the imaging modality of choice for the evaluation of sonographically indeterminate adnexal masses. Conventional MRI enables a confident pathologic diagnosis of various benign lesions due to accurate tissue characterization of fat, blood, fibrous tissue, and solid components. Additionally, functional imaging sequences, including perfusion- and diffusion-weighted imaging, improve the diagnostic efficacy of conventional MRI in differentiating benign from malignant adnexal masses. The ovarian-adnexal reporting and data system (O-RADS) MRI was recently designed to provide consistent interpretations in assigning risk of malignancy to ovarian and other adnexal masses, and to provide a management recommendation for each risk category. In this review, we describe the clinical application of multiparametric MRI for the evaluation of adnexal masses and introduce the O-RADS MRI risk stratification system.

Incidental adnexal masses considered indeterminate for malignancy are commonly observed on ultrasonography. Multiparametric MRI is the imaging modality of choice for the evaluation of sonographically indeterminate adnexal masses. Conventional MRI enables a confident pathologic diagnosis of various benign lesions due to accurate tissue characterization of fat, blood, fibrous tissue, and solid components. Additionally, functional imaging sequences, including perfusion- and diffusion-weighted imaging, improve the diagnostic efficacy of conventional MRI in differentiating benign from malignant adnexal masses. The ovarian-adnexal reporting and data system (O-RADS) MRI was recently designed to provide consistent interpretations in assigning risk of malignancy to ovarian and other adnexal masses, and to provide a management recommendation for each risk category. In this review, we describe the clinical application of multiparametric MRI for the evaluation of adnexal masses and introduce the O-RADS MRI risk stratification system.

Primary malignant lesions of the vagina are uncommon and represent approximately 1 -2% of all gynecologic malignancies. About 2% of all malignant vaginal lesions are primary sarcomas, the most common of these being leiomyosarcoma. We report the CT and MR imaging findings in a 41-year-old woman with vaginal leiomyosarcoma presenting as a bulky solid mass which caused expansion of the vaginal canal.
Adult ; Female ; Humans ; Leiomyosarcoma* ; Magnetic Resonance Imaging* ; Sarcoma ; Vagina*

A 21-year-old phenotypic female with 46,XY genotype presented with primary amenorrhea, headache, absence of secondary sex characteristics, and hypertension.Further evaluation confirmed male pseudohermaphroditism having no nterus and adnexase.After basic hormonal study and ACTH stimulation test, we concluded 17alpha-hydroxylase deficiency. Owing to the high risk of gonadal neoplasia in XY gonadal streaks, prophylactic removal of the steaks is recommended. Traditionally this procedure has been performed by laparotomy, but in this case laparoscopic gonadctomy was performed. Following treatment with hydrocrtisone, potassium, progesterone, 11-deoxycorticosterone, corticosterone and urinay pregnanediol levels were normalized. normal blood pressure measurements were achieved during treatment with hydrocortisone and estrogen with the patient. We report this case with a breif review of the literatures.
46, XY Disorders of Sex Development* ; Adrenal Hyperplasia, Congenital ; Adrenocorticotropic Hormone ; Amenorrhea ; Blood Pressure ; Corticosterone ; Estrogens ; Female ; Genotype ; Gonads ; Headache ; Humans ; Hydrocortisone ; Laparotomy ; Male* ; Potassium ; Pregnanediol ; Progesterone ; Sex Characteristics ; Young Adult

The major risk factor for ovarian cancer (OC) is mutation of the BRCA1 or BRCA2 DNA mismatch repair genes, which occurs in approximately 10% of OC cases. Most previous studies have demonstrated that BRCA1- and BRCA2-mutated OCs are associated with better prognosis than sporadic OCs. However, information about the patterns and clinical course of the metastatic spread of BRCA-mutated OCs is limited. Herein, we describe a case of OC with a BRCA1 mutation and skin metastases in a 49-year-old patient, which to the best of our knowledge has not been reported previously.
DNA Mismatch Repair ; Humans ; Middle Aged ; Neoplasm Metastasis* ; Ovarian Neoplasms* ; Prognosis ; Risk Factors ; Skin*

Serous cystadenomas of the pancreas are generally considered to be microcystic adenomas. Typical serous cystadenomas of the pancreas are encapsulated tumors composed of tiny cysts less than 2 cm in size showing sponge-like appearance with a central stellate scar or calcification on the cross-section. It has been recently reported, however, that serous cystadenomas may have macrocystic variants (major cysts more than 2 cm in size) that are radiologically indistinguishable from mucinous cystadenomas of the pancreas. We report the CT and MR imaging findings in a patient with mixed microcystic and macrocystic serous cystadenoma of the pancreas, indicating the histopathologic correlation. The mass was composed of two different types of cyst: multiple, small (<2 cm) with central calcification; and large (>2 cm) with peripheral calcification.
Adenoma ; Cicatrix ; Cystadenoma, Mucinous ; Cystadenoma, Serous* ; Humans ; Magnetic Resonance Imaging ; Pancreas*

BACKGROUND: Fine needle aspiration(FNA) is an accurate and safe method for the diagnosis of thyroid nodules. One of the limitations of FNA is the variable rate of unsatisfactory specimens, especially in small sized, deep seated or complex cystic nodules. To overcome this problem, ultrasound-guided FNA(US-FNA) has been widely used. In this study, the adequacy of cytologic specimens by US-FNA was compared with that of conventional palpation-guided FNA(P-FNA). METHODS: The medical records of all patients who were engaged in FNA due to thyroid nodules at Chungnam National University Hospital from January 2003 to July 2004 were retrospectively examined. The US-FNA and P-FNA were performed in 114 and 185 patients, respectively. RESULTS: Comparison of the adequacy of the two techniques in providing sufficient material for the cytologic diagnosis showed that specimens in 24(13.0%) and 6(5.3%) patients collected by P-FNA and US-FNA, respectively, were unsatisfactory(P=0.031). A total of 23 patients underwent thyroid surgery due to strong suspicion of malignancy at cytologic finding and/or on clinical judgement. Seventeen patients belonged to the P-FNA group and 6 patients to the US-FNA group. In the P-FNA group, a histologic diagnosis revealed two false-negative cytologic findings, but no false-negative findings were found in the US-FNA group. CONCLUSION: Compared with P-FNA, US-FNA may reduce the possibility of unsatisfactory cytologic specimens and the rate of false-negative diagnosis, and may improve the diagnostic accuracy in investigating thyroid nodules
Biopsy, Fine-Needle* ; Chungcheongnam-do ; Diagnosis ; Humans ; Medical Records ; Needles ; Retrospective Studies ; Thyroid Gland* ; Thyroid Nodule*

Lymphocytic hypophysitis is a rare inflammatory disorder in the pituitary gland. The lesion is usually confined to the adenohypophysis. Although the involvement of the posterior pituitary gland or the stalk is rare, such patients with diabetes insipidus have been reported. Surgery has been used to make the definitive diagnosis. Recent studies suggest, however, that the pathologic diagnosis may not be necessary always. We reported a case of Lymphocytic hypophysitis managed by methylprednisolone pulse therapy. A 50-year-old premenopausal woman with Lymphocytic hypophysitis and diabetes insipidus was treated with methylprednisolone pulse therapy. Her adenopituitary lesion disappeared and the diabetes insipidus resolved. The optimal management for patients with lymphocytic hypophysitis may be the high index of the suspicion prior to the extensive surgical resection. In addition, methylprednisolone pulse therapy may improve the clinical and MRI findings.
Anti-Inflammatory Agents/*administration & dosage ; Diabetes Insipidus/*drug therapy/etiology ; Female ; Humans ; Lymphocytosis/complications/*drug therapy ; Methylprednisolone/*administration & dosage ; Middle Aged ; Pituitary Diseases/complications/*drug therapy ; Pulse Therapy, Drug

Acetazolamide is a carbonic anhydrase inhibitor commonly used to treat glaucoma. It can cause metabolic acidosis and renal failure in the elderly and patients with chronic renal insufficiency. We report oliguric acute renal failure (ARF) caused by a conventional dose of acetazolamide for glaucoma in a patient with normal renal function. A 56-year-old woman with 20-year history of diabetes had general weakness, decreased urine output, nausea, and vomiting for 3 days. For the past 2 weeks, her glaucoma had been treated with acetazolamide. Blood-gas analysis showed pH 7.02, PCO2 27 mmHg, PO2 135 mmHg, and HCO3- 7.0 mmol/L. Her BUN was 65 mg/dL and creatinine, 9.1 mg/dL. She recovered after hemodialysis and hydration. Acetazolamide may cause severe ARF, even in patients with normal renal function, suggesting the importance of careful monitoring of renal function in patients taking acetazolamide.
Acetazolamide ; Acidosis ; Acute Kidney Injury ; Aged ; Carbonic Anhydrases ; Creatinine ; Female ; Glaucoma ; Humans ; Hydrogen-Ion Concentration ; Middle Aged ; Nausea ; Renal Dialysis ; Renal Insufficiency ; Renal Insufficiency, Chronic ; Vomiting

No abstract available.
Pneumonia*