RESUMEN
Uterine adenosarcomas are uncommon tumors. It is a biphasic tumor with both epithelial and mesenchymal component. The epithelial component is benign in nature, and the mesenchymal component is malignant. Metastasis is rare in adenosarcoma. We report a case of adenosarcoma with lymph nodal metastasis. A 20-year-old female presented with history of per vaginal bleeding for 1 month. Per vaginal examination revealed a fungating mass protruding through the cervical os. Ultrasonography and magnetic resonance imaging showed a large intrauterine mass. Biopsy of the mass done at an outside hospital was reported as rhabdomyosarcoma. Hence, she was given one cycle of neoadjuvant chemotherapy. Following this, she had profuse bleeding. Emergency hysterectomy with pelvic lymph nodal dissection was performed. The final histopathology was reported as adenosarcoma. One pelvic lymph node showed metastatic deposit of rhabdomyosarcomatous element. In young females presenting with polypoidal mass, uterine adenosarcoma can be considered in the differential diagnosis.
Asunto(s)
Adenosarcoma/diagnóstico , Ganglios Linfáticos/patología , Tumor Mulleriano Mixto/diagnóstico , Rabdomiosarcoma/diagnóstico , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias Uterinas/diagnóstico , Adenosarcoma/patología , Adenosarcoma/secundario , Antineoplásicos/administración & dosificación , Antineoplásicos/uso terapéutico , Biopsia , Diagnóstico Diferencial , Femenino , Humanos , Histerectomía , Escisión del Ganglio Linfático , Imagen por Resonancia Magnética , Tumor Mulleriano Mixto/tratamiento farmacológico , Tumor Mulleriano Mixto/patología , Metástasis de la Neoplasia , Rabdomiosarcoma/tratamiento farmacológico , Rabdomiosarcoma/patología , Ultrasonografía , Neoplasias del Cuello Uterino/tratamiento farmacológico , Neoplasias del Cuello Uterino/patología , Neoplasias del Cuello Uterino/secundario , Hemorragia Uterina/etiología , Neoplasias Uterinas/patología , Neoplasias Uterinas/secundario , Útero/diagnóstico por imagen , Útero/patología , Útero/cirugía , Adulto JovenRESUMEN
BACKGROUND: Thyroid nodules are common. They can be either benign or malignant. Solitary thyroid nodules (STN) have a high likelihood of being malignant. They should be characterized properly for optimum management. MATERIALS AND METHODS: In this study, we have analyzed our departmental data over a period of 5 years. All the patients who presented to the outpatient department with a clinically detected STN were included in the study group. Our approach was individualized. Preoperative ultrasonography (USG) and fine-needle aspiration cytology were planned in all these patients. Hemi thyroidectomy and total thyroidectomy with and without neck dissection were performed wherever appropriate. RESULTS: There were 162 cases of clinically detected STN. USG findings were available in 146 cases. Postoperative histopathology was reported as malignant in 58 cases. Malignant STN was more likely in males. Ultrasonographically detected solid STN were more prone for malignancy as compared to multinodular goiter (P = 0.000) Presence of micro calcification and cervical lymphadenopathy were more commonly noted in malignant thyroid swellings. CONCLUSION: Solitary thyroid nodules do have a high likelihood of harboring a malignancy. Solid echogenicity, micro calcification and cervical lymphadenopathy on USG were seen more frequently in malignant nodules.