1/8. Coil embolization of a tuboovarian anastomosis before uterine artery embolization to prevent nontarget particle embolization of the ovary.uterine artery embolization (UAE) is being used more frequently as a primary treatment for uterine leiomyoma. Performing UAE in women who desire future fertility is controversial because of the risks of premature menopause and the undetermined effects on pregnancy. The etiology of ovarian failure after UAE is not yet clearly defined, but one of the leading possibilities is nontarget embolization of the ovaries. In this case report, the authors describe a technique of selective coil embolization of a uterine artery-to-ovarian artery communication before UAE performed specifically to protect the ovary from nontarget embolization.- - - - - - - - - - ranking = 1keywords = menopause (Clic here for more details about this article) |
2/8. Contrast-enhanced sonography during uterine artery embolization for the treatment of leiomyomas.uterine artery embolization (UAE) is a successful and safe treatment for symptomatic leiomyomas. However, rare complications such as premature menopause and uterine necrosis can arise because of embolization of non-target tissues. We studied the feasibility of using contrast-enhanced sonography with intravenous SonoVue just before, during and after complete occlusion of both uterine arteries. In a patient with multiple, large, symptomatic leiomyomas, contrast-enhanced imaging established that the UAE was technically successful and that myometrial vascularity was not reduced. Our case suggests that ultrasound contrast agents may have a role in monitoring UAE and thus may help prevent ischemic complications. Further studies are required to confirm this.- - - - - - - - - - ranking = 1keywords = menopause (Clic here for more details about this article) |
3/8. Rapidly growing leiomyoma in a postmenopausal woman.We present here a case of a rapidly growing leiomyoma occurring after menopause. The tumor weighed 4329 g, suggesting the rapid accumulation of 'hyaline fibrosis'. A small amount of proliferative activity was detected as evidenced by ki-67 antigen immunoreactivity.- - - - - - - - - - ranking = 1keywords = menopause (Clic here for more details about this article) |
4/8. Fresh autologous transplantation of ovarian cortical strips to the anterior abdominal wall at the pfannenstiel incision site.OBJECTIVE: To describe an open surgical technique for transplanting fresh ovarion tissue to the anterior abdominal wall at the incision site and to determine whether ovarian function would be restored after transplantation. DESIGN: Case study. SETTING: Academic medical center. PATIENT(S): A 44-year-old patient who underwent an operation for uterine fibroids. INTERVENTION(S): Microsurgical reconstruction of ovarian cortex and its transplantation to the anterior abdominal wall at incision site of Pfannenstiel. MAIN OUTCOME MEASURE(S): Follicular development evident by ultrasound examination; restoration of serum FSH and LH levels to nonmenopausal range; and disappearance of menopausal symptoms. RESULT(S): Early postoperative FSH, LH, and E(2) levels showed that menopause was confirmed. Postoperative hormone levels at months 2, 3, and 6 were as follows: FSH: 77.86, 79.50, and 13.70 mIU/mL; LH: 34.60, 33.92, and 8.78 mIU/mL; E(2): 29, 46, and 48 pg/mL. The patient is still followed-up for postmenopausal status. CONCLUSION(S): Autotransplantation of cortical strips to the anterior abdominal wall at the incision site without further incision can be a logical solution for the patients at early climacteric age.- - - - - - - - - - ranking = 1keywords = menopause (Clic here for more details about this article) |
5/8. Necrotic leiomyoma and gram-negative sepsis eight weeks after uterine artery embolization.BACKGROUND: uterine artery embolization for symptomatic leiomyomata is generally safe, but rare life-threatening complications, including sepsis, can result. CASE: A 39-year-old woman with primary antiphospholipid syndrome, who was on chronic warfarin therapy, underwent uterine artery embolization for severe menorrhagia and a 12-cm intracavitary leiomyoma. Eight weeks postembolization, the patient, who had been essentially asymptomatic, presented in septic shock from gram-negative anaerobic bacteria. She underwent hysterectomy and bilateral salpingo-oophorectomy for a large infarcted necrotic leiomyoma and partial uterine necrosis. The patient's 8-day hospitalization required extended care in the intensive care unit and blood transfusion and resulted in surgical menopause in a patient who is not a candidate for hormone therapy. CONCLUSION: uterine artery embolization is a procedure not without significant risks. From published case reports, it appears that patients most at risk for severe infection of an infarcted leiomyoma after this procedure are those with a large dominant leiomyoma.- - - - - - - - - - ranking = 1keywords = menopause (Clic here for more details about this article) |
6/8. Malignant mesenchymoma arising from a uterine leiomyoma in the menopause.BACKGROUND: Malignant mesenchymoma is a rare tumor and location in the uterus is even rarer. We describe the first case of malignant mesenchymoma arising from a uterine fibroid in the menopause. CASE REPORT: A 64-year-old woman presented with abdominal pain and underwent surgery for a large "uterine fibroid" with suspicious features on ultrasound scan. The mass had developed after the menopause. histology showed benign leiomyomatous tissue with malignant areas consistent with malignant mesenchymoma. CONCLUSION: We report the first case of malignant mesenchymoma arising from the uterus in menopause. Certain radiological features may be associated with this tumor. Due to its rarity, information on management of uterine malignant mesenchymoma is lacking and management options of uterine leiomyosarcomas are reviewed as a surrogate.- - - - - - - - - - ranking = 7keywords = menopause (Clic here for more details about this article) |
7/8. Labial leiomyoma: a case report.leiomyoma is common in the myometrial layer of the uterus, and rarely found in other genital organs. Previous reports show multiple sites of leiomyoma outside the uterus eg. vagina, oral mucosa or mandible vascular leiomyoma. leiomyoma is normally a benign smooth muscle tumor and behaves as a hormone sensitive tumor Leiomyomas develop during the reproductive age and regress after menopause. The case of a 25 year old female with a large left labial leiomyoma presented as Bartholin's cyst. Illustrates the diagnostic difficulties in such cases. The management in this case was surgical excision. The definite diagnosis was confirmed by histologic examination as a labial leiomyoma.- - - - - - - - - - ranking = 1keywords = menopause (Clic here for more details about this article) |
8/8. Hormone-dependent spinal leiomyoma.A 43-year-old woman underwent subtotal removal of a cervical spinal leiomyoma in 1980 and 1981. When her (cyclic) symptoms recurred and tumor growth was demonstrated, she was treated with a synthetic anti-gonadotropic hormone (danazol; Danatrol) until menopause, when medication could be discontinued without further recurrence of her symptoms or increase in size of the residual tumor.- - - - - - - - - - ranking = 1keywords = menopause (Clic here for more details about this article) |