-
BMJ Case Reports Mar 2021Ectopic pregnancy is a common complication of early pregnancy. We present a very atypical case of an ectopic gestation in a woman who presented with a negative pregnancy...
Ectopic pregnancy is a common complication of early pregnancy. We present a very atypical case of an ectopic gestation in a woman who presented with a negative pregnancy test, a large pelvic mass, weight loss and bowel obstruction.
Topics: Female; Humans; Pelvic Neoplasms; Pregnancy; Pregnancy, Ectopic
PubMed: 33653828
DOI: 10.1136/bcr-2019-233534 -
Cancer Treatment Reviews Jul 2018One of the late complications associated with radiation therapy (RT) is a possible increased risk of second cancer. In this systematic review, we analysed the incidence... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
One of the late complications associated with radiation therapy (RT) is a possible increased risk of second cancer. In this systematic review, we analysed the incidence of rectal cancer following primary pelvic cancer irradiation.
METHODS
A literature search was conducted using the PubMed and EMBASE libraries. Original articles that reported on secondary rectal cancer after previous RT for a primary pelvic cancer were included. Sensitivity analyses were performed by correcting for low number of events, high risk of bias, and outlying results.
RESULTS
A total of 5171 citations were identified during the literature search, 23 studies were included in the meta-analyses after screening. A pooled analysis, irrespective of primary tumour location, showed an increased risk for rectal cancer following RT (N = 403.243) compared with non-irradiated patients (N = 615.530) with a relative risk (RR) of 1.43 (95% confidence interval [CI] 1.18-1.72). Organ specific meta-analysis showed an increased risk for rectal cancer after RT for prostate (RR 1.36, 95%CI 1.10-1.67) and cervical cancer (RR 1.61, 95% CI 1.10-2.35). No relation was seen in ovarian cancer patients. The modality of RT did not influence the incidence of rectal cancer.
CONCLUSIONS
This review demonstrates an increased risk for second primary rectal cancer in patients who received RT to the pelvic region. This increased risk was modest and could not be confirmed for all primary pelvic cancer sites. The present study does not provide data to change guidelines for surveillance for rectal cancer in previously irradiated patients.
Topics: Humans; Incidence; Neoplasms, Radiation-Induced; Pelvic Neoplasms; Rectal Neoplasms
PubMed: 29957373
DOI: 10.1016/j.ctrv.2018.05.008 -
CRSLS : MIS Case Reports From SLS 2022Extragonadal abdominopelvic teratomas in adults are extremely rare, and those in males are exceedingly rare. These masses are most commonly found incidentally and... (Review)
Review
BACKGROUND
Extragonadal abdominopelvic teratomas in adults are extremely rare, and those in males are exceedingly rare. These masses are most commonly found incidentally and require surgical excision for diagnostic confirmation after a thorough workup.
CASE PRESENTATION
This is a case report of a 49-year-old male who presented to a urology office with symptoms of hematuria, incidentally, found to have a pelvic mass on computed tomography urogram prompting colorectal surgical evaluation and subsequent laparoscopic complete excision. The clinical presentation, radiographic findings, and histopathological findings are described along with a literature review of extragonadal abdominopelvic mature cystic teratoma, also referred to as a sacrococcygeal teratoma.
DISCUSSION
A broad differential diagnosis was generated for this patient with a pelvic mass after complete work-up, consisting of a dermoid or epidermoid cyst, liposarcoma, or sacrococcygeal teratoma. Radiological features can aid in the diagnostic confusion that may present in the adult patient.
CONCLUSION
Albeit rare in the male and adult population, sacrococcygeal teratoma is a plausible differential diagnosis for a pelvic mass. Underrepresented in the literature in regard to guidelines on management, complete surgical excision is the gold standard, with laparoscopy being a reasonable approach.
Topics: Adult; Male; Humans; Middle Aged; Teratoma; Pelvic Neoplasms; Laparoscopy; Tomography, X-Ray Computed; Diagnosis, Differential
PubMed: 36299832
DOI: 10.4293/CRSLS.2022.00035 -
Oncology (Williston Park, N.Y.) Apr 2017Sexual and urinary morbidities resulting from treatment of pelvic malignancies are common. These treatment sequelae are significantly bothersome to patients and... (Review)
Review
Sexual and urinary morbidities resulting from treatment of pelvic malignancies are common. These treatment sequelae are significantly bothersome to patients and challenging to address. Awareness of these complications is critical in order to properly counsel patients regarding potential side effects and to facilitate prompt diagnosis and management. Addressing these issues often necessitates a coordinated multidisciplinary approach; however, the effort required often translates into improvement in patient quality of life. Herein we review the sexual and urinary side effects that may arise during or after treatment of pelvic malignancies.
Topics: Cancer Survivors; Humans; Pelvic Neoplasms; Quality of Life; Sexual Dysfunctions, Psychological; Urinary Incontinence, Stress
PubMed: 28412780
DOI: No ID Found -
Revista de Investigacion Clinica;... 2018Radiotherapy is one of the main treatment options used in pelvic cancers. Ionizing radiation induces damage to surrounding tissues, resulting in disruption of normal... (Review)
Review
Radiotherapy is one of the main treatment options used in pelvic cancers. Ionizing radiation induces damage to surrounding tissues, resulting in disruption of normal physiological functions and symptoms such as diarrhea, tenesmus, incontinence, and rectal bleeding, which can all significantly alter the patient's quality of life. These patients are at increased risk of developing protein-calorie malnutrition and micronutrient deficiencies. Therefore, designing a proper nutritional intervention plan, with an optimal proportion of protein, fat, and carbohydrates, is required to reduce or even reverse the patients' poor nutritional status, increase their tolerance and response to oncology treatment, decrease the rate of complications and improve their quality of life. The aim of this review was to establish a nutritional plan that includes recommendations on macronutrient proportions and micronutrient intake in patients receiving pelvic radiotherapy. The following nutritional plan has been recommended in the literature: Energy: 28-31 kcal/kg/day, using the Harris-Benedict formula adjusted for body weight in obese patients; protein: 20-30%; fat: 30-40%; and carbohydrates: 40-50%. The maintenance of adequate levels of Vitamin D, Vitamin E, Vitamin A, calcium, magnesium, thiamin, riboflavin, and niacin must be emphasized. Physical activity must also be increased to maintain muscle mass. Nutrient requirements must be established in an integral manner, considering the patient's age, nutritional status, and the presence of comorbidities. Unnecessary dietary restrictions should be avoided to ensure an adequate nutritional status.
Topics: Diet; Humans; Malnutrition; Nutrients; Nutritional Requirements; Nutritional Status; Pelvic Neoplasms; Quality of Life; Radiation Injuries
PubMed: 29943773
DOI: 10.24875/RIC.18002526 -
Revista de Investigacion Clinica;... 2018Radiotherapy is a fundamental part of the treatment of pelvic neoplasms. Up to 90% of patients develop gastrointestinal symptoms as a result of acute injury to the small... (Review)
Review
Radiotherapy is a fundamental part of the treatment of pelvic neoplasms. Up to 90% of patients develop gastrointestinal symptoms as a result of acute injury to the small and large intestine, particularly in the mucosa. Radiotherapy leads to atrophy of the intestinal epithelium, acute crypt inflammation, inflammatory infiltration of the epithelium, malabsorption of lactose, and biliary salts as well as alterations in pancreatic enzymes and biliary salts, resulting in the malabsorption syndrome and dysbiosis. The most commonly reported symptoms of pelvic radiation disease include changes in bowel habits (94%), decreased fecal consistency (80%), frequency of bowel movements (74%), bowel urgency (39%), and fecal incontinence (37%). Although nutritional interventions with dietary modifications have been reported to prevent and treat gastrointestinal symptoms, the evidence remains inconclusive.
Topics: Chemoradiotherapy; Diet; Gastrointestinal Diseases; Gastrointestinal Tract; Humans; Pelvic Neoplasms; Radiation Injuries
PubMed: 29943774
DOI: 10.24875/RIC.18002525 -
Gynecologic Oncology Jun 2019To describe clinical outcomes in patients with isolated pelvic failures after definitive radiation treatment for cervical cancer.
PURPOSE
To describe clinical outcomes in patients with isolated pelvic failures after definitive radiation treatment for cervical cancer.
METHODS AND MATERIALS
Cervical cancer patients with isolated pelvic failure after definitive radiation with brachytherapy boost were identified in a tertiary academic center database from 1997 to 2016. All patients received an FDG-PET scan prior to their initial treatment and at the time of their first recurrence. Isolated failures in the cervix or pelvic nodes were biopsy-proven. Distant failure and overall survival (OS) were censored outcomes.
RESULTS
Isolated pelvic failure was detected in 67(11%) out of 607 consecutive patients treated with external beam pelvic radiation and brachytherapy boost. The median time to isolated pelvic recurrence was 9 months (range 3-198). Median follow-up time for patients alive after isolated pelvic recurrence was 40 months (range 0.6-183). Of these 67 patients, 28(42%) received salvage surgery, 17(25%) received chemotherapy alone, and 22(33%) received neither surgery nor chemotherapy. The median time to distant failure after isolated pelvic failure was 20 months (95% CI 3-37), with no significant difference between patients treated surgically vs. non-surgically. FDG-avid pelvic and para-aortic nodes at initial presentation were associated with worse distant control after isolated pelvic failure (HR = 3.4, 95% CI 1.0-12). Median OS for patients treated with surgery, chemotherapy alone, and neither surgery nor chemotherapy was 29 months (95% CI 16-41), 12 months (95% CI 3-21), and 3 months (95% CI 1-5), respectively.
CONCLUSIONS
Patients who have pelvic and para-aortic nodal disease at initial presentation are at higher risk of failing distantly after isolated pelvic failure, which should be considered when counseling patients on aggressive surgical salvage. Surgical salvage was associated with prolonged survival after isolated pelvic failure.
Topics: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Aorta; Bone Neoplasms; Brachytherapy; Female; Fluorodeoxyglucose F18; Humans; Hysterectomy; Lung Neoplasms; Lymph Nodes; Lymphatic Metastasis; Middle Aged; Neoplasm Recurrence, Local; Pelvic Exenteration; Pelvis; Peritoneal Neoplasms; Positron-Emission Tomography; Radiopharmaceuticals; Salvage Therapy; Survival Rate; Uterine Cervical Neoplasms
PubMed: 30905434
DOI: 10.1016/j.ygyno.2019.03.104 -
International Journal of Surgery... Apr 2024The diagnostic ability of endoscopic ultrasound (EUS) for intestinal infiltration by pelvic masses has aroused considerable interest in many oncological settings. This...
BACKGROUND
The diagnostic ability of endoscopic ultrasound (EUS) for intestinal infiltration by pelvic masses has aroused considerable interest in many oncological settings. This study aimed to evaluate the effectiveness of EUS in predicting colorectal invasion in patients with pelvic masses and compare its accuracy with that of other imaging methods, namely pelvic MRI and abdominal computed tomography (CT), in predicting intestinal involvement in patients with histologically confirmed colorectal invasion.
METHODS
A hundred and eighty-four female patients with histologically confirmed benign or malignant pelvic masses were enrolled in a retrospective-prospective study. All patients underwent EUS, pelvic MRI, and one or more of abdominal CT, transvaginal sonography, and colonoscopy examinations before surgery. The surgical and pathological results were used as the gold standard to evaluate the diagnostic accuracy of EUS for colorectal invasion of pelvic masses.
RESULTS
This study included 184 patients who underwent surgery, with the time between EUS and surgery ranging from 1 to 309 (mean, 13.2) days. The diagnostic sensitivity, specificity, positive predictive value, and negative predictive value of EUS for benign and malignant pelvic masses infiltrating the intestine were 83.3, 97.8, 99.1, and 66.2%, respectively. The overall diagnostic accuracy was 87.0%.
CONCLUSIONS
EUS is a simple, noninvasive, reliable, and accurate technique for the preoperative diagnosis of pelvic masses infiltrating the intestine. The authors recommend the use of this technology by gynecologists, as well as its incorporation into the preoperative diagnostic process to determine the most suitable surgical method. This would help in avoiding unexpected situations and unnecessary resource wastage during surgery.
Topics: Humans; Female; Endosonography; Middle Aged; Adult; Aged; Retrospective Studies; Pelvic Neoplasms; Prospective Studies; Aged, 80 and over; Sensitivity and Specificity; Young Adult; Neoplasm Invasiveness; Tomography, X-Ray Computed; Magnetic Resonance Imaging
PubMed: 38668660
DOI: 10.1097/JS9.0000000000001124 -
Journal of Investigative Medicine High... 2020Breast cancer is the leading malignancy and the second most common cause of mortality in women. Although there have been advances in identifying biomarkers as potential...
Breast cancer is the leading malignancy and the second most common cause of mortality in women. Although there have been advances in identifying biomarkers as potential targets for therapy, triple-negative breast cancer (TNBC) continues to have a poorer prognosis than the other receptor subtypes. The most common sites of metastasis are bone, liver, lung, and brain. We present a patient with known TNBC presenting with nausea and vomiting in whom computed tomography revealed a right-side pelvic mass causing hydronephrosis. Biopsy was consistent with TNBC of the ureter, an unusual site for breast cancer involvement. She required ureteral stent placement to relieve obstruction and has had good response to paclitaxel. Hydronephrosis due to malignancy presents significant risk of morbidity and mortality due to compromised renal function and must be resolved promptly to avoid compromise of renal function.
Topics: Adenocarcinoma; Cerebellar Neoplasms; Female; Humans; Hydronephrosis; Middle Aged; Paclitaxel; Pelvic Neoplasms; Stents; Treatment Outcome; Triple Negative Breast Neoplasms; Ureter; Ureteral Obstruction
PubMed: 32043897
DOI: 10.1177/2324709620905954 -
Diagnostic and Interventional Imaging Feb 2016Pelvic extraperitoneal pelvic masses are relatively uncommon conditions and generally raise diagnostic imaging challenges. Magnetic resonance (MR) imaging plays a...
Pelvic extraperitoneal pelvic masses are relatively uncommon conditions and generally raise diagnostic imaging challenges. Magnetic resonance (MR) imaging plays a central role in the diagnosis of these masses due to its unique tissue-specific multiplanar capabilities that allow optimal pelvic mass localization and internal characterization. This article reviews the MR imaging presentation of extraperitoneal pelvic masses, gives clues that allow identifying their extraperitoneal and/or specific origin as well as suggests different steps for narrowing the differential diagnosis. These steps include systematic analysis of the clinical context, tumor location, relationships with major pelvic structures and close study of the internal components of the lesions.
Topics: Adolescent; Adult; Aged, 80 and over; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Pelvic Neoplasms
PubMed: 26404000
DOI: 10.1016/j.diii.2015.07.009