Multisystemic Benign Metastasizing Leiomyoma: An Unusual Condition with an Atypical Clinical Presentation

Benign metastasizing leiomyoma (BML) is a rarely found entity with few documented cases in the literature, usually occurring in women of reproductive age with a history of myomectomy or hysterectomy. The leiomyomas can metastasize to several organs, the lungs being the most commonly affected. We report a case of a 40-year-old female patient who presented at our institution with low back pain. She underwent a lumbar MR that revealed the presence of an expansive and compressive mass in the body of L4. This mass was biopsied, corresponding to a metastasizing leiomyoma with no malignant characteristics. Subsequently, a CT examination showed several soft tissue density round masses in both lungs, but the most striking feature was a 12 cm mass located in the left iliac crest. There was asymmetrical uterus enlargement, caused by the presence of several leiomyomas. Since the lesions were estrogen and progesterone positive, hormone suppression consisting of oophorectomy followed by anastrozole was the chosen treatment. No signs of progression were observed at the 6-month follow-up. This case is one of the very few that occurred in a woman with no previous uterine intervention, adding further evidence that surgery is not an essential condition for this entity to develop.

Download Full-text

Benign Metastasizing Leiomyoma: A Rare Type of Lung Metastases—Two Case Reports and Review of the Literature

Case Reports in Oncological Medicine ◽

10.1155/2014/842801 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 5

Author(s):

Rokana Taftaf ◽

Sandra Starnes ◽

Jiang Wang ◽

Ralph Shipley ◽

Tariq Namad ◽

...

Keyword(s):

Uterine Leiomyoma ◽

Progesterone Receptors ◽

Pulmonary Nodules ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

Benign Metastasizing Leiomyoma ◽

Ct Guided ◽

First Case ◽

History Of ◽

Metastasizing Leiomyoma

Benign metastasizing leiomyoma (BML) is a rare disease that usually occurs in women of reproductive age. They typically have history of uterine leiomyoma treated with hysterectomy. BML can metastasize to distant organs, with the lung being the most common organ. We report two patients who presented with benign metastasizing leiomyoma to the lung. Our first case was a fifty-two-year-old female who presented with multiple lung masses, with a past medical history of uterine leiomyoma who underwent hysterectomy 17 years ago. A CT-guided biopsy showed benign appearing spindle cells and pathology confirmed her diagnosis with additional positive estrogen/progesterone receptor stains. Our second case was a fifty-six-year-old female who presented with multiple cavitary pulmonary nodules. She subsequently underwent a video-assisted thoracoscopic surgery (VATS) with wedge resection of one of the nodules. Pathology confirmed the diagnosis based on morphology and immunohistochemical staining strongly positive for estrogen/progesterone receptors. Benign metastasizing leiomyoma is a rare condition which may affect women of reproductive age. This should be considered in the differential in patients who present with multiple pulmonary nodules, especially with a history of uterine leiomyoma. Additional stains, such as estrogen/progesterone receptors, may need to be done to confirm the diagnosis.

Download Full-text

Young Male with Bilateral ICA Dissection: Beyond CADISS Trial

Journal of Stroke Medicine ◽

10.1177/2516608520984289 ◽

2021 ◽

pp. 251660852098428

Author(s):

Vikas Bhatia ◽

Chirag Jain ◽

Sucharita Ray ◽

jay Kumar

Keyword(s):

Management Strategies ◽

Young Male ◽

Acute Onset ◽

The Body ◽

Artery Dissection ◽

Cervical Artery Dissection ◽

Stroke Study ◽

History Of

Objective: To report a case of young male with stroke and bilateral internal carotid artery (ICA) dissection. Background: Cervical Artery Dissection in Stroke Study trial has provided some insight on management of patients with ICA dissection. However, there is a need to modify the management strategies as per specific clinical scenario. Design/Methods: Case report and literature review. Results: A 45-year-old male presented with 1 month old history of acute onset numbness of right half of the body with slurring of speech. Computed tomography angiography showed complete occlusion of left cervical ICA just beyond origin with presence of fusiform dilatation and spiral flap in right extracranial cervical ICA. The patient was started on antiplatelets and taken for endovascular procedure using 2-mesh-based carotid stents. Patient was discharged after 3 days on antiplatelet therapy. At 1-year follow-up, there were no fresh symptoms. Conclusion: This case emphasizes the role of successful endovascular management of carotid dissection in a young male. These clinical situations may not be fully represented in trials, and a case-based approach is required.

Download Full-text

Overt Lower Gastrointestinal Bleeding and Pseudotumor: A Rare Presentation of Cytomegalovirus Infection

Case Reports in Medicine ◽

10.1155/2017/9732967 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Akanksha Agrawal ◽

Deepanshu Jain ◽

Sameer Siddique

Keyword(s):

Highly Active Antiretroviral Therapy ◽

The Body ◽

Cmv Infection ◽

Rare Presentation ◽

Multiple Organs ◽

Highly Active ◽

History Of ◽

Acquired Immunodeficiency ◽

Immunodeficiency Syndrome

Cytomegalovirus (CMV) is a ubiquitous organism which can infect multiple organs of the body. In an immunocompromised patient, it can have a myriad of gastrointestinal manifestations. We report a case of recurrent hematochezia and concomitant pseudotumor in an AIDS (acquired immunodeficiency syndrome) patient attributable to CMV infection. A 62-year-old man with a history of AIDS, noncompliant with highly active antiretroviral therapy (HAART), presented with bright red blood per rectum. Index colonoscopy showed presence of multiple ulcers, colonic stenosis, and mass-like appearing lesion. Biopsy confirmed CMV infection and ruled out malignancy. Cessation of dual antiplatelet therapy and compliance with HAART lead to clinical cessation of bleeding and endoscopic healing of ulcers with complete resolution of colon mass on follow-up colonoscopy.

Download Full-text

Dietary intake and age at natural menopause: results from the UK Women’s Cohort Study

Journal of Epidemiology & Community Health ◽

10.1136/jech-2017-209887 ◽

2018 ◽

Vol 72 (8) ◽

pp. 733-740 ◽

Cited By ~ 8

Author(s):

Yashvee Dunneram ◽

Darren Charles Greenwood ◽

Victoria J Burley ◽

Janet E Cade

Keyword(s):

Cohort Study ◽

Reproductive Age ◽

Food Groups ◽

Natural Menopause ◽

Age At Menopause ◽

Oily Fish ◽

History Of ◽

The Uk ◽

Study Participants

BackgroundAge at natural menopause is a matter of concern for women of reproductive age as both an early or late menopause may have implications for health outcomes.MethodsStudy participants were women aged 40–65 years who had experienced a natural menopause from the UK Women’s Cohort Study between baseline and first follow-up. Natural menopause was defined as the permanent cessation of menstrual periods for at least 12 consecutive months. A food frequency questionnaire was used to estimate diet at baseline. Reproductive history of participants was also recorded. Regression modelling, adjusting for confounders, was used to assess associations between diet and age at natural menopause.ResultsDuring the 4-year follow-up period, 914 women experienced a natural menopause. A high intake of oily fish and fresh legumes were associated with delayed onset of natural menopause by 3.3 years per portion/day (99% CI 0.8 to 5.8) and 0.9 years per portion/day (99% CI 0.0 to 1.8), respectively. Refined pasta and rice was associated with earlier menopause (per portion/day: −1.5 years, 99% CI −2.8 to −0.2). A higher intake of vitamin B6 (per mg/day: 0.6 years, 99% CI 0.1 to 1.2) and zinc (per mg/day: 0.3 years, 99% CI −0.0 to 0.6) was also associated with later age at menopause. Stratification by age at baseline led to attenuated results.ConclusionOur results suggest that some food groups (oily fish, fresh legumes, refined pasta and rice) and specific nutrients are individually predictive of age at natural menopause.

Download Full-text

A case report: delayed right ventricular pericardial fistula and aneurysm following penetrating traumatic injury—a controversial aetiology

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytaa183 ◽

2020 ◽

Vol 4 (4) ◽

pp. 1-5

Author(s):

Martina Steinmaurer ◽

Blanche Cupido ◽

Matthew Hannington ◽

Rodgers Manganyi

Keyword(s):

Pericardial Effusion ◽

Right Ventricular ◽

Cardiac Tamponade ◽

Traumatic Injury ◽

Clinical Signs ◽

The Body ◽

Delayed Presentation ◽

True Aneurysm ◽

History Of

Abstract Background Right ventricular aneurysms (RVAs) are rare. We present a case with a combined RVA and right ventricular pericardial fistula resulting in a pericardial effusion and cardiac tamponade. The RVA was detected 47 days after the patient suffered a gunshot wound. This report adds to the body of scarce literature on RVA aetiology, diagnoses, and treatment. Case summary A 30-year-old male patient presented with worsening respiratory distress over a 7-day period with clinical signs of cardiac tamponade following a history of a gunshot (with associated liver laceration, pulmonary embolism, right nephrectomy, and sepsis) 47 days prior. Transthoracic echocardiography showed a large circumferential pericardial effusion and an RVA. The patient was emergently taken for surgical repair of the RVA. Discussion Our case presents a delayed presentation of a gunshot heart and an aetiology with indications of and against a true aneurysm. It brings attention to possible complications of penetrating precordial injuries, with the need for consideration and possible evaluation at follow-up. The literature on the operative excision of RVA is reviewed and various aetiological factors and consequences are discussed.

Download Full-text

Convexity Meningioma Presenting as Postpartum Eclampsia

Tropical Doctor ◽

10.1177/004947550303300126 ◽

2003 ◽

Vol 33 (1) ◽

pp. 53-54 ◽

Cited By ~ 2

Author(s):

Bello B Shehu ◽

Nasiru J Ismail

Keyword(s):

Early Diagnosis ◽

The Body ◽

History Of ◽

Neurological Features ◽

The Right ◽

The Brain ◽

Tomography Scan ◽

Progressive Weakness ◽

In Pregnancy

A 37-year-old woman, Para 5+0 presented with a 1 year history of recurrent convulsions and progressive weakness of the right side of the body. She had been treated for postpartum eclampsia in her last delivery but symptoms recurred 3 months later. Evaluation including computerized tomography scan of the brain suggested a parieto-temporal meningioma, which was completely excised at craniotomy. Histology confirmed this to be a meningioma. The patient was well at 8 months of follow up. The growth of meningiomas may increase during pregnancy due to presence of receptors for progestational hormones in the tumour and the meningioma may become symptomatic in pregnancy, presenting as eclampsia. Close follow up of patients with eclampsia is necessary to identify neurological features that may lead to a diagnosis of meningioma. Early diagnosis is essential if a good outcome is to be ensured.

Download Full-text

Intramedullary Spinal Capillary Hemangioma: Case Report

Arquivos Brasileiros de Neurocirurgia Brazilian Neurosurgery ◽

10.1055/s-0035-1570100 ◽

2015 ◽

Vol 36 (02) ◽

pp. 125-127

Author(s):

Leonardo Welling ◽

Mariana Welling ◽

Eberval Figueiredo

Keyword(s):

Spinal Cord ◽

Complete Removal ◽

Conus Medullaris ◽

Capillary Hemangioma ◽

The Body ◽

Accurate Information ◽

Histopathological Diagnosis ◽

Intramedullary Lesion ◽

History Of

AbstractCapillary hemangiomas involving the neuraxis are very uncommon. In the spinal cord, they are located mainly intradural and extramedullary. To our knowledge, only four cases in conus medullaris have been previously described. In our case, a 46-year-old man was admitted with back pain, sphincter disturbances, as well as progressive weakness and numbness on the lower extremities. Magnetic resonance imaging revealed an undefined intramedullary lesion on the conus medullaris. The patient underwent microsurgery, which achieved complete removal. Histopathological diagnosis was compatible with capillary hemangioma. His postoperative course was uneventful and all symptoms, including bladder dysfunction clearly regressed. The treatment of intramedullary capillary hemangiomas is very critical in preventing unnecessary morbidity, providing accurate information with respect to prognosis, and establishes a regular outpatient follow-up. The natural history of this lesion involving the spinal cord is not well described, although they are common elsewhere in the body.

Download Full-text

Management of Small Renal Masses

10.2310/tywc.11094 ◽

2018 ◽

Author(s):

Keith A Lawson ◽

Antonio Finelli

Keyword(s):

Natural History ◽

Renal Mass ◽

The Body ◽

Renal Tumors ◽

Small Renal Mass ◽

Small Renal Masses ◽

Tumor Biopsy ◽

Renal Masses ◽

History Of

The rise in incidentally discovered enhancing solid renal tumors has spurred the development of new approaches to managing this unique clinical entity known as the small renal mass (SRM). These approaches are grounded on a better understanding of the natural history of SRM, with the goal to reduce the morbidity associated with their management and avoid overtreatment. In this chapter, we review the body of evidence pertaining to the classification and clinical management of SRMs with respect to diagnosis, treatment, and follow-up. In addition, we discuss the controversies and active areas of development for this rapidly evolving field that strides towards a precision medicine paradigm. This review contains 6 figures, 6 tables and 63 references Keywords: Small renal mass, renal cell carcinoma, radical nephrectomy, renal tumor biopsy, active surveillance, natural history, oncocytoma, robotic surgery, partial nephrectomy

Download Full-text

Elephantiasis and Directed Occupational Rehabilitation

Case Reports in Vascular Medicine ◽

10.1155/2019/6486158 ◽

2019 ◽

Vol 2019 ◽

pp. 1-3

Author(s):

Jose Maria Pereira de Godoy ◽

Henrique Jose Pereira de Godoy ◽

Ana Carolina Pereira de Godoy ◽

Maria de Fátima Guerreiro Godoy

Keyword(s):

Body Mass Index ◽

Body Weight ◽

Lower Limb ◽

Occupational Rehabilitation ◽

The Body ◽

Compression Stockings ◽

Left Lower Limb ◽

History Of ◽

Bilateral Lower Limb

The aim of the present study was to demonstrate the cure of elephantiasis over a ten-year follow-up period and novel discoveries with directed occupational rehabilitation. A 66-year-old female patient with a history of bilateral lower limb lymphedema reported the aggravation of the condition over the years, reaching stage III (elephantiasis). The physical examination confirmed elephantiasis. The circumference of the left lower limb was 106 cm. Her body weight was 106 kilograms, height was 160 cm, and the body mass index (BMI) was 41.6 kg/m2. The patient was submitted to intensive treatment for three weeks, which led to a 21-kg reduction in weight and 66 cm reduction in leg circumference. Ten years after treatment, the patient has maintained the results with the compression stockings. Elephantiasis can be cured, although lymphedema cannot. The cure of elephantiasis depends on maintaining the treatment of lymphedema after normalization or near normalization. Directed occupational therapy stimulates the search for new activities and a life closer to normality.

Download Full-text