Atypical leiomyoma: unusual locations and findings coupled with uncommon presentation (original) (raw)
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Cases Journal, 2009
Leiomyomas are benign tumours commonly occurring in the uterine wall. They are rarely seen in the vaginal wall leading to pressure symptoms on urinary tract. Indentation of leiomyoma from anterior vaginal wall into the bladder is rare and hence we report one such case. A 55 year old Caucasian woman presented to urology clinic with recurrent Urinary tract infection and pressure symptoms. After the diagnosis of a vaginal mass, she was referred to Gynaecology clinic. During the excision of the vaginal mass its indentation into the bladder was noted. Histology report confirmed the diagnosis of benign leiomyoma.
Journal of Minimally Invasive Gynecology, 2008
We report a case of retroperitoneal leiomyoma and a systematic review of the literature regarding this finding. A 45-year-old woman with menorrhagia and a complex pelvic mass underwent preoperative imaging and consequent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Histopathology revealed a 13-cm retroperitoneal, pedunculated leiomyoma arising from the uterus anterior to the internal cervical os. Literature review identified 105 cases of retroperitoneal leiomyomata from 1941 through 2007, with 37 cases, including our own, containing sufficient information for analysis. Abstracted variables included patient age, race, obstetric and gynecologic history, presentation and duration of symptoms, investigations, management, surgical findings, pathologic and immunohistochemical characteristics, duration of follow-up, evidence of recurrence and its management. Mean age (ϮSD) of the population was 46.27 Ϯ 13.19 years. More than 40% of patients had either undergone hysterectomy for uterine leiomyomata previously or had concurrent uterine leiomyomata. Of patients, 25% were asymptomatic, 31.3% experienced abdominal fullness, 18.8% had urinary symptoms, 18.8% had weight loss, and 18.8% had pelvic pain. Diagnostic evaluation was inconclusive and surgical excision was undertaken in all but 1 case. Median leiomyoma size was 12.0 cm (range 2.0-37.0 cm) with most in the posterior retroperitoneum, independent of the uterus. Pathologic and immunohistochemical investigations were comparable with those of uterine leiomyomata. Surgery was mostly curative with 5 reported cases of recurrence, 3 of which were then considered sarcomatous. Retroperitoneal leiomyomata present diagnostic and therapeutic challenges, and as such require heightened surveillance.
Challenges in the diagnosis and treatment of extrauterine leiomyomas: case series
International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 2021
Extrauterine leiomyoma is a rare disease with multiple potential metastasizing sites. Pathogenesis of this condition remains debatable with previous myomectomy a considerable risk factor. Diagnosis and treatment remain a challenge due to diverse presenting symptoms and the initial involvement of various specialties, which often cause distress in these patients. In this article, we present one case of pulmonary leiomyomas on expectant management, one case of wide-disseminated extrauterine leiomyomas including the bones, spines, soft tissues and peritoneum who underwent decompression laminectomy and biopsy of paravertebral mass and one case of retroperitoneal leiomyoma who underwent resection of the lesion.
A Rare Case of Retroperitoneal Leiomyoma
Case Reports in Surgery, 2012
Introduction. Leiomyoma uteri is one of the most common benign conditions for which women undergo hysterectomy every year. Fibroids found retroperitoneally are a rare entity, especially, primary retroperitoneal fibroid.Case Presentation. We report a case of 42-year-old para 1 who presented to our hospital with recurring retention of urine, lower abdominal and pelvic pain, and dyspareunia . Provisional diagnosis on the basis of examination and imaging was large subserosal fibroid with mild right-sided hydroureteronephrosis, due to pressure effect of the fibroid. Abdominal hysterectomy was done for the patient, and intraoperatively, a bulky uterus was found with multiple small fibroids on anterior and posterior walls, and a large fibroid approx.10×8 cm was found arising from the posterior surface at the level of internal os retroperitoneally, which was confirmed by histopathology as leiomyoma.Conclusion. Retroperitoneal fibroids are rare neoplasms and treatment is surgical removal. Pr...
Retroperitoneal leiomyomatosis: a case report
International Journal of Gynecological Cancer, 2005
Dursun P, Salman MC, Taskiran C, Yü ce K, Ayhan A. Retroperitoneal leiomyomatosis: a case report. Int J Gynecol Cancer 2005;15:1222-1225.
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
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.
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.