Discrepancies between preoperative diagnosis of tumors and the right uterine appendage and intraoperative data. Appendiculare mucocele, which manifests itself in the form of an appendage formation. Clinical case
DOI:
https://doi.org/10.15574/HW.2023.169.65Keywords:
right uterine appendages, mucocele, appendix, pyosalpinxAbstract
Tumor formations of the tubes, hydrosalpinxes, pyosalpixes have a number of discrepancies in outpatient service examinations and intraoperative clinical diagnosis.
Purpose - to report a unique case with discrepancies between the preoperative diagnosis (pyosalpinx, hydrosalpinx) and the intraoperative and postoperative definitive findings (appendicular tumor, mucocele).
Clinical case. A 50-year-old woman, a 3-year-old Mirena IUD wearer, applied for examination for pain in the right iliac region and a slight rise in temperature to 37-37.5 over the past 10 days. The examination showed the movement of the tumor on the right up to 7-4 cm, sensitive on palpation, uterine fibroids, and appendices on the left without features. Other history, physical examination, and laboratory tests were not remarkable, and there was no leukocytosis as in inflammatory processes. Ultrasound and MRI showed neoplasms of the right appendages of 7-5-4 cm, avascular and uterine fibroids - 3 subserosal nodes of 10-5 mm each. Intraoperatively Intact 2 fallopian tubes were detected, a tumor formation of the appendix 3-2-3 cm without adhesions was isolated. Laparoscopic appendectomy was performed along with conservative myomectomy and bilateral salpingectomy. Histopathology showed mucocele without atypia, myomas nodules, and fallopian tubes without features.
Conclusions. In the formation of the right appendages of the uterus, a thorough preoperative diagnosis is required, which does not always give a definitive answer to the clinical diagnosis. Diagnostic laparoscopy, visual and operational clinical experience of the surgeon, cytological and histological examination of intra- and postoperative results make it possible to carry out adequate surgical treatment. Patients should be informed about doubts between outpatient and intraoperative diagnosis, possible changes in the intraoperative surgical plan. Prompt care should be provided in institutions with appropriate teams and equipment.
The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
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