Cases reported "Uterine Neoplasms"

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1/5. Use of LHRH analogue to obtain reversible castration in a patient with benign metastasizing leiomyoma.

    The use of superactive LHRH analogue to provide a reversible form of castration is discussed in the context of the management of a patient with benign metastasizing leiomyoma. The aetiology and prognosis of this rare disease are briefly considered.
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ranking = 1
keywords = castration
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2/5. Utilization of luteinizing hormone-releasing hormone agonist in pulmonary leiomyomatosis.

    A patient presenting a recurrent episode of pulmonary leiomyomatosis has been treated with the LH-RH agonist buserelin at a dosage of 200 micrograms tid SC for 7 days, then 500 micrograms SC daily for a total period of 6 months. Basal serum E2 was suppressed during treatment and varied between 62 and 180 pmol/ml (mean, 129.4 /- 14.5). Pulmonary symptoms completely disappeared during treatment, but no objective regression of the pulmonary lesions was observed. Because of the uncertainty of response of benign metastasizing leiomyomas to castration and because of the reversibility of the medical treatment, LH-RH agonist may be preferred to surgical castration in this pathology.
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ranking = 0.4
keywords = castration
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3/5. Treatment of uterine fibroids with agonist analogs of gonadotropin-releasing hormone.

    Agonist analogs of GnRH were used to effect a "medical castration" in 14 patients with uterine fibroids, presenting with either an enlarged uterus, recurrent menometrorrhagia, and/or infertility. This study confirms prior reports of a reduction in uterine size and cessation of menometrorrhagia in patients with fibroids following treatment with GnRHa. Of interest, however, was the successful use of GnRHa as either the sole treatment for uterine fibroid-associated infertility, or as a preoperative adjunct in infertility patients scheduled for myomectomy. Three of the five infertility patients in this study achieved intrauterine pregnancies. Further study of the role of GnRHa treatment in infertility patients with uterine fibroids appears warranted.
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ranking = 0.2
keywords = castration
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4/5. Malignancy arising in extragonadal endometriosis: a case report and summary of the world literature.

    A case of clear cell carcinoma arising in endometriosis of the retroperitoneum is presented. It occurred 5 years after supracervical hysterectomy and bilateral salpingo-oophorectomy and following 4 years of estrogen therapy. The literature concerning malignancy developing in extragonadal endometriosis has been reviewed and is summarized as follows: 1) 45 cases have been compiled, of which 32 were carcinomas and 13 sarcomas; 2) adenocarcinoma was the most common histologic type, although virtually every tumor of mullerian derivation has been described; 3) the typical patient was nulliparous and perimenopausal; 4) the rectovaginal septum was the most common site, and in general the frequency of malignancy in a given site parallels the frequency of endometriosis in that location; 5) simultaneous tumors of the uterus or ovary were present in seven cases (15%); 6) prognosis appeared affected by site and histologic type; 7) a history of prior pelvic irradiation to effect castration was present in three (9%) of the patients with adenocarcinoma; and 8) four (12%) of the patients with adenocarcinoma were subjected to exogenous estrogens or estrogen-secreting ovarian tumors.
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ranking = 0.2
keywords = castration
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5/5. leiomyomatosis peritonealis disseminata associated with pregnancy.

    The first reported case in the English literature involving leiomyomatosis peritonealis disseminata (LPD) and a subsequent pregnancy is presented. A review of the literature revealed only 8 previous cases-all of which were treated by tubal ligation or surgical castration. The patient in this report was 22 years of age at the time of diagnosis, the youngest age at which LPD is known to have occurred. The LPD was first noted at primary cesarean section, and 20 months later at a second cesarean section performed at 35 1/2 weeks' gestation, the LPD had advanced to a stage that suggested possible malignancy. All biopsy specimens were subsequently reported as benign LPD.
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ranking = 0.2
keywords = castration
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