In lower abdomen suggesting ovarian mucinous cystadenocarcinoma with peritoneal metastasis was noted. Other possibilities suggested were primary carcinoma of mesenteric, peritoneal like mesothelium, or papillary carcinoma of peritoneum. Because of highly suggestion of ovarian malignancy preoperation, the patient underwent exploratory laparatomy with midline incision. is it illegal to buy viagra online in the us Total volume of four hundredcc ascitic fluid was aspirated and sent for cytology and culture. There were severe adhesions and miliary seeding all over the abdominal and pelvic organs. Adhesions were released. Then left ovary 5 ã— 5 ã— 6 â€‰cm appeared with hemorrhagic cyst and adhesion to the left fallopian tube. buy viagra cheap So left salpingo oophorectomy was done and the specimen was sent for frozen sections. The result of frozen sections was granulomatous inflammation compatible with tuberculosis. buy viagra cheap So peritoneal cavity was washed with normal saline and closed. buy viagra without prescription The result of permanent pathology was chronic granulomatous salpingitis compatible with tuberculosis. Ovary: hemorrhagic cyst of corpus luteum. buy generic viagra online Patient discharged with antituberculosis drugs. buy viagra canada Figure 1: microscopic picture showing chronic granulomatous inflammation with epitheloid histiocytes and langhans type multinucleated giant cells (case 1). Case 2. viagra coupon A 39 yearâ€“old married woman gravida 6, para 6 has been transferred to the gynecologic ward from the gasteroentrology ward with the complain of abdominal pain, weight loss and fever in the last 4 months (figure 2). Her past medical history was unremarkable, and in her surgical history, last 2 deliveries were through cesarean section and she performed the tubal ligation. It is worth to mention that her normal menstrual pattern has been changed to oligomenorrhea since last 6 months. viagra how long do effects last She had also a positive family history; her mother had been diagnosed with pulmonary tb her abdominopelvic examination revealed a fixed and tender mass in the pelvis. As case 1, due to positive family history for tb, a chest x-ray and skin tuberculin test has been performed and both were negative for tb profiling of serum tumor markers and revealed a high level of ca-125: 207â€‰u/ml. Esr: 27. Hemoglobin was 10â€‰mg%. generic viagra mg pills Pelvic ultrasonography disclosed uterus and adnexa as a large complex cystic mass shifting to the right with extensive adhesion to the adjacent structures. As the preoperation assessment was in favour of ovarian malignancy, the patient underwent exploratory laparatomy with a midline incision. viagra canada online There was no ascites, but miliary seeding all over the peritoneum and small bowel and large bowel, uterus, fallopian tubes and ovaries were seen, which were biopsied. buy viagra cheap A confluent mass containing uterus, ovaries and fallopian tube was seen which was necrotic. The frozen sections of the biopsied specimens showed granulation tissue, but as the family was completed and the mass w.