Paraurethral Leiomyoma as a Rare Cause of Lower Urinary Tract Symptoms in a Female of Reproductive Age| Chapter 4 | An Overview of Disease and Health Research Vol. 8

 

Leiomyomas are generally benign lesions originating from smooth muscle cells. However, paraurethral leiomyomas are a rare occurrence, with only a few cases being reported in the literature till date. In view of the scarce existing literature regarding paraurethral leiomyoma, their diagnosis and management pose a peculiar challenge.

 

Case Report: A case of a 43-year-old female, who presented with obstructive voiding symptoms of moderate severity for 4 months, is described. A mass of size 2.5 x 2 cm was palpable along the anterior wall of the vagina and the posterior wall of the urethra. The patient underwent surgical excision of the mass by the transvaginal route. This was confirmed to be leiomyoma on histopathology.

 

Conclusion: Paraurethral leiomyoma  is an  infrequent tumour arising from the periurethral smooth muscle and is an important differential diagnosis for paraurethral masses in females of reproductive age. In view of the limited experience with this entity, every case provides a significant insight for its diagnosis and management.

 

 

Author(s) Details

Sanjula Jethwani
Department of Urology and Renal Transplant, Government Medical College, Kozhikode, India.

 

A T Rajeevan
Department of Urology and Renal Transplant, Government Medical College, Kozhikode, India.

 

A V Venugopalan
Department of Urology and Renal Transplant, Government Medical College, Kozhikode, India.

 

 

Please see the book here :- https://doi.org/10.9734/bpi/aodhr/v8/6237

 

Incidental Identification of Krukenberg’s Tumour (KT): A Histopathological Perspective | Chapter 2 | Medical Science: Updates and Prospects Vol. 2

 

Krukenberg’s tumour (KT) is a metastatic ovarian malignancy characterised by bilateral ovarian enlargement and a nodular pattern of infiltration on radiology. KTs can be synchronous, where the metastasis is discovered within 3 months of the diagnosis of the primary tumour, or metachronous, where the metastasis is found after 3 months, frequently after the completion of initial therapy. This case report discusses an incidental diagnosis of Krukenberg’s Tumour (KT). A 48-year-old female was incidentally diagnosed with a Krukenberg tumour, involving the entire uterus, uterine leiomyomas, bilateral ovaries and fallopian tubes without any gross enlargement or cystic change in the ovaries. The patient underwent surgery to alleviate the symptoms associated with multiple uterine fibroids detected on ultrasound. She underwent a total abdominal hysterectomy with removal of both the adnexa, along with myomectomy. However, when the ovaries are not enlarged, and complaints of abdominal discomfort or pain are attributable to a fibroid, the possibility of a Krukenberg tumour is seldom considered. Under such circumstances, histopathology examination serves as the only tool to clinch the diagnosis because of its characteristic microscopic features. Recognition of KT is of paramount importance, as it alters both the management approach and prognostic outlook. Furthermore, it is also crucial to exclude mimics, especially tumours with mucinous differentiation, using ancillary techniques like special stains, immunohistochemistry and previous historical details for confirmation.

 

 

Author(s) Details

 

Kriti Chauhan
Metropolis Healthcare Ltd., India.

 

Aastha Sharma
Metropolis Lab Pvt. Ltd., India.

 

Gagandeep Singh
Dr. Singh Path Lab, Ropar, Punjab, India.

 

Please see the book here :- https://doi.org/10.9734/bpi/msup/v2/6598

 

Giant Uterine Fibroid by Giant Uterine Leiomyoma: A Case Report and Literature Review | Chapter 4 | Disease and Health Research: New Insights Vol. 5

The present case report discusses giant Uterine Fibroid by Giant uterine leiomyoma. The most frequent benign gynecologic tumor of the female pelvis is uterine leiomyoma, which develops from uterine smooth muscle. Giant fibroids, on the other hand, are extremely uncommon in modern treatment and provide management difficulties.  A 28-year-old nulliparous woman presented in a private clinic in Makurdi, Benue State, Nigeria with severe pain and a slow-growing abdominal mass with pressure symptoms due to a giant uterine fibroid. Laboratory analysis showed a blood haemoglobin concentration of 8.6 g/dL. The remainder of her laboratory results were within normal limits, and pregnancy was excluded. Transabdominal ultrasonography revealed a large hypoechoic mass originating from the uterus. Intraoperatively, the mass was huge, weighed 11.6 kg, was continuous with the uterus and tightly occupied the abdominal cavity with restricted mobility. Myomectomy was done after consideration of the patient’s wishes, fertility concerns and intraoperative findings. The patient did well without complications and was discharged on day six. She got married eight months later, got pregnant six months after marriage and delivered a baby boy through caesarean section nine months later.

 

Author (s) Details

Michael Tyodoo Maanongun
Department of Obstetrics and Gynecology, College of Health Sciences, Benue State University, Makurdi, Benue State, Nigeria.

 

Andrea Avershima Ornguze
Department of Obstetrics and Gynecology, College of Health Sciences, Benue State University, Makurdi, Benue State, Nigeria.

 

Babarinde Ojo
Department of Histopathology, College of Health Sciences, Benue State University, Makurdi, Benue State, Nigeria.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/dhrni/v5/1888

Effectiveness of Mifepristone in the Treatment of Uterine Leiomyoma | Chapter 10 | Recent Developments in Medicine and Medical Research Vol. 12

 The goal of this trial was to see how effective three months of oral mifepristone was at reducing the severity of symptoms and uterine and fibroid volume.

Methods: This was a prospective study undertaken in the Obstetrics & Gynecology department at Prathima Institute of Medical Sciences in Karimnagar, Telangana. Fifty symptomatic fibroids patients were given 25 mg of mifepristone daily for three months, and baseline data on Hb value, PBAC score, VAS (visual analogue scale), uterine volume, and fibroids volume were compared to those recorded at the end of the first month, third month, and three months after stopping mifepristone.

When compared to the pre-treatment value, Mifepristone treatment reduced mean PBAC score to 95% after one month, 98 percent after three months, and 58 percent after six months. After one month, 72 percent after three months, and 47 percent after three months of drug discontinuation, the mean VAS score was lowered to 67 percent, 72 percent after three months, and 47 percent after three months of drug discontinuation to pre-treatment value. In post-treatment follow-up patients, mean uterine volume was reduced by 24% after one month, 44% after three months, and 35% after six months when compared to pre-treatment values. In post-treatment follow-up patients, mean baseline fibroid volume was reduced by 25% after one month, 54% after three months, and 40% after six months. All of these measures increased slightly after quitting mifepristone, but they were still much lower than their baseline values. At the end of the third month of treatment, haemoglobin had increased by 2.12 gm/Dl from baseline, but had slightly reduced when compared to levels from the previous month. The baseline endometrium thickness was 7.4 mm, which grew to 8.24 mm after 3 months of treatment before returning to the baseline value, indicating that endometrial thickness was temporary throughout treatment. After treatment, 12 percent of patients became amenorrhoeic, however menstruation was restarted in 32.78 percent of post-treatment follow-up patients. During the research, there were only a few minor adverse effects.

Conclusion: A three-month course of low-dose oral Mifepristone 25 mg reduced menorrhagia, backache, dysmenorrhoea, and other related symptoms, reduced uterine and fibroid volume, and increased haemoglobin levels with little side effects.

Author(S) Details

Alla Satyanarayana Reddy
Department of Obstetrics & Gynaecology, Vinayaka Mission’s Research Foundation (DU), Vinayaka Mission’s Medical College, Karaikal, India.

Aruna Giri
Vinayaka Mission’s Research Foundation (DU), Salem, India.

View Book:- https://stm.bookpi.org/RDMMR-V12/article/view/4676

Study on Leiomyoma in the Space of Retzius | Chapter 11 | New Frontiers in Medicine and Medical Research Vol. 2

 Although leiomyomas are the most prevalent benign tumour in reproductive-age females, clinical diagnosis of them, particularly extrauterine leiomyomas, is difficult. The retzius space is one such area where they are frequently asymptomatic. Minor problems such as pain in the lower abdomen, urinary difficulties, pelvic mass, and infertility are common. Only a few cases of extrauterine leiomyoma have been recorded in the literature thus far, making therapy difficult.

Author (S) Details

Shweta
Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.

Shaheen Anjum
Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.

Zehra Mohsin
Department of Obstetrics and Gynecology, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.

Afzal Anees
Department of Surgery, Jawaharlal Nehru Medical College and Hospital, Aligarh Muslim Universit, Aligarh, Uttar Pradesh, India.

View Book :- https://stm.bookpi.org/NFMMR-V2/article/view/2684