Cases reported "Leiomyoma"

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1/47. Giant myoma and erythrocytosis syndrome.

    The objective of this study is to discuss the myomatous erythrocytosis syndrome in a patient with a giant subserous uterine myoma. She presented with plethora and an abdominal mass. After venesection of 4 units of blood, the preoperative haematocrit value of 53.3% and haemoglobin value of 17.5 g/dL had decreased to 48.6% and 16.8 g/dL levels, respectively. After the operative extraction of the giant subserous myoma with attached uterus weighing 14.2 kg, the haematocrit and the haemoglobin values had regressed to 40.3% and 14.3 g/dL levels, respectively. The findings indicated that the giant subserous myoma was the cause of the myomatous erythrocytosis syndrome in this patient.
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2/47. Pathologic features of uterine leiomyomas following uterine artery embolization.

    Bilateral uterine artery embolization has recently been employed as an alternative to operational treatment of uterine leiomyomas. The pathologic features induced by uterine artery embolization have not been previously described in detail. Usually patients experience symptomatic improvement with a reduction in size of the leiomyomas. This report describes the pathologic features in a series of 10 uterine leiomyomas where tissue was available for histologic examination following uterine artery embolization. Characteristic histologic features within the leiomyomas included massive necrosis, sometimes with dystrophic calcification, vascular thrombosis, and intravascular foreign material that elicited a histiocytic and foreign-body giant cell reaction. In some cases, intravascular foreign material was present elsewhere in the myometrium, the cervix, or paraovarian region. In occasional cases, there were foci of myometrial necrosis and microabscess formation beyond the confines of the leiomyomas. Foci of extrauterine inflammation were also occasionally identified. Histopathologists should be aware of these findings because the use of uterine artery embolization will possibly become more widespread in the future.
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3/47. Osteoclast-like giant cells in leiomyomatous tumors of the uterus. A case report and review of the literature.

    Osteoclast-like giant cells (OLGC) in leiomyomatous tumors of the uterus are rarely seen, and their significance is unknown. We present a case of a large leiomyomatous tumor in which OLGC were found in only few sections showing leiomyosarcoma whereas the majority of sections revealed a leiomyoma. Though radically operated, the patient died a few months later with recurrent tumor in the pelvis and metastases to the lungs.
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4/47. A bizarre giant leiomyoma.

    We report the clinical and imaging features of a huge deep leiomyoma of the rectus abdominis treated surgically in an 84-year-old man. Hypotheses are put forward to elucidate the etiology of this enigmatic localization, apparently the first described in the literature.
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5/47. streptococcus agalactiae endocarditis and giant pyomyoma simulating ovarian cancer.

    Group B streptococcus (streptococcus agalactiae) is a common etiology of bacteremia among adults. Pyomyoma is a rare infectious complication of uterine leiomyomas. We report the case of a diabetic postmenopausal woman with a giant pyomyoma simulating an ovarian cancer. It was associated with S. agalactiae endocarditis and deep venous thrombosis of the right external iliac and femoral veins. Treated initially with intravenous penicillin, amikacin, and anticoagulation, the patient later had abdominal hysterectomy with an uneventful recovery. We also review the cases of pyomyoma reported since 1945. Of 14 cases described (including ours), mortality was 21%. endocarditis was never reported in association with pyomyoma. The presence of bacteremia and a leiomyoma should raise suspicion for this disease.
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6/47. Giant leiomyoma of the esophagus.

    leiomyoma is the most common benign tumour found in the esophagus but it is, however, a rare neoplasm; in fact of all esophageal tumours, benign tumours account for fewer than 10%, of which 4% are leiomyomas. Leiomyomas should be removed when diagnosed, even if asymptomatic, because malignancy cannot otherwise be excluded and symptoms are likely to develop if treatment is delayed or omitted. Enucleation of esophageal leiomyoma is a safe and effective procedure. We report a case of symptomatic giant anular leiomyoma of the distal esophagus, compressing the trachea and the descending aorta, resected after right thoracotomy.
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7/47. Giant esophageal leiomyoma with secondary megaesophagus.

    A 25-year-old woman presented with a giant leiomyoma in the lower third of the esophagus. She had no digestive symptoms, although there was a severe esophageal dilation. Such a megaesophagus secondary to a leiomyoma has not been described previously. Esophagogastric resection was performed, followed by an uneventful recovery period. The literature on esophageal leiomyoma is reviewed.
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8/47. Giant uterine tumors: two cases with different clinical presentations.

    BACKGROUND: Giant uterine tumors are uncommon. However, they may be life threatening because of pressure effects on the lungs and other adjacent organs. Proper surgical management and careful perioperative care are essential to assure a good outcome after excision. CASE: Two women with giant uterine leiomyomata (weighing more then 40 kg [88 lb]) are discussed. In one case the leiomyoma led to severe pulmonary hypertension and respiratory failure necessitating an emergency operation. Abdominal hysterectomy and bilateral salpingo-oophorectomy were successfully carried out in both cases, which are among the largest tumors ever removed with survival of the patient. CONCLUSION: Different clinical manifestations can be expected in cases of giant uterine tumors according to which other organs are secondarily affected. Numerous difficulties may be encountered in the evaluation and removal of these tumors. A combined team consisting of gynecologic, general, and plastic surgeons is necessary for a successful outcome.
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9/47. Giant pelvic retroperitoneal leiomyoma arising from the rectal wall.

    BACKGROUND: Pelvic retroperitoneal leiomyomas arising from the rectal wall are rare. We present a case of a giant retroperitoneal leiomyoma mimicking bilateral solid adnexal masses in a postmenopausal woman. CASE: A 54-year-old postmenopausal woman presented with a large abdominopelvic mass. At surgery, the uterus was displaced anteriorly by a large retroperitoneal mass. The rectosigmoid colon was noted to course through the retroperitoneal mass. The patient underwent complete excision of the retroperitoneal mass along with a rectosigmoid resection of the involved colon with primary reanastomosis. Histopathology showed a leiomyoma arising from the muscularis propria of the rectum wall. CONCLUSION: Retroperitoneal masses that extend into the pelvis may mimic adnexal masses and, therefore, represent a rare finding at gynecologic surgery.
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10/47. Bladder leiomyoma: rare presentation as a pelvic mass.

    Bladder leiomyomas are rare tumors. They very rarely present as a pelvic mass. We present an interesting case where a giant bladder leiomyoma was mistaken to be an ovarian mass. A bladder preserving surgery was performed. The literature is reviewed and the management is discussed.
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