Pelvic tumor

Postrenal ARF is due to obstruction of urinary outflow. Causes include benign prostatic hypertrophy, pelvic tumors, and precipitation of renal calculi.7 Rapid resolution of postrenal ARF without structural damage to the kidney can occur if the underlying obstruction is corrected. Postrenal ARF accounts for less than 10% of cases of ARF.6... 

In addition to ALPE, mild acute renal failure, including dehydration, acute pyelonephritis, and renal pelvic tumors, is visualized as wedge-shaped contrast enhancement [15]. However, acute pyelonephritis and renal pelvic tumors are visualized as unilateral lesions, whereas ALPE is visualized as a bilateral lesion therefore, differentiation is possible. For a definitive diagnosis, the presence of patchy contrast enhancement must be demonstrated when the serum creatinine level is in the range from 1.2 to 3.5 mg/dl. However, as described above, a definitive diagnosis is not always necessary in clinical practice. 

This observation is related to that made by us (P4a) that kynurenine alone, or sometimes together with 3-hydroxykynurenine and 3-hydroxy-anthranilic acid, was found to be abnormally elevated in 17 of cases with renal tumors, in 3 of 6 cases with pelvic tumors, and in 1 of 2 cases with cystic renal disease. 

Modern imaging techniques are used for the diagnosis of pelvic floor or sphincter disorders. Furthermore, they are employed to determine the extent of pelvic diseases and the staging of pelvic tumors. In order to be able to recognize the structures seen on CT and MRI as well as on dynamic MRI, a detailed knowledge of the relationship of the anatomical entities within the pelvic anatomy is required. 

Pelvic exenteration is the curative method of choice in patients with central pelvic tumor recurrence and comprises colpectomy and hysterectomy with removal of the bladder (anterior exenteration) or of the bladder and rectosigmoid (complete exenteration). In addition,the intervention maybe performed as supralevator exenteration with partial resection of the levator plate or as translevator exenteration with vulvectomy and radical resection of the levator muscle, urogenital diaphragm, and vulvoperineal... 

Pelvic tumor recurrence typically leads to external ureteral obstruction through encasement of the ureters and their orifices, which manifests as hydroneph-... 

Fig. 9.12. Granulosa cell tumor. A 52-year-old female with a history of hysterectomy and unilateral oophorectomy for granulosa cell tumors several years before. A solid and cystic pelvic tumor with irregular margins displacing bowel loops is seen at the acetabular level. From imaging, it cannot be differentiated from an ovarian cancer...

Other maternal factors that may prolong or arrest labor include cervical leiomyomas or scarring of the cervix after prior surgery (conization, cerclage). Rare causes that prevent fetal descent are pelvic tumors such as large ovarian cysts or a pelvic kidney. 

The body phased-array coils available today allow imaging of the entire abdomen with high resolution and should be used whenever available to assess retroperitoneal lymph nodes in addition to evaluating the regional pelvic lymph nodes in all MRl examinations of a primary pelvic tumor. In patients with cervical or endometrial cancer, the demonstration of suspicious retroperitoneal lymph nodes is important for therapeutic planning in patients scheduled for postoperative radiotherapy. 

Malignant Pelvic tumor DMIO No myofibrils but myoglobin and... 

Retrocaval ureter causes a typical medial displacement of the right lumbar ureter that is appreciated on IVU (Fig. 5.27), but best demonstrated on CT. Ischiatic or crural herniation of the ureter may also occur the ureter will display an unusual lateral and anterior course (Fig. 5.28). Retroperitoneal tumoral processes and genitourinary pelvic tumors may determine displacement and secondary obstruction of the ureters (Fig. 5.29). A distended bladder also induces ureteral and pyelocalyceal dilatation, and, therefore, the size of the collecting system must be controlled after micturition. In severe cases constipation may displace and distend the ureters... 

Metastatic spread can occur by local extension, lymphatic drainage, or hematogenous dissemination.17 Lymph node metastases are more common in patients with large, undifferentiated tumors that invade the seminal vesicles. The pelvic and abdominal lymph node groups are the most common sites of lymph node involvement (Fig. 89-1). Skeletal metastases from hematogenous spread are the most common sites of distant... 

Pelvic examinations are effective in detecting obvious tumors with a sensitivity of 67% for detecting all tumors minimal or microscopic disease cannot be detected on physical examination.9 Pelvic examinations are non-invasive and well accepted, but they do not usually detect ovarian cancer until it is in an advanced stage. Therefore, routine pelvic examinations will not improve earlier diagnosis or help to decrease overall mortality.9... 

Tumor involves one or both ovaries with pelvic extension... 

Overall survival is affected by the success of the initial surgery to debulk the tumor to less than 1 cm of disease and response to first-line chemotherapy. The CA-125 level should be monitored with each cycle, and at least a 50% reduction in CA-125 after four cycles of taxane/platinum chemotherapy is related to an improved prognosis. Patients who achieve a complete response should have follow-up examinations every 3 months, including CA-125 determination, physical examination, pelvic examination, and appropriate diagnostic scans (e.g., CT scan, MRI, or PET scan) and should be evaluated for the detection of disease. Evaluate patients for resolution of any residual chemotherapy-related side effects, including neuropathies, nephrotoxicity, ototoxicity, myelosuppression, and nausea/vomiting. 

Prostatic tumor volume contributes to the levels of serum PSA as well as pathological staging, with higher PSA concentrations associated with advanced staging. In the majority of men, PSA concentrations at the time of surgery were found to be <4 ng/ml (organ confined). Half of those with PSA concentrations > 10 ng/ml had capsular penetration, whereas those with PSA values >50 ng/ml showed positive pelvic lymph nodes. 

Evaluation of CA 125 tests has shown moderate sensitivity, higher specificity, and predictive values in ovarian cancer patients when determining the presence of an intraperitoneal tumor or future occurrence at the time of second-look procedures. Studies have shown that the CA 125 level obtained at the time of a second-look procedure correlates reasonably well with the size of the tumor. As mentioned before, the predictive value of a marker depends on the prevalence of a particular type of malignancy in the intended population. Thus, evaluating a marker s diagnostic potential must be based on prevalence in a well-defined group for results to be generally applicable (i.e., prevalence of ovarian cancer in women with pelvic masses). 

Uterine leiomyomas, or fibroids, are the most common type of solid tumors in adult women, clinically apparent in at least 25% of those of reproductive age [24-26]. Abnormal menstrual bleeding, pelvic pain, and infertility are the most commonly experienced symptoms in these women. Uterine fibroids are the leading cause of hysterectomies performed in the United States, accounting for over 200,000 of these procedures each year. Other invasive surgical interventions for the treatment of uterine fibroids include myomectomy and uterine artery embolization. Leiomyomas are estrogen-responsive tumors that can be treated... 

The gamma camera, with computer-assisted data analysis, is used together with l3lI-hippuran to measure renal function. The renogram is of most clinical value in the assessment of ureter impairment m pre-and postoperative patients with carcinoma of the cervix and other pelvic and gynecological tumors. 

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