Does Big Mean Evil? Giant, but Benign Uterine Leiomyoma: Case Report and Review of the Literature

Brito, Luiz Gustavo Oliveira; Ueno, Natalia Lysei; Machado, MaÍra Rossmann

doi:10.1055/s-0040-1721351

Cited by 5 publications

(2 citation statements)

References 15 publications

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“…Nevertheless, a uterine volume of more than 13–14 gestational weeks is considered a relative contraindication for laparoscopic hysterectomies. In such cases, a classic open abdominal approach would be the most appropriate [ 97 ].…”

Section: Resultsmentioning

confidence: 99%

Currently Available Treatment Modalities for Uterine Fibroids

Micić,

Macura,

Andjić

et al. 2024

Medicina

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Uterine fibroids (leiomyomas and myomas) are the most common benign gynecological condition in patients presenting with abnormal uterine bleeding, pelvic masses causing pressure or pain, infertility and obstetric complications. Almost a third of women with fibroids need treatment due to symptoms. Objectives: In this review we present all currently available treatment modalities for uterine fibroids. Methods: An extensive search for the available data regarding surgical, medical and other treatment options for uterine fibroids was conducted. Review: Nowadays, treatment for fibroids is intended to control symptoms while preserving future fertility. The choice of treatment depends on the patient’s age and fertility and the number, size and location of the fibroids. Current management strategies mainly involve surgical interventions (hysterectomy and myomectomy hysteroscopy, laparoscopy or laparotomy). Other surgical and non-surgical minimally invasive techniques include interventions performed under radiologic or ultrasound guidance (uterine artery embolization and occlusion, myolysis, magnetic resonance-guided focused ultrasound surgery, radiofrequency ablation of fibroids and endometrial ablation). Medical treatment options for fibroids are still restricted and available medications (progestogens, combined oral contraceptives andgonadotropin-releasing hormone agonists and antagonists) are generally used for short-term treatment of fibroid-induced bleeding. Recently, it was shown that SPRMs could be administered intermittently long-term with good results on bleeding and fibroid size reduction. Novel medical treatments are still under investigation but with promising results. Conclusions: Treatment of fibroids must be individualized based on the presence and severity of symptoms and the patient’s desire for definitive treatment or fertility preservation.

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Section: Resultsmentioning

confidence: 99%

Currently Available Treatment Modalities for Uterine Fibroids

Micić,

Macura,

Andjić

et al. 2024

Medicina

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“…Sin embargo, la bibliografia recomienda métodos quirúrgicos como miomectomía e histerectomía (20). Ante esta situación, se realiza una laparotomía exploratoria en última instancia, con un halllazgo presuntivo de leiomioma uterino gigante subseroso pediculado de 24x20 cm de diámetro, siendo necesario realizar un estudio histopatológico para lograr diferenciarlo mesenquimales (19,21). Debido a la dificultad en el diagnostico preoperatorio, se sospecha de un leiomioma uterino gigante.…”

Section: Introductionunclassified

Tumor de estirpe mesenquimal uterino: Presentación de caso clínico y revisión bibliográfica

Gavilanes Sáenz,

López Haro

2024

MedicienciasUTA

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Introducción: Los tumores mesenquimales uterinos son relativamente frecuentes, se clasifican ampliamente en leiomiomas, leiomiosarcomas y tumores de músculo liso de potencial maligno incierto (STUMP). Su clínica es inespecífica y en ciertos casos debido a la dificultad en su diagnóstico se necesitan estudios especiales para ser clasificados como totalmente benignos o malignos. Objetivo: Describir el caso clínico de una paciente con tumor mesenquimal uterino realizando una revision adecuada y actualizada de la bibliografía. Materiales y métodos: Estudio descriptivo retrospectivo, mediante la presentación de un caso clínico. Previamente se obtuvo el consentimiento informado de la paciente, se realizó una revisión sistemática de información científica en los buscadores bibliográficos PubMed, Scopus, Nature Portafolio, Springer Link y Scielo. Resultados: Paciente de 50 años que consultó por distención abdominal y dolor abdominal difuso de aproximadamente 3 meses de evolución. Ecográficamente se visualizó una masa de contenido heterogéneo que impresiona originarse en ovarios con volumen de 4575 cc, la misma que se confirmó por tomografía axial computarizada, posteriormente se decide laparotomía exploratoria encontrando masa abdominopélvica dependiente de cuerno uterino izquierdo que impresiona mioma subseroso gigante con adherencias y abundante neovascularización a mesenterio por lo que se realiza histerectomía más anexectomía, se envía para estudio histopatológico que reveló neoplasia de estirpe mesenquimal sin especificar diagnóstico de benignidad o malignidad por lo que se solicita estudio inmunohistoquímico para clasificarlo. Conclusiones: A pesar de que la intervención quirúrgica constituye una medida inicial en el tratamiento ante la sospecha de tumor mesenquimal, resulta imperativo validar el diagnóstico mediante análisis histopatológico, inmunohistoquímico y, en algunos casos, mediante evaluación de la genética molecular. Este enfoque se realiza con el propósito de discernir entre una lesión maligna o benigna, permitiendo así la implementación de un protocolo de manejo y seguimiento apropiado

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Periprosthetic giant cell tumour of the tibia: en bloc resection and megaprosthesis revision

Panos,

Agathangelidis,

Givissis

et al. 2024

BMJ Case Rep

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We present a case detailing the diagnosis and management of a periprosthetic giant cell tumour in a female patient in her 70s, who had undergone total knee arthroplasty (TKA) for primary osteoarthritis in her right knee 7 years prior. The patient reported 4 months of painful weight-bearing. Various imaging modalities, including plain radiographs, CT scans and MRI, revealed a sizeable lytic lesion beneath the TKA prosthesis, along with loosening of the tibial component.Blood tests and analyses of synovial fluid ruled out periprosthetic joint infection, and a biopsy confirmed the diagnosis of a giant cell tumour of the bone. Treatment entailed en bloc resection of the tumour and revision of the TKA using a hinged, oncological-type megaprosthesis. Surgical procedures involved careful resection of the proximal tibia, preservation of vasculature and the creation of a medial gastrocnemius muscle flap. Following surgery, the patient underwent supervised rehabilitation with a functional brace.

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Does Big Mean Evil? Giant, but Benign Uterine Leiomyoma: Case Report and Review of the Literature

Cited by 5 publications

References 15 publications

Currently Available Treatment Modalities for Uterine Fibroids

Currently Available Treatment Modalities for Uterine Fibroids

Tumor de estirpe mesenquimal uterino: Presentación de caso clínico y revisión bibliográfica

Periprosthetic giant cell tumour of the tibia: en bloc resection and megaprosthesis revision

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