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- Large leiomyoma in a woman with Mayer-Rokitansky-Kuster-Hauser syndrome. [JOURNAL ARTICLE]
- J Radiol Case Rep 2013 Mar; 7(3):39-46.
Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a rare congenital anomaly characterized as aplasia or hypoplasia of uterus and vagina in women with normal development of secondary sex characteristics. It affects 1 in 4000-5000 female births. Women with this syndrome present with primary amenorrhoea. MRKH syndrome may be associated with renal, skeletal, cardiac and auditory anomalies. Women with MRKH syndrome may develop leiomyoma from a rudimentary uterus, though very rare. Initial investigation in women having MRKH syndrome with leiomyoma is ultrasonography (USG). However, CT and MRI are more accurate to evaluate the pelvic anatomy and pathologies.
- Aberrant expression and regulation of NR2F2 and CTNNB1 in uterine fibroids. [JOURNAL ARTICLE]
- Reproduction 2013 May 23.
Uterine fibroids are the most common benign tumour afflicting women of reproductive age. Despite the large healthcare burden caused by fibroids, there is only limited understanding of the molecular mechanisms that drive fibroid pathophysiology. Although a large number of genes are differentially expressed in fibroids compared to myometrium, it is likely most of these differences are a consequence of the fibroid presence, and are not causal. The aim of this study was to investigate expression and regulation of NR2F2 and CTNNB1 based on their potential causal role in uterine fibroid pathophysiology. We used RT-qPCR, Western blotting and immunohistochemistry to describe the expression of NR2F2 and CTNNB1 in matched human uterine fibroid and myometrial tissues. Primary myometrial and fibroid smooth muscle cell cultures were treated with progesterone and/or retinoic acid and sonic hedgehog conditioned media to investigate regulatory pathways for these proteins. We showed that NR2F2 and CTNNB1 are aberrantly expressed in fibroid tissue compared to matched myometrium, with strong blood vessel-specific localisation. Although the sonic hedgehog pathway was shown to be active in myometrial and fibroid primary cultures, it did not regulate NR2F2 or CTNNB1 mRNA expression. However, progesterone and retinoic acid combined regulated NR2F2 mRNA, but not CTNNB1, in myometrial but not fibroid primary cultures. In conclusion, we demonstrate aberrant expression and regulation of NR2F2 and CTNNB1 in uterine fibroids compared to normal myometrium, consistent with the hypothesis that these factors may play a causal role uterine fibroid development.
- Imaging findings of atypical leiomyoma of the urinary bladder simulating bladder cancer: a case report and literature review. [JOURNAL ARTICLE]
- Med Ultrason 2013 Jun; 15(2):161-163.
Atypical bladder leiomyoma is a rare bladder tumor that is difficult to be correctly identified by imaging techniques or cystoscopy. We present the imaging characteristics of an atypical bladder leiomyoma and review the relative literature, with the aim of enhancing awareness of the differential diagnosis of bladder leiomyoma, to avoid and reduce misdiagnosis. The imaging characteristics of the atypical leiomyoma were the cauliflower shaped, abundant vascularity, and calcification foci on the surface of the tumor. The patient was misdiagnosed with bladder cancer after an imaging study. The histopathological study established the definitive diagnosis.
- A rare inguinal mass: Round ligament leiomyoma. [JOURNAL ARTICLE]
- Int J Surg Case Rep 2013 Apr 11; 4(7):577-578.
INTRODUCTION:Leiomyoma of the round ligament is a rare condition and usually appears like an inguinal hernia. PRESENTATION OF CASE: We report a case of a 40 year-old women found to have an inguinal mass which it was finally diagnosed as leiomyoma. The patient was admitted to our hospital with a history of painless groin mass. The mass was thought to be irreducible inguinal hernia. Surgical exploration demonstrated a round ligament leiomyoma.
DISCUSSION:A smooth muscle tumor in the round ligament of the uterus in the inguinal region is a rare entity and can be mistaken for an irreducible inguinal hernia. It is a rare condition occurring predominantly in premenopausal middle-aged women. Abdominal, inguinal, and vulvar locations have been described. Surgical excision is the curative treatment.
CONCLUSION:Leiomyoma of the round ligament should be entertained as a possible etiology of inguinal mass.
- Uterine Artery Embolization and Its Effect on Fertility. [JOURNAL ARTICLE]
- J Vasc Interv Radiol 2013 May 20.
A systematic review of literature analyzing fertility following uterine artery embolization (UAE) is presented. Twenty-one studies describing pregnancy and complications of pregnancy following UAE were included. Low-level evidence from these studies suggests that pregnancy rates following UAE are comparable to the age-adjusted rates in the general population. Although pregnancy complication rates were similar to those in patients with untreated fibroid tumors, a few studies have reported higher miscarriage rates following UAE. Further randomized controlled trials comparing UAE versus other fertility-preserving treatments are necessary to confirm these findings.
- [Malignant neoplasms of the uterus in women treated with uterine artery embolization for presumed leiomyoma--description of three cases]. [English Abstract, Journal Article]
- Ginekol Pol 2013 Mar; 84(3):229-33.
Leiomyomas are the most common tumors of the uterus. Uterine artery embolization has been accepted as an alternative method for myomectomy or hysterectomy However lack of histologic conformation carries the risk of misdiagnosis of cancer so a thorough diagnostic testing is needed. Leiomyosarcomas are rare but very aggressive tumors of the uterine tract. The risk of leiomyosarcoma in myomata is very low, but it is necessary to remember about it, especially when we have no tissue for histological examination. Our report presents three cases of women diagnosed with leiomyosarcomas or endometrial cancer after uterine artery embolization for suspected symptomatic uterine fibroids.
- [Selective progesterone receptor modulator (ulipristal acetate--a new option in the pharmacological treatment of uterine fibroids in women]. [English Abstract, Journal Article]
- Ginekol Pol 2013 Mar; 84(3):219-22.
Uterine leiomyomata (fibroids) are very common, mostly benign tumors in women of reproductive age. Symptomatic fibroids cause significant morbidity and are characterized by heavy prolonged menstrual bleeding, by pain and pelvic pressure and, in some cases, they may lead to reproductive dysfunctions. Up to date, surgical procedures (hysterectomy or myomectomy) have been the dominant managements but recently uterine artery embolization and focused ultrasound surgery have also been taken into consideration. Hysterectomy is curative but for women of reproductive age the need for uterus-sparing medical therapy is evident. There are convincing data that progesterone and its receptors increase the proliferation activity of the cells in uterine leiomyomata, hence treatment with antiprogestins and progesterone receptor modulators seems to be reasonable. Results of a successfully completed phase III clinical trials with the application of ulipristal acetate (UPA) (first-in-class selective progesterone receptor modulator--SPRM) have been published at the beginning of this year Administration of 5 mg or 10 mg UPA daily has been shown to rapidly stop (within a week) excessive uterine bleeding, reduce the volume of the three largest fibroids by -44.8% and -54.8% for UPA 5 mg and 10 mg, respectively The effect on fibroid volume has been observed for up to 6 months after treatment cessation. It is also important that UPA restores patient Quality of Life scores to the level of healthy women and in the majority of patients resumes menstruation and ovulation within one month after treatment cessation. When compared with the Gn-RH agonist (leuprolide acetate), UPA has controlled uterine bleeding faster and more consistently (7 days vs. 30 days), fibroid reduction for up to 6 months has been smaller for Gn-RH a (-16.5%) and UPA has shown a superior safety profile as estradiol levels are maintained in the mid-follicular range. The UPA has caused temporary changes in endometrial morphology but 6 month after the treatment the endometrium returned to normal histology in the majority of cases. The presented results on the application UPA in the medical treatment of symptomatic uterine fibroids are very promising and gynecologists are given a new treatment option.
- Second trimester medical abortion in a woman with prior classical caesarean section and a uterine leiomyoma - A case report. [JOURNAL ARTICLE]
- Eur J Contracept Reprod Health Care 2013 May 22.
Background Medical abortion in women with the scar of a classical caesarean section (CS) and a large uterine leiomyoma is rarely attempted; it carries the risk of uterine rupture and haemorrhage. Case A 34-year-old multiparous woman with prior classical CS and a 14 × 10 × 9 cm leiomyoma arising from the uterine isthmus had an induced abortion at 14 weeks' gestation. Mechanical cervical priming with Dilapan(®)-S followed by vaginal misoprostol administration resulted in the uncomplicated expulsion of the uterine contents. Conclusions An early second trimester medical abortion with misoprostol was successfully performed in a woman with prior classical CS and a large uterine leiomyoma.
- RE: Uterine Fibroid Treatment Planning with the Diffusion Weighted Imaging Tool. [Journal Article]
- Korean J Radiol 2013 May; 14(3):547.
- [Laparoscopic removal of primary intestinal fibroid]. [English Abstract, Journal Article]
- Ginecol Obstet Mex 2013 Mar; 81(3):163-5.
Uterine fibroids are the most frequent solid benign tumors of the female pelvis. The most frequent location is the uterine corpus; however, it has been also reported in cervical placement and broad ligament. Rarely it has been reported a case of intestinal fibroid after previous history of myomectomy. We report the case of a patient, with no surgical history of interest, who underwent a diagnostic laparoscopy due to suspicion of malignant abdominal mass. Ajejunal fibroid was found, which was removed via laparoscopy without complications. Laparoscopy may be considered in case of intestinal fibriod despite its rarity, due to the better postoperative recovery and cosmetic outcomes compared to laparotomy.