The wandering spleen (WS) is a rare condition in which the spleen is not found in its usual location in the left hypochondrium but is positioned in the lower abdomen or the pelvis. This is a case of a 21-year-old woman who presented with chronic, intermittent, and subtle pain in the left lower quadrant of her abdomen. After clinical examination and ultrasound evaluation, an adnexal lesion was detected in the left lumbar area, and no splenic tissue was found in the left hypochondrium. The wandering spleen should be included in the differential diagnosis when encountering a patient with non-typical or acute abdominal pain. Accurate diagnostic evaluation can be performed with low-cost imaging modalities such as Doppler ultrasound.

Breast cancer is the most commonly occurring cancer in women, with invasive lobular carcinoma being the second most common histologic form. A 78-year-old female patient presented complaining of an enlarged palpable lymph node in the left axilla. Breast ultrasound, digital mammography, and contrast-enhanced spectral mammography (CESM) revealed no abnormal findings. Core needle biopsy of the lymph node revealed infiltrative, diffuse neoplastic growth suggestive of adenocarcinoma, indicating that the primary site should be sought in the breast. The patient underwent mastectomy and the histopathology was suggestive of invasive lobular carcinoma throughout the whole extent of the breast parenchyma. Breast cancer should be definitely included in the differential diagnosis of enlarged axillary lymph nodes, even if there is no other clinical or radiographic presentation of breast disease.

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Short oral presentation abstractsMethods: As the pandemic is going on for more than 2 years now enough data has been collected to make a comparison regarding the management of adnexal masses in relation to the non-COVID (before March, 2020) times. One year have picked from both era from a tertiary university hospital's gynecological ultrasound outpatient's data and have been analysed regarding patient and tumour characteristics including ADNEX score. Results: During the non-COVID interval 340 patients were examined of which 32 underwent regular follow-ups while 150 patients were operated on. From the operated group 145 patients (avg: 42.04yrs, 15-83yrs) have been included in the analysis (5 adolescents were excluded). In contrast during the COVID interval 211 patients (avg: 49.73yrs, 15-7yrs) have been examined of which 13 was followed up at least two times while 40 patients underwent operation. The ADNEX score of the COVID group was significantly higher than the other. The same correlation has been found in the patient age of the operated groups: COVID era patients proved to be older. However much higher portion of masses turned out to carry malignancy in the COVID group: 35.0% versus 13.1% respectively. Conclusions: Patient selection is crucial in those cases when the operation limits are set to extremely low limits. Preoperative ultrasound imaging combined with ADNEX model proved to be a successful and very powerful technique finding the best and most accurate method for patient with adnexal masses.