scholarly journals A case of adenomyosis with leiomyoma that was effectively treated with relugolix and kamishoyosan add-on therapy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yukifumi Sasamori ◽  
Kohei Takehara ◽  
Tsuyoshi Terashima ◽  
Takako Onodera ◽  
Keita Yatsuki ◽  
...  
Keyword(s):  
Side Effects ◽  
Lower Abdominal Pain ◽  
Abnormal Uterine Bleeding ◽  
Resonance Imaging ◽  
Phase 3 ◽  
Case Presentation ◽  
Hot Flush ◽  
Perimenopausal Women ◽  
Gonadotropin Releasing Hormone Receptor ◽  
Uterine Volume

Abstract Background Recently, relugolix, an oral gonadotropin-releasing hormone receptor antagonist, has been considered an effective therapy for leiomyoma based on a phase 3 study in Japanese women. Leiomyoma combined with severe adenomyosis occasionally occurs in perimenopausal women; however, little information on the effectiveness of relugolix against severe adenomyosis exists. Case presentation A 49-year-old woman was referred to our hospital with acute lower abdominal pain and abnormal uterine bleeding. Magnetic resonance imaging revealed multiple leiomyomas with diffuse adenomyosis. Left hydrosalpinx was also observed. The patient refused surgical treatment and preferred oral relugolix. Since she experienced a hot flush and headache induced by relugolix, a traditional Japanese Kampo, kamishoyosan, was added to improve the side effects of relugolix. The patient was asymptomatic at the time of this report and experienced a significant shrinkage in uterine volume. Ultimately, she avoided hysterectomy as desired. Conclusions To our knowledge, this is the first report of co-occurring adenomyosis and leiomyoma, which was effectively treated with relugolix. Although the management of adverse side effects, including hot flush and headache by relugolix, has recently attracted attention and controversy, relugolix add-on therapy with kamishoyosan may help treat menopausal symptoms.

scholarly journals Effectiveness of Mifepristone in the Treatment of Uterine Leiomyomata

2013 ◽  
Vol 8 (1) ◽  
pp. 22-25
Author(s):  
Mayurika Sinha ◽  
A Kyal ◽  
P Mukhopadhay
Keyword(s):  
Side Effects ◽  
Uterine Leiomyoma ◽  
Endometrial Hyperplasia ◽  
Lower Abdominal Pain ◽  
Simple Type ◽  
Age Group ◽  
Uterine Leiomyomata ◽  
Obstetrics And Gynaecology ◽  
Perimenopausal Women ◽  
A Prospective Study

Aims: The goal of this study was to determine the effects of mifepristone in perimenopausal women with leiomyomas, thereby to see a decrease in severity of symptoms and a decrease in size of the leiomyomas. Methods: This was a prospective study conducted at Eden HospitalMedical College and Hospital, Kolkatafrom July 2010 to June 2011. Fifty patients received 20-25mg mifepristone daily and comparison was made between pre and post treatment symptoms and leiomyoma volume. Results: All patients became amenorrhoeic after treatment, relieving heavy menstrual flow most complained of. Lower abdominal pain improved by > 80% in most patients and volume of leiomyoma decreased appreciably. The drug did not have any major side effects. Endometrial hyperplasia detected by ultrasound in 42% patients was only of simple type on biopsy. Conclusions: Mifepristone can be useful in treating symptomatic women with uterine leiomyoma in perimenopausal age group, in those awaiting surgery to stop bleeding and improve anaemia and to reduce size of tumor to make surgery technically easier, making it a cheaper alternative to GnRH agonists and without any major side effects. Nepal Journal of Obstetrics and Gynaecology / Vol 8 / No. 1 / Issue 15 / Jan- June, 2013 / 22-25 DOI: http://dx.doi.org/10.3126/njog.v8i1.8856

scholarly journals Diagnostic Approach in Perimenopausal Women with Abnormal Uterine Bleeding

2014 ◽  
Vol 2 (1) ◽  
pp. 12-14
Author(s):  
Shivani Singh ◽  
Poonam Yadav ◽  
Rekha Rani ◽  
Urvashi Verma
Keyword(s):  
South Asian ◽  
Abnormal Uterine Bleeding ◽  
Uterine Bleeding ◽  
Outpatient Department ◽  
Age Group ◽  
Class Iii ◽  
Diagnostic Efficacy ◽  
Medical College ◽  
Perimenopausal Women ◽  
Uterine Volume

ABSTRACT Introduction Abnormal uterine bleeding (AUB) is very common problem in patient attending outpatient department, especially in perimenopausal group. Objective To study prevalence of abnormal uterine bleeding and its type in perimenopausal women as well as to compare diagnostic efficacy of ultrasonography, hysteroscopy and histopathology. Material and method The study was carried out in Department of Obstetrics and Gynecology, Era Medical College, Lucknow, in 100 patient attending outpatient department with AUB in perimenopausal age group. Observation Most of the patients were multiparous, more than 50% belong to socioeconomic class III and IV and mean age was 43.05 ± 4.09 years. Commonest complaint was menorrhagia (45%) followed by metrorrhagia in 19% and menometorrhagia in 14%. Majority of patients (85%) had uterine volume between 151 and 250 cm3. Only three patient had uterine volume more than 252 cm3. Endometrial hyperplasia was diagnosed in 14% with ultrasonography, 11% on hysteroscopy while in 15% on hystopathological examination. Conclusion In perimenopausal women with AUB, ultrasonography should be first investigation because of its freely availability, noninvasiveness and cost effectiveness. How to cite this article Verma U, Garg R, Singh S, Yadav P, Rani R. J South Asian Feder Menopause Soc 2014;2(1):12-14.

Supramolecular Enhancement of Aminoxyl ORCA Contrast Agents

2019 ◽  
Author(s):  
Hamilton Lee ◽  
Jenica Lumata ◽  
Michael A. Luzuriaga ◽  
Candace Benjamin ◽  
Olivia Brohlin ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Side Effects ◽  
Magnetic Resonance ◽  
Tobacco Mosaic Virus ◽  
Contrast Agents ◽  
Single Molecule ◽  
Organic Radical ◽  
Resonance Imaging ◽  
Physiological Conditions

<div><div><div><p>Many contrast agents for magnetic resonance imaging are based on gadolinium, however side effects limit their use in some patients. Organic radical contrast agents (ORCAs) are potential alternatives, but are reduced rapidly in physiological conditions and have low relaxivities as single molecule contrast agents. Herein, we use a supramolecular strategy where cucurbit[8]uril binds with nanomolar affinities to ORCAs and protects them against biological reductants to create a stable radical in vivo. We further over came the weak contrast by conjugating this complex on the surface of a self-assembled biomacromolecule derived from the tobacco mosaic virus.</p></div></div></div>

Hilar cholangiocarcinoma

2018 ◽  
Vol 1 (3) ◽  
pp. 28-30
Author(s):  
Tanita Suttichaimongkol
Keyword(s):  
Magnetic Resonance ◽  
Hilar Cholangiocarcinoma ◽  
Critical Role ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Resonance Imaging ◽  
Extrahepatic Cholangiocarcinoma ◽  
Case Presentation ◽  
Duct Epithelium ◽  
Bile Duct Epithelium ◽  
High Degree

Cholangiocarcinoma is a primary biliary tract tumor arising from the bile duct epithelium. Classically, these tumors have been categorized according to their anatomic location as intrahepatic and extrahepatic. Hilar cholangiocarcinoma is the most common type of extrahepatic cholangiocarcinoma. It is the most difficult cancer to diagnose and therefore carries a poor prognosis with a 5-year survivalrate of less than 10%. Diagnostic imaging, coupled with a high degree of clinical suspicion, play a critical role in timely diagnosis, staging, and evaluation for surgical resectability. The most common imagingmodalities used for diagnosis and staging of hilar cholangiocarcinoma include ultrasound (US), computed tomography (CT), magnetic resonance imaging/magnetic resonance cholangiopancreatography(MRI/MRCP). This article showed a case presentation and reviewed the imaging appearance of hilar cholangiocarcinoma.   Figure 1  Greyscale sonography at the level of hepatic hilum revealed an ill-defined hilar mass (asterisk)resulting in upstream dilatation of right (arrow) and left (arrow head) main intrahepatic duct.  

scholarly journals Laparoscopic surgical management of a mature presacral teratoma: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Liming Wang ◽  
Yasumitsu Hirano ◽  
Toshimasa Ishii ◽  
Hiroka Kondo ◽  
Kiyoka Hara ◽  
...  
Keyword(s):  
Laparoscopic Resection ◽  
Mature Teratoma ◽  
Skin Incision ◽  
Histopathological Diagnosis ◽  
Tailgut Cyst ◽  
Resonance Imaging ◽  
Presumptive Diagnosis ◽  
Case Presentation ◽  
Contrast Enhanced ◽  
Magnetic Resonance Imaging Mri

Abstract Background Mature presacral (retrorectal) teratoma is very rare. We report a case in which a mature retrorectal teratoma in an adult was successfully treated with laparoscopic surgery. Case presentation A 44-year-old woman was diagnosed with a presacral tumor during a physical examination. Endoscopic ultrasonography (EUS) revealed a multilocular cystic lesion; the lesion was on the left side of the posterior rectum and measured approximately 30 mm in diameter on both contrast-enhanced pelvic computed tomography (CT) and magnetic resonance imaging (MRI). The presumptive diagnosis was tailgut cyst. However, the histopathological diagnosis after laparoscopic resection was mature teratoma. It is still difficult to preoperatively diagnose mature retrorectal teratomas. Conclusions Laparoscopic resection of mature retrorectal teratomas is a feasible and promising method that is less invasive and can be adapted without extending the skin incision.

scholarly journals Lymphangiography and focal pleurodesis treatment of chylothorax with an aberrant thoracic duct following oesophagectomy: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Tomoyuki Ishida ◽  
Jun Kanamori ◽  
Hiroyuki Daiko
Keyword(s):  
Magnetic Resonance Imaging ◽  
Interventional Radiology ◽  
Case Report ◽  
Magnetic Resonance ◽  
Thoracic Duct ◽  
Rare Case ◽  
Resonance Imaging ◽  
Case Presentation ◽  
Thoracostomy Tube ◽  
Magnetic Resonance Imaging Mri

Abstract Background Management of postoperative chylothorax usually consists of nutritional regimens, pharmacological therapies such as octreotide, and surgical therapies such as ligation of thoracic duct, but a clear consensus is yet to be reached. Further, the variation of the thoracic duct makes chylothorax difficult to treat. This report describes a rare case of chylothorax with an aberrant thoracic duct that was successfully treated using focal pleurodesis through interventional radiology (IVR). Case presentation The patient was a 52-year-old man with chylothorax after a thoracoscopic oesophagectomy for oesophageal cancer. With conventional therapy, such as thoracostomy tube, octreotide or fibrogammin, a decrease in the amount of chyle was not achieved. Therefore, we performed lymphangiography and pleurodesis through IVR. The patient appeared to have an aberrant thoracic duct, as revealed by magnetic resonance imaging (MRI); however, after focal pleurodesis, the leak of chyle was diminished, and the patient was discharged 66 days after admission. Conclusions Chylothorax remains a difficult complication. Focal pleurodesis through IVR can be one of the options to treat chylothorax.

scholarly journals Solitary fibrous tumor of the greater omentum: case report and review of literature

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Karim M. Eltawil ◽  
Carly Whalen ◽  
Bryce Knapp
Keyword(s):  
Solitary Fibrous Tumor ◽  
Management Strategy ◽  
Abdominal Mass ◽  
Lower Abdominal Pain ◽  
Greater Omentum ◽  
Team Approach ◽  
Review Of Literature ◽  
Case Presentation ◽  
Multidisciplinary Team Approach ◽  
Fibrous Tumor

Abstract Background Solitary fibrous tumor (SFT) is a rare neoplasm of mesenchymal origin occurring most often in the visceral pleura, however, it has been described in almost every anatomic location of the human body. While most SFTs have a benign behavior, they can potentially be locally aggressive and demonstrate a malignant behavior. Case presentation A 63 year-old male patient presented with lower abdominal pain and nausea and was noted on CT to have a large, heterogeneous lower abdominal mass with no evidence of metastatic disease. A surgical resection was performed and the mass appeared to be connected to the greater omentum with a vascular pedicle. It was not invading any intra-abdominal or pelvic organs. Pathology revealed an SFT of omental origin. The mitotic count was less than 4 per 10 high-power fields and all pathologic characteristics did not meet the criteria for a malignant SFT. Conclusions We report an extremely rare case of SFT originating from the greater omentum. A multidisciplinary team approach was followed to plan the patient’s management strategy.

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