Sdn Bhd

Slide Digitization by:

Digital Slide Seminar:

 

Day 1 (12.30 - 01.15pm)

 

Dr. Arfahiza Selimin

Frozen section in Gynae Pathology

Case 1:

  • 27 y.o, Malay, nulliparous with huge ovarian mass

  • Intraoperative :

- Huge right ovarian tumour

- cystic in nature

- FT and uterus : normal

 

Case 2:

  • 21 y.o, Malay, Para 1, LCB : >6 yrs ago

  • Abdominal distension x 2/52

  • LOA with significant LOW

  • TAS :

- Multilobated right ovarian mass, 15x12cm

- Partly thick septae

- No papillary projection

- Minimal ascites

  • CT TAP :

- Large multiseptated intraabdominal cystic mass likely arising from ovary

  • Intraoperative :

- Right ovarian mass, 20x15cm

- Capsule intact

- Minimal ascites

  • CA125, AFP and CEA : Normal limit.

 

Case 3:

  • 45 y.o, nulliparous

  • Underlying DM and HPT

  • Incidental finding of palpable mass about 30 wks size during admission for Rt DFU

  • CT TAP :

- Large well defined pelvic mass, possibly arising from left adnexa, 13.8 x 15.3 x 16cm.

  • Intraoperative :

- Huge Lt ovarian tumour, twisted x2

  • CA125 : 46 u/ml, CEA : 4.6 ng/ml, LDH : 626 U/L

 

Case 4:

  • 65 y.o, Malay, Para 4+1

  • Abdominal mass x 6/12

  • CT TAP :

- A large cystic lesion arising from Rt adnexa, 12.1 x 21.4 x 17.4cm.

- Enhancing thickened septae.

- Impression : Large adnexal mass with suspicious liver lesion.

  DifDx : Ovarian serous cystadenoca, ovarian mucinous cystadenoca

  • Intraoperative :

- Bilateral ovarian tumour, Rt : 15x20cm, twisted x1, cystic.

  Lt ovary : 7x7cm, cystic.

- Uetrus, Rt & Lt FT : Normal.

- No deposit.

- Minimal ascites.

  • CA125 : 77 u/ml, LDH : 249 U/L, CEA and AFP : Normal.

Case 5:

  • 51 y.o, Chinese, Para 2

  • Pipelle sampling : Endometrioid adenocarcinoma, FIGO grade 1

  • Intraoperative :

- Uterus enlarged, 14 weeks size

- Few enlarged Rt and Lt pelvic LN

- Paraaortic LN : not enlarged

- Ovary & fallopian tube : normal

Case 6:

  • 65 y.o, Para 6+1

  • Post menopausal bleeding  x 1 yr

  • No abdominal pain

  • No constitutional symptom

  • Biopsy: Endometrial ca, FIGO grade 1

Case 7:

  • 33 y.o, Para 2+1

  • Abdominal swelling x 3/12, increasing in size

  • Intraoperative :

- Rt ovarian tumour, mixed solid cystic component, 30x25cm

- Intact capsule with hypervascular area overlying the capsule

- Tumour adhered to lateral part of uterus, ruptured during manipulation

- containing chocolate fluid material

Case 8:

  • 43 y.o, Para 2, NKMI

  • Abdominal mass and distension, progressively increased in size.

  • CT TAP : Solid and cystic ovarian mass, likely left complex ovarian tumour.

  • Intraoperative :

- Left ovarian tumour, ruptured during manipulation.

- Containing yellowish fluid.

Case 9:

  • 33 y.o, Nulliparous and obese with primary subfertility for 7 yrs.

  • Abdominal distension x 6/12, LOW.

  • History of prolonged irregular per vaginal bleeding with uterine fibroid.

  • Hysteroscopy : VV : NAD, Cervix : Normal, Midcavity : Polypoidal growth at anterior wall.

  • Pipelle sampling : Atypical polypoid adenomyoma with suspicious early endometrioid adenocarcinoma.

  • Intraoperative :

- Enlarged, 14 to 16 weeks size.

- Huge multiloculated ovarian tumour, 40x25cm.

Case 10:

  • 22 y.o, nulliparous.

  • Abdominal mass with rapid increasing in size.

  • CT TAP : large lobulated pelvic mass most likely ovarian in origin.

  • CA125 : 110 u/ml, LDH : 3415 U/L, AFP and CEA : normal limit.

  • Intraoperative :

- large lobulated right solid ovarian tumour, 21x21x10cm.

- moderate adhesion between ovarian tumour and omentum.

- left ovary : normal.

Case 11:

  • 26 y.o, Nulliparous.

  • Abdominal distension with abdominal discomfort x 1 yr.

  • CT TAP :

- Huge multiseptated intraabdominal cystic mass likely right ovarian mass.

  • CA125 : 64 u/ml, AFP and βhCG : normal.

  • Intraoperative :

- Huge right ovarian tumour, multiseptated, capsule intact.

- minimal ascites.

- left ovary : normal.