Surgical management of a case of recurrent carcinoma cervix: a case report

Worldwide cervical cancer is the fourth most common cancers among females. Pelvic recurrence, distant metastases, or a combination of both can occur in patients of carcinoma cervix. A 42-year-old P2L2 with a history of carcinoma cervix stage 3-b came to our OPD for routine follow up. Two year back she was managed with chemoradiation for her primary carcinoma which had parametrium extension. There was a 1 × 1 cm lesion on the anterior vaginal wall which was diagnosed to be cervical recurrence. Patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy with pelvic lymphadenectomy. Patient is disease free till now. Treatment decisions should be individualised based on the performance status of the patient, the site of recurrence and/or metastases, the extent of metastatic disease, and prior treatment.

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Vesico-Vaginal Fistula Repair Through Abdominal Approach

KYAMC Journal ◽

10.3329/kyamcj.v11i3.49869 ◽

2020 ◽

Vol 11 (3) ◽

pp. 129-132

Author(s):

Hafiz Al Asad ◽

Asif Yazdani ◽

Zulfia Zinat Chowdhury ◽

Muhammad Faruk Hussain ◽

AKM Shahadat Hossaion ◽

...

Keyword(s):

Wound Infection ◽

Operative Time ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Pelvic Surgery ◽

Vaginal Fistula ◽

Abdominal Approach ◽

History Of ◽

Vesico Vaginal Fistula

Background: Vesico-Vaginal Fistula (VVF) is a major cause for concern in many developing countries with significant morbidity. Among the different techniques abdominal approach of VVF repair is important one. Objective: To find out the outcome of VVF repair by abdominal approach. Materials and Methods: It is a prospective study. Twenty-three patients with VVF were operated with abdominal approach from the period of January 2016 to January 2019. Age of patients, co-morbidities, cause, size and location of VVF were evaluated. Then abdominal approach of VVF repair was done. Operative time and need of blood transfusion were encountered. Post operative (POD) urine leakage, wound infection or other complications were enlisted. Patients were discharged with keeping urethral catheter for 14 days. Follow up was done after 1 and 3 month and in each follow up history and physical examination was done. All collected data were evaluated. Results: Mean age of the patient was 40 years. Among the 23 patients 12 (52%) patients had history of total abdominal hysterectomy, 9 had history of caesarian section and 2 cases had history of pelvic surgery. VVF repair was done at least 12 weeks after its occurrence. Operative time ranged from 90 minutes to 150 minutes. In the immediate POD no obvious complications were noted except one patient developed wound infection on 7th POD. Follow-up done as per schedule and no recurrence of VVF noted. Conclusion: VVF repair through abdominal approach is a feasible, safe and effective technique if performed meticulously. KYAMC Journal Vol. 11, No.-3, October 2020, Page 129-132

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Inflammatory myoglandular colonic polyp with adenomatous changes mimicking malignant tumor

Journal of Clinical Images and Medical Case Reports ◽

10.52768/2766-7820/1358 ◽

2021 ◽

Vol 2 (5) ◽

Author(s):

Sneha R Adidam ◽

◽

Seenath M ◽

Chalapathi R Adidam Venkata ◽

◽

...

Keyword(s):

Comprehensive Evaluation ◽

Colonic Polyps ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Right Hemicolectomy ◽

Colonic Polyp ◽

Ascending Colon ◽

History Of ◽

The Right

Inflammatory Myoglandular polyps (IMGPs) are rare intestinal polyps that occur frequently in the left colon and may present with hematochezia. Only a small number of cases have been reported in the right colon (2%). We present a case of IMGP in the proximal ascending colon. A 46-year-old woman of mixed ethnicity presented with a history of abdomino-pelvic pain and constipation. CT scan suggested possibility of malignancy. On colonoscopy, a non- obstructive polyp in proximal ascending colon was biopsied followed by right hemicolectomy. Patient also underwent total abdominal hysterectomy at the same time for fibroids. The colonic polyp revealed features of IMGP with focal adenomatous changes. The polyp was characterized by epithelial erosion, inflamed granulation tissue, hyperplastic and dilated glands, and proliferating smooth muscle. IMGP needs to be distinguished from other non-neoplastic colonic polyps, which includes Peutz-Jeghers polyps, inflammatory pseudopolyps, juvenile polyps, and inflammatory fibroid polyps. We report a large sized inflammatory myoglandular polyp with suspicious imaging findings and presence of adenomatous changes that mimicked malignancy that requires comprehensive evaluation and follow up.

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Laparoscopic Vessel Endometriosis Resection Surgery: A Case Report and Review of Literature

Case Reports in Obstetrics and Gynecology ◽

10.1155/2019/1375208 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Shadi Rezai ◽

Richard A. Giovane ◽

Tiffanie Mann ◽

Ninad M. Patil ◽

Elise Bardawil ◽

...

Keyword(s):

Exploratory Laparotomy ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Pathology Report ◽

Review Of Literature ◽

Pelvic Peritoneum ◽

Patient Reported ◽

History Of ◽

Large Vessels

Background. Endometriosis usually occurs in the pelvis and often involves the ovaries, the uterosacral and broad ligaments, and the pelvic peritoneum. In rare instances, it can occur in the vasculature of the pelvis. Patients with endometriosis present with abnormal pain, menstrual cycle disruption and infertility. Management of endometriosis is usually surgical with excision of the tissue via laparoscopic means. Case. A 42-year-old Gravida 5, Para 2-0-3-2 patient with a 22 year history of endometriosis, who had had multiple laparoscopic endometriosis resections, total abdominal hysterectomy, and an exploratory laparotomy with bilateral salpingo-oophorectomy, presented with left pelvic pain when standing, dyspareunia, and a 3.7 cm cyst on ultrasound. The patient underwent laparoscopic vessel endometriosis resection and excision of endometriotic nodules from external iliac vessels. Final pathology report showed evidence of old endometriosis in all locations. On interval follow-up, the patient reported sustained relief from pain. Conclusion. Complete resection of endometriosis from large vessels can be successfully achieved laparoscopically by a well-experienced surgeon with delicate, proper techniques.

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Laparoscopically Assisted Vaginal Hysterectomy Versus Total Abdominal Hysterectomy for Leiomyosarcoma Treatment: Analysis and Follow-Up of 20 Cases

Journal of Gynecologic Surgery ◽

10.1089/104240601753196236 ◽

2001 ◽

Vol 17 (3) ◽

pp. 91-95

Author(s):

Hun-Shan Pan ◽

Mike Yan-Sheng Lin ◽

Lee-Wen Huang ◽

Jiann-Loung Hwang

Keyword(s):

Vaginal Hysterectomy ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Laparoscopically Assisted Vaginal Hysterectomy ◽

Treatment Analysis

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Clear cell carcinoma of Mullerian origin in the urinary bladder: A rare entity

Journal of Clinical Urology ◽

10.1177/2051415820987668 ◽

2021 ◽

pp. 205141582098766

Author(s):

Harshit Garg ◽

Brusabhanu Nayak ◽

Tripti Nakra ◽

Prabhjot Singh ◽

Seema Kaushal

Keyword(s):

Urinary Bladder ◽

Cell Carcinoma ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Rare Entity ◽

Level Of Evidence ◽

History Of ◽

Carcinoma Of The Bladder

Mullerian neoplasms of the urinary system are rare but complex tumor-like lesions. The identification of the Mullerian neoplasm is crucial for patient management owing to its etiology, natural history, and prognosis. We present a case of a 42-year-old female with a history of three lower segment cesarean sections presenting with complaints of dysmenorrhea and suprapubic pain with no history of hematuria or any urinary symptoms. Magnetic resonance imaging revealed a 2 cm×2 cm exophytic lesion suspicious of being either a bladder lesion or an endometrial lesion infiltrating the urinary bladder. Cystoscopy and transurethral biopsy of this suspicious bladder tumor revealed a malignant tumor with papillary and tubulocystic architecture. Based on the overall histomorphological and immunohistochemical features, a diagnosis of clear cell carcinoma of Mullerian origin was made, and the patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy and partial cystectomy. The patient was kept on regular surveillance and showed no signs of recurrence at the one-year follow-up. Clear cell carcinoma of the bladder of Mullerian origin is a rare entity and is established on histopathology. Prompt diagnosis and a multidisciplinary approach are indispensable for management. Level of evidence: Level 4.

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DOUBLE TRANSOBTURATOR APPROACH TO TREATING CYSTOCELE

Urogynaecologia ◽

10.4081/uij.2008.3.17 ◽

2010 ◽

Vol 22 (3) ◽

pp. 17

Author(s):

S. Bandiera ◽

G. Raciti ◽

A. Aloisi ◽

M. Arena ◽

R. Giordano ◽

...

Keyword(s):

Retrospective Study ◽

Vaginal Wall ◽

Anterior Vaginal Wall ◽

Cure Rate ◽

Anterior Vaginal Wall Prolapse ◽

Safety And Efficacy ◽

Vaginal Erosion ◽

Lower Recurrence Rate ◽

A New Technique

The aim of this study is to show the safety and efficacy of the double transobturator approach, a new technique for anterior vaginal wall prolapse, using several different kinds of meshes (synthetic and biological).This is a retrospective study of 74 women treated between 2005 and 2007. The patients underwent a 3, 6 and 12 month follow-up. The anatomical cure rate, defined as grade of prolapse <2, was 79.7%. Fifteen patients had a recurrence, 12 were treated with biological VS meshes and 3 were treated with synthetic meshes. Vaginal erosion was reported in 5 (6.7%) of these patients, two of whom were treated with topic estrogenic therapy, and three of whom with partial excision. These results suggest that this technique is safe and efficacious and that the best meshes to use are synthetic meshes, because they have a lower recurrence rate than biological meshes.

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Uterus-sparing myomectomy for idiopathic uterine pyomyoma in a young woman: A case report

Aegean Journal of Obstetrics and Gynecology ◽

10.46328/aejog.v2i2.43 ◽

2020 ◽

Vol 2 (2) ◽

pp. 19-22

Author(s):

Ugur Sen ◽

Tuğba Karadeniz ◽

Emrah Beyan

Keyword(s):

Risk Factor ◽

Uterine Fibroids ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Proper Treatment ◽

Imaging Findings ◽

Cervical Stenosis ◽

Mortality And Morbidity ◽

Risk Of Mortality ◽

History Of

Pyomyoma, or suppurative leiomyoma, is a rare but serious complication of uterine fibroids. The mechanism of pyomyoma is an infection caused by microorganisms coming from ascending or hematogenously on the ground of necrosis following ischemia and infarction. It can be seen during the course of pregnancy or after abortion and birth. It can also develop after uterine instrumentation or due to cervical stenosis. Patients often present with pain and fever. It should be considered in cases had no other etiology of fever and had a history of uterine fibroids. Diagnosis and treatment are often delayed due to non-specific presentation and imaging findings. This delay increases the risk of mortality and morbidity such as fertility loss. In the vast majority of these cases, total abdominal hysterectomy is required. The case we presented is a premenopausal and sexually inactive woman without any history of pregnancy or uterine instrumentation or immunocompromised. This patient is the 5th case of pyomyoma without risk factor and the 3rd case that was successfully treated with myomectomy. Knowing the proper treatment of pyomyoma will be beneficial to prevent potential mortality and morbidity.

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Mullerian Adenosarcoma of the Endometrium in a 19-Year-Old Girl: Case Report and a Literature Review

10.26420/austincritcarecaserep.2021.1022 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Miyoshi A ◽

◽

Ueda Y ◽

Sato K ◽

Kimura T ◽

...

Keyword(s):

Adolescent Girls ◽

Transvaginal Ultrasound ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Tumor Biopsy ◽

Surgical Specimen ◽

Ultrasound Sonography ◽

History Of ◽

Magnetic Resonance Imaging Mri ◽

Gross Examination

Mullerian adenosarcoma of the endometrium in adolescent girls is extremely rare, with only fifteen cases under 20 years old having been reported to date. We describe here a new case of adolescent Mullerian adenosarcoma and provide an updated review of the previous literature on such rare tumors. Our 19-year-old case presented with a six-month history of prolonged menstruation. She had not yet had any sexual relationship. On gross examination, a fragile mass was seen in her vagina that bled easily. A 4.0×2.0 cm mass was visualized with Magnetic Resonance Imaging (MRI). The tumor seemed to slightly invade the myometrium of the uterine corpus. Transvaginal ultrasound sonography confirmed the presence of a 4.0 cm mass located in the cervix and vagina. The tumor biopsy was diagnosed as a Mullerian adenosarcoma of the endometrium. We performed a Total Abdominal Hysterectomy (TAH) and Bilateral Salpingectomy (BS). The post-surgical specimen was diagnosed as a pT1aNXM0 Mullerian adenosarcoma of the endometrium. The patient did not require adjuvant chemotherapy. She has been monitored every 3 months and has been without recurrence now for 28 months.

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A Novel Case of Fibroids after Menopause

Case Reports in Obstetrics and Gynecology ◽

10.1155/2018/9104719 ◽

2018 ◽

Vol 2018 ◽

pp. 1-2

Author(s):

Jade Edwards ◽

Hamza Katali

Keyword(s):

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Younger Women ◽

Benign Pathology ◽

Leiomyomatosis Peritonealis Disseminata ◽

Long Term Follow Up ◽

Risk Of Malignancy ◽

Risk Of Malignancy Index

Fibroids are a condition commonly seen as part of routine gynaecological practice and generally present with menorrhagia, infertility, or pressure symptoms depending on their exact location. We report the case of a postmenopausal 57-year-old lady presenting with left-sided pain and frequency with a complex 15 cm mass mid pelvis and an adjacent additional 7 cm cyst but a risk of malignancy index suggesting benign pathology. She underwent total abdominal hysterectomy (TAH) and right-sided salpingo-oophrectomy (RSO) on recommendation of the multidisciplinary team (MDT) and histology confirmed leiomyomatosis peritonealis disseminata. This rare but important condition is often confused with peritoneal carcinomatosis on imaging. The mainstay of treatment involves lesion and omental excision followed by removal of hormonal stimuli although this approach must be personalised as many younger women may wish to retain their uteri. Long-term follow-up is essential due to the potential for malignant transformation.

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