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Autopsy & Case Reports Sep 2020Primary broad ligament carcinoma is a very rare occurrence with 28 reported cases worldwide, to date. The epidemiology, treatment strategy and prognosis are still...
Primary broad ligament carcinoma is a very rare occurrence with 28 reported cases worldwide, to date. The epidemiology, treatment strategy and prognosis are still uncertain because of the scarcity of cases. Currently, all broad ligament carcinomas are managed similar to epithelial ovarian cancer. We report the case of a 43-year-old female with a prolonged complaint of abdominal pain and intermittent urinary retention, requiring frequent catheterization. She was diagnosed with obstructive right hydroureteronephrosis. The abdominal Contrast Enhanced Computed Tomography (CECT) revealed a well-defined heterogeneous lesion of 2.1х3х3.2cm size in the right lateral and posterior wall of the cervix. An ultrasound (USG)-guided Fine Needle Aspiration Cytology (FNAC) of the mass was done and it was suspected to be malignant. The patient underwent total abdominal hysterectomy, right salpingo-oophorectomy, pelvic lymph-nodal sampling, and peritoneal washing. Histological examination depicted an endometrioid adenocarcinoma of the broad ligament. She received adjuvant chemotherapy, followed by hormonal therapy. It has been five years since her surgery, and she is now alive and disease free.
PubMed: 33344309
DOI: 10.4322/acr.2020.176 -
Radiologia Brasileira 2020Although secondary involvement of the broad ligament by malignant tumors arising elsewhere in the abdomen and pelvis is common, primary tumors in this location are rare....
Although secondary involvement of the broad ligament by malignant tumors arising elsewhere in the abdomen and pelvis is common, primary tumors in this location are rare. Tumors of the broad ligament can be of mesenchymal and mixed nature, such as leiomyoma, the most common neoplasm; epithelial tumors of Müllerian type, imposing a challenge to differentiate them from other adnexal masses; unique tumors from mesonephric origin; and tumor-like lesions. Most neoplasms in this region, whether benign or malignant, usually present clinically with vague symptoms and are often discovered during a routine gynecological examination. Suspicion of such location and knowledge of the potential range of lesions of this region may allow for planning minimally invasive surgical interventions. To be considered tumor from the broad ligament, it should not be connected with either the uterus or the ovary. Thus, the imaging approach to establish the differential diagnosis includes excluding an ovarian, uterine, or tubal origin by recognizing these separately and by rebutting imaging clues pointing to these origins. This pictorial essay reviews some of the imaging findings that may suggest such location and presents some of the possible differential diagnoses by means of illustrative confirmed cases.
PubMed: 33071380
DOI: 10.1590/0100-3984.2019.0073 -
Clinical Case Reports Sep 2021Broad ligament pregnancy is a very rare life-threatening form of ectopic pregnancy, in which implantation occurs within the peritoneal cavity. The advantages of a...
Broad ligament pregnancy is a very rare life-threatening form of ectopic pregnancy, in which implantation occurs within the peritoneal cavity. The advantages of a laparoscopic approach over a laparotomy in this setting include a reduced estimated blood loss, a shorter operating time, reduced analgesic requirements, shorter hospital stay, and convalescence.
PubMed: 34552742
DOI: 10.1002/ccr3.4823 -
Maedica Sep 2022The oblique popliteal ligament (OPL), chief posterior support of the knee, is an extension of the semimembranosus (SM) tendon and runs superolaterally to the lateral...
The oblique popliteal ligament (OPL), chief posterior support of the knee, is an extension of the semimembranosus (SM) tendon and runs superolaterally to the lateral femoral condyle. Due to variations and immense functional value of the OPL, the present study was undertaken to explore the OPL morphology and morphometry. Thirty cadaveric lower limbs were dissected to observe the OPL in the floor of the popliteal fossa, and its general shape, number of bands and extensions were noted. The morphometry was done using digital callipers in which the length of the upper and lower margins as well as the width of the OPL at the medial and lateral attachments were measured. The width of bands and extensions were also recorded. The mean and standard deviation (SD) of all parameters have been also calculated. The morphological types of the OPL were categorized into four types, which were found in 40%, 50%, 6.6% and 3.3% of specimens, respectively. Types 1 and 2 OPL were band like. Type 1 showed an accessory upper band and type 2, a broad medial attachment. Type 3 was cord like, whereas type 4 was fan like and showed two upper bands. The mean length (upper), length (lower), width of the SM tendon expansion, width at attachment to the medial femoral condyle and width at the lateral attachment were 33.4 mm, 38.41 mm, 8.58 mm, 12.46 mm and 21.42 mm, respectively. The different morphological types of OPL may produce minor alterations in the stability of the knee, especially in trauma. The anatomical knowledge of OPL and its extensions is mandatory for knee surgery in all patients to avoid postoperative complications.
PubMed: 36540577
DOI: 10.26574/maedica.2022.17.3.641 -
BMJ Case Reports Aug 2013A broad ligament pregnancy is an extremely rare condition. The eventuality of such pregnancies reaching full term is even rarer. A full-term broad ligament pregnancy...
A broad ligament pregnancy is an extremely rare condition. The eventuality of such pregnancies reaching full term is even rarer. A full-term broad ligament pregnancy occurring through a rent in a previous lower segment caesarean scar has only been mentioned in literature but not reported. Our patient is an unbooked case, reported to us at 39 weeks of pregnancy. On clinical examination, an ultrasound and an MRI, a diagnosis of abdominal pregnancy was made. Ultimately the final diagnosis was made only on laparotomy. A broad ligament pregnancy was found with a rent in the previous caesarean scar communicating the fetal sac.
Topics: Adult; Broad Ligament; Female; Fetal Death; Gestational Age; Humans; Pregnancy; Pregnancy Trimester, Third; Pregnancy, Abdominal; Stillbirth
PubMed: 23925683
DOI: 10.1136/bcr-2013-010329 -
The Open Orthopaedics Journal 2017In the last years, basic research and arthroscopic surgery, have improved our understanding of shoulder anatomy and pathology. It is a fact that arthroscopic treatment... (Review)
Review
BACKGROUND
In the last years, basic research and arthroscopic surgery, have improved our understanding of shoulder anatomy and pathology. It is a fact that arthroscopic treatment of shoulder instability has evolved considerably over the past decades. The aim of this paper is to present the variety of pathologies that should be identified and treated during shoulder arthroscopy when dealing with anterior shoulder instability cases.
METHODS
A review of the current literature regarding arthroscopic shoulder anatomy, anatomic variants, and arthroscopic findings in anterior shoulder instability, is presented. In addition, correlation of arthroscopic findings with physical examination and advanced imaging (CT and MRI) in order to improve our understanding in anterior shoulder instability pathology is discussed.
RESULTS
Shoulder instability represents a broad spectrum of disease and a thorough understanding of the pathoanatomy is the key for a successful treatment of the unstable shoulder. Patients can have a variety of pathologies concomitant with a traditional Bankart lesion, such as injuries of the glenoid (bony Bankart), injuries of the glenoid labrum, superiorly (SLAP) or anteroinferiorly (. anterior labroligamentous periosteal sleeve avulsion, and Perthes), capsular lesions (humeral avulsion of the glenohumeral ligament), and accompanying osseous-cartilage lesions (Hill-Sachs, glenolabral articular disruption). Shoulder arthroscopy allows for a detailed visualization and a dynamic examination of all anatomic structures, identification of pathologic findings, and treatment of all concomitant lesions.
CONCLUSION
Surgeons must be well prepared and understanding the normal anatomy of the glenohumeral joint, including its anatomic variants to seek for the possible pathologic lesions in anterior shoulder instability during shoulder arthroscopy. Patient selection criteria, improved surgical techniques, and implants available have contributed to the enhancement of clinical and functional outcomes to the point that arthroscopic treatment is considered nowadays the standard of care.
PubMed: 28400880
DOI: 10.2174/1874325001711010119 -
Facts, Views & Vision in ObGyn Dec 2022Ancient schwannomas are benign tumours arising from the neural sheath of peripheral, cranial and autonomic nerves. They are commonly situated in the inner ear and spine...
Ancient schwannomas are benign tumours arising from the neural sheath of peripheral, cranial and autonomic nerves. They are commonly situated in the inner ear and spine with pelvic manifestations being rare. We present the case of a 30-year-old patient, who presented with an abdominal mass. MRI imaging suggested a broad ligament fibroid and open surgery was undertaken to remove it. Subsequent histology confirmed an ancient schwannoma. This case report details the rarity of such a condition and the need for a high index of suspicion as well as outlining management options and surveillance.
PubMed: 36724428
DOI: 10.52054/FVVO.14.4.049