Bimanual pelvic examination is not an effective method for identifying cases of adnexal mass at an early stage. Direct toxicity to sweat glands is described for several chemotherapeutic compounds. Surgery and histopathological examination is often required for definitive diagnosis and therapy. Torsion of a normal-sized ovary or of an ovary with cysts smaller than 5 cm is rare. Inflammation is not a prominent feature, although it is sometimes present. To what degree? Complex masses in this age group may represent in-utero or neonatal torsion.59 The risk of malignancy is extremely small, but complications requiring surgical intervention can arise from torsion, hemorrhage, or mass effect. Fas signaling mediated by p53 is an important pathway mediating apoptosis induced by cyclophosphamide in follicular keratinocytes, as both Fas and Fas ligand are upregulated in hair follicles following cyclophosphamide treatment, and mice treated with anti-Fas ligand antibody as well as Fas knockout mice both showed significantly reduced cyclophosphamide-induced alopecia and follicular atrophy along with markedly reduced apoptosis of follicular keratinocytes. Pregnancy must be excluded, and the possibility of complications of a sexually transmitted infection considered. Adjuvant therapy with cisplatin and doxorubicin became the standard regimen for advanced or recurrent endometrial cancer. The most effective chemotherapy regimens have been established by several GOG studies. Accessory or adjoining anatomical parts, as ovaries and fallopian tubes in relation to the uterus. Eczema may rarely simulate seborrheic blepharitis. Treatment involves surgical resection and adjuvant chemotherapy with or without radiation therapy (Tables 85.18 and 85.19). Surgical disorders of the adnexa are common, particularly in the adolescent period. Many effects of TCDD are mediated by its specific binding to the Ah receptor (AhR), a cytosolic ligand-activated transcription factor. A number of agents have been tested for their ability to prevent alopecia in these models, including cyclosporin A, minoxidil, antioxidants, apoptosis inhibitors, and a variety of cytokines and growth factors, all with variable degrees of effectiveness. Combinations of two or more chemotherapeutic agents usually induce a greater incidence and more severe alopecia than single-agent chemotherapy does. In the absence of findings suggestive of neoplasm, minimally invasive surgical techniques such as laparoscopy should be paired with cystectomy and ovarian conservation. Sebaceous glands and hair follicles also express EGFRs and are known targets in some cases of toxicity. FIGURE 55.27. Because skin lesions do not occur in all patients responding to treatment, a direct pharmacologic effect of these drugs on the skin is suspected, but exact mechanisms are not entirely understood. This leads to congestion, adnexal edema, ischemia, and necrosis. Lesley L. Breech MD, in Adolescent Medicine, 2008. Judith A. Blunt dissection separates the cyst from the ovarian capsule, allowing the cyst wall to be removed in toto (Fig. Benign adnexal masses typically have the following ultrasonographic features: low echogenicity, a thin cyst wall, unilocular or, if septated, a thin septation, and absence of internal papillary excrescences. It is important to distinguish follicular development arising from true precocious puberty from autonomously active cysts. FHU “Adnex” ul.M.Frysztackiego 32 ... 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