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Surgicopath June, 2018 Final

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The documents discuss various gynecological procedures and patient cases.

For patient Aiza Tolentino, the conditions mentioned include incomplete abortion at late 18 3/7 weeks AOG, non-septic, non-induced, hyperthyroidism not in storm, and anemia moderate.

Procedures mentioned for the cervix include cervical punch biopsy, cervical polypectomy, endocervical polypectomy, endocervical curettage, and fractional curettage.

Muhamad Saiful Anwar.

md
PAY 19
CHARITY 165
Inpatient 60
Outpatient 105
TOTAL 184
Inpatient Outpatient TOTAL
Vulva/Vagina - -
Cervix - 94 94
Uterus 14 17 31
Ovaries 7 - 7
Fallopian 51 - 51
tubes
Trophoblastic 1 - 1
disease
TOTAL 73 111
184
SERVICE
PROCEDURES
VULVA/VAGINA CERVIX
VULVA/VAGINA UTERUS OVARIES

FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX

UTERUS OVARIES FALLOPIAN TUBES OTHERS

VULVA/VAGINA CERVIX UTERUS OVARIES

FALLOPIAN TUBES OTHERS VULVA/VAGINA CERVIX

VULVA/VAGINA CERVIX
VULVA/VAGINA UTERUS OVARIES

FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX

UTERUS OVARIES FALLOPIAN TUBES OTHERS

VULVA/VAGINA CERVIX UTERUS OVARIES

FALLOPIAN TUBES OTHERS VULVA/VAGINA CERVIX


VULVA/VAGINA

Debridement and Cauterization of -


genital warts
Cauterization of genital warts -
Vulvar mass excision -
Total 0
VULVA/VAGINA CERVIX
VULVA/VAGINA UTERUS OVARIES

FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX

UTERUS OVARIES FALLOPIAN TUBES OTHERS

VULVA/VAGINA CERVIX UTERUS OVARIES

FALLOPIAN TUBES OTHERS VULVA/VAGINA CERVIX

VULVA/VAGINA CERVIX
VULVA/VAGINA UTERUS OVARIES

FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX

UTERUS OVARIES FALLOPIAN TUBES OTHERS

VULVA/VAGINA CERVIX UTERUS OVARIES

FALLOPIAN TUBES OTHERS VULVA/VAGINA CERVIX


CERVIX

Cervical punch biopsy -


Cervical polypectomy -
Endocervical polypectomy -
Endocervical curettage -
Fractional curettage -
Cold knife conization -
TOTAL
0
VULVA/VAGINA CERVIX
VULVA/VAGINA UTERUS OVARIES

FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX

UTERUS OVARIES FALLOPIAN TUBES OTHERS

VULVA/VAGINA CERVIX UTERUS OVARIES

FALLOPIAN TUBES OTHERS VULVA/VAGINA CERVIX

VULVA/VAGINA CERVIX
VULVA/VAGINA UTERUS OVARIES

FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX

UTERUS OVARIES FALLOPIAN TUBES OTHERS

VULVA/VAGINA CERVIX UTERUS OVARIES

FALLOPIAN TUBES OTHERS VULVA/VAGINA CERVIX


UTERUS
Exploratory laparotomy, Total Hysterectomy with Bilateral Salpingo-oophorectomy 13
(TAHBSO)
Exploratory laparotomy, Total Hysterectomy with Bilateral Salpingectomy (TAHBS) -
Exploratory laparotomy, Total Hysterectomy with Right Salpingo-oophorectomy, left/right -
salpingectomy (TAHUSO)
Exploratory laparotomy, Total Hysterectomy -
Polypectomy -
Endometrial Biopsy 17
Vaginal hysterectomy with anterior-posterior repair. -
Exploratory laparotomy, extrafascial hysterectomy 1
Hysteroscopic myomectomy with endometrial curettage -
Diagnostic hysteroscopy with endometrial curettage -
Endometrial polypectomy -
Punch biopsy of prolapsed mass of uterus -
TOTAL
31
VULVA/VAGINA CERVIX
VULVA/VAGINA UTERUS OVARIES

FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX

UTERUS OVARIES FALLOPIAN TUBES OTHERS

VULVA/VAGINA CERVIX UTERUS OVARIES

FALLOPIAN TUBES OTHERS VULVA/VAGINA CERVIX

VULVA/VAGINA CERVIX
VULVA/VAGINA UTERUS OVARIES

FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX

UTERUS OVARIES FALLOPIAN TUBES OTHERS

VULVA/VAGINA CERVIX UTERUS OVARIES

FALLOPIAN TUBES OTHERS VULVA/VAGINA CERVIX


OVARIES
Exploratory laparotomy, total hysterectomy with bilateral 2
salpingooophorectomy, peritonela fluid cytology, bilateral lymph
node dissection, Infracolic omentectomy, appendectomy, para-
aortic lymph node sampling, random peritoneal biopsy
Exploratory laparotomy, total hysterectomy with bilateral -
salpingooophorectomy, tumor debulking, appendectomy
Exploratory laparotomy, total hysterectomy with bilateral 3
salpingooophorectomy
Exploratory laparotomy, bilateral oophorocystectomy with -
chromopertubation
Exploratory laparotomy, unilateral oophorocystectomy with 1
chromopertubation
TOTAL 6
VULVA/VAGINA CERVIX
VULVA/VAGINA UTERUS OVARIES

FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX

UTERUS OVARIES FALLOPIAN TUBES OTHERS

VULVA/VAGINA CERVIX UTERUS OVARIES

FALLOPIAN TUBES OTHERS VULVA/VAGINA CERVIX

VULVA/VAGINA CERVIX
VULVA/VAGINA UTERUS OVARIES

FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX

UTERUS OVARIES FALLOPIAN TUBES OTHERS

VULVA/VAGINA CERVIX UTERUS OVARIES

FALLOPIAN TUBES OTHERS VULVA/VAGINA CERVIX


FALLOPIAN TUBES

Bilateral tubal ligation 49


EL, unilateral salpingectomy 2
Exploratory laparotomy, unilateral 0
oophorocystectomy
Bilateral salpingo-oophorectomy, TAH 0
TOTAL 51
VULVA/VAGINA CERVIX
VULVA/VAGINA UTERUS OVARIES

FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX

UTERUS OVARIES FALLOPIAN TUBES OTHERS

VULVA/VAGINA CERVIX UTERUS OVARIES

FALLOPIAN TUBES OTHERS VULVA/VAGINA CERVIX

VULVA/VAGINA CERVIX
VULVA/VAGINA UTERUS OVARIES

FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX

UTERUS OVARIES FALLOPIAN TUBES OTHERS

VULVA/VAGINA CERVIX UTERUS OVARIES

FALLOPIAN TUBES OTHERS TROPHOBLASTIC CERVIX


TROPHOBLASTIC DISEASE

Suction curettage 1
TOTAL 1
VULVA/VAGINA CERVIX
VULVA/VAGINA UTERUS OVARIES

FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX

UTERUS OVARIES FALLOPIAN TUBES OTHERS

VULVA/VAGINA CERVIX UTERUS OVARIES

FALLOPIAN TUBES OTHERS VULVA/VAGINA CERVIX

VULVA/VAGINA CERVIX
VULVA/VAGINA UTERUS OVARIES

FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX

UTERUS OVARIES FALLOPIAN TUBES OTHERS

VULVA/VAGINA CERVIX UTERUS OVARIES

FALLOPIAN TUBES OTHERS TROPHOBLASTIC CERVIX


OTHERS

Completion curettage 9
Diagnostic curettage 1
Manual placental extraction -
Excision of parasitic myoma -
TOTAL 10
HISTOPATHOLOGIC
HISTOPATHOLOGIC RESULTS
VULVA/ VAGINA
Gartner’s duct cyst
-
Condyloma acuminata -
Acute chronic vaginitis
-
Intradermal nevus
-
Hyperkeratosis, parakeratosis -
TOTAL -
HISTOPATHOLOGIC RESULTS
CERVIX

Cervical intraepithelial neoplasia -


Squamous cell carinoma, large cell non-keratinizing -
Endocervical polyp -
Ectocervical polyp -
Chronic endocervicitis -
Squamous metaplasia -
Degenerated deciduas -
Pseudodecidual reaction of stroma -
Nabothian cyst -
Adenosquamous carcinoma -
HISTOPATHOLOGIC RESULTS
UTERUS
Leiomyoma uteri 9
Adenomyosis 5
Endometrial polyp Atrophic type 1
hyperplastic type 1
Proliferative endometrium 3
Secretory endometrium with decidualization 1
Secretory endometrium 5
Cystic atrophy endometrium 3
Inactive endometrium with decidualization 1
Disordered proliferative endometrium 1
Carcinosarcoma (Malignant Mixed Mullerian Tumor) 1
Adenosquamous carcinoma 1
HISTOPATHOLOGIC RESULTS
OVARIES

Endometriotic cyst 4
Mucinous cystadenoma -
Serous cystadenoma -
Corpus luteum cyst 1
Cystic follicle 1
Mature cystic teratoma 2
Tubo ovarian abscess 1
Endometrioid adenocarcinoma -
Granulosa cell tumor -
Papillary carcinoma -
HISTOPATHOLOGIC RESULTS
FALLOPIAN TUBES

No diagnostic abnormality 49
recognized, both segments of
fallopian tubes
Tubal pregnancy, ruptured 2
Tubal pregnancy, unruptured -
Tuboovarian abscess 1
Paratubal cyst 1
HISTOPATHOLOGIC RESULTS
PLACENTA

Mature singleton placenta -


Immature singleton palcenta -
Acute chorioamnionitis -
Mature dichorionic diamnionic -
twin placenta
Mature monochorionic -
diamnionic twin placenta
Decidua -
PAP SMEAR CENSUS

Satisfactory for evaluation 94


Abnormal (SCCA, Keratinizing)
-
Abnormal (ASCUS)
-
Abnormal (AGUS)
-
Unsatisfactory
-
TOTAL 94
00 0
00 0
00 7
Name Alibuyog, maxima
Age/Parity 52yo/ G4P4 (4004)
Consultant -
Surgeon Dr. Iskandar
UTZ: Initial Dx: Endometrial polyp, hyperplastic type
• Adenomyosis. G4P4 (4004)
The uterus  AUB probably secondary to Plan:
isretroverted
endometrial pathology TAHBSO on Aug 21/2018
with globular
contour 6.9 x 11 x  Adenomyosis
12.8 cms. The  Multiple myoma uteri
mtometrium is
asymmetrically Procedure:
with the anterior Diagnostic curettage
and posterior
myometrium
Final Dx:
11cm. Thin
endometrium G4P3 (3013)
0.3cm • AUB secondary to endometrial
polyp
• Adenomyosis
• Multiple myoma uteri
• s/p Endometrial biopsy
Name Tapac, Yolanda
Age/Parity 65yo/ G1P1 (1001)
Consultant -
Surgeon Dr. Abuluyan
UTZ: Initial Dx: Atrophic endometrial polyp
Uterus slightly G1P1 (1001) Strips of athrophic endometrium
enlarged 4 x 4 x 5  AUB probably secondary to
cms, thickened
endometrial polyp Plan:
endometrium with
endometrial polyp  r/o malignancy Observation
0.9 x 1.7 x 1.8 cms
Atrophic ovaries Procedure:
Endometrial biopsy

Final Dx:
G1P1 (1001)
 AUB probably secondary to
atrophic endometrial polyp
 s/p Endometrial biopsy
Name Palting , Venus
Age/Parity 43yo/ G2P1 (1011)
Consultant -
Surgeon Dr. Iskandar
UTZ: Initial Dx: Predominantly blood clot with a fragment of Secretory
Uterus is anteverted G2P1 (1011) endometrium
globularly enlarged • AUB probably secondary to
due to presence of
endometrial pathology; Plan:
m1 posterior myoma
9.19 x 9.89 x 9.14 • Myoma uteri Underwent TAHBSO under private service
cms. M2 posterior
subserous myoma Procedure:
5.48 x 4.84 x Endometrial biopsy
4.88cms.
Endometrium thin. Final Dx:
Normal ovaries
G3P3 (3003)
• AUB probably secondary myoma
uteri;
• Myoma uteri
• s/p Endometrial biopsy
Secretory Endometrium
Name Pagtama, Erlinda
Age/Parity 58yo/ G5P5 (5005)
Consultant -
Surgeon Dr. Anwar
UTZ: Initial Dx: Adenosquamous carcinoma
Slightly enlarged G5P5 (5002)
globular • AUB prob secondary to endometrial Plan:
retroverted pathology; for EFHBSO with complete staging on august
uterus markedly • HTN Stage II; DM Type 2
thickened
endometrium Procedure:
with endometrial Diagnostic curettage
mass atrophic
ovaries Final Dx:
Ģ5P5 (5005)
• AUB secondary to Adenosquamous
carcinoma
• HTN Stage II; DM Type 2
 s/p diagnostic curettage
Name Pagaduan, Precy
Age/Parity 50yo/ G2P2 (2002)
Consultant -
Surgeon Dr Rosario
UTZ: Initial Dx: Endometrial polyp, hyperplastic type
• Normal sized Ģ2P2 (2002)
globular  AUB secondary to endometrial Plan:
anteverted uterus
pathology observation
with multiple
myoma.
Distorded Procedure:
endometrium Endometrial biopsy
with submucous
myoma. Consider Final Dx:
cystic follicle right Ģ2P2 (2002)
ovary. Normal left
 AUB secondary to endometrial
ovary
polyp
 s/p Endometrial biopsy
Name Cube, Jiji
Age/Parity 42yo/ G2P2 (2002)
Consultant -
Surgeon Dr Sutedja
UTZ: Initial Dx: Inactive endometrial glands with decidualization
• Normal uterus Ģ2P2 (2002)
• Thin  AUB secondary to hyperplasia Plan:
endometrium 0.3
without atypia OCP
cm
• Normal ovaries  s/p MPA for 3 months

Procedure:
Endometrial biopsy

Final Dx:
Ģ2P2 (2002)
 AUB secondary to hyperplasia
without atypia, resolved
 s/p MPA for 3 months
 s/p endometrial biopsy
Name Suniga, milagros
Age/Parity 49yo/ G2P2 (2002)
Consultant -
Surgeon Dr. liwanto
UTZ: Initial Dx: Secretory endometrium
• Slightly enlarged G3P3 (3003)
uterus with • AUB probably secondary to Plan:
myoma
myoma uteri for TAHBSO
intramural meas
7.2 x 9,3 x 9 cms.
Endometrium Procedure:
delineated. Endometrial biopsy
Normal ovaries
Final Dx:
G3P3 (3003)
 AUB secondary to hormonal
imbalance
 s/p endometrial biopsy
cases
00 8
Name Academia, Maryjane
Age/Parity 39yo/G3P3 (3003)
Consultant Dr. Quilala
Surgeon Dr. Agres
UTZ: Initial Dx: LEIOMYOMA UTERI, SUBSEROUS AND
The uterus is enlarged G3P3 (3003) INTRAMURAL, MULTIPLE.
PROLIFERATIVE ENDOMETRIUM.
measuring 19x26x14cm. By  Multiple myoma uteri CHRONIC CERVICITIS, CERVIX.
the presence of myoma  DM type 2-insulin requiring CORPUS ALBICANS, RIGHT OVARY.
growth multiple, intramural NO DIAGNOSTIC ABNORMALITY RECOGNIZED:
and subserous component. Procedure: LEFT OVARY AND BILATERAL FALLOPIAN TUBES.
There are several myoma Exlap, TAHBSO PARATUBAL CYST, RIGHT.
ONE LYMPH NODE, UNREMARKABLE.
that are numerous to count.
The biggest diameter is Final Dx:
about 6x5x4cm, no G3P3 (3003)
degenerative changes seen.  Multiple myoma uteri
Both ovaries are not  DM type 2-insulin requiring
visualized and probably  s/p Exlap, TAHBSO under
obscured by the presence of combined spinal-epidural
the myoma. anesthesia
 No ascites noted.
 Uterus converted to 20 x 15 x
10cm, nodular with multiple
myoma uteri (intramural &
subserous)
 Largest myoma measuring
8x6x3cm and smallest measuring
1x1cm
 Noted an iud in place in the
endometrial cavity
 Ant wall: 3cm
 Post wall: 5cm
 Endometrial thickness: 0.5cm
 Ovaries, fallopian tubes and other
abdominopelvic organs were
grossly normal
LEIOMYOMA UTERI
Name Venus, Victoria
Age/Parity 50yo/G3p2(2012)
Consultant Dr. Gregorio
Surgeon Dr. Jalog
UTZ: Initial Dx: Leiomyoma intramural
• Anteverted Ģ3P2 (2012) Secretory endometrium
uterus measuring  AUB probably secondary to Chronic cervicitis
6.5x6.4x6.4 cm
myoma uteri Corpus albicans, bilateral ovaries
• With myoma
nodule  s/p diagnostic curettage (atypical Hematosalpinx, right fallopian tube
measuring 6.5 x myoma) Unremarkable, left fallopian tube
6.4cm  s/p CS 2x (2005-CPD; 2009-RCS, Unremarkable, left and right parameria
• Endometrium is APH)
thickened at Procedure: Plan:
2.6cm Exlap, TAHBSO observation

Final Dx:
Ģ3P2 (2012)
 Myoma uteri
 s/p TAHBSO
 s/p diagnostic curettage (atypical
myoma)
 s/p CS 2x (2005-CPD; 2009-RCS,
APH)
Name Alegre, Febe
Age/Parity 59yo/G5P4(4013)
Consultant Dr. Acantilado
Surgeon Dr. Agres
UTZ: Initial Dx: LEIOMYOMA UTERI, SUBSEROUS.
Nabothian cysts G5P4 (4013) CYSTIC ATROPHY ENDOMETRIUM.
Normal sized  Myoma uteri CHRONIC CERVICITIS WITH NABOTHIAN CYSTS.
anteverted uterus CORPUS ALBICANS, BILATERAL OVARIES.
Myoma uteri. Procedure: NO DIAGNOSTIC ABNORMALITY RECOGNIZED:
Thin endometrium Exlap, TAHBSO BILATERAL FALLOPIAN TUBES.
Atrophic ovaries
Final Dx:
G5P4 (4013)
• Myoma uteri
• s/p Exlap, TAHBSO
Name Buban, Estrelita
Age/Parity 49yo/G4P4(4004)
Consultant Dr. Pastrana
Surgeon Dr. Abuluyan
UTZ: Initial Dx: ADENOMYOSIS.
Adenomyosis with G4P4 (4004) LEIOMYOMA UTERI, SUBMUCOUS.
adenomyoma, SQUAMOUS METAPLASIA WITH NABOTHIAN
 AUB secondary to adenomyosis
multiple myoma CYST.
uteri, thickened
 Multiple myoma uteri ACUTE SALPINGITIS, BILATERAL FALLOPIAN
endometrium (intramural and submucous) TUBES.
consider endometrial  s/p D & C (2017 - MMMH) CYSTIC FOLLICLE, LEFT OVARY.
hyperplasia, normal  s/p endometrial biopsy NO DIAGNOSTIC ABNORMALITY RECOGNIZED,
ovaries RIGHT OVARY.
(4/23/18)
Plan:
Procedure: DMPA q 3 months
Exlap, TAHBSO

Final Dx:
G4P4 (4004)
 Adenomyosis
 Multiple myoma uteri
(intramural and submucous)
 s/p D & C (2017 - MMMH)
 s/p endometrial biopsy
(4/23/18)
 S/P EXLAP, TAHBSO
12x10x7cm

5x3x2 cm

3x3cm
Name Arcitio, Minda
Age/Parity 46yo/G3P2(2012)
Consultant Dr. Acantilado
Surgeon Dr. Abuluyan
UTZ: Initial Dx: ADENOMYOSIS.
Normal 8x7x6 sized G3P2 (2012) LEIOMYOMA UTERI, MULTIPLE.
LATE PROLIFERATIVE ENDOMETRIUM.
globular  AUB-A1 ENDOCERVICAL TUNNEL CLUSTERS AND NABOTHIAN
anteverted  Multiple myoma CYSTS.
uterus with  DM Type 2 HEMATOSALPINX , BILATERAL.
features of NO DIAGNOSTIC ABNORMALITY RECOGNIZED: BILATERAL
diffuse Procedure: OVARIES.
adenomyosis Exlap, TAHBSO
and myoma Plan:
nodules Final Dx: DMPA q 3 months
Thickened G3P2 (2012)
endometrium  AUB-A1
Normal ovaries  Multiple myoma (intramural,
submucous)
 DM Type 2
 S/P Exlap TAHBSO
Name Taborite, Elisa
Age/Parity 55yo/ Ģ5P5 (5005)
Consultant Dr. Alfonso
Surgeon Dr. Uclusin
UTZ: Initial Dx: LEIOMYOMA UTERI, INTRAMURAL AND SUBMUCOUS.
Uterus is anteverted Ģ5P5 (5005) ADENOMYOSIS.
ATROPHIC ENDOMETRIUM.
superior to the  AUB secondary to prolapsed NABOTHIAN CYST,CERVIX.
mass which is submucous myoma; r/o CORPUS ALBICANS, BILATERAL OVARIES.
hypoehcoic and malignancy GERMINAL INCLUSION CYSTS, LEFT OVARY.
irregular in  s/p Endometrial biopsy (Feb NO DIAGNOSTIC ABNORMALITY RECOGNIZED: LEFT AND
shape probably 2018) RIGHT FALLOPIAN TUBES
the prolapsed
myoma sveral Plan:
hypoechoic Procedure: observe
areas are noted Exlap, TAHBSO
in the body of
the uterus. Final Dx:
Bilateral adnexa Ģ5P5 (5005)
could not be  AUB secondary to prolapsed
assesed in this submucous myoma
scan  s/p Endometrial biopsy (Feb
2018)
 s/p Exlap, TAHBSO under CSEA
(June 7, 2018)
- Asymmetrically
enlarged
to 8x6.5x5 cms
- Pinkish serosal lining
- Multiple nodulations
- Indentation at the
fundal area

On cut section: intracavitary mass- peduncle (4x2 cm)


attached to postero fundal area onnected to the prolapsed
mass (6x7x 5 cm) with irregular surface and on cut section is
a firm pearl white with whorled like pattern with no areas of
necrosis

The ovaries and fallopian


tubes are grossly normal
Nabothian cysts
Name Espiritu, Clarita
Age/Parity 62yo/ G5P3 (3023)
Consultant Dr. Alfonso
Surgeon Dr. Uclusin
UTZ: Initial Dx: LEIOMYOMA UTERI, SUBMUCOUS.
Dilated cervical canal G5P3 (3023) ATROPHIC ENDOMETRIUM.
CHRONIC CERVICITIS WITH NABOTHIAN CYSTS.
with 2 heterogenous • postmenopausal bleeding ENDOMETRIOTIC CYST, LEFT OVARY.
masses along the probably secondary to a CORPUS ALBICANS, RIGHT OVARY.
cervical canal prolapsing submucous myoma; NO DIAGNOSTIC ABNORMALITY RECOGNIZED: BILATERAL
measuring 3.4 x 4.1 x r/o leiomyosarcoma FALLOPIAN TUBES
3.7 cms and 4 x 5 x 4 • s/p endometrial biopsy, punch
cms could be biopsy (2018) Plan:
prolapsing • Hypertension st II- controlled observation
submucous myoma. • s/p CVA (2010)
Uterus enlarged to
37 x 15 x 32 cms. Procedure:
Huge Exlap, TAHBSO
pelvoabdominal
mass consider Final Dx:
myomatous growth G5P3 (3023)
• Myoma uteri
• s/p TAHBSO
• s/p endometrial biopsy, punch
biopsy (2018)
• Hypertension st II- controlled
• s/p CVA (2010)
001
Name Daoang, Erlinda
Age/Parity 70yo/G6P6 (6004)
Consultant Dr. Alfonso
Surgeon Dr. Uclusin
UTZ: Initial Dx: CARCINOSARCOMA (MALIGNANT MIXED MULLERIAN
Myometrial mass • G6P6 (6004) poorly differentiated TUMOR) ARISING IN AN ATROPHIC POLYP.
probably with adenocarcinoma, endometrium TUMOR SIZE: 5cm.
degenerative • Hypertension II; LYMPHOVASCULAR INVASION ABSENT.
changes. Ovarian • DM type II insulin requiring; LESS THAN 50% OF THE MYOMETRIAL INVASION.
pathology stage • s/p CVA (2013) with no residuals NEGATIVE FOR TUMOR:
1. endometrial • s/p diagnostic curettage(4/20/2018, - RIGHT EXTERNAL ILIAC LYMPH NODES.
pathology MMMH-MC) - RIGHT OBTURATOR LYMPH NODES.
probably - LEFT EXTERNAL ILIAC LYMPH NODE.
Procedure:
hyperplastic Exlap EHBSO with complete staging - LEFT OBTURATOR LYMPH NODES.
changes - LOWER UTERINE SEGMENT.
Final Dx: - LEFT AND RIGHT PARAMETRIA.
- PERITONEAL FLUID CYTOLOGY.
G6P6 (6004)
FIBROFATTY TISSUE LABELED AS, “PARA-AORTIC LYMPH
 Endometrioid adenocarcinoma,
NODE”.
endometrium, stage IA
OTHER FINDINGS:
 Hypertension II; - LEIOMYOMA UTERI WITH CALCIFICATIONS,
 DM type II insulin requiring; INTRAMURAL.
 s/p CVA (2013) with no residuals - ATROPHIC ENDOMETRIUM.
 s/p diagnostic curettage (4/20/2018, - NABOTHIAN CYST, CERVIX.
MMMH-MC) - FIBROMA, RIGHT OVARY.
 s/p Exlap PFC, EHBSO, BLND, IO, - CORPUS ALBICANS, LEFT OVARY.
PALS
- NO DIAGNOSTIC ABNORMALITY RECOGNIZED:
BILATERAL FALLOPIAN TUBES.
Plan:
Pelvic RT or chemotherapy
004
Name Buduan, Judith
Age/Parity 34yo/G3P2(2012)
Consultant Dr. Gregorio
Surgeon Dr. Edison
UTZ: Initial Dx: Mature cystic teratoma
The uterus is G3P2 (2012)
 Ovarian New Growth, Left, in Plan:
anteverted smooth
complication (twisted), probably For monitoring every 3 months
contour. The benign
endometrium is thick
(0.97cm) and
Procedure:
Exlap Left Oophorocystectomy with
hyperechoic. The chromopertubation
right ovary is normal.
The left ovary (11 x Final Dx:
G3P2 (2012)
11.57 x 8.66 cm) is
 Mature cystic teratoma, Left ovary,
converted into a in complication twisted
cystic structure with  s/p Exlap Left
Oophorocystectomy with
mix echoes probably
chromopertubation
dermoid. It is located
anterior and to the
left of the uterus.
Intra operative findings:

The left adnexa twisted 1x. The left


ovary is converted to 6 x 9 x 10cm,
necrotic with sebum and hair strands
on cut section.
The uterus is small wth smooth pinkish
serosal surface.
The right ovary and fallopian tube are
groosly normal.
The rest of the abdominopelvic organs
are grossly normal.
+/- 200 ml EBL
Name Dahilig, Normita
Age/Parity 43yo/G2P1 (1011)
Consultant Dr. Quilala
Surgeon Dr. Jalog/ Torida
UTZ: N/A Initial Dx: Tubo ovarian absecess, left.
G2P1 (1011) Leiomyoma uteri, multiple, intramural.
 Tubo ovarian abscess; t/c Proliferative endometrium.
rectovaginal fistula; Squoamos metaplasia, cervix.
 Failed medical management endometriosis, bilateral ovaries.
.
Procedure:
Emergency, Exlap, TAHBSO, Plan:
appendectomy, debridement, close Completion of antibiotic
of fistulous tract, insertion of JP
drain

Final Dx:
G2P1 (1011)
 Tubo ovarian abscess, left with
rectovaginal fistula;
 small/ atrophic kidney, left
 s/p exlap, adhesiolysis, TAHBSO,
appendectomy, debridement
and closure of fistulous tract,
insertion of JP drain
Fistulous tract

Fecaloid material
There is a fistulous tract at the
rectosigmoid connecting to the
posterior vaginal wall and upon
amputation of the specimen,
fecaloid material is noted at the
vaginal canal
The left ovary is converted to a cystic
mass measuring about 10x9x15cm, on
inadvertent rupture, it exuded about
700cc of yellowish-greenish foul smelling
thick discharge. It is adherent to the
anterior abdominal wall and posterior
wall of the uterus.
Name Tangonan, Myrene
Age/Parity 42yo/G8P8 (8008)
Consultant Dr. Cristobal
Surgeon Dr. Abuluyan
Abdominal CT scan Initial Dx: Mature cystic teratoma with hemorrhagic infarction,
Complex cystic mass G8P8 (8008) right ovary
7xx8cm at the right Adenomyosis uteri
• Ovarian new growth probably
adnexal region
benign in complication; Chronic cervicitis with nabothian cysts
with fluid fat
leveling and • s/p BTL (2015 – LCGH) Basal endometrium
1x1cm floating
solid mass Procedure: Plan:
Emergency, Exlap, TAHRSO DMPA q 3 months

Final Dx:
G8P8 (8008)
• Mature cystic teratoma, Right in
complication (twisted);
• s/p TAHRSO
• s/p BTL (2015 – LCGH)
Name Espanol, Genelene

Age/Parity 33yo/ G0
Consultant Dr. Alfonso
Surgeon Dr. Liwanto
UTZ: Initial Dx: LEIOMYOMA UTERI, INTRAMURAL.
There is an G0 ADENOMYOSIS.
SECRETORY ENDOMETRIUM.
abdominopelvic  Abdomino pelvic mass t/c ONG CHRONIC CERVICITIS WITH SQUAMOUS METAPLASIA.
mass, 13.10 x 8.6 probably malignant ENDOMETRIOTIC CYST AND CORPUS LUTEUM, LEFT
cm, multiseptated, OVARY.
predominantly Procedure: NO DIAGNOSTIC ABNORMALITY RECOGNIZED, LEFT
cystic and FALLOPIAN TUBE
Exlap PFC, USO, FS, possible TAHBSO,
anechoic with the with staging
thickest septum at Plan:
0.87cm. GnRh scheduled at PMD
Ovarian new Final Dx:
growth with G0
concomitant • Bilateral Endometriotic Cyst;
adenomyoma Adenomyosis;
considered. • s/p TAHBSO
RIGHT
OVARY
LEFT
OVARY

UTERUS
0 00
002
Name Denus, Maysie
Age/Parity 22yo/ G1P0
Consultant Dr. Gregorio
Surgeon Dr. Uclusin
UTZ: N/A Initial Dx: Ectopic tubal pregnancy, ruptured
G1P0
• t/c Ectopic pregnancy 8 3/7
weeks AOG, probably ruptured

Procedure:
EL, salpingectomy

Final Dx:
G1P0 (0010)
• Tubal pregnancy, ampullary left,
ruptured,
• s/p exlap, evacuation of
hemoperitoneum, left
salpingectomy
• Hemoperitoneum of 200mL
• Left fallopian tube converted to sausage like mass (4x3 cm)
With point of rupture about 2 cms containing blood clots and product of
conception
Name Tabulog, Irish
Age/Parity 40yo/ G5P4 (4004)
Consultant Dr. Quilala
Surgeon Dr. Torida
UTZ: N/A Initial Dx: Ectopic tubal pregnancy, ruptured
G1P0
• t/c Ectopic pregnancy 8 3/7
weeks AOG, probably ruptured

Procedure:
EL, salpingectomy

Final Dx:
G1P0 (0010)
• Tubal pregnancy, ampullary left,
ruptured,
• s/p exlap, evacuation of
hemoperitoneum, left
salpingectomy
Left fallopian tube

Right fallopian tube

100cc hemoperitoneum, the left fallopian tube is converted to a sausage like mass measuring
5x3x2cm with point of rupture at the ampulary segment at its mesentery from which blood
and products of conception are coming out. The right fallopian tube is converted to a sausage
like mass measuring about 6x3x2cm which contains blood on cut section. Uterus and ovaries
are grossly normal
Ectopic tubal pregnancy
000
0 01
Name Abran, Jona
Age/Parity 18yo/ G1P0
Consultant Dr. Alcaraz
Surgeon Dr. Agres

UTZ: N/A Initial Dx: Hydatiform Mole complete


G1P0
• Molar pregnancy 12 4/7 weeks AOG
Plan:
Procedure: Comgt with trophoblastic disease specialist
suction curettage/IV sedation b-hcg monitoring
(160,000-> 14,000-> 492.8)
Final Dx:
G1P0 (0010)
• Complete hydatidiform mole
• s/p Suction curettage under iv
sedation
• s/p PSI insertion
012
1. Sagsagat-Bayuga, Maricel Initial Dx: G3P2 (2002) Incomplete abortion, Early 9 Products of gestation
Age: 36yo weeks AOG, Non septic Non Induced
Surgeon: Dr Martin
Final Dx: G3P2 (2012) Completed Abortion Early
non septic non induced via Completion curettage
under IV sedation

2. Abdulwahab, Cairon Initial Dx: G6P2 (2032) Incomplete abortion 11 2/7 Products of gestation
Age: 39yo weeks AOG early, non-septic, non-induced; Poor
Surgeon: Dr. Rosario OB history for 3 consecutive abortions; s/p right
oophorectomy (2005, GRAMH); Elderly
multigravida

Final Dx: G6P2 (2042) Completed abortion early,


non-septic, non-induced, s/p completion curettage
under IV sedation; Poor OB history for 4
consecutive abortions; s/p right oophorectomy
(2005, GRAMH); Elderly multigravida
3. Sebastian, Rea Initial Dx: G2P1 (1001) Incomplete Abortion Early Products of gestation
Age: 20yo 10 4/7 weeks AOG, non septic non induced;
Surgeon: Dr Martin previous CS for DL (2015, MMMHMC)

Final Dx: G2P1 (1011) Completed abortion Early 10


4/7 weeks AOG, non septic non induced; s/p
completion curettage under IV sedation; previous
CS for DL (2015, MMMHMC
4. Cabinian, Nelia Initial Dx: G1P0
Age: 23y/o Incomplete abortion at 13 weeks AOG, nonseptic,
Surgeon: Dr. Santiago non-induced Products of conception

Final Dx: G1P0 (0010)


Completed abortion, late, nonseptic non-induced
s/p completion curettage under IV sedation

5. Tagudin, Camille Initial Dx: G2P1 (1001) Missed Abortion 12 5/7 Products of conception
Age: 25y/o weeks AOG
Surgeon: Dr. Martin
Final Dx: G2P1 (1011) Completed Abortion non
septic non induced, s/p dilatational and curettage
under IV sedation

6. Domingo, Decerry Initial Dx: G4P3 (3003) Incomplete abortion 12 4/7 Products of conception
Age: 20y/o weeks AOG, nonseptic, non-induced
Surgeon: Dr. Santiago
Final Dx: G4P3 (3013) Completed abortion, early,
nonseptic, non-induced s/p completion curettage
under IV sedation
7. Yamballa, Charmaine Initial Dx: G2P1 (1001) Incomplete Abortion 14
Age: 31y/o weeks AOG by unsure LMP, non septic non
Surgeon: Dr. Martin induced Products of conception

Final Dx: G2P1 (1011) Completed Abortion late


Non septic Non induced s/p completion curettage
under IV sedation

8. Cargado, Kaycy Lou Initial Dx: G3P2 (2002) Incomplete abortion 12 Products of conception
Age: 23y/o weeks AOG size, nonseptic, non-induced; t/c
Surgeon: Dr. Santiago seizure disorder
Final Dx: G3P2 (2012) Completed abortion, early,
nonseptic, non-induced s/p completion curettage
under IV sedation; Seizure disorder

9. Tolentino , Aiza Initial Dx: G3P1 (1011) incomplete abortion late 18 Products of conception
Age: 28y/o 3/7 weeks AOG non septic non induced ;
Surgeon: Dr. Suharno hyperthyroidism not in storm; anemia moderate

Final Dx: G3P1 (1021) completed abortion late 18


3/7 weeks AOG non septic non induced ;
hyperthyroidism not in storm; anemia moderate
s/p completion curetage under IV sedation
10. Tabaniag, Carol Initial Dx: G3P2 (1101) Incomplete abortion 9 5/7
Age: 29y/o weeks AOG nonseptic, non-induced; previous CS x
Surgeon: Dr. Santiago 1 (G1 – DL 2012, LCGH); G2 – VBAC; poor OB Products of conception
history for 1 preterm death (anencephaly)

Final Dx: G3P2 (1111) Completed abortion, early,


nonseptic, non-induced; previous CS x 1 (G1 – DL
2012, LCGH); G2 – VBAC; poor OB history for 1
preterm death (anencephaly)
11. Manayan, Jennilyn Initial Dx: G3P2 (2002) Incomplete abortion 14 4/7 Products of conception
Age: 24y/o weeks AOG induced, to consider septic
Surgeon: Dr. Santiago
Final Dx: G3P2 (2012) Completed abortion, late,
nonseptic, induced s/p completion curettage
under IV sedation
PRODUCTS OF GESTATION

• (+)VILLI
References

• Blausteins’s Pathology of Female Genital Tract. 6th edition


• Robbins and Cotran: Pathologic Basis of Disease. 8th edition

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