Surgicopath June, 2018 Final
Surgicopath June, 2018 Final
Surgicopath June, 2018 Final
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
VULVA/VAGINA CERVIX
VULVA/VAGINA UTERUS OVARIES
FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX
FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX
VULVA/VAGINA CERVIX
VULVA/VAGINA UTERUS OVARIES
FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX
FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX
VULVA/VAGINA CERVIX
VULVA/VAGINA UTERUS OVARIES
FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX
FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX
VULVA/VAGINA CERVIX
VULVA/VAGINA UTERUS OVARIES
FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX
FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX
VULVA/VAGINA CERVIX
VULVA/VAGINA UTERUS OVARIES
FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX
FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX
VULVA/VAGINA CERVIX
VULVA/VAGINA UTERUS OVARIES
FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX
Suction curettage 1
TOTAL 1
VULVA/VAGINA CERVIX
VULVA/VAGINA UTERUS OVARIES
FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX
VULVA/VAGINA CERVIX
VULVA/VAGINA UTERUS OVARIES
FALLOPIAN
VULVA/VAGINA
TUBES VULVA/VAGINA
OTHERS VULVA/VAGINA VULVA/VAGINA
CERVIX
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
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
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
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
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
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
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
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
• (+)VILLI
References