scholarly journals Degenerated fibroid: a diagnostic dilemma

Author(s):  
Nayanika Gaur ◽  
Manish Jha

Leiomyoma is one of the most commonly encountered benign gynaecological neoplasms. With a wide range of symptoms, sometimes even asymptomatic, these tumors are easy to diagnose and treat, unless there are degenerative changes, which makes them difficult to diagnose and differentiating them from other serious conditions including malignancy, thereby, complicating their management also. Here, the case present to you a case of 48-year-old women with symptoms and clinical examination suggesting fibroid uterus but imaging studies inconclusive to differentiate fibroid uterus with ovarian malignancy, thus, creating a diagnostic dilemma. Ultimately, patient underwent exploratory laparotomy, keeping possibility of ovarian malignancy. Histopathological examination of the specimen of total abdominal hysterectomy with bilateral salpingo-oopherectomy concluded extensive cystic degeneration of leiomyoma and no evidence of malignancy.

2017 ◽  
Vol 4 (5) ◽  
pp. 1483
Author(s):  
Sheela K. M. ◽  
Shanta Sadashivan ◽  
Keerthi C. P.

Primary carcinoma of fallopian tube is rare and accounts for only 0.7-1.5% of all gynecological malignancies. Majority of the patients are postmenopausal with mean age of 61 years. Study present a case of 48-year-old lady, who underwent total abdominal hysterectomy with bilateral salpingo oophorectomy for a clinical diagnosis of fibroid uterus. Histopathological examination revealed, in addition to intramural fibroids, bilateral serous papillary adenocarcinoma of fallopian tube. We present this case due to its rarity.


2020 ◽  
pp. 1-2
Author(s):  
Reddythota Sujeeva Swapna ◽  
V Siva Sankar Naik ◽  
C Bhavani ◽  
M Neeraja

Background: The Female Genital Tract is a hormone-responsive system to a degree unmatched by any other system in the body. The gross configuration of the uterus changes dramatically throughout life. It is a kind of 'Puppet on a string", thus manipulated throughout life by altering levels of ovarian hormones. Objective of the study: The present study is aimed at detailed histopathological evaluation of uterine lesions of hysterectomy specimens. Methodology: A total of 448 cases of hysterectomy specimens were received in the department of pathology GGH Ananthapur, for two years, were reviewed. The specimens were processed, and the histopathological diagnosis was studied. Result: Peak age group of hysterectomy was 40-49 years with 186 (41.51%) cases. The youngest patient was 21 years old, and the oldest was 75 years old. The most frequent type of hysterectomy done was total abdominal hysterectomy in 293 (65.4%) cases. Conclusion: Hysterectomy is the most common surgery performed in gynecological practice. A wide range of lesions were noted when hysterectomy specimens are subjected to histopathological examination.


2021 ◽  
Vol 8 (11) ◽  
pp. 3475
Author(s):  
Gayathre S. P. ◽  
Sivakumar T. ◽  
Aashmi Chandrikaa S. ◽  
Prashanth .

Uterine leiomyomas also called as fibroid uterus are commonest tumors of the female genitourinary tract, however the occurrence of a giant uterine fibroid is rare. The giant uterine leiomyomas pose a great diagnostic as well as surgical challenge due to its size, vague nonspecific symptoms and the inadvertent injury to the adjacent organs during surgery. Here we would like to report a case of a 42 years female, known psychiatric patient with complaints of progressive abdominal distension for 5 years with rapid enlargement in the past 1 year with amenorrhea for 6 months and constipation for 2 months. Pre-operatively patient was diagnosed with ovarian malignancy and was proceeded with staging laparotomy where the mass was found to be arising from the uterus. Patient underwent total abdominal hysterectomy with bilateral salpingo oophorectomy and pathological examination revealed fibroid uterus with cystic degeneration. Post-operatively the patient recovered well and was discharged and on follow up examination was found to have returned to her normal life.


Author(s):  
Jagannath Mishra ◽  
Supratim Bhattacharya ◽  
Arpita Pandia ◽  
Ashok Padhy ◽  
Manoranjan Mahapatra ◽  
...  

AbstractUterine sarcoma is a rare verity of smooth muscle tumor, accounting for 2 to 6% of uterine malignancies. Leiomyosarcoma (LMS) represents ~1% of overall uterine tumors and ~25 to 36% of uterine sarcomas. Here we present a case of uterine LMS in a 34-year-old nulliparous woman presented with huge distension of abdomen which was confused to be an ovarian malignancy. She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. The diagnosis of LMS is made by histopathological examination after surgery. Surgery is the only treatment and role of adjuvant therapy has not been clearly defined.


2020 ◽  
pp. 1-2
Author(s):  
Sangeeta Singh ◽  
Renu Jha ◽  
Seema Seema ◽  
Debarshi Jana

Background: Fibroids are the most common benign tumours of smooth muscle cells of uterus in females and typically found during the middle and later reproductive years. As fibroid is an estrogen and progesterone dependent tumour, it gradually decreases in size during starting of menopause. The objective of this presented study was to determine management options among fibroid uterus patients. Methods: 50 number of patients were included in this study those who’s age of 20-55, with symptomatic uterine fibroid and undergone hysterectomy or myomectomy. Postmenopausal, Pregnancy and Asymptomatic fibroid were excluded from this study. Results: The study showed that 52 percent of patient having fibroid uterus were belonged to 31-40 years of age. The mean age was 41.2±6.07. The majority 74% of patients in this study presented with menstrual abnormalities, 40% presented with abdominal lump. Dysmenorrhoea was 26%, 6% patient had primary subfertility and 14% secondary subfertility. Total Abdominal Hysterectomy (TAH) with unilateral salpingo- oophorectomy done in 10% cases, TAH with bilateral salpino-oophorectomy in 22% cases, non descent vaginal hysterectomy in 6% cases, myomectomy done in 20% cases and polypectomy was done in 2% cases. Conclusion: Uterine fibroids are very common in women and frequently in late reproductive and perimenopausal years. It is also a common gynecological problem in our country, which frequently disturbs the lives of woman. Women now have choice of therapies for the treatment of fibroids.


2011 ◽  
Vol 18 (01) ◽  
pp. 32-40
Author(s):  
TEHREEN RIAZ ◽  
SARWAT JABEEN ◽  
WASEEM TALIB ◽  
Nabeela Shami

Objectives: (1) To evaluate the risk of malignancy in surgically removed ovarian cysts that was before the operation neither simple nor complex. (2) To determine the relationship of age with type of ovarian tumour. (3) To categorize the management of these cases according to the intra-operative findings. (4) To analyze the occurrence of various histopathological types of tumour. Date Source: Medline Study Design: Single centered prospective descriptive study of 150 cases. Place and Duration of Study: Department of Obstetrics and Gynaecology at Shaikh Zayed Hospital Lahore from 1st July 2005 to,31st December 2006. Subject and method: 150 patients presented with adnexal cysts on preoperative ultrasonography, peroperative findings and histopathology reports. These patients were followed up in OPD. Results: Showed the distribution of non-neoplastic and neoplastic tumours which were 84% and 16% respectively. The occurrence of malignancy increased with advancing age especially after 45 years Common presentations were lower abdominal pain (53%) followed by menstrual disturbances (30%), abdominopelvic mass, abdominal distension and infertility. Risk of malignancy also increased with parity. 73% masses were unilateral, 84% benign masses were unilocular whilst 85% malignant masses were echogenic and the complex cysts with papillary projection and multiloculations showed 3-6 times higher risk of malignancy. Most patients were managed by exploratory laparotomy. Cystectomy and total abdominal hysterectomy were the commonest procedures performed. Regarding histopathologic evaluation 40% patients had tumours, 2.66% borderline malignancy and 13.3% malignant. 44% had non-neoplastic lesions. Serous and endometriotic cysts were the commonest benign histopathologic types and among malignant ones, epithelial ovarian tumours were the leading variants. Conclusions: Preoperative characterization of adnexal masses using sonographic and demographic data may have considerable potential in determining risk of malignancy and may be advantageous in terms of counseling patients for management.


2016 ◽  
Vol 8 (3) ◽  
pp. 212-213
Author(s):  
Indu Lata ◽  
Deepa Kapoor

ABSTRACT Struma ovarii (SO) is a rare special type of monodermal teratoma of ovary that predominantly consists of thyroid tissue (> 50%). In only 5 to 20% of cases hyperthyroidism is seen due to functional SO. We are reporting here a case of unilateral benign cystic SO in a 50-year-old postmenopausal lady presented with pain and heaviness in lower abdomen without any signs and symptoms of hyperthyroidism. Pelvic ultrasonogram showed right side tubo-ovarian mass and was planned for laparotomy. In preoperative investigation subclinical hyperthyroidism was diagnosed. Abdominal exploration showed cystic mass lesion in right ovary. She underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Histopathological examination diagnosed the mass as benign cystic SO. Patient became euthyroid after surgical removal of tumor. How to cite this article Lata I, Kapoor D. A Rare Case of Functional Ectopic Hyperthyroidism: Struma Ovarii. World J Endoc Surg 2016;8(3):212-213.


Author(s):  
Lata Singh ◽  
Taru Gupta ◽  
Snigdha Kumari ◽  
Sangeeta Gupta

Fibroids are benign smooth muscle tumors. Large fibroids are known to arise from the uterus, but occasionally from the broad ligament.  Here, we report a case of true broad ligament fibroid which is rare and difficult to diagnose in a 57 year old postmenopausal women with a large mass of 24 weeks size gravid uterus. Patient presented with pain lower abdomen and mass in abdomen with no other co-morbidity. This broad ligament fibroid was mimicking as ovarian tumor on ultrasonography and MRI as left ovary was not visualised separately, thus leading to diagnostic dilemma of ovarian malignancy. Mass resection with total abdominal hysterectomy and bilateral salpingo-oopherectomy was performed. No local or distant metastasis observed, and Histopathology showed true broad ligament fibroid of left side weighing 3.57 kilograms.


Rare Tumors ◽  
2016 ◽  
Vol 8 (4) ◽  
pp. 179-181 ◽  
Author(s):  
Yi Guo ◽  
Eleanor Chen ◽  
Darin J. Davidson ◽  
Venu G. Pillarisetty ◽  
Robin L. Jones ◽  
...  

Uterine leiomyosarcoma is a rare and aggressive malignancy with poor overall prognosis. There have been few reports of metastatic leiomyosarcoma in the gallbladder. We report a case of a 41-year-old female who underwent total abdominal hysterectomy due to presumed uterine fibroids. The postoperative pathology revealed high-grade pleomorphic leiomyosarcoma, with involvement of the uterine serosal surface. She subsequently underwent exploratory laparotomy, followed by pelvic radiation and chemotherapy. Since initial management she has developed metastatic disease and has been under treatment and surveillance for 11 years. She has undergone multiple surgical procedures and numerous lines of systemic therapy for metastatic leiomyosarcoma, including cholecystectomy for a metastatic lesion in the gallbladder. There have been no previous reports of metastatic leiomyosarcoma in the gallbladder. Despite extensive metastatic disease this patient has had prolonged survival with multi-modality management.


Author(s):  
Dinesh Pal Yadav ◽  
Ramgopal Yadav ◽  
Indra Bhati

Background: Hysterectomy is the most common gynecological surgery done in the females worldwide as it provides definitive cure to a wide range of gynecological diseases, both benign and malignant. The indications to perform this major surgery should always be justified and the pathology should be proved histopathologically. Histopathological analysis and review is mandatory to evaluate the appropriateness of the hysterectomy.Methods: A retrospective, longitudinal study was conducted in the Department of Obstetrics and Gynecology, UMAID Hospital, Dr. S.N. M.C. Jodhpur (Raj.) during October 2014 to March 2015.Total 105 cases were studied during this period. The study included all women undergoing planned abdominal hysterectomy. Data was recorded on proformas, including demographic characteristics and clinical features. Hysterectomy specimens were saved in 10% formalin and sent to the Department of Pathology. Histopathology reports were analyzed and compared with the indications of surgery to draw various informative conclusions.Results: Of 105 cases, 55(52.38%) were in the age group of 41 – 50, which comprised the commonest age group undergoing the surgery. Maximum women (95%) those underwent hysterectomy were multiparous. Most common preoperatively clinical diagnosis was leiomyoma uterus which was diagnosed clinically and sonographically in 51(48.57%) cases. On Histopathological examination, the commonest pathology, similar to clinical impression, was found to be Leiomyoma at 50.48% (n = 53). Adenomyosis (21.90%) was detected as Second most common pathology. Histopathological confirmation of pre-operative diagnosis was 89% for malignancy, 96% for fibroids, 100% for adenomyosis, 100% for pelvic inflammatory disease.Conclusions: There was a high correlation when the clinical diagnosis was a fibroid, adenomyosis and ovarian mass. Every hysterectomy specimen should be subjected to histopathological examination because it is mandatory for conforming diagnosis and ensuring optimal management, in particular of malignant disease.


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