Giant extragastrointestinal tumor in gynecological practice
Background. The urgency of the problem lies in the complexity of the diagnosis of giant extra-organ neoplasms of the pelvis and abdominal cavity, as well as in the fact that a giant extragastrointestinal tumor is an extremely rare abnormality.Bezhenar V.F., Rybakova M.G., Arakelyan B.V., Kuzmina N.S., Nutfullina G.M., Medvedeva I.V., Morozova M.A.
Case report. The paper describes a clinical case of a rare form of a giant extra gastrointestinal tumor in a 62-year-old patient who had a large MSCT and MRI neoplasm probably originating from the ovary. An irregularly shaped tumor was intraoperatively found, which occupies the entire abdominal cavity and pelvis, measures 25x20x15 cm, has predominantly a solid structure with multiple cavity inclusions, and necrotic areas. The tumor had adhesions to the omentum, with loops of the small intestine at 60 cm above the ileocecal angle, and also to the bladder peritoneum. The vascular bundles supplying the tumor were visualized in the adhesions. It was impossible to identify the organ belonging of a tumor. The final diagnosis was based on the morphological and immunohistochemical diagnosis of gastrointestinal stromal tumor; spindle-cell structure.
Conclusion. The differential diagnosis of large neoplasms localized in the pelvis is an important clinical task in the context of not only preventing possible complications that require emergency medical care by qualified specialists, but also assessing the risk of the malignant process and possible localization of the tumor in the adjacent organs, which necessitate the proper routing of the patient and the determination of the possibilities of a multidisciplinary approach.
Keywords
gastrointestinal stromal tumor
spindle-cell structure
gastrointestinal tract
large neoplasm
immunohistochemical study
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Received 21.08.2020
Accepted 25.12.2020
About the Authors
Vitaly F. Bezhenar, Dr. Med. Sci., Professor, Head of the Departments of Obstetrics, Gynecology and Neonatology and Reproductology, Head of the Clinic of Obstetrics and Gynecology, I.P. Pavlov First St. Petersburg State Medical University, Ministry of Health of Russia; Main supernumerary specialist obstetrician-gynecologist of the Health Committee of St. Petersburg. Tel.: +7(812)338-78-66. E-mail: bez-vitaly@yandex.ru. ORCID: 0000-0002-7807-4929. 197022, Russia, St. Petersburg, Lva Tolstogo str., 6-8.Margarita G. Rybakova, Dr. Med. Sci., Professor, Head of the Department of Pathological Anatomy, I.P. Pavlov First St. Petersburg State Medical University, Ministry of Health of Russia; Main supernumerary specialist in pathological anatomy of the Health Committee of St. Petersburg. Tel.: +7(812)338-78-66. ORCID: 0000-0002-8404.
197022, Russia, St. Petersburg, Lva Tolstogo str., 6-8.
Buzand V. Arakelyan, Dr. Med. Sci., docent, Deputy Head of the Clinic of Obstetrics and Gynecology, Professor of the Department of Obstetrics, Gynecology and Neonatology, I.P. Pavlov First St. Petersburg State Medical University, Ministry of Health of Russia. Tel.: +7(812)338-78-66.
E-mail: byuzand@mail.ru. ORCID: 0000-0002-2868-7997. 197022, Russia, St. Petersburg, Lva Tolstogo str., 6-8.
Natalya S. Kuzmina, Cand. Med. Sci., Head of the Oncology Department No. 7, Assistant of the Department of Obstetrics, Gynecology and Neonatology, I.P. Pavlov First St. Petersburg State Medical University, Ministry of Health of Russia. Tel.: +7(812)338-78-66. E-mail: dok.kuzmina@gmail.com. ORCID: 0000-0002-8404-1859.
197022, Russia, St. Petersburg, Lva Tolstogo str., 6-8.
Irina V. Medvedeva, obstetrician-gynecologist, Oncology Department No. 7 of the Clinic of Obstetrics and Gynecology, I.P. Pavlov First St. Petersburg State Medical University, Ministry of Health of Russia. Tel.: +7(812)338-78-66. E-mail: iriska18.05@mail.ru. ORCID: 0000-0002-5625-7855. 197022, Russia, St. Petersburg, Lva Tolstogo str., 6-8.
Gelfiya M. Nutfullina, Cand. Med. Sci., Assistant of the Department of Pathological Anatomy, I.P. Pavlov First St. Petersburg State Medical University, Ministry of Health
of Russia. Tel.: +7(812)338-78-66. 197022, Russia, St. Petersburg, Lva Tolstogo str., 6-8.
Maria A. Morozova, resident of the Clinic of Obstetrics and Gynecology, I.P. Pavlov First St. Petersburg State Medical University, Ministry of Health of Russia.
Tel.: +7(812)338-78-66. E-mail: mmorozova94@mail.ru. ORCID: 0000-0002-2710-460. 197022, Russia, St. Petersburg, Lva Tolstogo str., 6-8.
For citation: Bezhenar V.F., Rybakova M.G., Arakelyan B.V., Kuzmina N.S., Nutfullina G.M., Medvedeva I.V., Morozova M.A. Giant extragastrointestinal tumor in gynecological practice.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2021; 2: 173-178 (in Russian)
https://dx.doi.org/10.18565/aig.2021.2.173-178
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