Entrar/Registro  
HOME SPANISH
 
Ginecología y Obstetricia de México
   
MENU

Contents by Year, Volume and Issue

Table of Contents

General Information

Instructions for Authors

Message to Editor

Editorial Board






>Journals >Ginecología y Obstetricia de México >Year 2017, Issue 05


Vega-Ruiz FJ, Barceló-Mancillas DA, Gutiérrez-de la Vega D, Luis-Zárate H
Giant cystic leiomyoma that mimics an ovarian tumor. Report a case
Ginecol Obstet Mex 2017; 85 (05)

Language: Español
References: 22
Page: 325-330
PDF: 342.75 Kb.


Full text




ABSTRACT

Background: The fibroid or uterine fibroid is the most frequent benign tumor in women of childbearing age, with relative frequency, leiomyoma may be the site of degenerative phenomena, which may lead to confusion or error in diagnosis.
Case Report: A 48-year-old female, admitted to our service by the emergency department for a history of hypogastric pain radiating to both pits and flanks and an increase in the abdominal perimeter for a month And medium, negates weight loss, no history of chronic-degenerative diseases, or surgical. On abdominal examination, “globose” at the expense of adipose panicle and pelvic egg-dependent tumor, extending from symphysis pubis to below umbilical scar, solid consistency, regular edges, mobile, soft abdomen, not found Data of peritoneal irritation, during gynecological examination, external genitalia normal to speculum is found, mobile eutrophic cervix, non-painful, without endophytic or exophytic lesions, free sack bottoms, biimanual palpation is not possible to delimit uterine fundus or origin of The tumor, the results of requested paraclinics, including blood count, blood chemistry, liver function tests, coagulation tests and ovarian tumor markers were normal. The abdomino-pelvic ultrasound reports a normal uterus, well delimited margins, size 59 x 35 mm, with endometrium of 7 mm, as well as the presence of a large round-shaped tumor, the margins are smooth and well delimited, this lesion Presents liquid content with internal echoes, in addition to the presence of septa some up to 4 mm thick. Color Doppler is applied and there is only evidence of some thin vessels in peripheral form, the septa do not reveal vascularity, being compatible as first choice, with a cystadenoma, without being able to determine which side is the lesion. In the exploratory laparotomy, a 22 x 16 cm uterus is observed, with presence of myoma with probable cystic degeneration in the anterior face, macroscopically normal appendages, no free fluid is observed, total abdominal hysterectomy is performed.
Conclusion: Our case shows that, although the myoma presents typical images in most cases, when there are degenerative changes that distort the normal structure of the tumor, it may resemble an ovarian cystic tumor, and should therefore be Considered within the differential diagnosis of the adnexal masses.


Key words: Uterus, Leiomioma, Cystic degeneration.


REFERENCIAS

  1. Islam MS, Protic O, Giannubilo SR, Toti P, Tranquilli AL, Petraglia F, et al. Uterine leiomyoma: available medical treatments and new possible therapeutic options. J Clin Endocrinol Metab 2013;98:921-34.

  2. Okolo S. Incidence, aetiology and epidemiology of uterine fibroids. Best Pract Res Clin Obstet Gynaecol 2008;22: 571-88.

  3. Munro MG, Critchley HO, Broder MS, Fraser IS. FIGO classification system (PALM-COEIN) for causes of abnormal uterine bleeding in nongravid women of reproductive age. Int J Gynae- col Obstet 2011;113:3-13.

  4. Cramer SF, Patel A. The frequency of uterine leiomyomas. Am J Clin Pathol 1990;94:435-9.

  5. Downes E, Sikirica V, Gilabert-Estelles J, Bolge SC, Dodd SL, Maroulis C, et al. The burden of uterine fibroids in five European countries. Eur J Obstet Gynecol Reprod Biol 2010;152:96-101.

  6. Zimmermann A, Bernuit D, Gerlinger C, Schaefers M, Geppert K. Prevalence, symptoms and management of uterine fibroids: an international internet-based survey of 21,746 women. BMC Womens Health 2012;12:6.

  7. Borgfeldt C, Andolf E. Transvaginal ultrasonographic findings in the uterus and the endometrium: low prevalence of leiomyoma in a random sample of women age 25-40 years. Acta Obstet Gynecol Scand 2000;79:202-7.

  8. Chen CR, Buck GM, Courey NG, Perez KM, Wactawski- Wende J. Risk factors for uterine fibroids among women undergoing tubal sterilization. Am J Epidemiol 2001;153:20-6.

  9. Ross RK, Pike MC, Vessey MP, Bull D, Yeates D, Casagrande JT. Risk factors for uterine broids: reduced risk associated with oral contraceptives. Br Med J (Clin Res Ed) 1986;293:359-63.

  10. DeWaay DJ, Syrop CH, Nygaard IE, Davis WA, Van Voorhis BJ. Natural history of uterine polyps and leiomyomata. Obstet Gynecol 2002;100:3-12.

  11. D Rodriguez Morante, 2014“Patologìa benigna del cuerpo uterino” en González-Merlo, J, González Bosquet, E. y González Bosquet, J. Ginecología. Barcelona: Elsevier.

  12. Aydin C, Eric S, Yalc ̧in Y, Sen Selim H. A giant cystic leiomyoma mimicking an ovarian malignancy. Int J Surg Case Rep. 2013;4:1010-2.

  13. Low SCA, Chong CL. A case of cystic leiomyoma mimicking an ovarian malignancy. Ann Acad Med Singapore. 2004;33:371-4.

  14. Prayson RA, Hart WR. Pathologic considerations of uterine smooth muscle tumors. Obstet Gynecol Clin North Am. 1995;22:637-57.

  15. Cadron I, Leunen K, Van Gorp T, Amant F, Neven P, Vergote I. Management of borderline ovarian neoplasms. J Clin Oncol 2007;25:2928-37.

  16. McLucas B. Diagnosis, imaging and anatomical classification of uterine fibroids. Best Pract Res Clin Obstet Gynaecol. 2008;22:627-42.

  17. Sociedad Española de Ginecología y Obstetricia (SEGO). Guías de práctica clínica. Ginecología general. Miomas uterinos (actualizada 2015).

  18. Hurley V. Imaging techniques for fibroid detection. Bailliere’s Clin Obstet Gynaecol. 1998;12:213-24.

  19. Casillas J, Joseph RC, Guerra Jr JJ. CT appearance of uterine leiomyomas. Radiographics. 1990;10:999-1007.

  20. Dueholm M, Lundorf E, Hansen E, Ledertoug S, Olesen F. Accu- racy of magnetic resonance imaging and transvaginal ultrasonography in the diagnosis, mapping, and measurement of uterine myomas. Am J Obstet Gynecol. 2002;186:409-15.

  21. Segars JH, Parrott EC, Angel JD, Guo XC, Gao X, Bimbaum LS, et al. Proceedings from the Third National Institutes of Health International Congress on Advances in Uterine Leiomyoma Research: Comprehensive review, conference summary and future recommendations. Hum Reprod Update. 2014;20:309-33.

  22. Katsumori T, Nakajima K, Tokuhiro M. Gadolinium-enhanced MR imaging in the evaluation of uterine fibroids treated with uterine artery embolization. Am J Roentgenol. 2001;177:303-7.






>Journals >Ginecología y Obstetricia de México >Year 2017, Issue 05
 

· Journal Index 
· Links 






       
Copyright 2019