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Abstract
Introduction/Background Ovarian lymphoma is an exceptionally uncommon occurrence, constituting merely 1.5% of all ovarian tumors. It may manifest as either primary or secondary, affecting either one or both ovaries. Acute genital ulceration or ‘Lipschütz ulcer’ is an infrequent, self-limiting condition unrelated to sexual transmission commonly occurring in sexually inactive prepubertal or adolescent females. The cause remains undetermined in many cases, and the exact incidence is uncertain.
We present an intriguing case of a 58-year-old nulligravid experiencing symptoms of anuria . Our case covers the unusual aspects of our differential diagnoses, diagnostic approach, and surgical management employed to address a presentation of urine flow obstruction with a concurrent adnexal mass in a postmenopausal woman that lead to a diagnosis of ovarian lymphoma. Additionally, we delve into an uncommon dermatological complication associated with this case.
Methodology In our setting, a combined clinical assessment and ultrasound remain the gold standard for pre-operative diagnosis of ovarian lymphoma. More so, a pivotal aspect of reaching this diagnosis involves thorough clinicopathological and immunohistochemical examination.
Results A 58-year old nulligravid with no remarkable co-morbidities presented at the emergency room with a chief complaint of anuria. Physical examination revealed a palpable hypogastric mass about 16 weeks in size, solid, moveable and nontender. Imaging studies showed uterine myoma, enlarged lymph nodes, lumbar subcutaneous edema. The kidneys were unremarkable. She underwent exploratory laparotomy. Histopathologic assessment of the ovary was initially suggestive of a dysgerminoma, however, immunohistochemical staining was positive for CD19 and CD20, confirming the diagnosis of Non-Hodgkins lymphoma. The peritoneal fluid and omentum revealed no abnormality.
Conclusion The presentation and clinical characteristics of our case are distinct. While lymphomas can manifest an extensive array of symptoms, there is no record, to our knowledge, of ovarian lymphoma cases with anuria as the primary manifestation that lead to a unique dermatological Lipschütz ulcer complication.
Disclosures The authors declare no conflicts of interest that could have influenced the research conducted in this study.
