Cases reported "Uterine Neoplasms"

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1/30. 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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2/30. Ischemic uterine rupture and hysterectomy 3 months after uterine artery embolization.

    The exact frequency and extent of complications after uterine artery embolization (UAE) have yet to be documented in the literature. Ischemic necrosis and rupture of the uterus is a theoretical concern of this procedure. Rupture of the uterus from any cause is a very serious gynecologic complication requiring immediate surgical intervention to prevent death. Ischemic necrosis and rupture of the uterus can occur months after UAE. In our patient they occurred 3 months after UAE for treatment of symptomatic uterine myomas, and required hysterectomy. To our knowledge, this is the first report of ischemic uterine rupture after UAE in the united states.
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3/30. An unusual type of endometrial cancer, related to tamoxifen?

    tamoxifen, which is increasingly being used in breast cancer patients, has been associated with an elevated frequency of endometrial carcinoma. To our knowledge not a single case of uterine serous papillary carcinoma (USPC) has been documented during tamoxifen treatment. No conclusions as to a causal relationship are yet being made, but if it is due to tamoxifen, we should advise a strategy for prevention, because this subtype is not as curable as endometrioid carcinoma.
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4/30. Parasitic leiomyoma: a case report of an unusual tumor and literature review.

    Uterine leiomyomas are one of the most common tumors in women. Parasitic leiomyoma is an uncommon type of uterine leiomyoma. It may present with a wide spectrum of symptoms. The authors report a case of a 44-year-old woman who presented with a palpable pelvic mass and increased frequency of urination for 2 years. A parasitic leiomyoma that had blood supplies from the common iliac vessels was diagnosed during the operation. Total abdominal hysterectomy and mass removal were performed without complication. Even though a parasitic leiomyoma is uncommon, it should be included in the differential diagnosis of pelvic mass. The management depends on the operative finding and the desired fertility function of the patients. literature on parasitic leiomyoma is also reviewed.
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5/30. Skeletal muscle metastasis from uterine leiomyosarcoma.

    A case of a 68-year-old woman who presented with a rapidly enlarging painful right thigh mass is presented. She had a known diagnosis of uterine leiomyosarcoma following a hysterectomy for dysfunctional uterine bleeding. She subsequently developed a single hepatic metastatic deposit that responded well to radiofrequency ablation. Whole-body MRI and MRA revealed a vascular mass in the sartorius muscle and a smaller adjacent mass in the gracilis muscle, proven to represent metastatic leiomyosarcoma of uterine origin. To our knowledge, metastatic uterine leiomyosarcoma to the skeletal muscle has not been described previously in the English medical literature.
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6/30. Uterine lipoleiomyoma: a histopathological review of 17 cases.

    Lipoleiomyoma is a rare uterine tumor. The exact frequency and proliferation activity are not yet known. This study aims to know the frequency and evaluate the relation with renal angiomyolipoma. Lipoleiomyoma cases were immunohistochemically stained by antibodies for Ki-67, melanoma specific antigen HMB45, S-100 protein, and alpha smooth muscle actin (alpha-SMA). Frequency of uterine lipoleiomyoma among uterine myomatous tumor was 17/4904 (0.35%) in the Department of Human pathology, Field of Oncology, Kagoshima University Graduate School database (1983-2003). patients ranged from 45 to 74 years of age, and 10 cases were associated with leiomyoma. Six of 17 (35%) cases showed areas with renal angiomyolipoma-like vessels and atypical cellular features. Immunostaining was available in 12 cases. By Ki-67 labeling index, both muscle (average 1.38%) and fat (average 1.17%) portions of the tumor had greater proliferation than normal myometrium (average 0.76%), which suggests that fat portions of the tumor are proliferating adipose tissue rather than fatty degeneration of muscular counterpart. HMB45 antigen, which is positive in renal angiomyolipoma, was negative in three uterine cases having angiomyolipoma-like vessels (3/12). However, HMB45 antigen was positive in spindle-shaped tumor cells of three cases (3/12) which lacked angiomyolipoma-like vessels. Presence of angiomyolipoma-like blood vessels in these tumors is not an uncommon feature. However, the diagnosis of uterine angiomyolipoma should not be based on the result of HMB45 antigen immunoreactivity alone.
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7/30. Synchronous primary neoplasms of the uterine corpus and the ovary: a case report.

    OBJECTIVE: To determine the frequency of synchronous primary neoplasia of the ovaries in patients with primary malignant neoplasia of the uterus, and to analyze the clinical and histological characteristics of these cases. MATERIALS AND methods: Clinicopathological data from a series of patients treated for primary malignant neoplasia of the uterus between 1985 and November 2003 have been studied retrospectively. RESULTS: Synchronous primary neoplasia of the ovaries was found in 13 out of 173 patients (7.5%) treated for primary malignant neoplasia of the uterus. In four patients (2.3%) the histological findings suggested ovarian metastases from primary endometrial adenocarcinoma. In four other cases (2.3%) there was extension of the primary uterine sarcoma to the ovaries. In the remaining five cases (2.9%) primary endometrial adenocarcinoma coexisted with: a) ovarian cystadenocarcinoma in two cases, b) ovarian fibromathecoma in two cases, and c) ovarian tumor of borderline malignancy in one case. CONCLUSIONS: Coexistence of distinct primary neoplasias in the uterus and ovaries is rare. diagnosis of two primary malignancies in the uterus and ovaries should be based on histological examination. Treatment should be appropriate for both tumors, taking into consideration that treatment of one tumor will not lead to subtreatment of the other.
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8/30. Retained fragments after total laparoscopic hysterectomy.

    A 36-year-old woman had a history of worsening menorrhagia, refractory to medical therapy. She underwent a total laparoscopic hysterectomy. Postoperatively, she experienced significant dyspareunia, dysuria, and pelvic pain. Ten months after her initial procedure, laparoscopy revealed several parasitized fragments of uterine and cervical origin in the pelvis. As laparoscopic morcellation is performed with increased frequency, the need to understand its sequelae has also increased. A concern of morcellating tissue within the abdomen is the fate of fragments inadvertently left behind.
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9/30. Delayed leiomyoma degeneration after microwave endometrial ablation.

    BACKGROUND: Microwave endometrial ablation is an effective treatment for dysfunctional uterine bleeding. patients with leiomyomata, including submucosal leiomyomata up to 3 cm, may also be treated with microwave endometrial ablation. CASES: A 46-year-old woman with multiple leiomyomata and menometrorrhagia underwent microwave endometrial ablation. Two months after microwave endometrial ablation, she developed signs of peritoneal irritation. A negative laparoscopy excluded a thermal bowel injury. Imaging and clinical examination ultimately determined that her symptoms were due to leiomyoma degeneration. A 38-year-old woman with menometrorrhagia and leiomyomata underwent microwave endometrial ablation. Fifteen days after microwave endometrial ablation, she developed signs of peritoneal irritation. With a presumptive clinical diagnosis of microwave endometrial ablation degeneration, the patient was expectantly managed with pain medications and observation. CONCLUSION: Fibroid degeneration may have a delayed presentation after microwave endometrial ablation. Thermal bowel injury must be excluded in a patient presenting with signs of peritoneal irritation after microwave ablation of the endometrium before diagnosing leiomyoma degeneration, which can be managed expectantly.
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10/30. Uterine myoma in pregnancy.

    A review was made of the medical records of 76 patients with uterine myomas during pregnancy with the aim of studying the time and method of diagnosis, symptomatology, treatment, and outcome of pregnancy. In 11 patients (15%) myomectomy was performed during pregnancy. The frequency of abortion was 18% in patients treated both conservatively and with myomectomy. Myomectomy during pregnancy is discouraged in the literature. In cases where conservative treatment cannot be practised it seems that the risk of spontaneous abortion during pregnancy is not significantly increased when myomectomy is performed.
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