Cases reported "Leiomyoma"

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1/98. Case report: intrahepatic portal-hepatic venous shunts associated with a huge pelvic leiomyoma.

    We present a case of portal-systemic encephalopathy due to intrahepatic multiple portal-hepatic venous shunts. A 71-year-old woman was admitted to our hospital because of recurrent episodes of disturbed consciousness. She showed no clinical signs of portal hypertension. liver function was normal, except for an indocyanine green retention rate of 34% at 15 min and blood ammonia level of 282 microg/dL. Portal venography revealed dilatation of the portal vein and multiple portal-hepatic venous shunts, and a liver biopsy specimen revealed almost normal liver. Further clinical examination revealed a huge pelvic tumour. At laparotomy, two dilated veins were seen to arise from the pelvic tumour with blood flow into the mesentery. The tumour was resected successfully and a histological diagnosis of leiomyoma was made. The blood ammonia concentration decreased to the normal range postoperatively. A follow-up portal venogram demonstrated decreased portal vein dilatation and minor portal-hepatic venous shunts, considered to be congenital in origin. It is concluded that hepatic encephalopathy was produced in this patient due to an excess portal blood flow from the huge pelvic leiomyoma via the mesentery, with portosystemic shunting through pre-existent (probably congenital) intrahepatic anastomoses.
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2/98. A huge 6.2 kilogram uterine myoma coinciding with omental leiomyosarcoma: case report.

    Surgery for massive abdominal tumors is both interesting and challenging. We present a case involving a multiple uterine myoma weighing 6.2 Kg which coincided with omental leiomyosarcoma. To our knowledge, this is the first report of this type of condition in the English literature. A 44-year-old nulliparous woman had suffered from abdominal pain for a long time. A huge abdominal mass was palpated on physical examination. Computed tomography scanning revealed a huge pelvic-abdominal mass with the possibility of small bowel loops invaded by the mass. A 6-cm omental mass was incidentally found during the subsequent hysterectomy procedure. Perforation of the urinary bladder occurred during the dissection of adhesion. Resection of the omental mass, wide wedge resection of the invaded small bowel, primary repair of the bladder, and hysterectomy were performed. The final pathologic diagnosis was uterine leiomyomata with omental leiomyosarcoma. The patient returned home on postoperative day 14 and was well at the 18-month follow-up examination. The challenge of these tumors lies in their proper diagnosis and surgical management. More case reports and follow-up studies are needed to confirm the efficacy of their management.
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3/98. Intramural leiomyoma of the bladder.

    Mesodermal tumors of the urinary bladder are rare and the majority of them are malignant. We report a case of an intramural leiomyoma of the bladder presenting with symptoms of a mild lower urinary tract infection. The patient was managed with partial cystectomy and the outcome was excellent.
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4/98. Bladder leiomyoma: a rare cause of urinary stress incontinence.

    Lejomyoma of the bladder is an uncommon lesion and usually present as small intramural or submucosal lesions. Preoperative evaluation based on careful physical and radiologic examinations must rule out malignant and other lesions. It is readily and successfully treated in most cases with transurethral or open resection. The prognosis of this tumor is excellent and no malignant degeneration has been reported. The most common presentations are obstructive voiding symptoms, irritative symptoms, and hematuria. Occasionally, it may be a cause of urinary stress incontinence. Although this condition is rare, it should be considered in the causes of urinary stress incontinence.
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5/98. leiomyoma of the female urethra with upper tract dilation and treatment with transurethral resection: a case report and literature review.

    leiomyoma of the female urethra is a rare condition. It is a benign mesenchymal tumor that commonly presents with recurrent urinary tract infections and various lower urinary tract symptoms. We report a case of urethral leiomyoma and review the literature. A 44-year-old woman presented with severe irritative voiding symptoms without urinary tract infection and bilateral upper urinary tract dilation. Ultrasound and cystoscopy revealed a smooth mass arising from the urethra and projecting into the bladder. Transurethral resection of the mass was performed and 32 g of tissue was removed. There were no complications and the symptoms resolved completely, indicating this to be a safe approach. Histopathology showed the tumor to be leiomyoma.
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6/98. Urinary tract injuries during advanced gynecologic laparoscopy.

    Urinary tract injuries are important complications of laparoscopic surgery. The intraoperative diagnosis may be delayed, resulting in severe clinical complications, such as fistulas, in the immediate and late postoperative periods. A review of 776 endoscopic procedures revealed 6 urinary tract injuries and postoperative complications during laparoscopy. We believe that surgical experience, intraoperative diagnosis, immediate repair of the lesion, and close follow-up are the main factors contributing to decreased morbidity associated with these injuries.
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7/98. CT findings after uterine artery embolization.

    Asymptomatic uterine leiomyoma can be detected on routine computed tomography (CT) of the pelvis. Leiomyomas have been described as low attenuation masses that can disrupt the smooth contour of a normal uterus. Four women underwent uterine artery embolization for the treatment of uterine leiomyoma. CT findings include initial retention of contrast in fibroids the day of the procedure and central necrosis of the fibroid with subsequent cavitation as early as 1 month postprocedure.
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8/98. MRI appearance of a leiomyoma of the female urethra.

    Leiomyomas are rare in the urinary tract, with the kidney capsule being the most common location [1]. leiomyoma of the female urethra is very rare. In 1992, Cheng et al. reviewed a total of 29 cases. They concluded that urethral leiomyoma is a rare condition that is difficult to distinguish clinically from other urethral lesions and that a histological diagnosis is essential [2]. Although we agree that the histological diagnosis is essential, magnetic resonance imaging (MRI) provides useful pre-operative information in cases of leiomyoma of the female urethra, as our present case indicates. To our knowledge we report the second case of a primarily diagnostic approach with MRI for leiomyoma of the female urethra. Ikeda, R. (2001). Clinical Radiology56, 76-79.
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9/98. Uterine leiomyoma with massive lymphocytic infiltration simulating malignant lymphoma. A case report with immunohistochemical study showing that the infiltrating lymphocytes are cytotoxic T cells.

    Uterine leiomyoma with massive lymphoid infiltration is very rare and may simulate malignant lymphoma. To the best of our knowledge, this is the first description of such a lesion occurring in an Oriental, and the ninth case in the English literature. A 50-year-old Taiwanese woman had urinary frequency and nocturia because of a uterine myoma. The myomectomy specimen was identified as a well-defined tumor, 6.5-cm in diameter, the cut surface of which was pale, white and whorled. A massive lymphocytic infiltration accompanied by plasma cells and histiocytes was noted in the leiomyoma but not in the surrounding non-neoplastic myometrial fibers. Most infiltrating lymphocytes were positive for CD3 and T cell intracellular antigen-1, a cytotoxic marker. The postoperative course was uneventful, and the urinary symptoms improved within a 6-month follow-up period.
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keywords = urinary
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10/98. Malignant fibrous histiocytoma of the ileum at a site of previous surgery: report of a case.

    Sarcomas rarely arise in the intestinum, and leiomyosarcoma represents the majority of cases. With only seven cases reported in the available English literature up to now, malignant fibrous histiocytoma of the small intestine is exceedingly rare. Moreover, follow-up data are almost completely unavailable. We present herein the unique case of a malignant fibrous histiocytoma arising in a postoperatively adherent intestinal loop. To the best of our knowledge, this is the first such case ever to be described. The clinical history and the intraoperative findings suggested that chronic postoperative repair processes might have been a promoting factor in the tumorigenesis of this neoplasm, on the analogy of malignant fibrous histiocytoma arising at different sites. The patient recovered well but 9.5 years after surgical removal, a solitary recurrent tumor developed in the urinary bladder and progressed rapidly, highlighting the need for long-term, possibly life-long, surveillance of patients with this rare type of intestinal cancer.
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