scholarly journals Cystic pelvi-abdominal mass in pregnancy: An uncommon presentation of a subserosal leiomyoma

2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Natasha Sobey ◽  
Lauren Raubenheimer
Keyword(s):  
Abdominal Mass ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Ovarian Tumour ◽  
Imaging Findings ◽  
Diagnostic Challenge ◽  
Diagnostic Dilemma ◽  
Diagnostic Uncertainty ◽  
Histopathological Correlation ◽  
Uncommon Presentation

Uterine leiomyomas are common benign neoplasms. While generally easily diagnosed, variations in size and type of degeneration can drastically alter the imaging findings and result in diagnostic uncertainty. We present the case of a 34-year-old female with a large, cystic, pelvi-abdominal mass that was discovered in advanced pregnancy and misdiagnosed as an ovarian tumour. Intra-uterine demise of a viable foetus during an induction of labour and clinical deterioration necessitated further imaging and emergent surgical intervention. Further imaging, intra-operative findings and histopathological correlation revealed a pedunculated uterine leiomyoma with hyaline degeneration and areas of necrosis, complicated by left ovarian vein thrombosis. In addition to the intra-uterine demise, the unfortunate outcome included a total abdominal hysterectomy and unilateral salpingo-oophorectomy in a young patient. Typical leiomyomas are easily detected with imaging, however the varied clinical presentation and imaging findings in degenerating leiomyomas can prove a diagnostic challenge. This case describes a rare manifestation of a common condition and its subsequent diagnostic dilemma resulting in dire foeto-maternal outcomes.

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

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.

scholarly journals ADENEXAL CYSTS

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.

scholarly journals True broad ligament fibroid mimicking ovarian mass in a postmenopausal woman

2019 ◽  
Vol 8 (7) ◽  
pp. 2910
Author(s):  
Lata Singh ◽  
Taru Gupta ◽  
Snigdha Kumari ◽  
Sangeeta Gupta
Keyword(s):  
Broad Ligament ◽  
Total Abdominal Hysterectomy ◽  
Large Mass ◽  
Abdominal Hysterectomy ◽  
Gravid Uterus ◽  
Ovarian Mass ◽  
Lower Abdomen ◽  
Diagnostic Dilemma ◽  
Co Morbidity ◽  
Smooth Muscle Tumors

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.

scholarly journals Degenerated fibroid: a diagnostic dilemma

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.

scholarly journals Uterine Myoma: A Profile of Nepalese women

1970 ◽  
Vol 1 (2) ◽  
pp. 47-50
Author(s):  
Pramila Pradhan ◽  
Nitish Acharya ◽  
Binit Kharel ◽  
Manoj Manjin
Keyword(s):  
Abdominal Mass ◽  
College Teaching ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Early Marriage ◽  
Early Completion ◽  
Medical College ◽  
Underlying Risk Factor ◽  
The Mean ◽  
Myoma Uteri

Objectives: To determine the most common age and parity for the development of myoma uteri. To find out any relation between age of the last child and the development of myoma uteri. To determine the treatment protocal and outcome of treatment. Materials/methods: This study was carried out at Nepal Medical College Teaching Hospital from Jan 2001 to 31st June 2006. All cases of myoma uteri admitted in Gynaecological ward was included.. Histological evidence of myoma confirmed the diagnosis. Age, parity and age of the last child, clinical features, surgical procedures and outcome of surgery were considered. Results: A total of 137 cases of myoma uteri was operated during five and half years period. This represented 38.5 %of all abdominal hysterectomy performed during the same period. The mean age was 43.3 years with median parity at 1-3 and the mean age of last child at 12years. Excessive menstrual bleeding 73.0%, abdominal mass and pain 58.4%, dysmenorrhea 18.2% and infertility 7.3% were the common symptoms. Total abdominal hysterectomy was the mainstay of treatment. Patients were happy with the treatment specially those with severe and multiple symptoms Postoperative complications were not significant. There was one death due to pulmonary embolism who had mesothelioma of pleura diagnosed by pleural biopsy before operation. Conclusion: Early marriage and early completion of the family is the social trend in Nepalese society. Myoma is common in 4th-5th decade of life in multi parity with the age of last child around 12years. This long standing secondary infertility may be an underlying risk factor in the development of myoma uteri.   doi:10.3126/njog.v1i2.2397 N. J. Obstet. Gynaecol Vol. 1, No. 2, p. 47-50 Nov-Dec 2006   

Extrauterine endometrial stromal sarcoma arising in a background of endometriosis following prior total abdominal hysterectomy

2018 ◽  
Vol 10 (3) ◽  
pp. 133-135
Author(s):  
Jonathan Chapman ◽  
Blake Bartholomew ◽  
Sayf Al-Katib
Keyword(s):  
Endometrial Stromal Sarcoma ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Imaging Findings ◽  
Stromal Sarcoma

This article describes a case of endometrial stromal sarcoma arising in a background of endometriosis presenting several years after total abdominal hysterectomy. Discussion of endometrial stromal sarcoma ensues as well as review of pertinent imaging findings.

scholarly journals Ovarian dysgerminoma: a case report

2021 ◽  
Vol 10 (4) ◽  
pp. 1704
Author(s):  
Shamrao Ramji Wakode ◽  
Varsha Narayana Bhat
Keyword(s):  
Young Women ◽  
Ovarian Neoplasms ◽  
Abdominal Mass ◽  
Total Abdominal Hysterectomy ◽  
Malignant Tumour ◽  
Abdominal Hysterectomy ◽  
Tumour Mass ◽  
Mesenteric Lymph ◽  
Beta Hcg ◽  
Ovarian Dysgerminoma

An ovarian dysgerminoma is a rare, malignant tumour occurring in young women, accounting for 1% to 2% of all primary ovarian neoplasms. A 22 years old female presented with 6 months of amenorrhea and lump in the abdomen. Her physical examination was remarkable with 36 weeks sized huge abdominal mass. Subsequent computed tomography revealed 22×23×32.4 cm mixed density lesion in pelvi-abdominal region and multiple paraaortic and mesenteric lymph node with gross pleural effusion. On further evaluation raised beta-hcG and LDH were noted and hence dysgerminoma was suspected. Total abdominal hysterectomy with right salpingo-ophorectomy with resection of tumour mass with partial omentectomy and lymphadenectomy was performed. Histopathology reports were suggestive of dysgerminoma. 

scholarly journals Synchronous Choriocarcinoma and Epithelioid Trophoblastic Tumor Concurring at the Cesarean Scar: A Case Report and Review of the Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Chunyan Zeng ◽  
Shadi Rezai ◽  
Alexander C. Hughes ◽  
Cassandra E. Henderson ◽  
Juan Liu
Keyword(s):  
Inguinal Lymph Node ◽  
Abdominal Mass ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Lymph Node Biopsy ◽  
Review Of The Literature ◽  
Cesarean Scar ◽  
Node Biopsy ◽  
Epithelioid Trophoblastic Tumor ◽  
Bilateral Salpingectomy

We present a complicated case of recurrence of gestational trophoblastic neoplasms (GTN), mixed ETT and choriocarcinoma at an abdominal cesarean scar. This tumor consisted of typical morphologic and immunophenotypic features of ETT and choriocarcinoma. The tumor recurred despite the patient undergoing chemotherapy. The patient had this abdominal mass resected three times. The elements of ETT and coexisting choriocarcinoma varied each time. Due to re-recurrence of the tumor, the following decisions had been made: total abdominal hysterectomy, bilateral salpingectomy, right-sided inguinal lymph node biopsy. At the time of this report, recurrence was negative.

scholarly journals A case report on an unusual degeneration of uterine leiomyoma: Myxoid degeneration

2018 ◽  
Vol 7 (4) ◽  
pp. 185-186
Author(s):  
Rupa Paneru ◽  
Meena Thapa
Keyword(s):  
Case Report ◽  
Uterine Leiomyoma ◽  
Abdominal Mass ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
The Body ◽  
Cystic Degeneration ◽  
Dystrophic Calcification ◽  
Cystic Area ◽  
Myxoid Degeneration

Background: Leiomyomas are benign smooth muscle neoplasm that typically occurs from the myometrium. Most of the women with uterine leiomyoma remain asymptomatic. Various degeneration including hyaline, cystic, myxoid and red degeneration and dystrophic calcification occur in leiomyoma, among them myxoid degeneration occurs rarely. Here is a case report of 40 years with one living child and two abortions who came with complaints of feeling of heaviness and pain at lower abdomen for six months, palpable lower abdominal mass for four months and difficulty in passing urine since 15 days. Multiple fibroids with cystic degeneration were suspected in Computed Tomography scan report. The patient underwent Total Abdominal Hysterectomy with Bilateral Salphingectomy. On cut section there was a cystic area on the body of uterus containing 1. 1 liter of straw coloured fluid. Final histopathological findings concluded multiple leiomyoma with myxoid degeneration.

scholarly journals Ovarian Adult Granulosa Cell Tumor – a rare case report

2018 ◽  
Vol 13 (1) ◽  
pp. 57-60
Author(s):  
Rijuta Joshi ◽  
Gehanath Baral ◽  
Karishma Malla
Keyword(s):  
Granulosa Cell ◽  
Abdominal Mass ◽  
Granulosa Cell Tumor ◽  
Total Abdominal Hysterectomy ◽  
Late Recurrence ◽  
Abdominal Hysterectomy ◽  
Cell Tumor ◽  
Rare Case Report ◽  
Stage Ia ◽  
Post Menopausal

Introduction: Adult granulosa cell tumor is a rare tumor which accounts for 1% of all ovarian tumors.  They usually present with postmenopausal bleeding and abdominal mass. Inhibin is used as the tumor marker.Case: A 76 years multiparous post-menopausal women presented with vaginal bleeding for past three years and  painless  huge mass in lower abdomen.  She underwent total abdominal hysterectomy with bilateral salphingo-oophorectomy with bilateral pelvic lymphnode dissection with appendectomy. Histopathology showed the adult granulosa cell tumor with few mitosis, Stage IA. Her postoperative period was uneventful.Conclusion: Surgery is the mainstay of treatment of granulosa cell tumor and chemotherapy is indicated in advanced cases. Although they have better prognosis, life-long follow up is advised to detect late recurrence.

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