Unusual Leiomyoma Presentations and Management (original) (raw)
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Clinical Presentation & Operative Treatment of Leiomyoma of Uterus and its Outcome
Chattagram Maa-O-Shishu Hospital Medical College Journal, 2014
Introduction: Uterine leiomyoma is remarkably common, however only a subset of women have their fibroids clinically detected, symptomatic, or warrant surgical treatment. Mode of treatment depends on age of the patients, number, size and site of the myoma and also fertility status of the patients. Materials & methods: To evaluate the sociodemographic, clinical characteristics, management outcome and its determinants in BSMMU, Dhaka, Bangladesh, the study was carried out. 50 patients of diagnosed leiomyoma admitted in the BSMMU, Dhaka was selected for the study. Clinical profile, type of surgery and postoperative follow up findings were noted. Data was analyzed by computer based software SPSS -18. Results: The common complaints among the 50 patients were progressive menorrhagia (70%), abdominal swelling (50%), infertility (24%), weight in pelvis (38%), weakness/dizziness or syncopal attack after menstrual period (26%) and recurrent miscarriages (12%). The average uterine size at presentation was 15±9.7 weeks. The majority (70%) of the women presented with multiple leiomyomata. The commonest anatomical position of the myomas were multiple positions and intramural(80%). Total abdominal hysterectomy with or without bilateral sulphingo ophorectomy according to age was the commonest surgical procedure performed in thirty two (64%) cases. Myomectomy was done in 12(24%) cases and laparoscopic assisted vaginal hysterectomy was done in also 6(12%) of patients. Postoperative complications occurred in 24%(12) of the women. The most common complications were postoperative pyrexia 12%, blood loss warranting transfusion 8%, wound infection 10% and prolonged hospital stay 6%. Conclusion: Uterine fibroid is common in our environment and most of the patients had regular menstrual cycle with progressive menorragia. Its removal is commonly associated with post-operative pyrexia, blood loss, and anemia and wound infection. Preoperative correction of anemia appropriate use of antibiotics and strict hemostasis and asepsis can reduce these complications.
Clinicopathological assessment of leiomyoma uterus
Background: Uterine Leiomyoma are benign neoplasm composed of smooth muscle with variable amount of connective tissue 1 , is the commonest visceral neoplasm affecting females in reproductive age group 2. They are noted clinically in 20-30% of women over 30 years of age. Aim: To analyze the clinicopathologic spectrum of uterine leiomyomas with regards to their clinical and histopathological presentation, associated changes and variants. Methods: All hysterectomy and myectomy specimen received at Nalanda Medical College, Patna over a period of one year from Dec. 2018 to Nov. 2019,provisionally diagnosed as leiyomyoma clinically or/and sonologically .Clinical data obtained on a proforma after informed consent to patients. Specimens were fixed in 10% formalin, processed and embedded in paraffin blocks. Sections of 4-6 micron thickness were taken and stained with routine H&E stain and studied. Results: A total of 108 case of leiyomyoma were studied. Majority of the patients were between 41-50 years (45.37% cases). Menorrhagia was the commonest symptom constituting 38.88%. majority of cases were multiparous (87.03). Most common location of leiomyoma was intramural (57.40%) followed by subserosal (16.66%). 62.96% leiomyomas were single and 38.04% were multiple. Degenerative changes were observed in 15.74% cases, amongst which hyaline change was the most common (5.55%). Proliferative endometrium was most common endometrial finding (47.22%). Adenomyosis was associated with leiomyoma in 20.37% cases. Conclusions: Uterine leiomyoma is associated with degenerative changes and coexistent patholologies. Histopathological examination of hysterectomy specimens should be done to confirm the diagnosis for its proper management and rule out other pathologies, especially malignant lesions.
IAR Consortium, 2021
Uterine leiomyoma is the commonest benign tumor affecting women of reproductive age group, features may range from being asymptomatic to severe symptoms affecting the quality of life significantly. T his study was undertaken to evaluate the possible factors which produce the various symptomatology in women having leiomyomas. T his observational h ospitalbased study was done in a tertiary care center on 100 women of reproductive age group with leiomyoma uterus attending the Gynecology dept. T he incidence of fibromyomas increased with increasing age, with AUB (HMB) being the most common complaint followed by dysmenorrhea, infertility, recurrent pregnancy losses, pressure symptoms and pain in abdomen. Most common type of leiomyoma being intramural, followed by subm ucous, subserous and broad ligament and cervical fibroid (including polyps).
Atypical presentation of leiomyoma: A case report
International Journal of Clinical Obstetrics and Gynaecology, 2021
Leiomyoma is a benign tumor of the uterus. It typically does not present with weight loss, massive ascites, gastrointestinal symptoms, elevated CA125, and elevated alpha fetoprotein. This was a rare case of a 48-year-old nullipara, emaciated with grossly distended abdomen, huge abdominal mass corresponding to 36 weeks' gestation, associated anorexia, easy satiety, constipation and vomiting that had TAH and BSO for suspected ovarian malignancy, which histology report revealed leiomyoma. Abdominal ultrasound scan done noted huge right ovarian mass, possibly malignant, with massive ascites. Findings at surgery, revealed a large, firm mass with necrotic patches, attached to the uterine fundus by a thin stalk 5 x 3 cm thick and to the omentum by large dilated blood vessels and adhesions. Mass weighed 5.8 kg. Eleven (11) liters of ascitic fluid was aspirated, sent for cytology and report showed no malignant cells. Histology confirmed a degenerated leiomyoma with no evidence of malignancy. Atypical presentation of leiomyoma can mimic that of malignancy. This knowledge will help Clinicians and Gynaecologists to have a high index of suspicion with such clinical features, in making prompt diagnosis and instituting appropriate management.
Clinicopathological Study of Uterine Leiomyomas – A Retrospective Study
Journal of Pharmaceutical Research International
Leiomyomas are benign tumors of the uterus affecting women of the reproductive age group. They are the most common gynaecologic neoplasms in women. The aim of our study was to analyse and correlate the histopathological findings of leiomyomas in 203 hysterectomy specimens received in the department of Pathology at Saveetha Medical College and to further delineate the associated changes and variants that were observed in the leiomyoma specimens. In this study we found that the dominant age group was 31-50 years of age with multiple leiomyomas being more common than solitary ones. The most commonly observed location was intramural. Majority of the hysterectomy specimens showed a proliferative pattern of endometrium. Degenerative changes were observed in 26 cases with hyaline degeneration being the most common secondary change. There were multiple uterine pathologies associated with the uterine leiomyomas of which ovarian cortical cysts were the most frequently noted. The histopatholog...
African health sciences, 2011
Uterine leiomyoma is remarkably common, however only a subset of women have their fibroids clinically detected, symptomatic, or warrant surgical treatment. Its removal is commonly associated with complications. To prevent or control the occurrence of this complication requires the understanding of the factors associated with the complications. To evaluate the sociodemographic, clinical characteristics, management outcome and its determinants in southwestern Nigeria. Study was carried out at two large tertiary hospitals in the south west region of Nigeria. Retrospective review of case records of all surgically managed cases of uterine leiomyoma over a period of 25 years. One hundred and fifty nine women with uterine leiomyoma seen and managed surgically in South-Western Nigeria were the participants. The common presenting complaints were menstrual irregularities (47.7%), abdominal swelling (39.1%) and infertility (31.9%). The average uterine size at presentation was 15±9.7 weeks. The...
Atypical leiomyoma of the uterus: A case report
International Journal of Case Reports and Images, 2016
International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties. Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. IJCRI publishes Review Articles, Case Series, Case Reports, Case in Images, Clinical Images and Letters to Editor.
Era's Journal of Medical Research
To study the histomorphological spectrum of uterine leiomyoma variants. This study is done over a period of three year (May 2019 to May 2022) in the Department of Pathology, LNMC, Bhopal. Total of 316 hysterectomy and 14 myomectomy specimens were studied. Specimens were fixed in formalin and paraffin embedded. H&E stained tissue sections were studied. In the study we performed retrospective analysis of hysterectomy and myomectomy specimen and 330 cases of leiomyoma were evaluated. Among 330 cases, 316(95.75%) were hysterectomy specimen for varying indication and 14(4.24%) were myomectomy specimen. Histologically the usual leiomyomas was comprising of 164(49.69%) cases followed by hyalinised leiomyoma 70(21.21%), myxoid leiomyoma 15(4.54%), hydropic change 12(3.63%), cellular 11(3.33%), lipoleiomyoma 10(3.03%), calcification 10(3.03%), infarct type necrosis 10(3.03%), mitotically active 8(2.42%), symplastic 7 (2.12%), schwanonian 6(1.81%), epithelioid 3(0.90%), dissecting leiomyoma 2...
Therapeutic approach of uterine leiomyoma; choosing the most appropriate surgical option
Journal of Clinical and Investigative Surgery, 2021
The most common benign pelvic tumor in young women is uterine leiomyoma. It is often asymptomatic, but can cause symptoms such as pelvic-abdominal pain, vaginal bleeding, urinary and intestinal transit disorders. If there is a suspicion of malignancy, it is necessary to perform fractional uterine curettage to establish the histopathological diagnosis.The surgical treatment of uterine leiomyoma includes several procedures: myomectomy, subtotal or total hysterectomy. The procedure will be chosen depending on the patient's particularities: BMI, uterine size, leiomyoma location, surgical history or other associated pathologies.Laparoscopic hysterectomy has a 45-minute shorter duration of intervention than vaginal hysterectomy, and the conversion rate to the open procedure is lower.Laparoscopically treated cases have fewer postoperative complications compared to other surgical procedures and have a shorter hospitalization and recovery time.The recurrence rate of uterine leiomyoma is ...
Uterine leiomyoma in a 19-year-old girl: Case report and literature review Case presentation
A previously healthy 19-year old female presented to the gynaecological clinic with gradual abdominal distension for six months, associated with progressive abdominal discomfort. There was no history of nausea, vomiting, weight loss, or anorexia. She reported no changes in bowel habits and denied genitourinary symptomatology. Menarche occurred at 14 years of age, and her menstrual periods had always been regular. She denied recent sexual activity and was not currently taking oral contraceptives. The remainder of the patient's history, including a focused family history, was non-contributory. Physical examination revealed the presence of a somewhat firm, irregular, nontender, and mobile mass arising from the pelvis, corresponding in size to a pregnant uterus of 24 weeks' gestation. Laboratory analysis showed a blood haemoglobin concentration of 12.6 g/dL. The remainder of her laboratory results were within physiological parameters, and pregnancy was excluded. Transabdominal ultrasonography revealed globular uterine enlargement and a hypoechoic mass measuring 18 cm × 14 cm. The ovaries and adnexa were not visualized because they were obscured by the enlarged, bulky uterus. Neither ascites nor hydronephrosis was noted. The patient was counselled about the diagnosis of uterine fibroid and underwent exploratory laparotomy after proper counselling and written informed consent. Intraoperatively, the uterus was grossly enlarged by a large fibroid measuring 16 cm x 10 cm and ). Both ovaries and fallopian tubes were normal. Figure 1: Intraoperative image of the exteriorized uterus, showing the large fundal leiomyoma