Huge Leiomyoma Research Articles

Neglected case of a huge leiomyoma in an elderly postmenopausal woman: a case report

BackgroundFibroids are benign tumors of the female reproductive tract originating from the myometrial smooth muscle cells. They are a frequent occurrence in women of childbearing age but their incidence is rare after menopause. In addition, there is a remote possibility of malignant transformation to leiomyosarcoma in less than 1% of cases.Case presentationWe hereby report a case of large fibroid in a postmenopausal Indian female with rapid growth, raising the suspicion of malignant transformation into leiomyosarcoma. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Histopathology report confirmed it to be benign leiomyoma without any evidence of neoplasia.ConclusionSudden enlargement of leiomyoma in postmenopausal women should not be ignored due to possible malignant transformation and is to be dealt immediately with hysterectomy followed by histopathology.

Successful Application of Manual Hand Morcellation Technique in Giant Leiomyoma: A Case Report

Introduction: Uterine leiomyoma is the most common benign neoplasm of the female reproductive tract. However, he use of the laparoscopy approach for giant myomas is still controversial and rarely performed. Only few cases have been published in the literature. Retrieval of giant myoma in laparoscopy is difficult and still challenging even by a power morcellator.
 Case presentation: A 39 years old para 3 woman was referred to the gynaecology department with abdominal swelling during the previous 3 years. No family history, past medical and gynaecology history disease was reported. A physical examination revealed a firm huge palpable abdominal mass with identifiable borders. The mass extended to her umbilicus. The abdominal ultrasound revealed a markedly enlarged and lobular uterus containing intramural uterine leiomyoma measuring 15 x14 cm without ascites. No additional pathology was noted. The results of the laboratory examination were within normal limit. She was offered laparoscopy removal of myoma.
 Conclusion: The case concludes the efficiency, reliability, and safety of laparoscopy surgery to treat huge leiomyoma and try to consider manual hand morcellation to remove the entire myoma to reduce spreading malignancy through electrical morcellation. Although a laparoscopic approach for a huge myoma has several challenges, it does represent an option for minimally invasive removal of giant myoma.
 Keywords: Giant leiomyoma, Laparoscopy, Leiomyoma, Morcellation, Manual morcellation

Magnetic Resonance Imaging-Guided Focused Ultrasound Surgery for Patients with Multiple Leiomyomas and/or Huge Leiomyoma

Magnetic Resonance Imaging-Guided Focused Ultrasound Surgery for Patients with Multiple Leiomyomas and/or Huge Leiomyoma

MRI-guided High-intensity Focused Ultrasound As An Alternative Treatment Option For Multiple Leiomyomas And Huge Leiomyomas

High-intensity focused ultrasound surgery is a potential non-invasive surgery for eliminating leiomyoma. In this short communication, we introduced an alternative role of this method for cases of multiple leiomyomas and huge leiomyomas with effective outcomes along with the pros and cons of these findings.

Vaginal myomectomy of a huge prolapsed cervical leiomyoma

Cervical myomas arise from the smooth muscle cells of the cervix accounting for 2% of all uterine leiomyomas. This is a case report of a 31-year-old lady who presented with a white, watery vaginal discharge, and a 6-hour history of protrusion per vaginam. Examination revealed a progressively increasing mass protruding per vaginam. She underwent a vaginal myomectomy, and a leiomyoma 13 × 12 × 7 cm with areas of necrosis was removed. She did well postoperatively. Vaginal myomectomy is an effective procedure for patients with huge leiomyomas.

Endoscopic submucosal tunnel dissection for a large esophageal subepithelial leiomyoma to prevent postprocedural stenosis

Summary A 27-year-old man with a huge esophageal leiomyoma, 4.5 cm in size, at the distal esophagus suffered from postprandial belching and chest discomfort. Endoscopic submucosal tunnel dissection was implemented to resect his leiomyoma. His symptoms resolved after tumor resection without any sequelae, such as luminal stricture that often occurs after large-size esophageal lesion resection. Endoscopic submucosal tunnel dissection has been reported to be a useful method for the resection of esophageal submucosal tumors; however, such large-size tumors are rare.

Recurrent huge leiomyoma of the urethra in a female patient: A case report.

Urethral leiomyoma is an extremely rare condition that arises from the smooth muscle of the urethra. To the best of our knowledge, there is only a single reported recurrence treated by a repeat excision in the literature to date. The present study reports an exceptionally rare case of a recurrent huge leiomyoma of the female urethra. The 47-year-old female was diagnosed with a huge mass located between the urethra and vagina during a gynecological examination. The patient had no symptoms and was successfully treated with transabdominal excision. Pathological examinations revealed a leiomyoma of the urethra. The patient was followed up for one year without any sign of recurrence.

Elective cesarean myomectomy: A report of two cases

Myomectomy at the time of cesarean section has traditionally been discouraged due to the risks of hemorrhage and increased postoperative morbidity. However with the new frontiers in surgical practice, successfully performed cesarean myomectomies in selected patients has continuously been reported. Two cases of multiple uterine leiomyoma coexisting with pregnancy were selected, counseled, and had elective cesarean myomectomy. The first patient was a 38-year-old primigravida with 22 years history of subfertility. Her antenatal period was largely uneventful. Her evaluation revealed a singleton pregnancy coexisting with multiple uterine fibroid. At 38 weeks of gestation, she had cesarean section and myomectomy. Thirty-six seedlings were removed. The largest was 12 Χ 8 cm and she lost 1 L of blood. She was discharged home on the 8 th postoperative day in good condition. The second case was a 33-year-old primigravida who was diagnosed with uterine fibroid in pregnancy. She also had an uneventful antenatal care and at 38 weeks gestational age, she had the removal of a huge intramural leiomyoma from the lower uterine segment (12 Χ 14 cm) during cesarean section to get access to the baby. She lost 1.2 L of blood and was transfused two pints of blood. Her postoperative condition was satisfactory. She was discharged home on the 7 th postoperative day. Cesarean myomectomy can be successfully performed with careful planning, patient selection, and skillful surgery. However, blood transfusion services should be available.

A case of intravascular leiomyomatosis extending to inferior vena cava, right heart, and pulmonary artery

Intravascular leiomyomatosis is a rare entity of benign smooth muscle tumor invading into the lumen of veins. Although these tumors are histologically benign they sometimes extend into the cardiac cavity and can cause sudden death due to their incarceration into the artrioventricular orifice. We present a case of the intravascular leiomyomatosis originating from huge leiomyoma in the pelvic cavity and extending to the ovarian veins, the inferior vena cava, the right atrium, the right ventricle and the pulmonary artery. She underwent surgery by a single-stage o including laparotomy and venotomy without thoracotomy, and the tumor was successfully removed. Therefore, we report this case with a brief review of the literature.

414: How to Expand the Limit of the Indication of a Total Laparoscopic Hysterectomy

Indications for total laparoscopic hysterectomy do not exist, and cases of huge leiomyomas or cervical leiomyomas are often excluded from these indications because of their difficulty. However, with appropriate technical training and the standardization of this operation procedure, the limit of the indications for total laparoscopic hysterectomy have been expanded. In this video, I will show my technical training method and our standardized procedure for TLH. We will aslo introduce two clinical TLH cases (case 1: 3100g huge leiomyoma, case 2: 1080g cervical leiomyoma) which are normally excluded from the indications.

Hypointensity on Postcontrast MR Imaging from Compression of the Sacral Promontory in Enlarged Uterus with Huge Leiomyoma and Adenomyosis

In patients with huge leiomyoma and with adenomyosis of the uterus, a peculiar area of hypointensity was occasionally observed on postcontrast magnetic resonance (MR) imaging in the dorsal portion of the enlarged uterus near the sacral promontory. We describe the imaging characteristics of these MR findings and correlate them with histopathological findings to examine whether the areas represent specific pathological changes. Ten patients with huge leiomyomas and two with huge adenomyotic lesions whose imaging revealed the hypointensity were enrolled. All had enlarged uteri that extended beyond the sacral promontory. MR findings of the hypointense areas were evaluated and correlated with histopathological findings in 5 patients with leiomyoma and two with adenomyosis who had hysterectomy. The ten patients with leiomyoma showed flare-shaped hypointensity arising from the dorsal surface of the uterine body that extended deep into the tumor. The base of the hypointense areas was narrow in 5 patients with intramural leiomyoma and broad in five with subserosal leiomyoma. Two patients with adenomyosis showed nodular-shaped areas of hypointensity in front of the sacral promontory. Precontrast T(1)- and T(2)-weighted MR images showed no signal abnormalities in the portions corresponding to the hypointensity in any of the 12 patients. Pathological examinations showed no specific findings in the portions corresponding to the hypointensity in the 7 patients who had hysterectomy. The areas of hypointensity may represent functional changes, such as decreased localized blood flow caused by compression of the sacral promontory.

A Case of Huge Leiomyoma of the Broad Ligament with Secondary Cystic Degeneration

A Case of Huge Leiomyoma of the Broad Ligament with Secondary Cystic Degeneration

A Case of Huge Leiomyoma of the Uterus

A Case of Huge Leiomyoma of the Uterus