Fimbrial dermoid cyst with elevated CA19-9 levels: a case report

We report the case of a 39-year-old woman who presented in an acute setting with pelvic pain, an adnexal mass on imaging and a high CA19-9 level. She was taken for surgery, where a large dermoid cyst was found at the fimbrial end of a fallopian tube at the time of laparoscopy, with no apparent connection to either ovary and absence of ovarian necrosis. This was corroborated on final histology. Dermoid cysts in aberrant locations are usually reported at Caesarean section or during laparoscopic sterilisation and thus, understandably, a pre-operative CA19-9 level is rarely available. That and the rarity of these 'ectopic dermoids' make it hard to give further support for a causative association with the high tumour marker levels. Some authors suggest that auto-amputation of a dermoid cyst or part thereof and subsequent reimplantation may give rise to this phenomenon, and thus the term 'wandering dermoid' has been applied to similar situations. This is what we postulated as the cause in our case. It is likely that a full understanding of the aetiology of wandering dermoid cysts will remain elusive, given the paucity of cases.
Source: Case Reports in Womens Health - Category: OBGYN Source Type: research

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Publication date: Available online 11 November 2019Source: Brazilian Journal of Anesthesiology (English Edition)Author(s): Başak Altiparmak, Melike Korkmaz Toker, Ali İhsan Uysal, Yağmur Kuşçu, Semra Gümüş DemirbilekAbstractBackground and objectivesThe primary aim of this study is to assess the effect of US-ESP on postoperative opioid consumption after laparoscopic cholecystectomy. The secondary aims are to assess the effects of ESP block on intraoperative fentanyl need and postoperative pain scores.MethodsPatients between 18–70 years old, ASA I-II were included in the study and randomly allocat...
Source: Brazilian Journal of Anesthesiology - Category: Anesthesiology Source Type: research
No abstract available
Source: Annals of Surgery - Category: Surgery Tags: LETTERS AND REPLIES Source Type: research
Conclusions: Laparoscopic distal gastrectomy with D2 lymphadenectomy for locally advanced gastric cancer shows benefits in terms of lower complication rate, faster recovery, and less pain compared with open surgery.
Source: Annals of Surgery - Category: Surgery Tags: RANDOMIZED CONTROLLED TRIALS Source Type: research
ConclusionThe rare clinical entity of a WS necessitates a targeted diagnostic evaluation and therapy. Clinical details, diagnostic studies and treatment are discussed here.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
ConclusionSurgical RCTs have always been difficult to undertake, yet there are 16 RCTs in the area of endometriosis-associated pain. Ethical considerations, the equipoise of surgeons and participants and follow-up duration are all important parameters in establishing RCTs. We must also be willing to accept and adopt the evidence when it does demonstrate a particular outcome – such as the fact that surgical uterosacral nerve disruption does not improve pain, or that disc excision does not substantially reduce complications compared to segmental resection for bowel disease as prior non-randomized studies suggested. If ...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Conclusion Patients undergoing laparoscopic CDO repair at our institution benefited from shorter time to full enteral feeds, and reduced the need for PN as well as postoperative pain medication. [...] Georg Thieme Verlag KG Stuttgart · New YorkArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text
Source: European Journal of Pediatric Surgery - Category: Surgery Authors: Tags: Original Article Source Type: research
Robotic-Assisted Nissen Fundoplication with the Senhance® Surgical System: Technical Aspects and Early Results. Surg Technol Int. 2019 Oct 04;35: Authors: Schmitz R, Willeke F, Darwich I, Kloeckner-Lang SM, Saelzer H, Labenz J, Borkenstein DP, Zani S Abstract INTRODUCTION: Robotic-assisted surgery continues to evolve. Technical advantages are reported for intracorporal suturing, a technique with a long learning curve in conventional laparoscopy. The success of laparoscopic fundoplication relies on precise suturing at the hiatus and of the fundal wrap. Therefore, robotic assistance can be a useful t...
Source: Surgical Technology International - Category: Surgery Tags: Surg Technol Int Source Type: research
Authors: Consalvo V, D'Auria F Abstract BACKGROUND: The laparoscopic appendectomy approach (LAA) for acute appendicitis has fewer intra- and post-operative complications, less pain, and smaller scars compared to the traditional open appendectomy approach (OAA), but a higher frequency of intra-abdominal abscess (IAA). The relationship between this higher frequency of IAA and the omission of appendicular stump invagination is difficult to explain, even though such invagination of the appendicular stump is the only difference between standard LAA and OAA. PMID: 31687786 [PubMed - as supplied by publisher]
Source: Surgical Technology International - Category: Surgery Tags: Surg Technol Int Source Type: research
Risk Factors for Moderate to Severe Pain during the First 24 Hours after Laparoscopic Bariatric Surgery While Receiving Intravenous Patient-Controlled Analgesia. Anesthesiol Res Pract. 2019;2019:6593736 Authors: Iamaroon A, Tangwiwat S, Nivatpumin P, Lertwacha T, Rungmongkolsab P, Pangthipampai P Abstract Objective: To investigate the incidence of and risk factors for moderate to severe pain during the first 24 hours after laparoscopic bariatric surgery. Materials and Methods: This retrospective study included morbidly obese patients who underwent laparoscopic sleeve gastrectomy or Ro...
Source: Anesthesiology Research and Practice - Category: Anesthesiology Tags: Anesthesiol Res Pract Source Type: research
Prediction of Adnexal Torsion by Ultrasound in Women with Acute Abdominal Pain. Ultraschall Med. 2019 Nov 08;: Authors: Bardin R, Perl N, Mashiach R, Ram E, Orbach-Zinger S, Shmueli A, Wiznitzer A, Hadar E Abstract PURPOSE:  To investigate the accuracy of ultrasound in the diagnosis of adnexal torsion. MATERIALS AND METHODS:  Retrospective cohort analysis of 322 women, presenting to a tertiary medical center with acute abdominal pain, who underwent gynecological examination, sonographic evaluation and laparoscopic surgery, between 2010 and 2016. Findings for adnexal torsi...
Source: Ultraschall in der Medizin - Category: Radiology Authors: Tags: Ultraschall Med Source Type: research
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