Huge uterine fibroid in a postmenopausal woman associated with polycythaemia—A case report

Ghaffar, Nor Aliza Abdul; Ismail, Mohd Pazudin; Mahmood, Nik Mohamed Zaki Nik; Daud, Khurshiah; Abdullah, Abu Dzarr

doi:10.1016/j.maturitas.2008.03.013

Cited by 15 publications

(10 citation statements)

References 4 publications

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“…UL are hormone-driven benign neoplasms of the uterus composed mostly of SMC and fibroblasts with a profound component of extracellular matrix (ECM). UL are present in single or multiple numbers, with size ranging from millimeters to 20 cm or more in diameter 3 . In 25-50% of women with ULs, the enlarged and deformed uterus can cause symptoms such as heavy or prolonged menstrual bleeding resulting in anemia, reduced fertility, and pregnancy complications 4 .…”

mentioning

confidence: 99%

Evidence of a causal relationship between genetic tendency to gain muscle mass and uterine leiomyomata

Sliz

Tyrmi

Rahmioğlu

et al. 2021

Preprint

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Uterine leiomyomata (UL) are the most common benign tumours of the female genital tract with an estimated lifetime incidence of up to 70%. To date, 7 genome-wide association studies have identified 35 loci predisposing to UL. To improve the understanding of the underlying genetic pathways, we conducted the largest genetic association study of UL to date in 426,558 European women from FinnGen and a previously published UL meta-GWAS. We identified 36 novel and replicated 31 previously reported loci. Annotations of the potential candidate genes suggest involvement of smooth muscle cell differentiation and/or proliferation-regulating genes in modulating UL risk. Our results further advocate that genetic predisposition to increased fat-free mass may be causally related to UL risk, underscoring the involvement of altered muscle tissue biology in UL pathophysiology. Overall, our findings provide novel insights into genetic risk factors related to UL, which may aid in developing novel treatment strategies.

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mentioning

confidence: 99%

Evidence of a causal relationship between genetic tendency to gain muscle mass and uterine leiomyomata

Sliz

Tyrmi

Rahmioğlu

et al. 2021

Preprint

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“…Uterine myomas occur in approximately 15 -20% of women in their reproductive years. [1] In the present case, the large abdominal mass induced an increase in IAP that resulted in changes in the haemodynamics of the patient. A large intra-abdominal mass may cause immobility, breathlessness, and the inability to lie supine.…”

Section: Discussionmentioning

confidence: 52%

“…However, in cases of large uterine myoma, intraabdominal pressure (IAP) can increase, which interferes with the pulmonary, renal, splanchnic and cardiovascular systems by elevating and splinting the diaphragm and partially occluding the inferior vena cava (IVC). [1] If untreated, IAP rises and multiple organ failure begins, and may progress to abdominal compartment syndrome (ACS), defined as a sustained IAP of 20 mmHg or higher and associated with new organ dysfunction. [2] Removal of the mass is the treatment of choice for ACS; however, gradual decompression is necessary.…”

Section: Corresponding Author: M C Choi (Oursk79@chaackr)mentioning

confidence: 99%

Respiratory arrest caused by a large uterine myoma: A case report

et al. 2016

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Large abdominal masses increase intra-abdominal pressure, thus changing the haemodynamics of the patient by elevating the diaphragm and causing partial occlusion of the inferior vena cava (IVC). Large abdominal masses present many challenges, including life-threatening risks due to severe cardiovascular, pulmonary, and circulatory problems, as well as technical difficulties of surgery and postoperative complications. We report a case of a large pelvic-abdominal myoma with perioperative pulmonary compromise. The goal of this report was to familiarise other surgeons with the alterations in the pathophysiology and management of large abdominal masses. Seongnam-si, Gyeonggi-do, Korea Corresponding author: M C Choi (oursk79@cha.ac.kr) It is rare to see patients present with exertional dyspnoea caused by a pelvic mass such as uterine myoma without underlying cardiopulmonary disease. The most common symptom of myoma is menstrual disturbance. However, in cases of large uterine myoma, intraabdominal pressure (IAP) can increase, which interferes with the pulmonary, renal, splanchnic and cardiovascular systems by elevating and splinting the diaphragm and partially occluding the inferior vena cava (IVC). S Afr J Obstet Gynaecol[1] If untreated, IAP rises and multiple organ failure begins, and may progress to abdominal compartment syndrome (ACS), defined as a sustained IAP of 20 mmHg or higher and associated with new organ dysfunction.[2] Removal of the mass is the treatment of choice for ACS; however, gradual decompression is necessary. We report a case of perioperative respiratory failure precipitated by increased IAP, which was caused by a large abdo mino pelvic myoma. Case reportA 42-year-old virgin woman presented to the emergency room for gradually worsening exertional dyspnoea and remarkable abdominal distension. Gradual abdominal distension had been noted by the patient over the past 3 years, but she became symptomatic only a week before admission. Medical and surgical histories were unremarkable. The patient complained of tachypnoea, and her oxygen saturation (SpO 2 ) on room air was 89%. Abdominal examination revealed generalised abdominal distension with a mass located through the entire abdomen. The patient's height was 170 cm, and weight was 55 kg. Laboratory tests indicated hypoxaemia in arterial blood gas analysis (pH 7.43, partial pressure of carbon dioxide (pCO 2 ) 45.5 mmHg, partial pressure of oxygen (pO 2 ) 54.7 mmHg) and mildly elevated liver enzymes (aspartate aminotransferase (AST) 68 IU/L, alanine transferase (ALT) 72 IU/L). Other biochemical parameters, including tumour marker levels (CA 125 15.3 U/mL and CA 19-9 26.82 U/mL) were within normal ranges. Abdominopelvic computed tomography (CT) revealed a large, heterogeneous, multiseptated ovoid pelvic mass measuring 37 × 25 × 12 cm, occupying the pelvis and abdomen up to the diaphragm. It was unclear whether it was from the uterus, adnexa, or another organ (Fig. 1). Chest CT angiogram showed no signs of pulmonary embolism and the echocardiogram ...

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“…However women with fibroids sometimes have polycythemia [6] due to increased production of erythropoietin and also thrombocytosis in response to excess bleeding [7]. These two hematological complications are well known to be associated with venous thromboembolism and are one mechanism by which this occurs in patients with fibroids.…”

Section: Menorrhagiamentioning

confidence: 99%

Counselling Patients with Uterine Fibroids: A Review of the Management and Complications

Simms-Stewart

Fletcher

2012

Obstetrics and Gynecology International

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Huge uterine fibroid in a postmenopausal woman associated with polycythaemia—A case report

Cited by 15 publications

References 4 publications

Evidence of a causal relationship between genetic tendency to gain muscle mass and uterine leiomyomata

Evidence of a causal relationship between genetic tendency to gain muscle mass and uterine leiomyomata

Respiratory arrest caused by a large uterine myoma: A case report

Counselling Patients with Uterine Fibroids: A Review of the Management and Complications

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