scholarly journals Vaginal Leiomyoma: A Case Report

2021 ◽  
Vol 59 (237) ◽  
Author(s):  
Miki Shah ◽  
Rachana Saha ◽  
Niranjan KC

Leiomyomas are common benign tumors of the uterus, affecting 20-30% of women of reproductive age group. But vaginal leiomyomas remain an uncommon entity with only about 300 reported cases. The first case was described in 1733. Only a few cases have been reported in Nepal to date. Tumors are thought to arise from Mullerian smooth muscle cells in the sub-epithelium of the vagina. Vaginal leiomyomas are usually situated in the anterior vaginal wall. Here, we report a case of a 48-year old multipara who presented the outpatient department with the ultrasonographic report showing multiple uterine fibroids but was asymptomatic. A physical examination showed a mass in the right vaginal wall. Pervaginal removal of the tumor was performed and subsequent histopathology revealed a vaginal leiomyoma. Removal of the tumor by the vaginal route, wherever possible, with the subsequent histopathological examination, appears to be the optimum management plan.

2015 ◽  
Vol 12 (3) ◽  
pp. 219-221
Author(s):  
D Mallick ◽  
M Saha ◽  
S Chakrabarti ◽  
J Chakraborty

Tumors of the broad ligament are uncommon. Leiomyoma, which is the commonest female genital neoplasm, is also the most common solid tumor of the broad ligament. Leiomyomas affect 30% of all women of reproductive age but the incidence of broad-ligament leiomyoma is <1%. These benign tumors are usually asymptomatic. A case is being described where a 52 year old presented with gradual abdominal swelling which was clinically and radiologically diagnosed as ovarian malignancy. On abdominal and bimanual palpation a soft cystic mass was noted in the right pelvic region. CA 125 was mildly raised. CEA, CA 19.9 levels were within normal limit. The radiological diagnosis was ovarian cyst with possibility of malignant changes. Staging laparotomy and histopathological examination of the resected specimen revealed a right sided broad ligament leiomyoma with cystic changes. The degenerative changes in the leiomyoma lead to the clinical and radiological diagnostic confusion. Thus, though uncommon, broad ligament leiomyoma should be considered during evaluation of adnexal masses for optimal patient management. The above description of leiomyoma in the broad ligament is a highly unique case and thus deserves appropriate attention.Kathmandu University Medical Journal Vol.12(3) 2014; 219-221


2019 ◽  
Vol 48 ◽  
Author(s):  
Andréia Vitor Couto de Amaral ◽  
Francine Mucha ◽  
Igor Borges De Oliveira ◽  
Camila Franco De Carvalho ◽  
Wanessa Ferreira De Ataide ◽  
...  

Background: Canine transmissible venereal tumor (CTVT) is a peculiar neoplasm resulting from the transmission of host cancerous cells to another canid by implantation. Transmission occurs among reproductive age dogs, especially those with unrestricted sexual activity. It usually occurs on the external genitalia of dogs and other areas are unusual. However, implants have been described in injured mucosa, as well as metastases in lymph nodes, spleen, skin, anus and perianal space, oral mucosa, nasal mucosa, eyeball and brain. The purpose of this report is to describe the first case of exclusively extragenital ocular CTVT in a prepubescent female dog.Case: A 6-month-old mixed-breed, non-spayed and prepubescent female dog, showing a fast-growing reddish-colored mass in the right eye (RE), was examined. Blepharospasm, mild serosanguineous secretion, chemosis and a smooth surface reddish mass with 2.5 cm in length occupying the orbital area were observed during physical examination, impairing the visualization of the right eyeball. For ocular ultrasonography examination of the affected eye, acepromazine was used (0.03 mg/kg) associated with methadone (0.3 mg/kg) intramuscularly, and propofol (4 mg/kg) for induction and 0.2 mg/kg for maintenance, intravenously. Ultrasonography examination evidenced an amorphous hyperechogenic structure, medial to the RE, with homogeneous echotexture, punctiform vascularization to amplitude Doppler (Power Doppler), measuring 2.8 cm in length and 1.4 cm in diameter, causing eyeball distortion and rejection. Based on ultrasonography results and with the patient still anesthetized, an incisional biopsy of the peribulbar mass was performed with a 5 mm disposable punch. The final CTVT diagnosis was possible after histopathological analysis. No more CTVT nodules were found, especially in the vulva, which had a prepubescent appearance, consistent with age. Treatment with 4 sessions of chemotherapy with vincristine sulfate resulted in complete remission of the tumor mass. In the second session, it was already possible to visualize the eyeball with a significant remission of the tumor mass, ruling out neoplastic exceresis. At this time, threat response, normal direct and consensual photopupillary reflexes, normal eyelid reflex, corneal surface without slit lamp biomicroscopy and fluorescein staining were present in the RE. Nevertheless, there were mild diffuse corneal edema and slight ciliary injection. One percent prednisolone eye drops (8/8 h) and tobramycin eye drops (6/6 h) were prescribed for 1 week. In the fourth session of chemotherapy, no changes were observed in the RE.Discussion: In the present case, the diagnosis of CPVD in a prepubertal patient, primary orbital TVTV, and the fact that the structure of the eye bulb and visual function remain intact, even with the significant volume of orbital neoplasia, are highlighted. A single report of skin CTVT in an 11-month-old prepubescent female dog was found. It is important to emphasize that CTVT is typically of dogs of reproductive age that have genital masses. Usually, extragenital masses are related to the act of licking, scratching, biting or sniffing the primary tumor (self-implantation), or rarely, by metastasis, a fact not observed in the present report, since the ocular mass was the only manifestation. Treatment was conducted according to indications of the literature. Four injections of vincristine sulfate were necessary, observing complete remission of the tumor mass with no relapse after 30 days. In this case report, it was possible to observe that CTVT may reveal unusual behaviors regarding epidemiology, which, added to the rare form of exclusively extragenital ocular clinical manifestation, impose a diagnostic challenge, making the histopathological examination an important tool for diagnosis.


2019 ◽  
Vol 47 (05) ◽  
pp. 360-364
Author(s):  
Bettina Habenbacher ◽  
Anna M. Adrian ◽  
Pieter Nelissen

AbstractA 2.5-year-old spayed female Siamese cat was presented with a recurrent exudative wound in the right perirectal fossa. Clinical examination at presentation revealed a 1 cm long open wound with purulent discharge in the right perirectal fossa but was otherwise unremarkable. A computed tomography contrast-enhanced study showed a tracking sinus which could be traced from the right dorsolateral perianal region right up to the level of the vagina. Surgical exploration was performed from the perirectal region. The intermuscular sinus tract, which formed a cystic structure and connected to the vaginal wall, was en bloc excised. Histopathological examination confirmed the diagnosis of a dermoid sinus in the perirectal fossa with vaginal infiltration. To the authors’ knowledge, this is the first case report in the veterinary literature of the successful surgical management of a dermoid sinus in the perianal region connected to the vaginal wall in a cat.


2019 ◽  
Vol 2019 ◽  
pp. 1-4 ◽  
Author(s):  
Chuchu Arega ◽  
Wubshet Girma ◽  
Jose Manuel Sanchez Diaz

Background. Angiofibroma is an uncommon type of vascular benign tumor that is made up of blood vessels and fibrous (connective) tissue. First described in 1997, it usually occurs in middle aged females and is clinically often thought to represent a cyst. Unlike most of the other site specific vulvovaginal mesenchymal lesions, cellular angiofibroma has a marked predilection for the vulva with only occasional examples reported in the vagina. Case Detail. A 17-year adolescent nulligravid girl presented with a history of irregular vaginal bleeding of two-year duration and history of lower abdominal swelling; on examination, she had pale conjunctiva, 20-week sized firm, irregular, nontender abdominopelvic mass, and a firm huge anterior vaginal wall mass, with difficulty to reach at the cervix and hemoglobin of 9.7 gm/dL, and a diagnosis of cervical myoma plus anemia was made, which was supported by imaging studies. Finally it was found to be angiofibroma of the vagina. Conclusion. Angiofibromas are benign tumors, which rarely occur in vagina. Although middle aged females are affected more, angiofibromas can affect females of reproductive age group and can cause abnormal uterine bleeding.


2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Sarantis Blioskas ◽  
Sotiris Sotiriou ◽  
Katerina Rizou ◽  
Triantafyllia Koletsa ◽  
Petros Karkos ◽  
...  

Plexiform neurofibromas are benign tumors that tend to occur in patients suffering from neurofibromatosis type 1 (NF-1). This report addresses a rare case where the tumor affected the parotid gland, deriving almost exclusively from the peripheral portion of the facial nerve. A 6-year-old male was referred to us complaining about a gradually enlarging swelling over the right parotid area. Imaging localized the lesion to the superficial lobe of the parotid gland, suggesting a neurofibroma. Cosmetic disfigurement and a functional deficit led us to perform complete surgical resection. Meticulous surgical dissection as well as auriculotemporal nerve origin made complete extirpation possible with almost zero morbidity and ensured alleviation of both aesthetic impairment and pain. This is the first case of an intraparotid PN in a pediatric NF-1 patient, which originated from branches of the auriculotemporal nerve and particularly from fibers of the autonomic nervous system. Radical surgical excision was decided according to established decision-making algorithms.


2019 ◽  
Vol 11 (3) ◽  
pp. 89-93
Author(s):  
Yohanes Widjaja ◽  
Khairuddin Djawad ◽  
Saffruddin Amin ◽  
Widyawati Djamaluddin ◽  
Dirmawati Kadir ◽  
...  

Abstract Introduction. Leprosy is a disease that predominantly affects the skin and peripheral nerves, resulting in neuropathy and associated long-term consequences, including deformities and disabilities. According to the WHO classification, there are two categories of leprosy, paucibacillary (PB) and multibacillary (MB). The standard treatment for leprosy employs the use of WHO MDT (Multi Drug Treatment) regimen, despite its multiple downsides such as clofazimine-induced pigmentation, dapsone-induced haematological adverse effects, poor compliance due to long therapy duration, drug resistance, and relapse. Multiple studies and case reports using ROM regimen have reported satisfactory results. Nevertheless, there are still insufficient data to elucidate the optimum dosage and duration of ROM regimen as an alternative treatment for leprosy. Previous experience from our institution revealed that ROM regimen given three times weekly resulted in a satisfactory outcome. Case Reports. We report two cases of leprosy treated with ROM regimen from our institution. The first case was PB leprosy in a 64-year-old male who presented with a single scaly plaque with erythematous edge on the right popliteal fossa. Sensibility examination showed hypoesthesia with no peripheral nerve enlargement. Histopathological examination confirmed Borderline Tuberculoid leprosy. ROM regimen was started three times weekly for 6 weeks and the patient showed significant clinical improvement at the end of the treatment with no reaction or relapse until after 6 months after treatment. The second case was MB leprosy in a 24-year-old male patient with clawed hand on the 3rd-5th phalanges of the right hand and a hypoesthetic erythematous plaque on the forehead. Histopathology examination confirmed Borderline leprosy. The patients received ROM therapy 3 times a week with significant clinical improvement after 12 weeks. Conclusion. ROM regimen given three times weekly for 6 weeks in PB leprosy and 12 weeks in MB leprosy resulted in a significant clinical improvement. Thus, ROM regimen could be a more effective, safer, faster alternative treatment for leprosy.


Author(s):  
Manpreet Kaur ◽  
Rajiv Kamal Gupta ◽  
Simrat Jit Kaur ◽  
Panchampreet Kaur

Background: Leiomyomas are benign tumors of smooth muscle cells commonly encountered in women of reproductive age group. Aim of this study was to conduct a histopathological study of leiomyomas in hysterectomy specimens and to correlate them with clinical findings.Methods: A prospective study was done on 130 hysterectomy specimens clinically diagnosed as leiomyoma. The specimens were subjected to histopathological examination.Results: In this study, the most common age group was 31-50 years (87.69%). Most common complaint was menorrhagia (51.54%). In endometrium, the most common histopathological diagnosis was proliferative phase (46.15%) followed by endometrial hyperplasia (19.23%). The most common secondary change was hyalinization and the most common site was intramural (62.9%).Conclusions: Hysterectomy is a commonly performed procedure in the management of uterine leiomyomas. The ultimate diagnosis and prognosis depends on the histopathological examination; therefore, every operated specimen must be subjected to histopathology. 


2019 ◽  
Author(s):  
Alice Luddi ◽  
Camilla Marrocco ◽  
Laura Governini ◽  
Bianca Semplici ◽  
Valentina Pavone ◽  
...  

Abstract STUDY QUESTION Are selective markers for the neuronal differentiation such as microtubule-associated protein 2 (MAP-2) and synaptophysin (SYP) as well as the nerve growth factor (NGF) expressed by fibroids, myometrium and eutopic endometrium? SUMMARY ANSWER Neuronal markers NGF, MAP-2 and SYP are highly expressed in fibroids compared with matched myometrium, and this neurogenic pathway is upregulated by tumor necrosis factor (TNF) alpha in cultured smooth muscle cells (SMCs). WHAT IS KNOWN ALREADY Uterine fibroids or leiomyomas are the most common benign tumors, accounting for approximately one-third of hysterectomies. The present trend is to improve the medical treatment avoiding surgery, also for fertility sparing; hence, the pathogenic mechanisms are investigated, aiming to develop new therapeutic strategy. STUDY DESIGN, SIZE, DURATION This laboratory-based case–control study is focused on fibroids and myometrial specimens obtained between 2015 and 2017 from 15 women of reproductive age at the proliferative phase of the menstrual cycle. Leiomyomas, matched myometrium and endometrium from each woman were analyzed. Control endometrium was obtained from women undergoing surgery for ovarian cyst (n = 15). PARTICIPANTS/MATERIALS, SETTING, METHODS qRT-PCR, western blotting and immunostaining were applied to evaluate the expression of neurogenic markers; the effects of TNF on NGF, MAP-2 and SYP expression in cultured SMCs from leiomyomas and matched myometrium were analyzed. MAIN RESULTS AND THE ROLE OF CHANCE qRT-PCR analyses using tissues from clinical patients showed that the levels of NGF, MAP-2 and SYP mRNA were significantly higher in uterine leiomyomas compared with their matched myometrium (P < 0.05), whereas only NGF was significantly increased in eutopic endometrium compared with healthy endometrium. In primary SMCs, isolated from fibroids or from the adjacent myometrium, NGF, MAP-2 and SYP mRNA expression were significantly increased by TNF treatment (P < 0.05). Finally, human endometrial stromal cells prepared from the endometrium of patients affected by uterine fibroids display higher TNF expression (P < 0.001). LIMITATIONS, REASONS FOR CAUTION qRT-PCR analysis and immunofluorescence validation are robust methods demonstrating a clear upregulation of neurogenic factors in leiomyomas, even though additional studies are needed to establish a correlation between increased neuronal gene expression and degree of pain, as well as the involvement of inflammation mediators in the development of the neurogenic unhinge. Therefore, more in vivo studies are needed to confirm the results achieved from primary cultured SMCs. WIDER IMPLICATIONS OF THE FINDINGS The increased expression of neurogenic factors in uterine fibroids and endometrium may contribute to explain the painful stimuli. Accordingly, these neurogenic pathways may represent potential therapeutic avenues to treat the fibroid-related disorders. STUDY FUNDING/COMPETING INTEREST(S) This study was supported by research grants from the University of Siena. The authors declare no conflict of interest. TRIAL REGISTRATION NUMBER N/A.


2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Luca Giovanella ◽  
Fabrizio Fasolini ◽  
Sergio Suriano ◽  
Luca Mazzucchelli

A 68-year-old woman with solid/trabecular follicular thyroid carcinoma inside of an autonomously functioning thyroid nodule is described in this paper. The patient was referred to our clinic for swelling of the neck and an increased pulse rate. Ultrasonography showed a slightly hypoechoic nodule in the right lobe of the thyroid. Despite suppressed TSH levels, the -pertechnetate scan showed a hot area corresponding to the nodule with a suppressed uptake in the remaining thyroid tissue. Histopathological examination of the nodule revealed a solid/trabecular follicular thyroid carcinoma. To the best of our knowledge, this is the first case of hyperfunctioning follicular solid/trabecular carcinoma reported in the literature. Even if a hyperfunctioning thyroid carcinoma is an extremely rare malignancy, careful management is recommended so that a malignancy will not be overlooked in the hot thyroid nodules.


2010 ◽  
Vol 46 (2) ◽  
pp. 138-142 ◽  
Author(s):  
Marjorie E. Milne ◽  
Christina McCowan ◽  
Ben P. Landon

Spontaneous pneumothorax is rarely reported in the cat. This case report describes the use of computed tomography (CT) to diagnose pulmonary bullae in an adult cat with recurrent spontaneous pneumothorax. A large bulla in the right middle lung lobe and several blebs in other lobes were identified by CT. Partial lobectomy of the right middle and right and left cranial lung lobes was successfully performed to remove the affected portions of lung. Histopathological examination suggested bronchopulmonary dysplasia (BPD) as the underlying cause for development of the pulmonary bulla. This is the first case report in the veterinary literature describing the use of CT to identify pulmonary bullae in the cat with BPD as a possible underlying cause.


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