Canine Uterine Leiomyoma with Epithelial Tissue Foci, Adenomyosis, and Cystic Endometrial Hyperplasia

An 11-year-old Labrador Retriever bitch with a history of intermittent, sanguineous vaginal discharge of a six-month duration was presented. During exploratory laparotomy, two well-delineated, intramural masses were identified bilaterally in the uterine horns. Histopathologic examination of the mass on the left horn showed that it was a typical leiomyoma. However, the second mass appeared with an unusual coexistence of histological lesions, involving epithelial tissue foci, mild focal adenomyosis, and cystic endometrial hyperplasia. Interestingly, such combination was never encountered before in dogs. Although uterine leiomyoma is quite usual in the reproductive system of female dogs, this case resembled relevant cases of human uterine adenomyomas in morphology, and thus it was offered a similar tentative diagnosis.

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Ultrasonographic, Surgical, and Histopathological Findings of a Uterine Leiomyoma in a Cow

Case Reports in Veterinary Medicine ◽

10.1155/2012/536204 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Arvind Sharma ◽

Adarsh Kumar ◽

Sheikh Imran ◽

Pankaj Sood ◽

Rajesh Kumar Asrani

Keyword(s):

Uterine Leiomyoma ◽

Exploratory Laparotomy ◽

Interesting Case ◽

Abdominal Tumor ◽

Transabdominal Ultrasonography ◽

Histopathological Findings ◽

The Right ◽

Tentative Diagnosis ◽

Echogenic Foci ◽

Crossbred Cow

The objective of this case report was to describe the ultrasonographic, surgical, and histopathological findings of a rare clinical case of uterine leiomyoma in a 5-year-old Holstein crossbred cow presented for diagnosis and treatment of infertility. Transrectal palpation revealed a large nonpainful mass suspected to be an abscess or a tumor in the caudal abdomen on the right side. Transabdominal ultrasonography revealed a round mass with irregular hypoechogenic/echogenic foci and a thin echogenic capsule around it. Ultrasonographic-guided centesis of the lesion under local analgesia did not yield any foul smelling aspirate leading to a tentative diagnosis of an intra-abdominal tumor. The lesion was later confirmed by exploratory laparotomy and histopathology as a case of uterine leiomyoma. The cow gave birth to a live normal calf 12 months following the surgery. Rectal examination after parturition revealed no evidence of the tumor at the surgical site. Ultrasonography enabled prompt, noninvasive diagnosis of uterine leiomyoma and proved to be a useful decision-making tool in the abdominal surgery of the cow. This is an interesting case which broadens the spectrum of the causes of infertility in cattle.

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Mummified papyraceous fetuses in the abdominal cavity of an elderly female dog with pyometra

Arquivo Brasileiro de Medicina Veterinária e Zootecnia ◽

10.1590/s0102-09352012000200009 ◽

2012 ◽

Vol 64 (2) ◽

pp. 311-317 ◽

Cited By ~ 1

Author(s):

F.A. Voorwald ◽

C.F. Tiosso ◽

D.J. Cardilli ◽

G.H. Toniollo

Keyword(s):

Uterine Rupture ◽

Rare Case ◽

Endometrial Hyperplasia ◽

Abdominal Cavity ◽

Exploratory Laparotomy ◽

Uterine Horn ◽

Implantation Failure ◽

Corrective Surgery ◽

Elderly Female ◽

History Of

This paper reports on a rare case of fetal papyraceous mummification after asymptomatic uterine rupture in an elderly female dog with pyometra. The patient had a history of mating six months before the examination but no apparent signs of gestation or parturition. Exploratory laparotomy was used to identify a rupture of the left uterine horn and the presence of cystic endometrial hyperplasia and pyometra. Two mummified papyraceous fetuses were observed in the abdominal cavity and had adhered to the spleen, pancreas, intestine and omentum. Ovariehysterectomy and corrective surgery were performed. The patient had remained healthy after uterine rupture until a new estrous cycle and the development of pyometra. Bitches that are 10 years old or more are predisposed to implantation failure, pregnancy or parturition problems and they should not be breed to avoid complications.

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Giant uterine leiomyoma: a case report with literature review

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184548 ◽

2018 ◽

Vol 7 (11) ◽

pp. 4779

Author(s):

Sonali Kalyan ◽

Sonam Sharma

Keyword(s):

Uterine Leiomyoma ◽

Clinical Presentation ◽

Exploratory Laparotomy ◽

Uterine Leiomyomas ◽

Cystic Degeneration ◽

Diagnostic Dilemma ◽

Benign Leiomyoma ◽

History Of ◽

Abdominal And Pelvic Pain

Uterine leiomyomas are one of the most common entities encountered in routine gynaecological practice; however, the giant uterine myomas are very rare and can often create a diagnostic dilemma and therapeutic challenge owing to their size, non-specific clinical presentation and degenerations. Here, in this article we review the literature on giant uterine leiomyomas and report one such case in a 38-year-old woman who presented with the complaints of vague abdominal lump, enlargement of abdomen, dysmenorrhea, lower abdominal and pelvic pain since last 2 years and a 6-month history of increased frequency of micturation. Physical examination and radiological investigations suggested a giant abdominopelvic mass, probably a uterine or an ovarian malignancy. An exploratory laparotomy was performed followed by total hysterectomy. Grossly, the specimen was a 15.2 kg uterine leiomyoma measuring 18x18x13 cm in size. Histologically, the benign leiomyoma showed cystic degeneration. The patient’s post-operative and follow-up period was uneventful.

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Endometritis and Cystic Endometrial Hyperplasia in a Goat

Journal of Veterinary Diagnostic Investigation ◽

10.1177/104063870501700418 ◽

2005 ◽

Vol 17 (4) ◽

pp. 393-395 ◽

Cited By ~ 2

Author(s):

Zaher A. Radi

Keyword(s):

Case Report ◽

Caesarean Section ◽

Endometrial Hyperplasia ◽

Plasma Cells ◽

Histopathologic Examination ◽

Boer Goat ◽

First Case ◽

Cellular Debris ◽

Superficial Epithelium ◽

Cystic Masses

Histologic examination was performed on uterine biopsy samples of irregular cystic masses noted during caesarean section of a 2-year-old female Boer goat. Histopathologic examination revealed multifocal erosions of the superficial epithelium and multifocal infiltration of the endometrium by widely scattered viable and degenerate neutrophils, lymphocytes, and plasma cells admixed with mild amounts of cellular debris and hemorrhage. The endometrium was markedly expanded by many irregular cystic and hyperplastic glands. This is the first case report of endometritis and cystic endometrial hyperplasia in a goat in North America.

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Sigmoid Volvulus in 16-year-old Boy with an Associated Anomalous Congenital Band

The American Surgeon ◽

10.1177/000313481307901114 ◽

2013 ◽

Vol 79 (11) ◽

pp. 1140-1141 ◽

Cited By ~ 4

Author(s):

Ann A. Albert ◽

Tracy L. Nolan ◽

Bryan C. Weidner

Keyword(s):

Abdominal Pain ◽

African American Male ◽

Pediatric Patients ◽

Primary Anastomosis ◽

Exploratory Laparotomy ◽

Sigmoid Volvulus ◽

Sudden Onset ◽

Contrast Enema ◽

Pediatric Age Group ◽

History Of

Sigmoid volvulus, a condition generally seen in debilitated elderly patients, is extremely rare in the pediatric age group. Frequent predisposing conditions that accompany pediatric sigmoid volvulus include intestinal malrotation, omphalomesenteric abnormalities, Hirschsprung's disease, imperforate anus and chronic constipation. A 16-year-old previously healthy African American male presented with a 12 hour history of sudden onset abdominal pain and intractable vomiting. CTwas consistent with sigmoid volvulus. A contrast enema did not reduce the volvulus, but it was colonoscopically reduced. Patient condition initially improved after colonoscopy, but he again became distended with abdominal pain, so he was taken to the operating room. On exploratory laparotomy, a band was discovered where the mesenteries of the sigmoid and small bowel adhered and created a narrow fixation point around which the sigmoid twisted. A sigmoidectomy with primary anastomosis was performed. The diagnosis of sigmoid volvulus may be more difficult in children, with barium enema being the most consistently helpful. Seventy percent of cases do not involve an associated congenital problem, suggesting that some pediatric patients may have congenital redundancy of the sigmoid colon and elongation of its mesentery. The congenital band found in our patient was another potential anatomic factor that led to sigmoid volvulus. Pediatric surgeons, accustomed to unusual problems in children, may thus encounter a condition generally found in the debilitated elderly patient.

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The Invisible Burden of the Vietnam War: From the Memoirs of a Soviet Officer

Quaestio Rossica ◽

10.15826/qr.2020.2.473 ◽

2020 ◽

Vol 8 (2) ◽

Author(s):

Andrey Lyamzin

Keyword(s):

Everyday Life ◽

Vietnam War ◽

Reproductive System ◽

Legal Status ◽

Health It ◽

The Everyday ◽

Human Reproductive ◽

History Of ◽

Post Traumatic ◽

The Vietnam War

This article publishes and analyses an interview with Lieutenant Colonel V. V. Skoryak, a Soviet military specialist who took part in the Vietnam War for eleven months in 1970. The interview describes little-known facts about military advisers’ stay in the country, when they mostly stayed far away from the frontline and dealt with the preparation and maintenance of the S‑75 high-altitude air defence systems. Special attention is paid to the everyday life of the advisers and their legal status, which helps reveal new aspects of the “everyday history” of war. Skoryak speaks about the ideological, moral, and psychological preparedness of the Soviet people to fulfil their “international duty”, which, according to him, was internally motivated. He also analyses post-traumatic syndromes in Soviet military men: it was especially frequent and profound in the early stages of the conflict. Additionally, the interview contains information about the medical care provided to the participants of the conflict and the consequences for their health. It puts forward some ideas about how the chemical weapons used by the Americans affected the human reproductive system. The interview provides an emotional assessment of the war and their place in the biography of a Soviet officer.

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Aetiology of vaginal discharge in children

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20170502 ◽

2017 ◽

Vol 3 (1) ◽

pp. 83

Author(s):

Parimalam Kumar ◽

Suguna K. ◽

Lavanya P.

Keyword(s):

Vaginal Discharge ◽

Descriptive Analysis ◽

Age Groups ◽

Juvenile Diabetes ◽

Sexually Transmitted ◽

Anatomy And Physiology ◽

History Of ◽

Group A ◽

Aetiological Diagnosis ◽

Anti Fungal

Background: Vaginal discharge [VD] is the most common gynecologic complaint in children. The causes vary from being physiological to sexually transmitted diseases. The anatomy and physiology of the vulva and vagina and the vaginal flora influence the causes to some extent. As the above factors vary as the child grows, the etiology varies too. At any age, VD is responsible for a significant morbidity. Hence enumerating the causes and identifying the common causes in specific age groups will help in development of preventive measures and early appropriate treatment. The aim of the study was to enumerate the cause of VD in children attending the OPD at Government Royapettah Hospital and to find out the causes of VD in specific age groups less than 2 year, 2-9 years and 9-14 years.Methods: A retrospective analysis of twenty girls less than 14 years of age with VD details were collected from the STI cards of twenty children in the age group upto 14 years, with vaginal discharge, who attended the STI clinic at GRH, KMC will be selected and their symptoms, clinical examination findings, results of relevant investigations noted from their hospital records. Children with HIV infection, immunosuppression due to juvenile diabetes mellitus/ malignancy and history of sexual abuse will be excluded. The results tabulated and a descriptive analysis done to find out the most common aetiology in different age groups in children. Descriptive analysis was applied to analyse the results.Results: Out of the twenty children studied 40, 10, 50 percent of the girls were in group A, B and C respectively. Youngest child was 6 months old and oldest was 14 years. In 10% of girls the incidence of VD was physiological and in 90% it was due to pathological causes. In 50% of children the causative agent could be demonstrated by laboratory investigations. Candida was the commonest agent demonstrated in 25% of girls studied. In 35% cases the cause was unidentifiable. Bacterial, parasitic and dermatological causes constituted to 10%, 15%, 10% of aetiology of VD respectively. In one child [5%] who had genital psoriasis, the clinical features of candidal infection was negative.Conclusions: Aetiological diagnosis was very important in children with VD. Not all VD in children are infective and hence anti-fungal and anti-bacterial agents should not be prescribed without adequate clinical and or microbiological evidence. Pin worm infestation should be considered as a cause of VD in girls with perianal excoriation and nocturnal worsening of symptoms.

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Treatment algorithm for uterine leiomyoma for women of reproductive age taking into account genetic factors

Reproductive health of woman ◽

10.30841/2708-8731.3.2021.234256 ◽

2021 ◽

Vol 3 ◽

pp. 81-86

Author(s):

А.G. Kornatska ◽

M.A. Flaksemberg ◽

O.Y. Borysiuk ◽

G.V. Chubei ◽

Z.I. Rossokha

Keyword(s):

Hormonal Therapy ◽

Gene Polymorphisms ◽

Uterine Leiomyoma ◽

Endometrial Hyperplasia ◽

Receptor Gene ◽

Uterine Cavity ◽

Preoperative Preparation ◽

Estrogen Receptor Gene ◽

Esr1 Gene ◽

Minor Alleles

The objective: to determine the association of estrogen receptor gene polymorphisms ESR1 and progesterone PGR with the development of uterine leiomyoma (UL) and to develop a patient management algorithm based on the results of ultrasound and genetic studiesMaterials and methods. Comprehensive examination was made for 90 women with intramural myoma in the age from 26 to 45 years, which additionally included determination of the presence of the Progins polymorphism of the PGR gene and polymorphic variants A351G and T397C of the ESR1 gene. Further treatment depended on the polymorphisms of the studied genes, the number and size of myomatous nodules (MN) and their position in relation to the uterine cavity.Results. Minor alleles for the estrogen receptor gene ESR1 T397C were detected in 87.2% of women with MN over 40 mm in diameter, while they were 54.2% in women with MN less than 20 mm (p<0.05). The minor alleles of ESR1 gene locus A351G were also significantly more common in women with large MN compared to LU less than 20 mm – 69.2% versus 37.5% (p<0.05). The polymorphism of the progesterone receptor regulator gene PGR Progins was found in 33.3% of patients with small size LU and from 7.7% to 18.5% in women with large LU and MN larger than 20 mm in diameter at ultrasound.Treatment was started with hormonal therapy and in the presence of the T1/T1 genotype of the PGR Progins gene and the absence of endometrial hyperplasia according to histological examination, was prescribed hormonal therapy with mifepristone 50 mg daily for 3 months, followed by monitoring of the course of the disease.GnRH agonists were prescribed as preoperative preparation in the case of detection of PGR Progins gene polymorphisms (T1/T2 or T2/T2 genotypes), endometrial hyperplasia and MN over 40 mm. In the case of small nodules that do not deform the uterine cavity and an ESR1 gene reference genotype, contraceptive OCs were recommended for six months or more to stabilise LU growth. MN over 30 mm distorting the uterine cavity and the presence of ESR1 minor alleles of the oestrogen receptor gene were the grounds for surgical treatment of such an LU.As a result of this approach, the incidence of pain syndrome decreased by almost 4.7 times, menstrual disorders in the form of hyperpolymenorrhoea and AUB by 8 times. An improvement in general well-being was subjectively reported by 64.4% of the patients, «without change» – by 24.4% of the patients. Only 11.1% of women reported a worsening of subjective sensations, which was associated with the side effects of therapy. The size of the lymph nodes decreased considerably in 44.4% of the patients, a partial effect was noticed by 26.7% of the women. There was observed no growth of the nodes in the patients during treatment or after it. A pregnancy occurred in 68.5% of the patients and ended in childbirth in 86.5% of cases.Conclusion. Consideration of the patient’s genetic status contributes to the improvement of LU treatment outcomes. The most effective is to prescript mifepristone in patients with MN under 40 mm, including multiple ones, when the operation is associated with a high risk. In the case of larger mets (over 50 mm), hormonal therapy is less effective and can be used for preoperative preparation. This approach allows to control symptoms and reduce the size of the node in 72.2% of patients and in 68.5% of cases the pregnancy can be achieved.

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VAGINAL DISCHARGE

The Professional Medical Journal ◽

10.29309/tpmj/2011.18.04.2644 ◽

2011 ◽

Vol 18 (04) ◽

pp. 598-603

Author(s):

SHAHIDA SHAIKH ◽

SALEEM AKHTER SHAIKH ◽

INAYAT MAGSI

Keyword(s):

Vaginal Discharge ◽

Tertiary Care ◽

Care Hospital ◽

College Hospital ◽

Internally Displaced ◽

Syndromic Management ◽

Sexually Transmitted ◽

Medical College ◽

Abnormal Growth ◽

History Of

Objective: To observe the results of syndromic management in women living in IDPs camps complaining of chronic vaginal discharge. Design: Descriptive study. Setting: Medical Camps at Larkana set by Chandka Medical College Hospital for Internally Displaced Persons (IDPs) due to floods. Period: 1st September 2010 to 31st December 2010. Material and Methods: Total 200 symptomatic patients aged from 20 to 50 years suffering from chronic vaginal discharge having history of more than 6 months duration were included in the study. Asymptomatic as well as pregnant women and patients with abnormal cervix and having abnormal growth on cervix were excluded from the study. A detailed history and examination (including speculum and vaginal) was done and a proforma was filled. All these patients were given empirical treatment recommended by WHO as syndromic management consisting of stat doses of antifungal along with antibiotics, where no laboratory tests are required before treatment. Results: Next to vaginal discharge which was main symptom in all patients, the other symptoms like dusparunia, dysuria, itching ,lower abdomen pain and low backache was reported 9%, 16%, 20%, 24% and 31% respectively. Also 8% patients reported post coital bleeding. All patients were married and the mean age of the patients was 28+0.2 years and 15% of them were over 40 years. Mean parity was 4±1.Vaginal infection improved in 65% of the patients excellently with a first line single course of antibiotic and percentage raised up to 88% with second course. 19(9.5%) patients couldn’t be followed as they left that camp and 5(2.5%) patients who did not improve with two courses of antibiotics had big cervical erosions, referred to nearby tertiary care hospital for further management. Conclusions: IDPs live in poor conditions in camps without basic facilities and where it is difficult to perform bedside tests like microscopy, Potassium Hydroxide, wet mount films and tests for Sexually transmitted diseases like Chlamydia and gonorrhea are not available, syndromic management there is a rational way of treating cases of chronic vaginal discharge to get quicker response in such desperate women.

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The clinical study of the incisional hernia and its management

International Surgery Journal ◽

10.18203/2349-2902.isj20172781 ◽

2017 ◽

Vol 4 (7) ◽

pp. 2281

Author(s):

Navdeep Garg ◽

Pooja Batra ◽

Sharadendu Bali

Keyword(s):

Incisional Hernia ◽

Previous History ◽

Exploratory Laparotomy ◽

Suture Repair ◽

Age Group ◽

Common Complication ◽

Response Sets ◽

History Of ◽

Sublay Mesh ◽

Mesh Hernioplasty

Background: Hernia is defined as abnormal protrusion of viscus through a normal or abnormal weakness in the wall of its containing cavity. Incidence of Incisional hernias is 60%. It is the most common complication after exploratory laparotomy followed by LSCS.Methods: Data was collected for 30 cases of incisional hernia according to the proforma which included detailed history, clinical examination and investigation. Data was tabulated, analyzed and results interpreted.Results: Incisional hernia was more common in females with the ratio 1.5:1. The incidence of incisional hernia was highest in the age group ranging from 30-50 years. Most of the patients presented with chief complaint of swelling (100%) followed by pain and swelling (24%). Incisional hernia was more common in patients of previous history of abdominal procedures (explorative laparotomy 53%) followed by gynaecological operations (23%). Out of 30 patients studied, 20 underwent only mesh hernioplasty (67%), 10 underwent sublay mesh hernioplasty (23%).Conclusions: With prosthetic mesh, defects of any size can be repaired without tension. The polypropylene mesh, by inducing inflammatory response sets up scaffolding that in turn induces the synthesis of collagen. Thus, the superiority of mesh repair over suture repair can be accounted for.

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