Cases reported "Leiomyoma"

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1/1723. MRI of round ligament leiomyoma associated with Mayer-Rokitansky-Kuster-Hauser syndrome.

    We report the magnetic resonance appearance of a case of round ligament leiomyoma that presented as a rapid growing inguinal mass in a patient with Mayer-Rokitansky-Kuster-Hauser syndrome. ( info)

2/1723. Intrapartum ultrasonographic depiction of fetal malpositioning and mild parietal bone compression in association with large lower segment uterine leiomyoma.

    With normal flexion of the fetal head prior to and during early normal labor, the fetal biparietal diameter becomes engaged in (and subsequently traverses) the anterior posterior aspect of the pelvic inlet. Thus, the biparietal diameter (characterized sonographically by depiction of the falx cerebri, thalami, and cavum septum pellucidum) will be obtainable upon transverse suprapubic placement of the ultrasound transducer during the first stage of labor. Deflexion, or extension, of the fetal head may be demonstrated sonographically at the level of the cervical spine. Recently, during intrapartum ultrasonographic assessment of a nulliparous patient with a known, large, lower-segment, uterine fibroid, exhibiting poor progress of labor, the fetal biparietal diameter was documented upon midsagittal suprapubic placement of the transducer. In addition, mild compression of the distal parietal fetal bone was demonstrated and considered consistent with compression by the leiomyoma. Following abdominal delivery, due to fetal distress and arrest of descent, significant deflexion of the fetal head (not suspected by intrapartum cervical examinations) and mild parietal bone depression, consistent with the ultrasonographic examination, were noted. ( info)

3/1723. leiomyoma of the uterus showing skeletal muscle differentiation: a case report.

    A case of uterine leiomyoma with skeletal muscle differentiation is described. The patient is a 40-year-old woman who underwent abdominal hysterectomy and left salpingo-oophorectomy for fibroids. Evidence of skeletal muscle differentiation was evident at light and electron microscopy in one out of three "ordinary" leiomyomas. This was also shown by positive immunoreactions with antiskeletal muscle actin and myoglobin antisera. To our knowledge, this is the second case reported of the occurrence of skeletal muscle differentiation within a uterine leiomyoma and highlights the divergent differentiating potential of smooth muscle cells. ( info)

4/1723. sciatic neuropathy secondary to a uterine fibroid: a case report.

    Lesions of the sciatic nerve outside the pelvis have been well described. Lesions within the pelvis, however, are far less common. We report the case of a 55-yr-old woman with a history of chronic low back pain who presented with progressive right buttock and posterolateral right lower limb pain associated with right foot numbness and tingling. She denied any associated low back or left lower limb pain. The patient was initially treated for a probable right lumbosacral radiculopathy, without improvement. A subsequent magnetic resonance image of the lumbosacral spine revealed multilevel disc degeneration at L3-4 through L5-S1, without disc herniation or canal stenosis. A magnetic resonance image of the pelvis revealed a markedly enlarged uterus, with a large pedunculated myoma impinging on the right sciatic foramen. The patient underwent a subtotal abdominal hysterectomy, with resolution of her right lower limb pain. This case illustrates the importance of considering intrapelvic causes of sciatic neuropathy. To our knowledge, this is the first reported case of sciatic neuropathy secondary to a uterine fibroid. ( info)

5/1723. A mullerian duct remnant myoma misdiagnosed as ovarian cancer in a woman with vaginal agenesis--a case report.

    leiomyoma are very common in the normal uterus; however, they are rather rare in mullerian duct remnant. We report a case of mullerian duct remnant leiomyoma associated with vaginal agenesis. The mass had papillary growth with cystic-solid components by ultrasound. Ovarian cancer was suspected preoperatively. Finally, a fibroid with hyalinization and chondroid metaplasia was diagnosed histopathologically. To the best of our knowledge, this is the first case of mullerian duct remnant leiomyoma with degeneration, mimicking ovarian cancer by ultrasound. We provide the clinical details of this case and discuss a diagnostic pitfall. ( info)

6/1723. Embolic occlusion of the blood supply to uterine myomas: report of 2 cases.

    Uterine myomas are the most common tumours of the female genital tract and with menorrhagia provide the most common indications for hysterectomy. Whilst myomectomy is a surgical alternative, it is associated with greater morbidity and a higher blood transfusion rate. Arterial embolization of myomas is a nonsurgical treatment option that can be performed as an outpatient procedure, is cheaper than myomectomy, permits preservation of reproductive potential, and may not only be associated with less morbidity than myomectomy but also may not cause adhesions which could compromise fertility. This paper details 2 cases treated by this technique. ( info)

7/1723. Laparoscopic ultrasound guidance for laparoscopic resection of benign gastric tumors.

    Laparoscopic excision of gastric leiomyoma is technically feasible and safe, but it may fail to localize the exact placement of the lesion because of the lack of tactile sensitivity. The authors present two cases of small gastric leiomyomas that were resected by a totally laparoscopic approach, assisted with intraoperative laparoscopic ultrasonography because the lesions could not be palpated. A gastric wedge resection with tumor-free margins was performed with an endostapler device. Use of a harmonic scalpel to divide the gastroepiploic vessels facilitated the laparoscopic procedure. ( info)

8/1723. Primary orbital leiomyoma and leiomyosarcoma.

    A case of an extremely rare primary orbital leiomyoma in a 25-year-old male patient is presented who had a lifelong history of deviation of the left eye globe with slight enophthalmos and reduced motility. Because of pain and increasing deviation of the eye the tumor was totally resected. On histologic examination the tumor showed ossification which is extremely rare so that a calcifying fibroma had to be ruled out. In immunohistochemistry, however, this tumor stained with smooth muscle antigen. Less than 2% of cells stained positive for Ki-S1, a proliferation marker. The second case is a rare primary orbital leiomyosarcoma in an 84-year-old female patient that showed massive growth. After exenteration histologic examination showed a dedifferentiated highly malignant soft tissue tumor which expressed desmin and smooth muscle actin but was negative for myoglobin, S-100 and HMB-45. ( info)

9/1723. leiomyoma of the thyroid gland.

    Primary smooth muscle tumors of the thyroid gland are very rare neoplasms, leiomyosarcomas comprising the majority of these. Only three cases of primary leiomyoma have been reported to date, all of which have occurred in females of varying ages. We present the morphological, immunohistochemical and ultrastructural features of a fourth case of leiomyoma of the thyroid gland, occurring in a post-menopausal woman with a history of uterine leiomyomas. ( info)

10/1723. 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. ( info)
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