The Imaging and Pathological Features of Metastatic Leiomyosarcoma in the Gallbladder

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.

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A rare association of uterine leiomyoma with mesenteric vein thrombosis and bowel gangrene: case report

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20211167 ◽

2021 ◽

Vol 10 (4) ◽

pp. 1721

Author(s):

Rajneesh Rawat ◽

Manik Gedam ◽

Jyoti Baghel ◽

Shalini Baghel

Keyword(s):

Uterine Fibroid ◽

Uterine Fibroids ◽

Exploratory Laparotomy ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Mesenteric Vein Thrombosis ◽

Mesenteric Vein ◽

Vein Thrombosis ◽

Jejunoileal Anastomosis ◽

Bowel Gangrene

Uterine fibroids are the most common benign pelvic tumors in women. There are many complications reported with fibroids. However, mesenteric vein thrombosis and small bowel gangrene caused by a uterine fibroid are rare. This manuscript reports a rare case of 40 year female with a large uterine fibroid associated with mesenteric vein thrombosis and bowel ischemia. She underwent exploratory laparotomy in which resection of gangrenous bowel including jejunum and ileum was done along with left sided jejunostomy and right sided ileostomy. Total abdominal hysterectomy with bilateral salpingooophorectomy was done followed by jejunoileal anastomosis 6 weeks later. Hence, in patients presenting with acute abdomen and uterine fibroids, bowel gangrene must be included in the differential diagnosis.

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Large cervical fibroid: a rare case report

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20193577 ◽

2019 ◽

Vol 8 (8) ◽

pp. 3414

Author(s):

Sunanda N.

Keyword(s):

Uterine Fibroids ◽

Total Abdominal Hysterectomy ◽

Large Mass ◽

Abdominal Hysterectomy ◽

Reproductive Age ◽

Pelvic Tumors ◽

Rare Case Report ◽

Tender Mass ◽

Restricted Mobility ◽

Reproductive Age Group

Although leiomyomas are the most common pelvic tumors presenting in the reproductive age group, cervical fibroids are rare accounting for 2% of all uterine fibroids. We report a case of 40 year old lady presenting with a firm, non-tender mass of 22-24 weeks size pregnant uterus with restricted mobility. Laparotomy showed a large mass arising from the anterior lip of cervix, with a small uterus pushed posteriorly. Enucleation followed by total abdominal hysterectomy was done. Large cervical fibroids are rare, presenting with surgical difficulties. Careful dissection by expert hands is needed in the management of such cases.

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Current treatment of double hit and double expressor lymphoma

Hematology ◽

10.1182/asheducation-2017.1.295 ◽

2017 ◽

Vol 2017 (1) ◽

pp. 295-297 ◽

Cited By ~ 4

Author(s):

Patrick M. Reagan ◽

Andrew Davies

Keyword(s):

Cell Lymphoma ◽

B Cell Lymphoma ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Current Treatment ◽

Current Data ◽

Lymphoid Cells ◽

High Grade ◽

Computed Tomography Scans

Abstract A 60-year-old female presented with abdominal pain and distension. Following computed tomography scans of the abdomen and pelvis, she was taken urgently to the operating room, with the belief that she had appendicitis with perforation. At laparotomy, the findings were consistent with an ovarian carcinoma; there was extensive infiltration of the ovary, bowel, and omental deposits. Cytoreductive surgery was performed including total abdominal hysterectomy and bilateral salpingo-oophorectomy. The final pathology, however, revealed infiltration with medium-sized atypical lymphoid cells positive for CD20, CD10, MYC, BLC2, and BCL6 by immunohistochemistry. MYC and BCL2 translocations were identified by fluorescence in situ hybridization consistent with a diagnosis of high-grade B-cell lymphoma with rearrangements of MYC and BCL2. With the current data available, what is the optimal treatment of this patient?

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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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CLINICAL PROFILE AND MANAGEMENT OPTION OF FIBROID UTERUS PATIENTS OF OBSTETRICS AND GYNAECOLOGY DEPARTMENT OF DMCH, LAHERIASARAI, BIHAR

10.36106/ijsr/0137418 ◽

2020 ◽

pp. 1-2

Author(s):

Sangeeta Singh ◽

Renu Jha ◽

Seema Seema ◽

Debarshi Jana

Keyword(s):

Uterine Fibroids ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Management Options ◽

Fibroid Uterus ◽

Number Of Patients ◽

Study Results ◽

The Mean ◽

Benign Tumours ◽

Symptomatic Uterine Fibroid

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.

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Adenoid Basal Carcinoma of Cervix: A Rare Case Report

Nepalese Medical Journal ◽

10.3126/nmj.v3i2.35054 ◽

2020 ◽

Vol 3 (2) ◽

pp. 392-394

Author(s):

Alina Karna ◽

Nisha Sharma

Keyword(s):

Pap Smear ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Low Grade ◽

High Grade ◽

Squamous Intraepithelial Lesion ◽

Adenoid Cystic ◽

Carcinoma Of Cervix ◽

Rare Case Report ◽

Intraepithelial Lesion

Adenoid basal carcinoma of the uterine cervix is a rare low-grade tumor and its cell origin is still obscure. Adenoid basal carcinoma can be confused with adenoid basal hyperplasia, adenoid cystic carcinoma, and basaloid squamous cell carcinoma of the cervix. We present here a case of a 59 year-old-female who initially presented with a high-grade squamous intraepithelial lesion on Pap smear. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Histopathology revealed focal invasive adenoid basal carcinoma with extensive areas of a high-grade squamous intraepithelial lesion involving the endocervical gland. The immunohistochemical stain was positive for p16.

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ADENEXAL CYSTS

The Professional Medical Journal ◽

10.29309/tpmj/2011.18.01.1855 ◽

2011 ◽

Vol 18 (01) ◽

pp. 32-40

Author(s):

TEHREEN RIAZ ◽

SARWAT JABEEN ◽

WASEEM TALIB ◽

Nabeela Shami

Keyword(s):

Demographic Data ◽

Lower Abdominal Pain ◽

Abdominal Distension ◽

Exploratory Laparotomy ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Ovarian Tumour ◽

Risk Of Malignancy ◽

Histopathologic Evaluation ◽

Operative Findings

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.

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Delayed presentation of giant uterine fibroids in a Nigerian private specialist health facility

SAGE Open Medical Case Reports ◽

10.1177/2050313x211063137 ◽

2021 ◽

Vol 9 ◽

pp. 2050313X2110631

Author(s):

Joseph Ifeanyichukwu Ikechebelu ◽

Boniface Chukwuneme Okpala ◽

George Uchenna Eleje ◽

Cyril Emeka Nwachukwu ◽

Louis Anayo Nwajiaku ◽

...

Keyword(s):

Low Income ◽

Uterine Fibroids ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Low Income Countries ◽

Delayed Presentation ◽

Abdominal Drain ◽

Abdominal Myomectomy ◽

Major Operation ◽

Private Specialist

Giant uterine fibroids (leiomyoma or myomas) which are fibroid masses greater than 11.4 kg are very rare. Although benign in nature, it may present with symptoms that impact negatively on the quality of life and health of the patient and impose greater management challenges. We present two cases of giant uterine fibroids that were successfully managed in a private specialist hospital without complications. Case 1 was a 38-year-old nulliparous Nigerian woman who presented with giant uterine fibroids (11.6 kg) who initially had delay of surgery due to fear that after surgery she may lose her “womb” or not be able to conceive after the operation. Later, she had successful open abdominal myomectomy, with the use of Foley catheters as improvise equipment for tourniquet and abdominal drain. Anti-adhesion agent was not used. Case 2 was a 47-year-old nulliparous Nigerian teacher with giant fibroids (13.2 kg) who also initially had delayed surgery due to fear that fibroid surgery is a major operation that it may get complicated and she may die. Also, she was afraid that she may not have her womb in her next world if she gets reincarnated. She had total abdominal hysterectomy and bilateral salpingo-oophorectomy without complications. For both cases, pre-surgery leiomyosarcoma assessment with computed tomography scan or magnetic resonance imaging and anti-adhesion agent were not used due to very unaffordable high costs. These reports of giant uterine fibroids (leiomyoma or myomas) are very rare gynecological entity, and management can be successful despite overwhelming challenges in low-income countries. Cheaper, affordable and available alternatives (improvises) can be resorted to for tackling its challenges in low-income settings.

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Degenerated fibroid: a diagnostic dilemma

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20201265 ◽

2020 ◽

Vol 9 (4) ◽

pp. 1766

Author(s):

Nayanika Gaur ◽

Manish Jha

Keyword(s):

Histopathological Examination ◽

Exploratory Laparotomy ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Cystic Degeneration ◽

Ovarian Malignancy ◽

Imaging Studies ◽

Diagnostic Dilemma ◽

Fibroid Uterus ◽

Wide Range

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.

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