Use of Radioactive Seed Localization to Guide Removal of a Nonpalpable Endometriotic Lesion: A Case Report

Publication date: February 2020Source: Journal of Minimally Invasive Gynecology, Volume 27, Issue 2Author(s): Lara Quintas, Sergi Vidal-Sicart, Rafael Salvador, Camil Castelo-Branco, Adela Saco, Francisco CarmonaABSTRACTExtrapelvic endometriosis is a rare and usually misdiagnosed entity. Some extrapelvic endometriotic lesions are small and nonpalpable, which makes them difficult to locate and remove. Here, we report the use of radioactive seed localization to locate and guide the excision of a small, nonpalpable endometriotic lesion. A 32-year-old woman presented with disabling pain in the right inguinal area. Magnetic resonance imaging and abdominal ultrasound results showed an 11-mm nodule in the abdominal wall, in the vicinity of the groin, consistent with an endometriotic lesion. The radioactive seed was placed within the lesion with the help of ultrasonography, and excision was guided with a portable gamma camera. Complete excision of the endometriotic nodule was achieved. We propose radioactive seed localization as an accurate and feasible technique for the treatment of nonpalpable endometriotic lesions.
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research

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ConclusionAn unusual presentation of regular menstruation and nonspecific abdominal pain delays the diagnosis, which can lead to complications such as endometriosis and infertility. Awareness is required; otherwise, misdiagnosis clearly can occur.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
Extrapelvic endometriosis is a rare and usually misdiagnosed entity. Some extrapelvic endometriotic lesions are small and nonpalpable, which makes them difficult to locate and remove. Here, we report the use of radioactive seed localization to locate and guide the excision of a small, nonpalpable endometriotic lesion. A 32-year-old woman presented with disabling pain in the right inguinal area. Magnetic resonance imaging and abdominal ultrasound results showed an 11-mm nodule in the abdominal wall, in the vicinity of the groin, consistent with an endometriotic lesion.
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Tags: Case Report Source Type: research
Extrapelvic endometriosis is a rare and usually misdiagnosed entity. Some extrapelvic endometriotic lesions are small and non-palpable, which makes them difficult to locate and remove. Here we report the use of radioactive seed localization (RSL) to locate and guide the excision of a small, non-palpable endometriotic lesion. A 32-year old woman presented with disabling pain in the right inguinal area. Magnetic resonance imaging and abdominal ultrasound results showed an 11-mm nodule in the abdominal wall, in the vicinity of the groin, consistent with an endometriotic lesion.
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Tags: Case Report Source Type: research
Publication date: Available online 27 June 2019Source: Journal of Minimally Invasive GynecologyAuthor(s): Suhua Shi, Guantai Ni, Li Ling, Huafeng Ding, Yihui Zhou, Zhimin DingAbstractStudy ObjectiveTo evaluate high-intensity focused ultrasound (HIFU) ablation therapy for abdominal wall endometriosis.DesignA retrospective study.SettingGynecological department of a teaching hospital in China.PatientsThirty patients with abdominal wall endometriosis were treated from May 2013 to December 2015.InterventionsThirteen patients were treated with HIFU ablation, and 17 patients were treated with surgical resection.Measurements and M...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Conclusion Four types of USL endometriosis were summarized according to the ultrasound characteristics and the distribution of USL involvement was also concluded according to the results of surgery. TVS has significant value in diagnosis of USL endometriosis and can be used as a first-line tool for diagnosis. Ethics Statement The Medical Science Ethics Committee of Shenzhen People’s Hospital approved this study (No. 2018100). Each patient or an appropriate family member provided informed written consent to obtain clinical materials. Author Contributions YZ and BD conceived and designed the whole experiments and ...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Assessment of biomarkers in women with endometriosis-associated pain using the ENG contraceptive implant or the 52 mg LNG-IUS: a non-inferiority randomised clinical trial. Eur J Contracept Reprod Health Care. 2018 Oct 29;:1-7 Authors: Margatho D, Mota Carvalho N, Eloy L, Bahamondes L Abstract OBJECTIVE: The aim of the study was to assess the serum levels of the following biomarkers in women with endometriosis-associated pelvic pain before and after six months of using the etonogestrel (ENG) contraceptive implant or the 52 mg levonorgestrel-releasing intrauterine system (LNG-IUS): cancer ...
Source: The European Journal of Contraception and Reproductive Health Care - Category: Reproduction Medicine Authors: Tags: Eur J Contracept Reprod Health Care Source Type: research
Publication date: Available online 30 March 2018 Source:Journal of Minimally Invasive Gynecology Author(s): Bertine L. Stehouwer, Manon N.G. Braat, Sebastiaan Veersema Two females (29 and 35 years of age) presented with an abdominal wall mass in close proximity to a caesarean scar. The main complaints consisted of pain at the site of the mass, with catamenial exacerbations. Clinical and imaging findings were consistent with abdominal wall endometriosis in both cases. First, hormonal treatment was started, which proved unsuccessful. Typically at this point the proposed treatment would be wide-surgical excision. Alternative...
Source: Journal of Minimally Invasive Gynecology - Category: OBGYN Source Type: research
Two women (29 and 35 years of age) presented with an abdominal wall mass in close proximity to a cesarean scar. The main complaints consisted of pain at the site of the mass with catamenial exacerbations. Clinical and imaging findings were consistent with abdominal wall endometriosis in both cases. First, hormonal treatment was started, which proved unsuccessful. Typically, at this point, the proposed treatment would be wide surgical excision. Alternatively, magnetic resonance imaging –guided high-intensity focused ultrasound treatment was offered with the goal to diminish pain complaints noninvasively.
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Tags: Case Report Source Type: research
Two females (29 and 35 years of age) presented with an abdominal wall mass in close proximity to a caesarean scar. The main complaints consisted of pain at the site of the mass, with catamenial exacerbations. Clinical and imaging findings were consistent with abdominal wall endometriosis in both cases. First, hormonal treatment was started, which proved unsuccessful. Typically at this point the proposed treatment would be wide-surgical excision. Alternatively, MR-HIFU treatment was offered with the goal to diminish pain complaints non-invasively.
Source: The Journal of Minimally Invasive Gynecology - Category: OBGYN Authors: Tags: Case Report Source Type: research
ConclusionOwing to the possibility to perform a complete assessment of all pelvic compartments at one time, MRI represents the best imaging technique for preoperative staging of endometriosis, in order to choose the more appropriate surgical approach and to plan a multidisciplinary team work.Teaching Points• Endometriosis includes ovarian endometriomas, peritoneal implants and deep pelvic endometriosis.• MRI is a second-line imaging technique after US.• Deep pelvic endometriosis is associated with chronic pelvic pain and infertility.• Endometriosis is characterized by considerable diagnostic delay.&bull...
Source: Insights into Imaging - Category: Radiology Source Type: research
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