PAPILLARY ADENOCARCINOMA OF FEMALE PELVIS CHRISTOS KARALIS, MD. скачать в хорошем качестве

PAPILLARY ADENOCARCINOMA OF FEMALE PELVIS CHRISTOS KARALIS, MD.

This is a 53 years old white female patient with significant past medical history of endometriosis who was found on an MRI of lower abdomen to have a mass lesion at the right pelvis. The patient was complaining of right lower quadrant of her abdomen and numbness of her right lower extremity. She was first evaluated with CT scan of the lower abdomen which showed the lesion at the right side of her pelvis. Subsequently to the CT scan she had the MRI which confirmed the presence of the lesion. The patient she underwent an endoscopic ultrasound of her rectum which showed a 3.5 x 3 cm lesion between her right ovary and the wall of recto - sigmoid area. The mass appeared to be distinct from pelvic structures. It appeared to be invading though the rectal wall and that showed also endoscopically with the presence of a superficial ulcer at the junction of the rectum and sigmoid colon. Endoscopic biopsies from the ulcer were negative for ulcer. An FNA of the lesion was performed during endoscopic ultrasound which showed a papillary adenocarcinoma. Immunochemistry studies showed that the lesion was related to the internal reproductive organs of the patient. It was positive for CA-125, CDX-2, cytokeratin 7, estrogen receptors, progesterone receptors, and negative for cytokeratin 20. Since no direct relationship was noted with either one of the patient's internal reproductive organs on CT, MRI and EUS the lesion was thought to represent malignant transformation of intrapelvic endometriosis as result of endometriosis that the patient received for in vitro fertilization that she had 10 years back. This was confirmed later during surgery.