Giant kidney worms in a patient with renal cell carcinoma

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Kuehn, Jemima; Lombardo, Lindsay; Janda, William M; Hollowell, Courtney M P

2016-01-01

Dioctophyma renale (D. renale), or giant kidney worms, are the largest nematodes that infect mammals. Approximately 20 cases of human infection have been reported. We present a case of a 71-year-old man with a recent history of unintentional weight loss and painless haematuria, passing elongated erythematous tissue via his urethra. CT revealed a left renal mass with pulmonary nodules and hepatic lesions. On microscopy, the erythematous tissue passed was identified as D. renale. On subsequent ...

Giant kidney worms in a patient with renal cell carcinoma.

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Kuehn, Jemima; Lombardo, Lindsay; Janda, William M; Hollowell, Courtney M P

2016-03-07

Dioctophyma renale (D. renale), or giant kidney worms, are the largest nematodes that infect mammals. Approximately 20 cases of human infection have been reported. We present a case of a 71-year-old man with a recent history of unintentional weight loss and painless haematuria, passing elongated erythematous tissue via his urethra. CT revealed a left renal mass with pulmonary nodules and hepatic lesions. On microscopy, the erythematous tissue passed was identified as D. renale. On subsequent renal biopsy, pathology was consistent with renal cell carcinoma. This is the first reported case of concomitant D. renale infection and renal cell carcinoma, and the second reported case of D. renale infection of the left kidney alone. 2016 BMJ Publishing Group Ltd.

Giant extrarectal leiomyoma in a woman with pregnancy of 22 weeks

International Nuclear Information System (INIS)

Lombana, Luis Jorge; Dominguez, Luis Carlos; Bermudez, Charles

2007-01-01

Leiomyomas of anorectal localization are infrequent tumors originated from vaginal smooth muscle of the rectal wall or less frequently from the recto-vaginal septum. The primary management of this entity is surgical. Only a few cases have been reported in the literature and none has been reported during gestation. In this document we report the case of a 37 year old woman, with a 22 week pregnancy, who noted the presence of a recto-vaginal mass compatible with a gigantic extra rectal leiomyoma of a rapidly progressive nature, associated with intense pain and bowel obstruction symptoms, which was successfully resected through a transperineal approach

Primary mediastinal leiomyma mimicking a giant mediastinal cyst: A case report

International Nuclear Information System (INIS)

Hwang, Yeong Uk; Kim, Su Young; Lee, Byung Hoon; Hwang, Yoon Joon; Lee, Ji Young; Kim, You Sung; Kim, Han Seong

2016-01-01

Primary mediastinal leiomyoma is an extremely rare benign tumor of smooth muscle. Most common radiographic appearance is a well circumscribed heterogeneous solid mass. We reported a case of giant cyst-like lesion at the middle mediastinum, which was pathologically confirmed as a primary mediastinal leiomyoma

Primary mediastinal leiomyma mimicking a giant mediastinal cyst: A case report

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Hwang, Yeong Uk; Kim, Su Young; Lee, Byung Hoon; Hwang, Yoon Joon; Lee, Ji Young; Kim, You Sung; Kim, Han Seong [Ilsan Paik Hospital, Inje University College of Medicine, Goyang (Korea, Republic of)

2016-08-15

Primary mediastinal leiomyoma is an extremely rare benign tumor of smooth muscle. Most common radiographic appearance is a well circumscribed heterogeneous solid mass. We reported a case of giant cyst-like lesion at the middle mediastinum, which was pathologically confirmed as a primary mediastinal leiomyoma.

Risk factors for adenomyosis, leiomyoma and concurrent adenomyosis and leiomyoma.

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Güzel, Ali İrfan; Akselim, Burak; Erkılınç, Selçuk; Kokanalı, Kuntay; Tokmak, Aytekin; Dolmuş, Başar; Doğanay, Melike

2015-06-01

To evaluate the risk factors for adenomyosis, leiomyoma and concomitant adenomyosis and leiomyoma in patients with treatment-resistant menometrorrhagia. A retrospective study was conducted on 129 women who underwent abdominal hysterectomy for treatment-resistant menometrorrhagia. The patients were divided into four groups according to the postoperative histopathology: concomitant adenomyosis and leiomyoma (n = 33), adenomyosis only (n = 26), leiomyoma only (n = 48) and controls (n = 22). Patients without any organic uterine pathology constituted the control group. Age at menarche was higher in the concomitant adenomyosis and leiomyoma group compared to the adenomyosis only group (P = 0.006). The mean age (P = 0.007), age at menarche (P = 0.001) and gravidity (P = 0.001) were higher in the concomitant adenomyosis and leiomyoma group compared to the leiomyoma only group. Preoperative hemoglobin was lower in the concomitant adenomyosis and leiomyoma, adenomyosis only, and leiomyoma only groups than the control group (P leiomyoma only, and concomitant adenomyosis and leiomyoma, from the control group. Patients in the adenomyosis group were older (OR, 1.20; 95%CI: 1.05-1.50) and had a lower age at menarche (OR, 0.42; 95%CI: 0.19-0.89) than the other groups. Preoperative anemia may be a useful predictor of adenomyosis. Older patients, and patients who had a lower age at menarche, were also more likely to have adenomyosis. © 2015 The Authors. Journal of Obstetrics and Gynaecology Research © 2015 Japan Society of Obstetrics and Gynecology.

Cotyledonoid Leiomyoma

African Journals Online (AJOL)

Cotyledonoid leiomyoma is a very rare tumor among the ever expanding repertoire of growth variants described in benign uterine leiomyoma. We report a case of cotyledonoid leiomyoma in a 39-year-old (unmarried) women presented with lump in abdomen. On laparotomy, a large multinodular, tan colored, exophytic, ...

Incarcerated giant uterine leiomyoma within an incisional hernia: a case report.

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Exarchos, Georgios; Vlahos, Nikolaos; Dellaportas, Dionysios; Metaxa, Linda; Theodosopoulos, Theodosios

2017-11-01

Uterine leiomyomas presenting as incarcerated or strangulated hernias in surgical emergencies are extremely rare and should be considered in the differential diagnosis in patients with known uterine fibroids and an irreducible ventral abdominal wall hernia. Detailed history and multidisciplinary approach optimize the diagnosis and decision making toward surgical treatment.

Primary ovarian leiomyoma

International Nuclear Information System (INIS)

Mathew, Marian; Krolikowski, Anderzj; Al-Haddabi, Ibrahim; Nirmala, Vadakkepat

2005-01-01

Ovarian leiomyoma is a rare and incidentally detected neoplasm, clinically indistinguishable from subserous leiomyomas and ovarian fibromas, until histopathological confirmation. We present a case of leiomyoma arising primarily from the ovary in a 35 year old woman. (author)

Giant Bilateral Renal Angiomyolipomas and Lymphangioleiomyomatosis Presenting after Two Successive Pregnancies Successfully Treated with Surgery and Rapamycin

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Ramón Peces

2011-01-01

Full Text Available We report the case of a 25-year-old woman who presented with abdominal and flank pain with two successive pregnancies and was diagnosed of giant bilateral renal AMLs and pulmonary LAM associated with TSC in the post-partum of her second pregnancy. This case illustrates that in women with TSC rapid growth from renal AMLs and development of LAM may occur with successive pregnancies. It also stresses the potential for preservation of renal function despite successive bilateral renal surgery of giant AMLs. Moreover, the treatment with a low-dose rapamycin may be an option for LAM treatment. Finally, a low-dose rapamycin may be considered as an adjuvant treatment together to kidney-sparing conservative surgery for renal AMLs.

Benign metastasizing leiomyoma of the cervical spine 31 years after uterine leiomyoma resection.

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Berti, Aldo F; Santillan, Alejandro; Velasquez, Luis A

2015-09-01

We report a 74-year-old woman presenting with a leiomyoma of the cervical spine 31 years after uterine leiomyoma resection. Benign metastasizing leiomyoma to the cervical spine is very rare. To the best of our knowledge, this is the fourth reported patient with a leiomyoma metastasizing to the cervical spine and that with the longest latency period for this type of tumor, 31 years. The pathological features were typical of leiomyoma. Copyright © 2015 Elsevier Ltd. All rights reserved.

Metastasizing leiomyoma to heart.

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Consamus, Erin N; Reardon, Michael J; Ayala, Alberto G; Schwartz, Mary R; Ro, Jae Y

2014-01-01

Cardiac smooth muscle tumors are rare. Three different clinical settings for these tumors have been reported, including benign metastasizing leiomyoma from the uterus, primary cardiac leiomyoma and leiomyosarcoma, and intravenous cardiac extension of pelvic leiomyoma, which is the most common. We present a case of a 55-year-old woman with a benign metastasizing leiomyoma to the heart 17 years after hysterectomy and 16 years after metastasis to the lung. Immunohistochemical stains for smooth muscle actin, desmin, and estrogen and progesterone receptors were positive, indicating a smooth muscle tumor of uterine origin. To our knowledge, this is only the fourth reported case of benign metastasizing leiomyoma to the heart and the first case of long-delayed cardiac metastasis after successful treatment of pulmonary metastasis. It illustrates that benign metastasizing leiomyoma should be included in the differential diagnosis of cardiac tumors in patients with a history of uterine leiomyoma, especially when associated with pulmonary metastasis.

Uterine Leiomyoma: Hysterosalpingographic Appearances

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Firoozeh Ahmadi

2008-01-01

Full Text Available Uterine leiomyoma is the most common benign tumor of genital tract. The etiology of myomasis unknown. Leiomyoma shows a broad spectrum of radiographic appearances depending on thenumber, size, and location of the tumor. The diagnostic method for uterine leiomyomas is basedprimarily on the clinical situation. Despite of the varied diagnostic options such as; transvaginalsonography, sonohysterography, hysteroscopy, laparoscopy and MRI; hysterosalpingography isstill one of the valuable imaging methods for identification of uterine leiomyoma.The various features of the proved leiomyoma are illustrated in this pictorial review. The incidence,risk factors and clinical features will also be discussed briefly.

Uterine artery embolization for leiomyomas. Examination of correlation between degree of leiomyoma perfusion determined by enhanced MR i-Drive method and leiomyoma volume change on MR image

International Nuclear Information System (INIS)

Arimoto, Hiroshi; Yamamoto, Kazuhiro; Yamaguchi, Hiroyuki; Terai, Yoshito; Ohmichi, Masahide; Narabayashi, Isamu

2007-01-01

The objective of this study was to evaluate the correlations of leiomyoma volume reduction with the perfusion pattern of leiomyomas and signal intensity on T2-weighted images. Magnetic resonance (MR) imaging was performed on 11 patients with 35 symptomatic uterine leiomyomas before and 3 and 6 months after uterine artery embolization (UAE). The correlation between leiomyoma perfusion pattern and percent leiomyoma volume reduction was assessed. The mean percent leiomyoma volume reductions were 41.1% 3 months and 58.4% 6 months after UAE. The mean percent volume reductions of highly perfused leiomyomas were 58.6% 3 months and 85.7% 6 months after UAE. The reduction rates of poorly perfused leiomyomas were 37.9% 3 months and 49.1% 6 months after UAE. Well-perfused leiomyomas are more likely to reduce in leiomyoma volume. It is thought that a patient with a well-perfusion myoma is a good candidate for UAE. (author)

Bladder Leiomyoma.

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Caliskan, Selahattin; Sungur, Mustafa

2017-03-01

Leiomyoma of the bladder is a very rare disorder that accounts for 0.43% of all bladder neoplasms. Although the pathophysiology of the bladder leiomyoma is unknown, there are some theories in it. The patients can be asymptomatic; and clinical symptoms, when present, are associated with the tumor size and location. Imaging techniques such as ultrasonography, intravenous urography, computed tomography, and magnetic resonance imaging are helpful but definitive diagnosis is made by histopathological examination. Surgical resection of tumor with transurethral, open, laparoscopic and robotic approaches is the main treatment. We present a case of leiomyoma of the bladder in an adult male patient.

Pulmonary Benign Metastasizing Leiomyoma from the Uterine Leiomyoma: A Case Report

International Nuclear Information System (INIS)

Kołaczyk, Katarzyna; Chamier-Ciemińska, Katarzyna; Walecka, Anna; Chosia, Maria; Szydłowska, Iwona; Starczewski, Andrzej; Grodzki, Tomasz; Smereczyński, Andrzej; Sawicki, Marcin

2015-01-01

Benign metastasizing leiomyoma (BML) is a rare condition described as multiple well-differentiated leiomyomas at sites distant from the uterus. Apart from lungs it has also been reported in lymph nodes, heart, brain, bone, skin, eye and spinal cord. We present a case of pulmonary benign metastasizing leiomyoma in a female patient admitted to our hospital with suspicion of left adnexal tumor. A 45-year-old woman was referred to our hospital with suspicion of left adnexal tumor. The control transvaginal ultrasound examination performed at admission to the Gynecological Department excluded adnexal neoplasm. However, a large amount of fluid within the Douglas pouch raised the oncological concern. The patient underwent myomectomy in 2005. In the same year she was diagnosed with multiple lung nodules and underwent pulmonary wedge resection with the diagnosis of pulmonary benign metastasizing leiomyoma being stated. The decision of reevaluation of the specimen, control CT and puncture of the Douglas pouch fluid was made. Computed tomography performed at the Department of Diagnostic Imaging and Interventional Radiology of the Pomeranian Medical University Hospital revealed multiple, bilateral nodules. The microscopic examination of the samples confirmed the initial diagnosis of benign metastasizing leiomyoma with no evidence of neoplastic cells within the fluid. Pulmonary benign metastasizing leiomyoma is a rare entity. However, it should be always taken into consideration in women with a previous or coincident history of uterine leiomyoma, especially when no evidence of other malignancy is present

Leiomyoma of the sternothyroid muscle.

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Rowe, Meghan E; Khorsandi, Azita S; Guerrero, Dominick R; Brett, Elise M; Sarlin, Jonathan; Urken, Mark L

2016-01-01

Leiomyomas are benign cutaneous tumors of smooth muscle origin. Only a small percentage of leiomyomas arise in the head and neck region. We present the first case of leiomyoma arising in the sternothyroid muscle of the neck. We analyze the clinical presentation, pathology, and histology for a single case study. The histologic findings of the tumor located in the sternothyroid muscle support the diagnosis of leiomyoma. This is the first case of leiomyoma arising in the sternothyroid muscle, and only the second reported case of leiomyoma in the strap muscles of the neck. Leiomyoma should be included in the differential diagnosis of soft tissue tumors in the head and neck region. A histological analysis is essential in determining both tumor type and subtype, which will inform the proper course of treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

Efficacy of percutaneous sclerotherapy through pig tail drainage tube for giant hepatic and renal cysts under CT guidance

International Nuclear Information System (INIS)

Huang Xiaoming; Huang Yongbin; Geng Lei; Zhang Haitao

2008-01-01

Objective: To evaluate the safety and efficacy of percutaneous sclerotherapy through pig tail drainage tube for giant hepatic and renal cysts under CT guidance. Methods: Seventeen cases of giant hepatic and renal cyst were percutaneously implanted with 7 F pig tail drainage tube under CT guidance, together with daily injection of dehydrated ethanol or acetic acid. The drainage tube should be clamped after injection of sclerosing agent for cystic fluid 500 ml, immediate reopening of the drainage tube should be taken sright after the sclerotherapy. The withdrawal of drainage tube should be taken after resclerotherapy for all patients with < 10 ml of 24 h. drainage volume, including average of 40 d for hepatic cyst and 10 d for renal cyst. Results: 6 months after scletotherapy, all patients showed under US examination and 'healed' for all 17 cases, with successful rate up to 100%. No complication of bleeding, infection and cardioencephalovascular events occurred. Conclusion: CT guided pereutaneous sclerotherapy through pig tail drainage tube for giant hepatic and renal cysts is simple, safe and satisfactory efficacy. (authors)

Giant renal artery pseudoaneurysm caused by rupture of renal angiomyolipoma following pregnancy: Endovascular treatment and review of the literature

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Ilkay S Idilman

2014-01-01

Full Text Available Renal angiomyolipoma is a hamartomatous, benign tumor composed of blood vessels, fatty tissue and smooth muscle cells, and is often detected incidentally. It can also be associated with the tuberous-sclerosis complex (TSC. Pregnancy and use of oral contraceptives are known to be associated with an increased risk of tumoral rupture and bleeding. Herein, we report a unique case of renal angiomyolipoma associated with TSC who presented with hypovolemic shock as a result of spontaneous rupture of a giant renal pseudoaneurysm, immediately after pregnancy. Emergency endovascular treatment was successful with sparing of most of the affected kidney as demonstrated by follow-up computed tomography imaging.

Labial Leiomyoma

International Nuclear Information System (INIS)

Sultana, R.; Humayun, S.

2015-01-01

Extrauterine smooth muscle tumors are rare. Labial leiomyomas arise from dartos muscle of the genitalia. A 45 years old lady presented with a right labial swelling. It was clinically diagnosed as a Bartholin cyst. The gross appearance of the tissue was that of myoma so it was managed by surgical excision. The definitive diagnosis was confirmed on histopathology as labial leiomyoma. (author)

Proteoglycans in Leiomyoma and Normal Myometrium

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Barker, Nichole M.; Carrino, David A.; Caplan, Arnold I.; Hurd, William W.; Liu, James H.; Tan, Huiqing; Mesiano, Sam

2015-01-01

Uterine leiomyoma are a common benign pelvic tumors composed of modified smooth muscle cells and a large amount of extracellular matrix (ECM). The proteoglycan composition of the leiomyoma ECM is thought to affect pathophysiology of the disease. To test this hypothesis, we examined the abundance (by immunoblotting) and expression (by quantitative real-time polymerase chain reaction) of the proteoglycans biglycan, decorin, and versican in leiomyoma and normal myometrium and determined whether expression is affected by steroid hormones and menstrual phase. Leiomyoma and normal myometrium were collected from women (n = 17) undergoing hysterectomy or myomectomy. In vitro studies were performed on immortalized leiomyoma (UtLM) and normal myometrial (hTERT-HM) cells with and without exposure to estradiol and progesterone. In leiomyoma tissue, abundance of decorin messenger RNA (mRNA) and protein were 2.6-fold and 1.4-fold lower, respectively, compared with normal myometrium. Abundance of versican mRNA was not different between matched samples, whereas versican protein was increased 1.8-fold in leiomyoma compared with myometrium. Decorin mRNA was 2.4-fold lower in secretory phase leiomyoma compared with proliferative phase tissue. In UtLM cells, progesterone decreased the abundance of decorin mRNA by 1.3-fold. Lower decorin expression in leiomyoma compared with myometrium may contribute to disease growth and progression. As decorin inhibits the activity of specific growth factors, its reduced level in the leiomyoma cell microenvironment may promote cell proliferation and ECM deposition. Our data suggest that decorin expression in leiomyoma is inhibited by progesterone, which may be a mechanism by which the ovarian steroids affect leiomyoma growth and disease progression. PMID:26423601

Halofuginone suppresses growth of human uterine leiomyoma cells in a mouse xenograft model.

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Koohestani, Faezeh; Qiang, Wenan; MacNeill, Amy L; Druschitz, Stacy A; Serna, Vanida A; Adur, Malavika; Kurita, Takeshi; Nowak, Romana A

2016-07-01

Does halofuginone (HF) inhibit the growth of human uterine leiomyoma cells in a mouse xenograft model? HF suppresses the growth of human uterine leiomyoma cells in a mouse xenograft model through inhibiting cell proliferation and inducing apoptosis. Uterine leiomyomas are the most common benign tumors of the female reproductive tract. HF can suppress the growth of human uterine leiomyoma cells in vitro. The mouse xenograft model reflects the characteristics of human leiomyomas. Primary leiomyoma smooth muscle cells from eight patients were xenografted under the renal capsule of adult, ovariectomized NOD-scid IL2Rγ(null) mice (NSG). Mice were treated with two different doses of HF or vehicle for 4 weeks with six to eight mice per group. Mouse body weight measurements and immunohistochemical analysis of body organs were carried out to assess the safety of HF treatment. Xenografted tumors were measured and analyzed for cellular and molecular changes induced by HF. Ovarian steroid hormone receptors were evaluated for possible modulation by HF. Treatment of mice carrying human UL xenografts with HF at 0.25 or 0.50 mg/kg body weight for 4 weeks resulted in a 35-40% (P leiomyoma cells in an in vivo model, HF was administered to mice whose tolerance and metabolism of the drug may differ from that in humans. Also, the longer term effects of HF treatment are yet unclear. The results of this study showing the effectiveness of HF in reducing UL tumor growth by interfering with the main cellular processes regulating cell proliferation and apoptosis are in agreement with previous studies on the effects of HF on other fibrotic diseases. HF can be considered as a candidate for reducing the size of leiomyomas, particularly prior to surgery. This project was funded by NIH PO1HD057877 and R01 HD064402. Authors report no competing interests. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights

Increased progesterone receptor expression in uterine leiomyoma: correlation with age, number of leiomyomas, and clinical symptoms.

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Tsigkou, Anastasia; Reis, Fernando M; Lee, Meng H; Jiang, Bingjie; Tosti, Claudia; Centini, Gabriele; Shen, Fang-Rong; Chen, You-Guo; Petraglia, Felice

2015-07-01

To investigate the possible correlation between progesterone receptor (PR) expression in uterine leiomyoma or adjacent myometrium and patient's age, size/number of leiomyomas, or clinical symptoms such as dysmenorrhea, acyclic pelvic pain, or menstrual and intermenstrual uterine bleeding. Cross-sectional study. Referral center. Sixty-two Chinese women undergoing elective hysterectomy for uterine leiomyomata. None. Evaluation of PR-total and PR-B mRNA with real-time polymerase chain reaction; PR-A and PR-B proteins quantified by Western blot in leiomyoma tissue and myometrium; symptoms rated by the patients using visual analog scores. The PR-B mRNA and PR-A and PR-B proteins were more concentrated in leiomyomas than in matched myometrium. A direct correlation between PR-B mRNA levels in leiomyoma and age (r = 0.347) and number of tumors (r = 0.295) was found. Conversely, there was an inverse correlation between PR-B mRNA levels in leiomyoma and dysmenorrhea (r = -0.260) and intermenstrual bleeding (r = -0.266). Multiple regression analysis indicated that age (β = 0.363) and the number of myomas (β = 0.296) were independently associated with PR-B mRNA levels in leiomyoma tissue. The levels of PR-B mRNA in leiomyoma tissue are directly associated with the number of tumors and inversely correlated with the intensity of intermenstrual bleeding and dysmenorrhea, suggesting that PR signaling may favor leiomyoma growth while attenuating clinical symptoms. This duality should be taken into account in the clinical management of patients with symptomatic uterine leiomyoma. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Leiomyoma and leiomyoma cellulare of the fallopian tube: review of the literature and case reports

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Dobrosława L. Sikora-Szczęśniak

2016-11-01

Full Text Available Introduction: Leiomyoma of the fallopian tube is extremely rare, and its version – leiomyoma cellulare (LC of the fallopian tube is absolutely unique. Aim of the study was to review literature reports on leiomyomas of the fallopian tubes, and to present cases of leiomyoma and LC of the fallopian tubes in the patients operated on in our ward. Material and methods : There were fewer than 100 cases of leiomyomas of the fallopian tubes discussed in the literature up to 1993. Case 1. Leiomyoma of the left fallopian tube was detected postoperatively in a 68-year-old patient, G.K., on histopathological examination after laparoscopic total hysterectomy with bilateral adnexa.Case 2. A 56-year-old patient, K.T., with LC of the fallopian tube was qualified for laparoscopy. At operation, the procedure was converted to microlaparotomy due to the tumor size. The adnexa on the right side with the tumor of the fallopian tube were excised, and the left fallopian tube was excised, too. Histopathological microscopy found leiomyoma cellulare partim epithelioides. Results: In the presented cases, the extent of operation was connected with the clinical picture, and in the case of LC of the right fallopian tube, with intraoperative histopathological findings. In both cases the postoperative course was uneventful. Conclusions : Diagnosis of leiomyoma and LC of the fallopian tube, like in the other organs of the female genital tract, is possible only due to results of histopathological microscopy.

Uterine leiomyoma

International Nuclear Information System (INIS)

Swe, Than-Than; Onitsuka, Hideo; Kawamoto, Kenji; Ueyama, Toshihiko; Tsuruchi, Nobuhiro; Masuda, Kouji

1992-01-01

To correlate the signal intensity of uterine leiomyoma with its pathologic characteristics, with particular emphasis on the fibrous component, 33 magnetic resonance (MR) examinations that revealed 93 leiomyomas were prospectively studied. All patients were imaged in axial and sagittal planes with different spin-echo pulse sequences to obtain T 1 -, T 2 -weighted, and proton density images. Nondegenerative leiomyomas (N-62) showing a homogeneous signal of low intensity, and degenerative leiomyomas (N-31) with a heterogeneous signal of variable intensity on T 2 -weighted images could be correlated. Histopathological assessment of fiber constitution and degeneration, and MR intensity were interpreted by independent observers. There was excellent accord between the averages for MR intensity, T 2 relaxation time and fiber content, although the intensity values in each fiber grade showed a wide range. The greater the fiber content the lower the MR intensity on T 2 -weighted images, and the shorter the T 2 relaxation time (p<0.0001). In addition, the manner in which fiber distribution affected MR appearance was also elucidated. These data contribute to guidelines for precise tissue differentiation of myogenic tumors on MR images, and for MR imaging tissue diagnosis of any lesion with a considerable fibrous element. (author)

Uterine leiomyoma: comparative study with MRI and histopathology

International Nuclear Information System (INIS)

Zhang Rong; Liang Biling; Fu Jiaping; Li Yong; Shen Jun

2003-01-01

Objective: To compare MRI findings of uterine leiomyomas with histologic subtypes, and to evaluate the value of enhanced MRI in differentiating leiomyoma subtypes. Methods: Forty-two cases of uterine leiomyomas with MRI and pathology were analyzed between 1998 and 2002. 101 uterine leiomyomas were analyzed. 34 cases were examined with Philips T5-II super-conducting magnetic resonance system (0.5T) using surface coil and 8 cases with Philips Intera 1.5 T super-conducting magnetic resonance system using body phase array coil. Plain scan were acquired with SE T 1 -weighted imaging and TSE T 2 -weighted imaging. Conventional contrast imaging was obtained with SE T 1 -weighted imaging after iv injection of Gd-DTPA (0.1mmol/kg). MR features were observed and compared with that of the pathological types. Results: Almost all the leiomyomas showed slight hypointensity or isointensity on T 1 -weighted images. Most ordinary (97%) leiomyomas displayed hypointensity on T 2 -weighted images. Most cellular (75%) and degenerated (55%) leiomyomas manifested as hyperintensity on T 2 -weighted images. The signal intensity was not statistically different between cellular leiomyomas and degenerated leiomyomas (χ 2 =4.192, P>0.05). However, there was a statistically significant difference in the signal intensity on T 2 -weighted images between ordinary leiomyomas and cellular or degenerated leiomyomas (χ 2 =81.564, P<0.05). The signal homogeneity was statistically different in leiomyomas among different pathological types. Three patterns of enhancement occurred in ordinary leiomyomas, but mostly showed homogeneously enhanced. Most cellular leiomyomas showed homogenous enhancement, the degenerated leiomyomas mostly displayed peripheral and mild enhancement. Conclusion: The signal intensity on MR imaging was different in leiomyomas with different pathological subtype. The Gd-DTPA enhanced scans was not indispensable for the diagnosis and detection of leiomyomas, but it can help to

Primary iris leiomyoma.

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Yeaney, Gabrielle A; Platt, Sean; Singh, Arun D

Intraocular leiomyomas are uncommon and usually occur in the ciliary body. Primary leiomyoma of the iris is both rare and a difficult diagnosis to make, given melanocytic tumors are more common and may be amelanotic. The somewhat controversial diagnosis of iris leiomyoma requires further confirmation by immunohistochemistry and electron microscopy. Herein, we describe a 58-year-old man with a 2-mm round translucent pink lesion of the iris. The tumor was excised by sector iridectomy. Immunohistochemistry showed positivity for both smooth muscle actin and desmin and negativity for S-100, HMB45, SOX10, MelanA, CD31, CD34, and h-caldesmon. Epstein-Barr virus-associated smooth muscle tumor was excluded by chromogenic in situ hybridization-Epstein-Barr virus-encoded RNA. Ultrastructural analysis showed cytoplasmic myofilaments with focal fusiform densities and micropinocytotic vesicles. Our review of previous literature confirmed the unusual nature of this tumor. Primary iris leiomyoma should be considered in the differential of an amelanotic S-100-immunonegative iris tumor. Copyright © 2016 Elsevier Inc. All rights reserved.

Symplastic Leiomyoma in the Suprarenal Inferior Vena Cava

International Nuclear Information System (INIS)

Kahveci, Volkan; Ogur, Torel; Cipe, Gokhan; Ozdemir, Sevim; Hazinedaroglu, Selcuk

2012-01-01

Leiomyomas are benign tumors of the soft tissue and may develop in any location where smooth muscle is present. Leiomyoma in the inferior vena cava is a rarely seen pathology, and symplastic leiomyoma is also a rare histological variant of leiomyoma. In this case, we present a rare histological variant of symplastic leiomyoma in the inferior vena cava (IVC). This is the first radiologically reported case of a symplastic leiomyoma of the IVC

Metastatic spinal epidural leiomyoma: a case report

International Nuclear Information System (INIS)

Seo, Yoo Na; Kim, Yong Woo; Park, Yeong Mi; Cha, Seong Sook; Bae, Jae Ik; Eun, Choong Ki; Lee, Seon Joo; Lee, Gyung Kyu

2006-01-01

We report here on a case of a spinal extradural leiomyoma in a 67-year-old woman, and this tumor was in a very unusual location for a leiomyoma. Because the patient underwent hysterectomy for a uterine leiomyoma 20 years ago, we can speculate that the spinal lesion was a metastatic leiomyoma

Metastatic spinal epidural leiomyoma: a case report

Energy Technology Data Exchange (ETDEWEB)

Seo, Yoo Na; Kim, Yong Woo; Park, Yeong Mi; Cha, Seong Sook; Bae, Jae Ik; Eun, Choong Ki [College of Medicine, Inje University, Sangye Paik Hospital, Seoul (Korea, Republic of); Lee, Seon Joo [College of Medicine, Inje University, Busan Paik Hospital, Busan (Korea, Republic of); Lee, Gyung Kyu [College of Medicine, Hallym University, Hangang Sacred Heart Hospital, Seoul (Korea, Republic of)

2006-11-15

We report here on a case of a spinal extradural leiomyoma in a 67-year-old woman, and this tumor was in a very unusual location for a leiomyoma. Because the patient underwent hysterectomy for a uterine leiomyoma 20 years ago, we can speculate that the spinal lesion was a metastatic leiomyoma.

Rare mediastinal leiomyoma in a child.

Science.gov (United States)

Hakeem, Zubair Ashraf; Rathore, Shyam Singh; Wahid, Abdul

2017-07-01

Leiomyoma of the mediastinum is rare. They are thought to arise from the smooth muscle cells of the media of mediastinal vascular structures and structure containing smooth muscle. Most mediastinal leiomyomas are seen in association with oesophagus in the posterior mediastinum. We present a case of huge leiomyoma in a 1.5 years old male child arising in the lower anterior mediastinum with compression of heart, liver and deformity of rib cage. Median sternotomy and a separate concomitant right mini-thoracotomy was done and tumor excised. Histopathology proved it to be a leiomyoma.

Giant kidney worm (Dioctophyma renale) infections in dogs from Northern Paraná, Brazil.

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Nakagawa, Tizianne Larissa Duim Ribeiro; Bracarense, Ana Paula Frederico Rodrigues Loureiro; dos Reis, Antônio Carlos Faria; Yamamura, Milton Hissashi; Headley, Selwyn Arlington

2007-04-30

This article describes the pathological observations of Dioctophyma renale in dogs from the northern region of the State of Paraná, Brazil. A female, 6-year-old dog, Fila Brasileiro breed and a 16-year-old, male Poodle were diagnosed positive for D. renale during routine necropsy. Clinically, both dogs demonstrated hematuria, and the Poodle had a radiographic diagnosis of prostatic tumor, but neither had a clinical diagnosis of this infection prior to necropsy. Three giant worms were observed in the urinary bladder of the first case and one within the renal pelvis of the other dog. Histological findings were similar in both cases and represented compressive atrophy due to the presence of the nematode. Additionally, aspects of the life cycle, pathogenesis and epidemiology associated with this parasitism in Brazil are also discussed.

Unusual presentation of cutaneous leiomyoma

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Sapnashree Bhaskar

2014-01-01

Full Text Available Herein, we report a case of leiomyoma cutis because of its rarity and unusual presentation. The case presented with a solitary leiomyoma lesion which was painless. However, the adjacent normal appearing area was tender. A biopsy of the lesion as well as of a portion of the adjacent normal appearing area was taken, which confirmed the diagnosis of cutaneous leiomyoma. This may suggest the dormant nature of the disease which has not yet become apparent.

Disseminated leiomyoma cells can be identified following conventional myomectomy.

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Sandberg, E M; van den Haak, L; Bosse, T; Jansen, F W

2016-12-01

Uncontained morcellation of leiomyomas during laparoscopic surgery has recently been discouraged, as undetected malignant tumours, namely leiomyosarcomas, could be fragmented which may result in upstaged disease. However, enucleating leiomyomas per se may be inappropriate from an oncological perspective because complete, radical resection of malignant tumours to prevent further tumour growth or recurrence is not achieved. Thus, the aim of this study was to determine whether spillage of leiomyoma cells occurs during laparotomic myomectomy. Observational study. Tertiary academic centre in the Netherlands. Women undergoing laparotomic myomectomy were included in the study. Peritoneal abdominal washings were obtained on two occasions during the myomectomy procedure; the first one immediately after opening the abdomen and the second one after resection of the leiomyoma(s). Cytological evaluation of the fluids was performed. The presence of leiomyoma cells in any of the washings. Five patients were included in this pilot study. All first washings were negative for leiomyoma cells. However, cytology positive for the presence of leiomyoma cells was found in three of the five second, post-myomectomy washings. Tissue spillage from leiomyoma(s) occurs during conventional open myomectomy. The clinical relevance of tissue dissemination after myomectomy is unclear but it cannot be excluded that this may negatively affect the patient's outcome if there is malignant change within the enucleated leiomyoma(s). Therefore, it is questionable whether morcellation in specially designed containment bags after laparoscopic myomectomy, guarantees any additional oncological safety. Even during conventional myomectomy, tissue spillage occurs during resection of leiomyoma(s). © 2016 Royal College of Obstetricians and Gynaecologists.

Urological complications of uterine leiomyoma: a review of literature.

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Dagur, Gautam; Suh, Yiji; Warren, Kelly; Singh, Navjot; Fitzgerald, John; Khan, Sardar A

2016-06-01

Uterine leiomyomas are common gynecologic tumor in reproductive-aged women, by age 50, diagnosis shared by urologist, gynecologists and radiologists. The goal of this article is to review the current literature, study the impact of leiomyoma on female lower urinary tract, examine the cause female sexual dysfunction and provide a comprehensive review of current diagnostic, imaging studies, and current treatment of leiomyoma. Clinical leiomyoma studies published from 1956 through 2015 were identified using the PubMed search engines and the key words leiomyoma, fibroid in the current literature. Impact of leiomyoma on the lower urinary tract including female sexual dysfunction was reviewed with terms of "urinary retention", "bladder", "urethra", "dyspareunia", "incontinence", "incomplete bladder emptying", "female sexual dysfunction", and "lower urinary tract" to study the urological and sexual effects of leiomyoma. Literature related to leiomyoma was reviewed from 1965 to present. Women with uterine leiomyomata complained of pelvic pain, menstrual irregularities, infertility, lower urinary tract symptoms and sexual dysfunction. Leiomyoma is a common tumor of the uterus that often clinically impacts on the lower urinary tract and results in urological and sexual symptoms. Leiomyoma can compress and grow into and become adherent to the bladder and surrounding pelvic organs or metastasize into peritoneal organs. Leiomyoma can enlarge and compress the urinary bladder, urethra, and lower end of the ureters. Leiomyoma can cause embarrassing sexual dysfunction in females. Current literature of non-surgical and surgical therapy of leiomyoma is described.

Bladder leiomyoma presenting as dyspareunia: Case report and literature review.

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Xin, Jun; Lai, Hai-Ping; Lin, Shao-Kun; Zhang, Qing-Quan; Shao, Chu-Xiao; Jin, Lie; Lei, Wen-Hui

2016-07-01

Leiomyoma of the bladder is a rare tumor arising from the submucosa. Most patients with bladder leiomyoma may present with urinary frequency or obstructive urinary symptoms. However, there are a few cases of bladder leiomyoma coexisting with uterine leiomyoma presenting as dyspareunia. We herein report an unusual case of coexisting bladder leiomyoma and uterine leiomyoma presenting as dyspareunia. A 44-year-old Asian female presented to urologist and complained that she had experienced dyspareunia over the preceding several months. A pelvic ultrasonography revealed a mass lesion located in the trigone of urinary bladder. The mass lesion was confirmed on contrast-enhanced computed tomography (CT). The CT scan also revealed a lobulated and enlarged uterus consistent with uterine leiomyoma. Then, the biopsies were then taken with a transurethral resection (TUR) loop and these biopsies showed a benign proliferation of smooth muscle in a connective tissue stroma suggestive of bladder leiomyoma. An open local excision of bladder leiomyoma and hysteromyomectomy were performed successfully. Histological examination confirmed bladder leiomyoma coexisting with uterine leiomyoma. This case highlights a rare presentation of bladder leiomyoma, dyspareunia, as the chief symptom in a patient who had coexisting uterine leiomyoma. Bladder leiomyomas coexisting with uterine leiomyomas are rare and can present with a wide spectrum of complaints including without symptoms, irritative symptoms, obstructive symptoms, or even dyspareunia.

Perfusion-weighted MR imaging of uterine leiomyoma

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Takase, Hiroyasu; Munechika, Hirotsugu [Showa Univ., Tokyo (Japan). School of Medicine

2001-06-01

Serial images of uterine leiomyoma in gradient-echo, echo-planar, magnetic resonance imaging were taken to draw a {delta}R2{sup *} curve after intravenous bolus injection of Gd-DTPA. The {delta}R2{sup *} integral was calculated from a {delta}R2{sup *} curve to have relative perfusion of uterine leiomyoma. We then, evaluated the amount of perfusion correlated with MR findings, size and number of leiomyoma or the clinical symptoms and established that perfusion was correlated positively with the findings of T2 weighted images and clinical symptoms but not with other MR findings or size and number of leiomyoma. In conclusion, we presumed that the clinical symptoms could be reduced by decreasing of an amount of perfusion of uterine leiomyoma in some means. However, it remained uncertain why severe clinical symptoms were associated with a high amount of perfusion in uterine leiomyomas. (author)

Spontaneous parasitic leiomyoma in a post-partum woman.

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Iida, Mana; Ishikawa, Hiroshi; Shozu, Makio

2016-12-01

We report a case of spontaneous parasitic leiomyoma in a 30-year-old post-partum woman. A subserosal leiomyoma had been noted at the first trimester screening, and she had experienced persistent abdominal pain during her previous pregnancy. She was referred to hospital with severe abdominal pain at 7 months after delivery. We detected a homogenous solid tumor that resembled the subserosal leiomyoma but was completely detached from the uterus. On laparoscopy the vascularization of the tumor was supplied from the omentum, which was tightly adherent to the tumor. Histopathologically, the tumor was surrounded by a fibrous vascular capsule, and broadly hyalinized and partially calcified, consistent with a degenerated uterine leiomyoma. Detachment of a pedunculated subserosal leiomyoma from the uterus following adhesion to other pelvic structures throughout pregnancy may result in a parasitic leiomyoma, a rare subtype of uterine leiomyoma. © 2016 Japan Society of Obstetrics and Gynecology.

Perianal atypical leiomyoma: A case report.

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Sun, Pingliang; Ou, Hailing; Huang, Shen; Wei, Longxiang; Zhang, Sen; Liu, Jiali; Geng, Shuguang; Yang, Kun

2017-12-01

Reports on perianal atypical leiomyoma, a perianal tumor, are rare. We confirmed a perianal atypical leiomyoma by its clinical presentation, magnetic resonance imaging findings, and immunohistochemistry. A 28-year-old female with a perianal mass found more than 4 years ago. The 5cm_4cm_4cm sized mass was located on the left side of the anus and vagina; The magnetic resonance imaging (MRI) scan revealed: A 4.1cm × 5.2cm × 4.9cm sized round mass was observed on the left side of the circumference. Perianal atypical leiomyoma. anal peripheral mass resection was performed under lumbar anesthesia. The postoperative course was uneventful, healing, the patient was discharged. Perianal atypical leiomyomas are benign tumors, but with the clinically atypical leiomyoma, it is sometimes difficult to distinguish between potential malignant smooth muscle tumors,and there may be malignant changes. Surgery should ensure complete resection, and to avoid postoperative recurrence, there should be a regular follow-up.

Fetal Arthrogryposis Secondary to a Giant Maternal Uterine Leiomyoma

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José María Vila-Vives

2012-01-01

Full Text Available Arthrogryposis multiplex congenital is a rare condition defined as contractures in multiple joints at birth due to disorders starting in fetal life. Its etiology is associated with many different conditions and in many instances remains unknown. The final common pathway to all of them is decreased fetal movement (fetal akinesia due to an abnormal intrauterine environment. Causes of decreased fetal movements may be neuropathic abnormalities, abnormalities of connective tissue or muscle, intrauterine vascular compromise, maternal diseases, and space limitations within the uterus. When the cause of arthrogryposis is space limitations in uterus, the most common etiology is oligohydramnios. The same can result from intrauterine tumours as fibroids, although to our knowledge there are only two papers reporting cases of fetal deformities related to uterine leiomyomas. We describe a well-documented exceptional case of arthrogryposis associated with the presence of a large uterine fibroid. It could illustrate the importance of a careful and appropriate assessment of uterine fibroids before and in the course of a pregnancy considering that they can cause both serious maternal and fetal complications.

Vaginal Approach to Excise a Rare Paraurethral Leiomyoma

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Jagan K. Kansal

2016-11-01

Full Text Available Leiomyomas are benign tumors of smooth muscle origin occurring throughout the genitourinary system. While leiomyomas in the uterus are frequently seen, urethral and paraurethral leiomyomas are extremely rare with a hand full of cases in the literature. Typically, periurethral leiomyomas can present with a mass protruding from the urethra originating from the proximal and posterior portion of the urethra. Herein, we present a new case of a paraurethral leiomyoma causing mass effect on the bladder leading to lower urinary tract symptoms (LUTS with no gross involvement of the urethra.

Technique and methods in uterine leiomyoma embolization

International Nuclear Information System (INIS)

Helmberger, T.K.; Jakobs, T.F.; Reiser, M.F.

2003-01-01

Uterine leiomyomas are the most common benign tumors of the female urogenital tract. Beside the classic surgical treatment options the minimal-invasive embolization therapy of the leiomyomas increasingly gains importance world-wide. Technique, complications, and results of uterine leiomyoma embolization will be presented. After careful evaluation of indications for embolization the procedure is mostly performed under conscious sedation. A single-sided femoral access route together with cross-over technique generally allows for a flow-directed embolization via both uterine arteries. After embolizing the vessels supplying the tumor, the uterine arteries should be still patent. The success rate of embolization of uterine leiomyomas ranges between 85 and 100%, whereas a reduction in size of the tumors in 42 to 83% and a relief of symptoms in up to 96% can be achieved. The total complication rate is about 10% with mainly ''minor complications''. Worldwide only three deaths following embolization of uterine leiomyomas were reported. The high technical and clinical success rate together with a low complication rate make the embolization of uterine leiomyomas a minimally-invasive alternative to the classic treatment. As long term results are not available indication to embolization of uterine leiomyomas must be carefully established in consensus with gynecologists. (orig.) [de

Medical Treatment of Uterine Leiomyoma

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Sabry, Mohamed; Al-Hendy, Ayman

2012-01-01

Uterine leiomyomas (also called myomata or fibroids) are the most common gynecologic tumors in the United States. The prevalence of leiomyomas is at least 3 to 4 times higher among African American women than in white women. Pathologically, uterine leiomyomas are benign tumors that arise in any part of the uterus under the influence of local growth factors and sex hormones, such as estrogen and progesterone. These common tumors cause significant morbidity for women and they are considered to be the most common indication for hysterectomy in the world; they are also associated with a substantial economic impact on health care systems that amounts to approximately $2.2 billion/year in the United States alone. Uterine myomas cause several reproductive problems such as heavy or abnormal uterine bleeding, pelvic pressure, infertility, and several obstetrical complications including miscarriage and preterm labor. Surgery has traditionally been the gold standard for the treatment of uterine leiomyomas and has typically consisted of either hysterectomy or myomectomy. In recent years, a few clinical trials have evaluated the efficacy of orally administered medications for the management of leiomyoma-related symptoms. In the present review, we will discuss these promising medical treatments in further detail. PMID:22378865

Pelvic Myxoid Leiomyoma Mass between Vagina and Rectum

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Omar AlShalabi

2016-01-01

Full Text Available Leiomyomas are the most common pelvic tumors in women. About 20–30% of women older than 35 are affected. Rare conditions of leiomyomas have extrauterine locations. Myxoid degeneration is a rare type of leiomyoma degeneration. We report a case of solid-cystic myxoid leiomyoma in a 53-year-old woman complained of constipation, urinary hesitation, and malodorous vaginal discharge with palpable 17×12 cm mass between vagina and rectum. Regarding the inferior location of the mass, a perineal approach was used to enucleate it. This rare location has not been mentioned before. The woman was finally diagnosed by pathologists which was myxoid leiomyoma.

Pelvic Myxoid Leiomyoma Mass between Vagina and Rectum.

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AlShalabi, Omar; Alahmar, Fadi Obaied; Aljasem, Hazem; Alsaid, Bayan; AlShalabi, Abdulghani

2016-01-01

Leiomyomas are the most common pelvic tumors in women. About 20-30% of women older than 35 are affected. Rare conditions of leiomyomas have extrauterine locations. Myxoid degeneration is a rare type of leiomyoma degeneration. We report a case of solid-cystic myxoid leiomyoma in a 53-year-old woman complained of constipation, urinary hesitation, and malodorous vaginal discharge with palpable 17 × 12 cm mass between vagina and rectum. Regarding the inferior location of the mass, a perineal approach was used to enucleate it. This rare location has not been mentioned before. The woman was finally diagnosed by pathologists which was myxoid leiomyoma.

Leiomyoma of urinary bladder with bladder stone

International Nuclear Information System (INIS)

Farouk, K.; Gondal, M.; Khan, A.

2008-01-01

Leiomyoma of the urinary bladder is a rare benign mesenchymal tumour. We describe here a case of leiomyoma of the urinary bladder in a 65-year-old gentleman who presented with haematuria, passage of clots and combined obstructive and irritative urinary symptoms. The investigations revealed a vesical calculus and a mass on the left lateral wall of the urinary bladder. Cystolitholapaxy and transurethral resection of the tumour was performed. Histopathological report of the resected tumour revealed a leiomyoma of the urinary bladder. So far, a leiomyoma of the urinary bladder and a concomitant vesical calculus have not been described in literature. (author)

Urethral Leiomyoma: A Rare Clinical Entity

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Ng Beng Kwang

2016-01-01

Full Text Available Extrauterine leiomyomas are encountered occasionally, which can pose a diagnostic dilemma and challenge to the gynaecologist. We report a rare case of urethral leiomyoma. A 31-year-old woman with history of primary subfertility presented with mass at her urethral meatus and lower urinary tract symptoms. She underwent examination under anaesthesia and excision of the urethral mass. Histopathological examination confirmed leiomyoma. Diagnosis and management of this common growth situated at a rare location were reviewed and discussed.

Ovarian steroids, stem cells and uterine leiomyoma: therapeutic implications.

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Moravek, Molly B; Yin, Ping; Ono, Masanori; Coon, John S; Dyson, Matthew T; Navarro, Antonia; Marsh, Erica E; Chakravarti, Debabrata; Kim, J Julie; Wei, Jian-Jun; Bulun, Serdar E

2015-01-01

Uterine leiomyoma is the most common benign tumor in women and is thought to arise from the clonal expansion of a single myometrial smooth muscle cell transformed by a cellular insult. Leiomyomas cause a variety of symptoms, including abnormal uterine bleeding, pelvic pain, bladder or bowel dysfunction, and recurrent pregnancy loss, and are the most common indication for hysterectomy in the USA. A slow rate of cell proliferation, combined with the production of copious amounts of extracellular matrix, accounts for tumor expansion. A common salient feature of leiomyomas is their responsiveness to steroid hormones, thus providing an opportunity for intervention. A comprehensive search of PUBMED was conducted to identify peer-reviewed literature published since 1980 pertinent to the roles of steroid hormones and somatic stem cells in leiomyoma, including literature on therapeutics that target steroid hormone action in leiomyoma. Reviewed articles were restricted to English language only. Studies in both animals and humans were reviewed for the manuscript. Estrogen stimulates the growth of leiomyomas, which are exposed to this hormone not only through ovarian steroidogenesis, but also through local conversion of androgens by aromatase within the tumors themselves. The primary action of estrogen, together with its receptor estrogen receptor α (ERα), is likely mediated via induction of progesterone receptor (PR) expression, thereby allowing leiomyoma responsiveness to progesterone. Progesterone has been shown to stimulate the growth of leiomyoma through a set of key genes that regulate both apoptosis and proliferation. Given these findings, aromatase inhibitors and antiprogestins have been developed for the treatment of leiomyoma, but neither treatment results in complete regression of leiomyoma, and tumors recur after treatment is stopped. Recently, distinct cell populations were discovered in leiomyomas; a small population showed stem-progenitor cell properties, and

Unaware of a large leiomyoma: A case report with respect to unusual symptoms of large leiomyomas

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Barış Mülayim

2015-12-01

Conclusion: Patients might have no symptoms or might be unaware of the presence of a large uterine leiomyoma, as in our case; however, large leiomyomas have various unusual symptoms in addition to the common ones. These symptoms should not be disregarded or underestimated.

Zygomatic leiomyoma. Case report.

Science.gov (United States)

Robiony, M; Demitri, V; Costa, F; Politi, M

1996-12-01

Leiomyoma is a benign tumor that originates from the smooth muscle. If often develops in the uterus and in organs rich of smooth muscle like bowel and subcutaneous tissue. It is infrequently observed in the oral nasal cavities or in paranasal sinuses. The authors, after an accurate revision of the literature, present their first case of zygomatic leiomyoma. They underline the diagnostic aspects in relationship to histologic and immunohistochemical examinations, for surgical therapy.

Paraurethral leiomyoma in a postmenopausal woman

DEFF Research Database (Denmark)

Shim, Susy; Borg, Camilla Skovvang; Majeed, Huda Galib

2015-01-01

Leiomyomas are benign tumors extending from smooth muscle cells and only few cases of paraurethral leiomyomas have been described in the literature. They are often seen in the reproductive age and around 50% of the cases are asymptomatic. We describe a 59-year-old woman with a solid mobile tumor...... below the symphysis revealed at a gynecological examination. Transvaginal ultrasound and MRI confirmed the tumor and excision of the paraurethral tumor was carried out. The histological examination showed a benign paraurethral leiomyoma. The postoperative period was characterized by urethral pain...

Uterine arterial embolization to treat uterine leiomyoma

International Nuclear Information System (INIS)

Wang Huali; Han Lu; Wang Feng

2002-01-01

Objective: To assess the clinical effects of uterine arterial embolization on uterine leiomyoma. Methods: The authors treated 21 patients with uterine leiomyoma by Seldinger's uterine arterial embolization. The 4.0 F Cobra catheter was laced into the double uterine arteries with Polyvinyl Alcohol Foam (PVA) particles as the embolization. At 3 and 6 months postoperatively, the authors investigated the effects of the embolization. Results: After uterine arterial embolization, the volume of uterine leiomyoma decreased and menorrhagia was under controlled. The symptoms of anemia and oppression were relieved. The physiologic functions of ovary and uterus were preserved completely. Conclusions: Uterine arterial embolization is an effective and less invasive way to treat uterine leiomyoma

Radiologic features of gastric leiomyosarcoma and leiomyoma

International Nuclear Information System (INIS)

Yang, Seoung Oh; Choi, Byung Ihn; Han, Man Chung; Kim, Chu Wan

1985-01-01

Smooth muscle tumors of stomach are unusual tumors, accounting for 1-3% of primary gastric malignancies. Diagnosis of these tumors is important because of the more favorable prognosis of this tumor than that of gastric carcinoma. A retrospective study was made in 18 patients who had pathology-proven gastric leiomyoma and leiomyosarcoma to identify radiologic characteristics for recent 6 years from Jan. 1978 to July. 1984 at Department of Radiology, Seoul National University Hospital. The results were as follows: 1. Age of 13 cases of gastric leiomyosarcoma ranged from 36 to 70 with average of 51 and the male to female ratio was 10 ; 3. Age of 5 cases of gastric leiomyoma ranged from 24 to 67 with average of 44 and the male to female ratio was 3 : 2. 2. Clinically, gastric leiomyosarcoma had epigastric pain in 7 cases, palpable mass in 4 cases, melena in 3 cases, haematemesis in 2 cases, 5 cases of gastric leiomyoma also had above symptoms respectively. 3. Of the 13 cases of gastric leiomyosarcoma studied by upper gastrointestinal examination, 6 cases (32%) involved the fundus, 10 cases (50%) in the body, 3 cases (18%) in the antrum. Of the 5 cases of gastric leiomyoma, 4 cases were confined to the fundus and 1 case in the body. 4. The size of the 13 gastric leiomyosarcoma ranged from 5 to more than 20 cm in diameter. The size of the 5 gastric leiomyomas ranged from 3 to 9 cm in diameter. 5. The growth type of gastric leiomysarcoma was exophytic in 8 cases, endogastric in 1 case and mixed pattern in 4 cases. The growth type of gastric leiomyoma were exophytic in 1 case, endogastric in 2 cases and mixed in 2 cases. 6. Mucosal pattern of gastric leiomyosarcoma were mainly effaced pattern in 10 cases (77%), but 3 cases (23%) showed irregular destruction. 1 case of gastric leiomyoma showed mucosal irregularity. 7. Ulceration was present in 10 cases of gastric leiomyosarcoma either single or multiple. 2 cases of gastric leiomyoma showed small ulcerations. Calciflation

Hereditary leiomyomatosis and renal cell cancer presenting as metastatic kidney cancer at 18 years of age : implications for surveillance

NARCIS (Netherlands)

van Spaendonck-Zwarts, Karin Y.; Badeloe, Sadhanna; Oosting, Sjoukje F.; Hovenga, Sjoerd; Semmelink, Harry J. F.; van Moorselaar, R. Jeroen A.; van Waesberghe, Jan Hein; Mensenkamp, Arjen R.; Menko, Fred H.

Hereditary leiomyomatosis and renal cell cancer (HLRCC) is an autosomal dominant syndrome characterized by skin piloleiomyomas, uterine leiomyomas and papillary type 2 renal cancer caused by germline mutations in the fumarate hydratase (FH) gene. Previously, we proposed renal imaging for FH mutation

Leiomyoma of the trachea : a case report

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Lee, Heon; Han, Young Min; Lee, Sang Yong; Chung, Gyung Ho; Kim, Chong Soo; Sohn, Myung Hee; Choi, Ki Chul [Chonbuk National Univeristy Hospital, Chonju (Korea, Republic of)

1997-12-01

Tracheal leiomyoma is a rare benign tumor arising from the smooth muscle in the tracheal wall. As in other cases of benign tracheal tumors, the obstructive symptoms due to leiomyoma are similar to those of asthma and bronchitis, and diagnostic delay is therefore common. We describe the case of a patient with leiomyoma arising from the trachea and review the literature, with particular emphasis on the two dimensional CT images. (author). 5 refs., 3 figs.

Leiomyoma of the trachea : a case report

International Nuclear Information System (INIS)

Lee, Heon; Han, Young Min; Lee, Sang Yong; Chung, Gyung Ho; Kim, Chong Soo; Sohn, Myung Hee; Choi, Ki Chul

1997-01-01

Tracheal leiomyoma is a rare benign tumor arising from the smooth muscle in the tracheal wall. As in other cases of benign tracheal tumors, the obstructive symptoms due to leiomyoma are similar to those of asthma and bronchitis, and diagnostic delay is therefore common. We describe the case of a patient with leiomyoma arising from the trachea and review the literature, with particular emphasis on the two dimensional CT images. (author). 5 refs., 3 figs

Integrin β1 regulates leiomyoma cytoskeletal integrity and growth

Science.gov (United States)

Malik, Minnie; Segars, James; Catherino, William H.

2014-01-01

Uterine leiomyomas are characterized by an excessive extracellular matrix, increased mechanical stress, and increased active RhoA. Previously, we observed that mechanical signaling was attenuated in leiomyoma, but the mechanisms responsible remain unclear. Integrins, especially integrin β1, are transmembrane adhesion receptors that couple extracellular matrix stresses to the intracellular cytoskeleton to influence cell proliferation and differentiation. Here we characterized integrin and laminin to signaling in leiomyoma cells. We observed a 2.25 ± 0.32 fold increased expression of integrin β1 in leiomyoma cells, compared to myometrial cells. Antibody-mediated inhibition of integrin β1 led to significant growth inhibition in leiomyoma cells and a loss of cytoskeletal integrity. Specifically, polymerization of actin filaments and formation of focal adhesions were reduced by inhibition of integrin p1. Inhibition of integrin β1 in leiomyoma cells led to 0.81 ± 0.02 fold decrease in active RhoA, and resembled levels found in serum-starved cells. Likewise, inhibition of integrin β1 was accompanied by a decrease in phospho-ERK. Compared to myometrial cells, leiomyoma cells demonstrated increased expression of integrin α6 subunit to laminin receptor (1.91 ± 0.11 fold), and increased expression of laminin 5α (1.52±0.02), laminin 5β (3.06±0.92), and laminin 5γ (1.66 ± 0.06). Of note, leiomyoma cells grown on laminin matrix appear to realign themselves. Taken together, the findings reveal that the attenuated mechanical signaling in leiomyoma cells is accompanied by an increased expression and a dependence on integrin β1 signaling in leiomyoma cells, compared to myometrial cells. PMID:23023061

Leiomyoma and adenomyosis: US and MR findings

International Nuclear Information System (INIS)

Jee, Mi Hyun; Lee, Yeon Soo; Kim, Mi Hye; Kweon, Young Hwa; Cha, Kyung Soo; Hong, Ju Hee; Kim, Soon Yong; Bae, Seong Hee; Shim, Jung Weon

1992-01-01

Leiomyoma and adenomyosis of the uterus are the most common gynecologic disorders in an enlarged uterus. The characteristic US and MR findings in differentiation between both lesions were prospectively evaluated in 30 patients. Of 30 patients, 15 were leiomyomas, 6 were adenomyosises, 8 were leiomyomas and adenomyosises, and 1 was a normal pregnancy, histologically. The total number of leiomyoma nodules were 49 while adenomyosises were 14 (9 diffuse and 5 focal). Among 49 myomas nodules, 36 were correctly diagnosed by sonography. The characteristic US findings of uterine leiomyoma were well defined nodules (36), hypoechoic peripheral rim (16), and whorl-like internal echoes (13). Forty four of the 49 myoma nodules were correctly diagnosed by MRI. The characteristic MR findings of myoma were well defined nodules (43), peripheral low signal intensity rim on T1WI (13) and T2WI (9), and peripheral high signal intensity rim on T2WI (5). Among 14 adenomyosises, 9 were correctly diagnosed by sonography. The characteristic US findings of adenomyosis were diffuse uterine hypertrophy more than 5.5cm in AP diameter with endometrial displacement and no significant echo change in myometrium. All 14 adenomyosis as were correctly diagnosed from MRI. On T2WI, adenomyosis appeared as ill defined localized or diffuse thickening of the junctional zone more than 1cm in thickness. It was our conclusion that to differentiate between leiomyoma and adenomyosis focused on should be the detection of existence of nodule in leiomyoma, the primary sign, not on the secondary indirect sign

Intratumoral Vasculopathy in Leiomyoma Treated With Tranexamic Acid.

Science.gov (United States)

Kudose, Satoru; Krigman, Hannah R

2017-07-01

Although intravascular thrombi and infarct-type necrosis have been reported in leiomyomas following tranexamic acid therapy, intratumoral vasculopathy resembling acute atherosis has not been reported to date in patients without exposure to gonadotropin receptor agonist. We describe a case of intratumoral vasculopathy resembling acute atherosis in a leiomyoma in a 49-year-old woman, with hereditary hemorrhagic telangiectasia and menorrhagia, treated with tranexamic acid. The patient had no exposure to gonadotropin receptor agonists. Pathologic examination of the hysterectomy specimen showed a 5.7-cm submucosal leiomyoma containing multiple arteries with fibrinoid change accompanied with abundant subintimal foamy macrophages and occasional luminal thrombi. The vascular media showed scant lymphocytic inflammation without necrosis. The leiomyoma contained numerous mast cells and edematous areas. Vessels outside of the leiomyoma showed neither fibrinoid changes nor inflammation. The patient is alive and well with no signs of systemic vasculitis. We demonstrate that intratumoral vasculopathy resembling acute atherosis may be seen in leiomyomas from patients taking tranexamic acid and postulate that this change results in vascular thrombosis, tumoral edema, and infarct-type necrosis.

Potential genetic anticipation in hereditary leiomyomatosis-renal cell cancer (HLRCC).

Science.gov (United States)

Wong, Mei Hua; Tan, Chuen Seng; Lee, Soo Chin; Yong, Yvonne; Ooi, Aik Seng; Ngeow, Joanne; Tan, Min Han

2014-06-01

Hereditary leiomyomatosis-renal cell cancer (HLRCC) is an autosomal dominant disorder characterised by cutaneous leiomyomas, symptomatic uterine leiomyomas and aggressive type II papillary renal cell carcinoma. It is caused by heterozygous mutations in the fumarate hydratase (FH) gene on chromosome 1q43. We present evidence of genetic anticipation in HLRCC syndrome. A comprehensive literature review was performed to determine the potential for genetic anticipation in HLRCC syndrome. The normal random effects model was used to evaluate for genetic anticipation to ensure reduction in bias. A total of 11 FH kindreds with available multi-generational data were identified for analysis. The mean difference in age at diagnosis of RCC between the first and second generation was -18.6 years (95 % CI -26.6 to -10.6, p anticipation for uterine leiomyomas was observed (p = 0.349). We report preliminary evidence of genetic anticipation of RCC in HLRCC syndrome. Additional clinical validation is important to confirm this observation, which may have practical implications on counseling and timing of surveillance initiation. Exploration of the underlying mechanisms of anticipation in HLRCC would be of considerable biological interest.

Cystoscopic enucleation of bladder leiomyoma

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Ghassan A Barayan

2012-01-01

Full Text Available We are presenting a rare case of bladder leiomyoma. A 61-year-old female patient was found to have a bladder mass during a work up of lower urinary tract symptoms. After full investigation, she underwent transurethral excision of the mass. The histopathology revealed typical feature of bladder leiomyoma. No recurrence was seen after a follow-up period of 12 months.

Symplastic leiomyoma of uterus: a rare histological variant

International Nuclear Information System (INIS)

Yasmeen, F.; Hafeez, M.; Hameed, S.; Ibnerasa, S.N.

2008-01-01

Symplastic leiomyoma is a rare histological variant of leiomyoma. This is a case report of a young nulliparous patient who presented with primary infertility for 2 years and swelling in lower abdomen for 6 months. Intramural fibroid was diagnosed during a pelvic ultrasound. Histopathology of that myomectomy showed symplastic leiomyoma with absent mitotic figures. The patient was managed as for a benign tumor. (author)

Investigating the loss of work productivity due to symptomatic leiomyoma.

Science.gov (United States)

Hasselrot, Klara; Lindeberg, Mia; Konings, Peter; Kopp Kallner, Helena

2018-01-01

Leiomyoma affects up to 50% of fertile women, leading to morbidity such as bleeding or pain. The effect of symptomatic leiomyoma on the productivity of employed women is understudied. The present study investigates productivity loss in a Swedish setting in women with symptomatic leiomyoma compared to healthy women. Women seeking care for leiomyoma and heavy menstrual bleeding (HMB) were recruited at nine Swedish sites. Healthy controls with self-perceived mild to normal menstruation were recruited at routine visits. Cases and controls were employed without option to work from home. After recruitment, all women reported the work productivity and activity impairment (WPAI) questionnaire, the pictorial blood assessment chart (PBAC) and pain on the visual analog scale (VAS). Women with symptomatic leiomyoma (n = 88) missed more working time during menses compared to asymptomatic controls (n = 34): 7.6 vs 0.2% p = 0.003. The proportion of impairment while working was also significantly higher in women with symptomatic leiomyoma (43.8 vs 12.1% p100). Symptomatic leiomyoma leads to loss of working hours as well as loss of productivity during working hours, and affects women in other daily activities. Increased awareness of the impact of leiomyomas on women's lives is needed, and timely and appropriate management of the symptomatic leiomyomas could improve work productivity and quality of life.

Small leiomyosarcoma of the renal capsule: CT findings

Energy Technology Data Exchange (ETDEWEB)

Roy, C.; Pfleger, D.; Tuchmann, C.; Guth, S.; Gangi, A. [Department of Radiology B, Chirurgie A, Hopitaux Universitaires de Strasbourg (France); Lindner, V. [Department of Pathology, Hopitaux Universitaires de Strasbourg (France); Morel, M. [Clinique Saint-Francois, 1, rue Colome, F-67 500 Haguenau (France)

1998-03-01

Three unusual cases of small-size leiomyosarcoma of the perirenal space were studied with CT. The renal capsule has been proved to be the origin of this type of tumor. A CT examination is accurate in suggesting the site of origin and excluding a renal cell carcinoma. However, unless evidence of invasion is noted, it is impossible on CT features to discriminate leiomyosarcoma from a benign leiomyoma. (orig.) With 3 figs., 21 refs.

Fine mapping of the uterine leiomyoma locus on 1q43 close to a lncRNA in the RGS7-FH interval

NARCIS (Netherlands)

Aissani, B.; Zhang, K.; Mensenkamp, A.R.; Menko, F.H.; Wiener, H.W.

2015-01-01

Mutations in fumarate hydratase (FH) on chromosome 1q43 cause a rare cancer syndrome, hereditary leiomyomatosis and renal cell cancer (HLRCC), but are rare in nonsyndromic and common uterine leiomyoma (UL) or fibroids. Studies suggested that variants in FH or in a linked gene may also predispose to

Vaginal leiomyoma: MRI features with pathologic correlation

Directory of Open Access Journals (Sweden)

Avantika Gupta

2015-06-01

Full Text Available We present a rare case of vaginal leiomyoma presenting as prolapsed vaginal mass in a 45 years old woman. The leiomyoma was found to arise from the right lateral vaginal fornix with a vascular stalk. MRI showed homogenous hypointense signals on T1W1 and iso to hyperintense signals on T2W1 images with moderate heterogenous enhancement on post contrast images. It was enucleated via vaginal route and the histopathological examination confirmed the diagnosis of vaginal leiomyoma.

In vitro effects of phthalate esters in human myometrial and leiomyoma cells and increased urinary level of phthalate metabolite in women with uterine leiomyoma.

Science.gov (United States)

Kim, Jin Hee; Kim, Sung Hoon; Oh, Young Sang; Ihm, Hyo Jin; Chae, Hee Dong; Kim, Chung-Hoon; Kang, Byung Moon

2017-04-01

To investigate the possible role of phthalate, a ubiquitous chemical used in consumer products, in the pathogenesis of uterine leiomyoma. Experimental and prospective case-control study using human samples. University hospital. Fifty-three women with histologic evidence of uterine leiomyoma and 33 surgical controls without leiomyoma. Human myometrial and leiomyoma cells were treated with di-(2-thylhexyl)-phthalate (DEHP). Cell viability assay and Western blot analyses after in vitro DEHP treatment; high-performance liquid chromatography electrospray ionization tandem mass spectrometry in cases and controls. In vitro treatment with DEHP led to an increased viability and increased expressions of proliferating cell nuclear antigen, B-cell lymphoma 2 protein, and type I collagen in myometrial and leiomyoma cells. The urinary concentration of mono-(2-ethyl-5-carboxypentyl) phthalate was higher in women with leiomyoma compared with controls. These findings suggest that exposure to phthalate may play a role in the pathogenesis of uterine leiomyoma by enhancing proliferative activity, exerting an antiapoptotic effect, and increasing collagen contents in myometrial and leiomyoma cells. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Increased expression of electron transport chain genes in uterine leiomyoma.

Science.gov (United States)

Tuncal, Akile; Aydin, Hikmet Hakan; Askar, Niyazi; Ozkaya, Ali Burak; Ergenoglu, Ahmet Mete; Yeniel, Ahmet Ozgur; Akdemir, Ali; Ak, Handan

2014-01-01

The etiology and pathophysiology of uterine leiomyomas, benign smooth muscle tumors of the uterus, are not well understood. To evaluate the role of mitochondria in uterine leiomyoma, we compared electron transport gene expressions of uterine leiomyoma tissue with myometrium tissue in six uterine leiomyoma patients by RT-PCR array. Our results showed an average of 1.562 (±0.445) fold increase in nuclear-encoded electron transport genes. These results might suggest an increase in size, number, or activity of mitochondria in uterine leiomyoma that, to our knowledge, has not been previously reported. © 2014 by the Association of Clinical Scientists, Inc.

Video-assisted lobectomy for endobronchial leiomyoma.

LENUS (Irish Health Repository)

Bartosik, Waldemar

2011-02-01

Endobronchial leiomyomas are rare tumours arising from the smooth muscle on the bronchial tree. We describe a patient with a six-month history of chest infections, who was treated surgically with a video-assisted thoracic surgery (VATS) lobectomy. The pathology revealed an endobronchial leiomyoma that coexisted with postobstructive pulmonary non-necrotising granulomas.

Incidence and characteristics of uterine leiomyomas with FDG uptake

International Nuclear Information System (INIS)

Nishizawa, Sadahiko; Inubushi, Masayuki; Kido, Aki; Miyagawa, Masao; Inoue, Takeshi; Shinohara, Katsura; Kajihara, Makoto

2008-01-01

Uterine leiomyomas sometimes show focal 18 F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) images that may result in a false-positive diagnosis for malignant lesions. This study was conducted to investigate the incidence and characteristics of uterine leiomyomas that showed FDG uptake. We reviewed FDG-PET and pelvic magnetic resonance (MR) images of 477 pre-menopausal (pre-MP, age 42.1±7.3 years) and 880 post-MP (age 59.9±6.8 years) healthy women who underwent these tests as parts of cancer screening. Of 1357, 323 underwent annual cancer screening four times, 97 did three times, 191 did twice, and the rest were screened once. Focal FDG uptake (maximal standardized uptake value >3.0) in the pelvis was localized and characterized on co-registered PET/MR images. Uterine leiomyomas were found in 164 pre-MP and 338 post-MP women. FDG uptake was observed in 18 leiomyomas of 17 of the 164 (10.4%) pre-MP women and in 4 leiomyomas of 4 of the 338 (1.2%) post-MP women. The incidence was significantly higher in pre-MP women than in post-MP women (chi-square, P<0.001). Of the 22, 13 showed signal intensity equal to or higher than that of the myometrium on T2-weighted MR images, which suggested abundant cellularity, whereas the majority of leiomyomas without FDG uptake showed low signal intensity. Of the 13 women, 12 examined more than twice showed substantial changes in the level of FDG uptake in leiomyomas each year with FDG uptake disappearing or newly appearing. These changes were observed frequently in relation with menopause or menstrual phases. Leiomyomas with focal FDG uptake were seen in both pre- and post-MP women with a higher incidence in pre-MP women. Abundant cellularity and hormonal dependency may explain a part of the mechanisms of FDG uptake in leiomyomas. It is important to know that the level of FDG uptake in leiomyomas can change and newly appearing FDG uptake does not necessarily mean malignant transformation. (author)

Diffusion-weighted MR imaging of uterine leiomyomas following uterine artery embolization

International Nuclear Information System (INIS)

Sutter, Olivier; Shotar, Eimad; Guerrache, Youcef; Place, Vinciane; Oprea, Raluca; Le Dref, Olivier; Boudiaf, Mourad; Soyer, Philippe; Dohan, Anthony; Dautry, Raphael; Sirol, Marc; Ricbourg, Aude

2016-01-01

To test whether variations in apparent diffusion coefficient (ADC) values of uterine leiomyomas after uterine artery embolization (UAE) may correlate with outcome and assess the effects of UAE on leiomyomas and normal myometrium with magnetic resonance imaging (MRI). Data of 49 women who underwent pelvic MRI before and after UAE were retrospectively reviewed. Uterine and leiomyoma volumes, ADC values of leiomyomas, and normal myometrium were calculated before and after UAE. By comparison with baseline ADC values, a significant drop in leiomyoma ADC was found at 6-month post-UAE (1.096 x 10"-"3 mm"2/s vs. 0.712 x 10"-"3 mm"2/s, respectively; p < 0.0001), but not at 48-h post-UAE. Leiomyoma devascularization was complete in 40/49 women (82 %) at 48 h and in 37/49 women (76 %) at 6 months. Volume reduction and leiomyoma ADC values at 6 months correlated with the degree of devascularization. There was a significant drop in myometrium ADC after UAE. Perfusion defect of the myometrium was observed at 48 h in 14/49 women (28.5 %) in association with higher degrees of leiomyoma devascularization. Six months after UAE, drop in leiomyoma ADC values and volume reduction correlate with the degree of leiomyoma devascularization. UAE affects the myometrium as evidenced by a drop in ADC values and initial myometrial perfusion defect. (orig.)

Diffusion-weighted MR imaging of uterine leiomyomas following uterine artery embolization

Energy Technology Data Exchange (ETDEWEB)

Sutter, Olivier; Shotar, Eimad; Guerrache, Youcef; Place, Vinciane; Oprea, Raluca; Le Dref, Olivier; Boudiaf, Mourad [Hopital Lariboisiere, AP-HP, Department of Body and Interventional Imaging, Paris (France); Soyer, Philippe; Dohan, Anthony [Hopital Lariboisiere, AP-HP, Department of Body and Interventional Imaging, Paris (France); Universite Paris-Diderot, Sorbonne Paris Cite, Paris (France); UMR INSERM 965, Hopital Lariboisiere, Paris (France); Dautry, Raphael; Sirol, Marc [Hopital Lariboisiere, AP-HP, Department of Body and Interventional Imaging, Paris (France); Universite Paris-Diderot, Sorbonne Paris Cite, Paris (France); Ricbourg, Aude [Hopital Lariboisiere-AP-HP, Department of Obstetrics and Gynecology, Paris (France)

2016-10-15

To test whether variations in apparent diffusion coefficient (ADC) values of uterine leiomyomas after uterine artery embolization (UAE) may correlate with outcome and assess the effects of UAE on leiomyomas and normal myometrium with magnetic resonance imaging (MRI). Data of 49 women who underwent pelvic MRI before and after UAE were retrospectively reviewed. Uterine and leiomyoma volumes, ADC values of leiomyomas, and normal myometrium were calculated before and after UAE. By comparison with baseline ADC values, a significant drop in leiomyoma ADC was found at 6-month post-UAE (1.096 x 10{sup -3} mm{sup 2}/s vs. 0.712 x 10{sup -3} mm{sup 2}/s, respectively; p < 0.0001), but not at 48-h post-UAE. Leiomyoma devascularization was complete in 40/49 women (82 %) at 48 h and in 37/49 women (76 %) at 6 months. Volume reduction and leiomyoma ADC values at 6 months correlated with the degree of devascularization. There was a significant drop in myometrium ADC after UAE. Perfusion defect of the myometrium was observed at 48 h in 14/49 women (28.5 %) in association with higher degrees of leiomyoma devascularization. Six months after UAE, drop in leiomyoma ADC values and volume reduction correlate with the degree of leiomyoma devascularization. UAE affects the myometrium as evidenced by a drop in ADC values and initial myometrial perfusion defect. (orig.)

The role of progesterone signaling in the pathogenesis of uterine leiomyoma

Science.gov (United States)

Kim, J. Julie; Sefton, Elizabeth C.

2011-01-01

Uterine leiomyomas are benign tumors that originate from the myometrium. Evidence points to ovarian steroid hormones, in particular, progesterone as major promoters of leiomyoma development and growth. While progesterone action in leiomyomas involves the classical nuclear receptor effects on gene regulation, there is growing evidence that signaling pathways are directly activated by the progesterone receptor (PR) and that PR can interact with growth factor signaling systems to promote proliferation and survival of leiomyomas. Studies investigating the genomic and non-genomic actions of PR and its role in leiomyoma growth are summarized here. Studies testing various selective progesterone receptor modulators for the treatment of leiomyomas are also highlighted. An increased understanding of the mechanisms associated with progesterone-driven growth of leiomyomas is critical in order to develop more efficient and targeted therapies for this prevalent disease. PMID:21672608

Erythrocytosis caused by giant chromophobe renal cell carcinoma: a case report indicating a 9-year misdiagnosis of polycythemia vera.

Science.gov (United States)

Guo, Renbo; Liang, Yiran; Yan, Lei; Xu, Zhonghua; Ren, Juchao

2017-09-06

Erythrocytosis, a rare paraneoplastic syndrome, generally occurs in patients with clear cell renal cell carcinoma and has never been reported in patients with chromophobe renal cell carcinoma. We report a case of a young man suffering from a giant (22-cm) mass on his left kidney. Because of a history of polycythemia vera, the patient had been treated for the condition for 9 years. Radical nephrectomy was successfully performed, and the postoperative pathologic examination confirmed a diagnosis of chromophobe renal cell carcinoma. Unexpectedly, the symptom of erythrocytosis disappeared after the surgery. Further examination and analysis were performed, and we finally attributed his erythrocytosis to chromophobe renal cell carcinoma. Chromophobe renal cell carcinoma could cause erythrocytosis, but the clear-cut mechanism needs further research. Secondary erythrocytosis such as those related with renal tumors should be taken into consideration during the diagnosis of polycythemia vera.

Degenerated uterine leiomyomas mimicking malignant bilateral ovarian surface epithelial tumors

Energy Technology Data Exchange (ETDEWEB)

Hwang, Yi Boem Ha; Lee, Hae Kyung; Lee, Min Hee; Choi, Seo Youn; Chung, Soo Ho [Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of)

2017-07-15

Uterine leiomyomas are the most common benign uterine neoplasms. Undegenerated uterine leiomyomas are easily recognizable by the typical imaging findings on radiologic studies. However, degenerated fibroids can have unusual and variable appearances. The atypical appearances due to degenerative changes may cause confusion in diagnosis of leiomyomas. In this article, we report a case of a patient with extensive cystic and myxoid degeneration of uterine leiomyoma, mimicking malignant bilateral ovarian surface epithelial tumors.

Benign Metastatic Leiomyoma Presenting as a Hemothorax

Directory of Open Access Journals (Sweden)

Anna M. Ponea

2013-01-01

Full Text Available Uterine leiomyomas have been reported to metastasize to various organs including the lungs, skeletal muscles, bone marrow, peritoneum, and heart. They may present with symptoms related to the metastases several years after hysterectomy. These tumors regress after menopause, and it is rare to detect active tumors in postmenopausal women. Despite their ability to metastasize, they are considered to be benign due to the lack of anaplasia. Pulmonary benign metastasizing leiomyoma is usually detected in the form of pulmonary nodules incidentally on imaging. Tissue biopsy of these nodules is required to identify them as benign metastasizing leiomyomas. Immunohistochemical analysis and molecular profiling may further help detect any malignant transformation in it. Untreated pulmonary benign metastasizing leiomyoma may result in the formation of cystic structures, destruction of lung parenchyma, and hemothorax and may cause respiratory failure. Surgical resection and hormonal therapy help prevent progression of this disease and provide an avenue for a cure.

Leiomyoma of the nipple diagnosed by MRI

International Nuclear Information System (INIS)

Cho, Hyung JI; Kim, Sung Hun; Kang, Bong Joo; Kim, Hanna; Song, Byung Joo; Lee, Ah Won

2012-01-01

Leiomyoma of the nipple is a rare, benign, non-epithelial tumor that is thought to arise from smooth muscle fibers in the subareolar tissue of the breast. We report an unusual case of leiomyoma of the nipple in a 32-year-old woman in whom the diagnosis was made by ultrasound-guided core needle biopsy. She came to our hospital complaining of a recently enlarged nipple with discharge and erosion in the region of the left nipple-areolar complex. This mass was evaluated by mammography, ultrasonography, and magnetic resonance imaging (MRI). To the best of our knowledge, this is the first case of a leiomyoma of the nipple examined by MRI. MRI showed an oval mass with circumscribed margins that appeared as an intermediate signal intensity on both T1- and T2-weighted images. A dynamic MRI study showed a rim-enhancing oval mass with delayed persistent enhancement. Ultrasound-guided core needle biopsy revealed spindle cell proliferation consistent with leiomyoma of the nipple

Role of Apoptosis in the Development of Uterine Leiomyoma: Analysis of Expression Patterns of Bcl-2 and Bax in Human Leiomyoma Tissue With Clinical Correlations.

Science.gov (United States)

Csatlós, Éva; Máté, Szabolcs; Laky, Marcella; Rigó, János; Joó, József Gábor

2015-07-01

To describe gene expression patterns of the apoptotic regulatory genes Bcl and Bax in human uterine leiomyoma tissue. To investigate the relationship between alterations of gene expression patterns and several relevant clinical parameters. We obtained samples from 101 cases undergoing surgery for uterine leiomyoma for gene expression analysis of the Bcl-2 and Bax genes. Gene expression was quantified using RT-PCR technique. In the leiomyoma group, the Bcl-2 gene was significantly overexpressed compared with the control group although there was no such difference in the gene expression of Bax. Gene activity of Bcl-2 positively correlated with the tumor number in individual uterine leiomyoma cases. Although there was no significant correlation between the length of the cumulative lactation period before the development of uterine leiomyoma and Bcl-2 gene expression in the leiomyoma tissue, we observed a trend for a shorter cumulative lactation period to be associated with overexpression of the Bcl-2 gene. Overexpression of the antiapoptotic Bcl-2 gene appeared to be a factor in the development of uterine leiomyoma, whereas gene activity of the proapoptotic Bax gene did not seem to play a role in the process.

Aberrant expression of erythropoietin in uterine leiomyoma: implications in tumor growth.

Science.gov (United States)

Asano, Ryoko; Asai-Sato, Mikiko; Miyagi, Yohei; Mizushima, Taichi; Koyama-Sato, Makiko; Nagashima, Yoji; Taguri, Masataka; Sakakibara, Hideya; Hirahara, Fumiki; Miyagi, Etsuko

2015-08-01

Myomatous erythrocytosis syndrome is a rare complication of uterine leiomyoma caused by erythropoietin (EPO) that is produced by tumor cells. We assessed the EPO expression in leiomyomas and investigated the effects of EPO on the tumor growth. Tissue samples were collected from 114 patients with uterine leiomyomas who underwent myomectomy or hysterectomy in Yokohama City University Hospital. From 17 patients, the corresponding normal myometrium was also collected. All samples were analyzed for EPO messenger RNA (mRNA) expression by real-time reverse transcription-polymerase chain reaction. EPO protein expression was determined by an enzyme-linked immunosorbent assay. The relationships between EPO expression and clinicopathological features were retrospectively analyzed using the patients' charts. Blood vessel density and maturity were assessed using hematoxylin-eosin staining and CD34 immunohistochemistry. EPO mRNA expression was detected in 108 of 114, or 95%, of the leiomyomas. The mean EPO mRNA expression in the leiomyoma was higher than the corresponding normal myometrium (3836 ± 4122 vs 1455 ± 2141; P = .025 by Wilcoxon rank test). The EPO mRNA expression in the leiomyomas varied extensively among samples, ranging from undetectable levels to 18-fold above the mean EPO mRNA of normal myometrium. EPO protein production was observed concomitant with mRNA expression. A positive correlation of leiomyoma size and EPO mRNA expression was shown by Spearman rank correlation coefficient (ρ = 0.294; P = .001), suggesting the involvement of EPO in leiomyoma growth. The blood vessel maturity was also significantly increased in EPO-producing leiomyomas (high vessel maturity in high vs low EPO group: 67% vs 20%; P = .013 by Fisher exact test). This report demonstrates that EPO is produced in most of conventional leiomyomas and supports a model in which EPO accelerates tumor growth, possibly by inducing vessel maturity. Our study suggests one possible mechanism by which

A case of bladder leiomyoma with literature review

International Nuclear Information System (INIS)

Zeng Sihui; Chen Zhiguang; Liang Biling

2006-01-01

Objective: Preliminarily analysis of the MRI features of bladder leiomyoma. Methods: The MRI manifestations were analyzed with review of previous released literatures in a case of bladder leiomyoma, which was confirmed by pathology. Results: The lesion manifested homogeneous intermediate signal intensity both on non-enhanced T 1 WI and T 2 WI, and intermediate enhancement on contrast enhanced T 1 WI. There was no pedicle on the tumor and the tumor-bladder junction had an acute angle, indicating its benign nature. Conclusion: Non-epithelial tumor has characteristic signals in non-enhanced MRI, in which the leiomyoma of bladder is the most frequent benign neoplasm encountered. Considering enhanced MRI findings, the morphology and growth pattern of the tumor, accurate diagnosis can be made in some cases of bladder leiomyoma, providing valuable informations for surgical planning. (authors)

Ultrasound and MR imaging findings of vulvar leiomyoma: case report

International Nuclear Information System (INIS)

Lee, Jeong Hee; Lee, Jin Hee; Woo, Seong Ku; Kim, Sang Pyu

2002-01-01

Leiomyomas are common benign neoplasms that can occur at any anatomical site containing smooth muscle, though most originate in the female genital tract. Leiomyomas of the vulval perineum are, however, very rare. We report the ultrasonographic (US) and MR imagings of a vulvar leiomyoma, and briefly review the literature

Ultrasound and MR imaging findings of vulvar leiomyoma: case report

Energy Technology Data Exchange (ETDEWEB)

Lee, Jeong Hee; Lee, Jin Hee; Woo, Seong Ku; Kim, Sang Pyu [Keimyung University School of Medicine, Taegu (Korea, Republic of)

2002-11-01

Leiomyomas are common benign neoplasms that can occur at any anatomical site containing smooth muscle, though most originate in the female genital tract. Leiomyomas of the vulval perineum are, however, very rare. We report the ultrasonographic (US) and MR imagings of a vulvar leiomyoma, and briefly review the literature.

A Patient Presenting with Concurrent Testis Torsion and Epididymal Leiomyoma

Directory of Open Access Journals (Sweden)

E. Arpali

2013-01-01

Full Text Available Leiomyomas are the second most common tumors of epididymis. Patients with leiomyomas are sometimes misdiagnosed with testicular tumors. A Case of a patient with a scrotal mass presenting with testicular torsion is reported. Concurrent occurrence of testicular torsion and epididymal leiomyoma is an extremely rare condition.

Abnormal expression of leiomyoma cytoskeletal proteins involved in cell migration.

Science.gov (United States)

Ura, Blendi; Scrimin, Federica; Arrigoni, Giorgio; Athanasakis, Emmanouil; Aloisio, Michelangelo; Monasta, Lorenzo; Ricci, Giuseppe

2016-05-01

Uterine leiomyomas are monoclonal tumors. Several factors are involved in the neoplastic transformation of the myometrium. In our study we focused on dysregulated cytoskeletal proteins in the leiomyoma as compared to the myometrium. Paired tissue samples of ten leiomyomas and adjacent myometria were obtained and analyzed by two‑dimensional gel electrophoresis (2-DE). Mass spectrometry was used for protein identification, and western blotting for 2-DE data validation. The values of ten cytoskeletal proteins were found to be significantly different: eight proteins were upregulated in the leiomyoma and two proteins were downregulated. Three of the upregulated proteins (myosin regulatory light polypeptide 9, four and a half LIM domains protein 1 and LIM and SH3 domain protein 1) are involved in cell migration, while downregulated protein transgelin is involved in replicative senescence. Myosin regulatory light polypeptide 9 (MYL9) was further validated by western blotting because it is considered to be a cell migration marker in several cancers and could play a key role in leiomyoma development. Our data demonstrate significant alterations in the expression of cytoskeletal proteins involved in leiomyoma growth. A better understanding of the involvement of cytoskeletal proteins in leiomyoma pathogenesis may contribute to the identification of new therapeutic targets and the development of new pharmacological approaches.

[Benign Metastasizing Leiomyoma of the Lung;Report of a Case].

Science.gov (United States)

Sawada, Takahiro; Yamamoto, Satoshi; Sugihara, Hajime; Iwasaki, Akinori

2017-02-01

A 71-year-old woman, in whom computed tomography revealed a solitary mass shadow at the base of the left lung, underwent resection of the mass. Histopathological examination showed estrogen receptor-positive leiomyoma cells growing in cords and mixed with glandular structures composed of alveolar cells. These findings led to a diagnosis of benign metastatic leiomyoma. Benign metastatic leiomyoma is a rare disease in which histologically benign uterine leiomyoma cells metastasize to different sites of the body. However, in this patient, the presence of uterine myoma was not confirmed in the past or at present. She had a history of cervical conization, which suggests that a small amount of the leiomyoma component contained in cervical tissue may have been forced into blood vessels during surgical manipulation, causing lung metastasis.

Leiomyoma of the breast: A Case report

Directory of Open Access Journals (Sweden)

Ferruh Balaban

2012-06-01

Full Text Available Leiomyomas are benign smooth muscle neoplasms thatare common in the genitourinary and gastrointestinaltracts. They can occur anywhere in the body but are rarein the breast. Here we report a case of leiomyoma in thebreast in a 43 years old woman with histological, immünohistochemicalcharacteristics and review the literature.

Esophageal leiomyoma arising in an epiphrenic diverticulum

International Nuclear Information System (INIS)

Hamilton, S.

1988-01-01

A 32-year old woman was found at surgery to have an esophageal leiomyoma arising within an epiphrenic diverticulum. These uncommon conditions may rarely occur together, causing difficulty in diagnosis of the leiomyoma. Other neoplasms may also arise in an epiphrenic diverticulum and should be borne in mind in this situation. (orig.)

Differentiation between ovarian fibroma and subserosal leiomyoma by MR imaging

International Nuclear Information System (INIS)

Choi, Sang Yeol; Lee, Jun Woo; Kim, Chang Won; Kim, Yong Woo; Lee, Suck Hong

2000-01-01

To evaluate the findings and differential points of ovarian fibroma and subserosal leiomyoma, as seen on MR images. The MRimaging findings of 31 surgically confirmed cases of ovarian fibroma (n=3D6) and subserosal leiomyoma (n=3D25; 28) lesions were evaluated. Multiplanar T1-T2-weighted and postcontrast T1-weighted images were obtained using a 1.5T MR unit, and histologic examination was also performed. The MR findings were analyzed in terms of signal intensity, the presence and definition of margin, the histologic finding of hyperintense lesion on T2-weighted images, the presence of the bridging vessel sign, degree of enhancement, and the presence of ipsilateral ovary and ascites. Both fibromas and leiomyomas showed hypo- or isointensity compared with uterine myometrium on T1-weighted images and compared with skeletal muscle on T2-weighted images. The latter revealed intratumoral hyperintense lesions in most cases of ovarian fibroma and subserosal leiomyoma. Three of four ovarian fibromas had a well defined margin after cystic change, but in 24 of 26 subserosal leiomyomas the margin was ill defined. The 'bridging vessel sign' was visible only in subserosal leiomyomas (22/28), and in all cases the enhancement of ovarian fibromas were less than that of myomtetrium. Subserosal leiomyomas (12/28), seen on enhancement as isointense or hyperintense to myometrium, showed a greater degree of enhancement than ovarian fibromas (0/6). Ipsilateral ovary was rarely seen in ovarian fibromas (1/6), but commonly seen in subserosal leiomyomas (20/250. Ascites was present in one case of ovarian fibroma. A defined margin of an intratumoral hyperintense lesion, as seen on T2-weighted images, and the presence or absence of the 'bridging vessel sign' and ipsilateral ovary are useful signs when differentiating between ovarian fibromas and subserosal leiomyomas. (author)

The Mechanism and Function of Epigenetics in Uterine Leiomyoma Development

Science.gov (United States)

Yang, Qiwei; Mas, Aymara; Diamond, Michael P.; Al-Hendy, Ayman

2015-01-01

Uterine leiomyomas, also known as uterine fibroids, are the most common pelvic tumors, occurring in nearly 70% of all reproductive-aged women and are the leading indication for hysterectomy worldwide. The development of uterine leiomyomas involve a complex and heterogeneous constellation of hormones, growth factors, stem cells, genetic, and epigenetic abnormalities. An increasing body of evidence emphasizes the important contribution of epigenetics in the pathogenesis of leiomyomas. Genome-wide methylation analysis demonstrates that a subset of estrogen receptor (ER) response genes exhibit abnormal hypermethylation levels that are inversely correlated with their RNA expression. Several tumor suppressor genes, including Kruppel-like factor 11 (KLF11), deleted in lung and esophageal cancer 1 (DLEC1), keratin 19 (KRT19), and death-associated protein kinase 1 (DAPK1) also display higher hypermethylation levels in leiomyomas when compared to adjacent normal tissues. The important role of active DNA demethylation was recently identified with regard to the ten-eleven translocation protein 1 and ten-eleven translocation protein 3-mediated elevated levels of 5-hydroxymethylcytosine in leiomyoma. In addition, both histone deacetylase and histone methyltransferase are reported to be involved in the biology of leiomyomas. A number of deregulated microRNAs have been identified in leiomyomas, leading to an altered expression of their targets. More recently, the existence of side population (SP) cells with characteristics of tumor-initiating cells have been characterized in leiomyomas. These SP cells exhibit a tumorigenic capacity in immunodeficient mice when exposed to 17β-estradiol and progesterone, giving rise to fibroid-like tissue in vivo. These new findings will likely enhance our understanding of the crucial role epigenetics plays in the pathogenesis of uterine leiomyomas as well as point the way to novel therapeutic options. PMID:25922306

Differentiation between ovarian fibroma and subserosal leiomyoma by MR imaging

Energy Technology Data Exchange (ETDEWEB)

Choi, Sang Yeol; Lee, Jun Woo; Kim, Chang Won; Kim, Yong Woo; Lee, Suck Hong [College of Medicine, Pusan National University, Pusan (Korea, Republic of)

2000-01-01

To evaluate the findings and differential points of ovarian fibroma and subserosal leiomyoma, as seen on MR images. The MRimaging findings of 31 surgically confirmed cases of ovarian fibroma (n=3D6) and subserosal leiomyoma (n=3D25; 28) lesions were evaluated. Multiplanar T1-T2-weighted and postcontrast T1-weighted images were obtained using a 1.5T MR unit, and histologic examination was also performed. The MR findings were analyzed in terms of signal intensity, the presence and definition of margin, the histologic finding of hyperintense lesion on T2-weighted images, the presence of the bridging vessel sign, degree of enhancement, and the presence of ipsilateral ovary and ascites. Both fibromas and leiomyomas showed hypo- or isointensity compared with uterine myometrium on T1-weighted images and compared with skeletal muscle on T2-weighted images. The latter revealed intratumoral hyperintense lesions in most cases of ovarian fibroma and subserosal leiomyoma. Three of four ovarian fibromas had a well defined margin after cystic change, but in 24 of 26 subserosal leiomyomas the margin was ill defined. The 'bridging vessel sign' was visible only in subserosal leiomyomas (22/28), and in all cases the enhancement of ovarian fibromas were less than that of myomtetrium. Subserosal leiomyomas (12/28), seen on enhancement as isointense or hyperintense to myometrium, showed a greater degree of enhancement than ovarian fibromas (0/6). Ipsilateral ovary was rarely seen in ovarian fibromas (1/6), but commonly seen in subserosal leiomyomas (20/250. Ascites was present in one case of ovarian fibroma. A defined margin of an intratumoral hyperintense lesion, as seen on T2-weighted images, and the presence or absence of the 'bridging vessel sign' and ipsilateral ovary are useful signs when differentiating between ovarian fibromas and subserosal leiomyomas. (author)

Differential expression of estrogen receptor α and β isoforms in multiple and solitary leiomyomas

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Shao, Ruyue; Fang, Liaoqiong; Xing, Ruoxi; Xiong, Yu; Fang, Liaoqiong; Wang, Zhibiao

2015-01-01

Uterine leiomyomas are benign myometrial neoplasms that function as one of the common indications for hysterectomy. Clinical and biological evidences indicate that uterine leiomyomas are estrogen-dependent. Estrogen stimulates cell proliferation through binding to the estrogen receptor (ER), of which both subtypes α and β are present in leiomyomas. Clinically, leiomyomas may be singular or multiple, where the first one is rarely recurring if removed and the latter associated to a relatively young age or genetic predisposition. These markedly different clinical phenotypes indicate that there may different mechanism causing a similar smooth muscle response. To investigate the relative expression of ERα and ERβ in multiple and solitary uterine leiomyomas, we collected samples from 35 Chinese women (multiple leiomyomas n = 20, solitary leiomyoma n = 15) undergoing surgery to remove uterine leiomyomas. ELISA assay was performed to detect estrogen(E_2) concentration. Quantitative real-time PCR analysis was performed to detect ERα and ERβ mRNA expression. Western blot and immunohistochemical analysis were performed to detect ERα and ERβ protein expression. We found that ERα mRNA and protein levels of in multiple leiomyomas were significantly lower than those of solitary leiomyomas, whereas ERβ mRNA and protein levels in multiple leiomyomas were significantly higher than those in solitary leiomyomas, irrespectively of the menstrual cycle stage. In both multiple and solitary leiomyomas, ERα expression was higher than that of ERβ. E_2 concentration in multiple and solitary leiomyomas correlated with that of ERα expression. ERα was present in nuclus and cytoplasma while estrogen receptor β localized only in nuclei in both multiple and solitary leiomyomas. Our findings suggest that the difference of ERα and ERβ expression between multiple and solitary leiomyomas may be responsible for the course of the disease subtypes. - Highlights: • In both multiple

Differential expression of estrogen receptor α and β isoforms in multiple and solitary leiomyomas

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Shao, Ruyue; Fang, Liaoqiong [State Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and The Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016 (China); Xing, Ruoxi [Institute of Life Science, Chongqing Medical University, Chongqing 400016 (China); Xiong, Yu [Department of Obstetrics and Gynecology, Chongqing Hifu Hospital, Chongqing 401121 (China); Fang, Liaoqiong, E-mail: lqfang06@163.com [State Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and The Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016 (China); Wang, Zhibiao, E-mail: wangzb@cqmu.edu.cn [State Key Laboratory of Ultrasound Engineering in Medicine Co-Founded by Chongqing and The Ministry of Science and Technology, Chongqing Key Laboratory of Biomedical Engineering, College of Biomedical Engineering, Chongqing Medical University, Chongqing 400016 (China)

2015-12-04

Uterine leiomyomas are benign myometrial neoplasms that function as one of the common indications for hysterectomy. Clinical and biological evidences indicate that uterine leiomyomas are estrogen-dependent. Estrogen stimulates cell proliferation through binding to the estrogen receptor (ER), of which both subtypes α and β are present in leiomyomas. Clinically, leiomyomas may be singular or multiple, where the first one is rarely recurring if removed and the latter associated to a relatively young age or genetic predisposition. These markedly different clinical phenotypes indicate that there may different mechanism causing a similar smooth muscle response. To investigate the relative expression of ERα and ERβ in multiple and solitary uterine leiomyomas, we collected samples from 35 Chinese women (multiple leiomyomas n = 20, solitary leiomyoma n = 15) undergoing surgery to remove uterine leiomyomas. ELISA assay was performed to detect estrogen(E{sub 2}) concentration. Quantitative real-time PCR analysis was performed to detect ERα and ERβ mRNA expression. Western blot and immunohistochemical analysis were performed to detect ERα and ERβ protein expression. We found that ERα mRNA and protein levels of in multiple leiomyomas were significantly lower than those of solitary leiomyomas, whereas ERβ mRNA and protein levels in multiple leiomyomas were significantly higher than those in solitary leiomyomas, irrespectively of the menstrual cycle stage. In both multiple and solitary leiomyomas, ERα expression was higher than that of ERβ. E{sub 2} concentration in multiple and solitary leiomyomas correlated with that of ERα expression. ERα was present in nuclus and cytoplasma while estrogen receptor β localized only in nuclei in both multiple and solitary leiomyomas. Our findings suggest that the difference of ERα and ERβ expression between multiple and solitary leiomyomas may be responsible for the course of the disease subtypes. - Highlights: • In both

Association between magnetic resonance imaging findings of uterine leiomyomas and symptoms demanding treatment

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Ruuskanen, Anu J., E-mail: anu.ruuskanen@kuh.fi [Department of Clinical Radiology, Kuopio University Hospital, Kuopio (Finland); Hippelaeinen, Maritta I., E-mail: maritta.hippelainen@kuh.fi [Department of Obstetrics and Gynaecology, Kuopio University Hospital, Kuopio (Finland); Sipola, Petri, E-mail: petri.sipola@kuh.fi [Department of Clinical Radiology, Kuopio University Hospital, Kuopio (Finland); University of Eastern Finland, Faculty of Health Sciences, Institute of Clinical Medicine, Kuopio (Finland); Manninen, Hannu I., E-mail: hannu.manninen@kuh.fi [Department of Clinical Radiology, Kuopio University Hospital, Kuopio (Finland); University of Eastern Finland, Faculty of Health Sciences, Institute of Clinical Medicine, Kuopio (Finland)

2012-08-15

Purpose: To evaluate the association between magnetic resonance imaging (MRI) derived uterine and leiomyoma characteristics and symptoms demanding treatment. Materials and methods: Consecutive patients (n = 122; mean age, 47.5 years) with symptomatic leiomyomas participated in a prospective study. The leiomyoma/endometrium relationship, sizes of leiomyomas and uteri, and number and enhancement of leiomyomas were determined by MRI. Submucosal leiomyomas were classified as protruding either {>=}50% or <50% into the uterine cavity. Results: Sixty-nine patients (57%) had menorrhagia and pressure symptoms, while 26 (21%) had only menorrhagia and 27 (22%) pressure symptoms alone. Leiomyomas with {>=}50% protrusion into the uterine cavity were detected more often in patients with both symptoms or just menorrhagia than in those with pressure symptoms only (18/69 [26%] versus 1/27 [4%], P = 0.013; 10/26 [39%] versus 1/27 [4%], P = 0.002, respectively). The degree of enhancement of leiomyomas was higher (P = 0.005) and leiomyomas were smaller (P = 0.002) in patients with menorrhagia than in those with pressure symptoms. Large uterine and leiomyoma measures were associated with increased urinary frequency (P values 0.002-0.032). Urinary stress incontinence, abdominal pain, and pressure on the back were not associated with MRI findings. Conclusion: In comparison with pressure symptoms, menorrhagia is associated with smaller uterine and leiomyoma size and with more intense enhancement. While a submucosal leiomyoma largely protruding into the cavity contributes to menorrhagia, significance of a minor submucosal component seems to be unclear. The large leiomyoma and uterine volumes contribute to increased urinary frequency, whereas other mechanisms for urinary stress incontinence and pain symptoms should be considered.

The utility of diffusion-weighted MR imaging for differentiating uterine sarcomas from benign leiomyomas

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Tamai, Ken; Saga, Tsuneo; Morisawa, Nobuko; Fujimoto, Koji; Togashi, Kaori; Koyama, Takashi; Mikami, Yoshiki

2008-01-01

The usefulness of diffusion-weighted (DW) magnetic resonance (MR) imaging for the diagnosis of uterine sarcomas was investigated, as well as whether DW images and quantitative measurement of apparent diffusion coefficient (ADC) values can facilitate differentiating uterine sarcomas from benign leiomyomas. MR images including DW images were obtained in 43 surgically treated patients with 58 myometrial tumors, including seven uterine sarcomas (five leiomyosarcomas and two endometrial stromal sarcomas) and 51 benign leiomyomas (43 ordinary leiomyomas, two cellular leiomyomas and six degenerated leiomyomas). Qualitative analysis of non-enhanced and postcontrast MR images and DW images and quantitative measurement of ADC values were performed for each myometrial tumor. Both uterine sarcomas and cellular leiomyomas exhibited high signal intensity on DW images, whereas ordinary leiomyomas and most degenerated leiomyomas showed low signal intensity. The mean ADC value (10 -3 mm 2 /s) of sarcomas was 1.17 ± 0.15, which was lower than those of the normal myometrium (1.62 ± 0.11) and degenerated leiomyomas (1.70 ± 0.11) without any overlap; however, they were overlapped with those of ordinary leiomyomas and cellular leiomyomas. In addition to morphological features on nonenhanced and postcontrast MR sequences, DW imaging and ADC measurement may have a potential ability to differentiate uterine sarcomas from benign leiomyomas. (orig.)

Leiomyoma of Testis –Rare Benign Mimicker of Testicular Malignancy

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Asif Baliyan

2017-10-01

Full Text Available Leiomyomas are benign tumours that originate from any organ containing smooth muscles. The testis is an extremely rare site. We report a case of testicular leiomyoma in a 50-year-old. Testis-associated leiomyomas are a benign and rare disease presenting as a painless, slowly-growing mass. Only histological examination with immunohistochemistry can validate the diagnosis.

Zosteriform cutaneous leiomyoma: a rare cutaneous neoplasm

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Bari, A.U.

2013-01-01

Cutaneous leiomyomas are firm, round to oval, skin-coloured to brownish papules and nodules that may present as a solitary, few discrete or multiple clustered lesions. Different uncommon patterns of multiple leiomyoma distribution have been noted as bilateral, symmetrical, linear, zosteriform, or dermatomal-like arrangement. One such rare presentation was seen in a 23-year-old patient who presented with zosteriform skin coloured, occasionally painful cutaneous lesions over left shoulder region. Histopathology confirmed the diagnosis of cutaneous leiomyoma. He was symptomatically managed with non-steroidal anti-inflammatory agents and topical capcicum cream. Case is reported here due to rare occurrence of this benign cutaneous neoplasm in an atypical pattern and on uncommon site. (author)

Leiomyoma of the bladder and MRI

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Kabbaj, N.; Dafiri, R.; Imani, F.; Benslimane, L.; Benchekroun, A.

1998-01-01

Unlike epithelial tumors, connective tissue tumors are uncommon, representing only 3 % of all bladder tumors. Leiomyoma of the bladder is the most frequent non-epithelial benign tumor of the bladder. Magnetic resonance imaging (MIR) is highly useful for diagnostic purposes and to determine the degree of extension. Only few reports of sonographic findings have been reported for leiomyoma of the bladder. The tumor usually develops within the bladder. Extra-vesicular formations have also been reported as well as a few intramural localizations. The characteristic feature is the absence of mucosal involvement. We analyzed the MRI findings in a case of leiomyoma of the bladder with intra and extra-vesicular development inflammatory reaction of the bladder wall and uterine adherences in a woman with a past history of chronic cystitis. The role of diagnostic MRI is discussed. (author)

Leiomyoma of the appendix: a case report

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Kim, Seong Hoon; Cho, Hyun Cheol; Son, Mi Young [Dae-Gu Veterans Hospital, Daegu (Korea, Republic of)

2007-05-15

Leiomyomas of the appendix are rare and most are encountered incidentally during exploration of the abdomen for some other disease, during postmortem examination, or in the course of routine pathologic examinations of surgical specimens. We report here the findings of ultrasonography, CT and surgery of a case of leiomyoma that arose from the appendix; this lesion was pathologically confirmed.

Mifepristone inhibits extracellular matrix formation in uterine leiomyoma.

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Patel, Amrita; Malik, Minnie; Britten, Joy; Cox, Jeris; Catherino, William H

2016-04-01

To characterize the efficacy of mifepristone treatment on extracellular matrix (ECM) production in leiomyomas. Laboratory study. University research laboratory. None. Treatment of human immortalized two-dimensional (2D) and three-dimensional (3D) leiomyoma and myometrial cells with mifepristone and the progestin promegestone (R5020). Expression of COL1A1, fibronectin, versican variant V0, and dermatopontin in treated leiomyoma cells by Western blot analysis and confirmatory immunohistochemistry staining of treated 3D cultures. Treatment with progestin stimulated production of COL1A1, fibronectin, versican, and dermatopontin. Mifepristone treatment inhibited protein production of these genes, most notably with versican expression. Combination treatment with both the agonist and antagonist further inhibited protein expression of these genes. Immunohistochemistry performed on 3D cultures demonstrated generalized inhibition of ECM protein concentration. Our study demonstrated that the progesterone agonist R5020 directly stimulated extracellular matrix components COL1A1, fibronectin, versican, and dermatopontin production in human leiomyoma cells. Progesterone antagonist mifepristone decreased protein production of these genes to levels comparable with untreated leiomyoma cells. Published by Elsevier Inc.

Leiomyoma originating from axilla: A rare case report and differential diagnosis.

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Kim, Ho Jun; Baek, Sang Oon; Rha, Eun Young; Lee, Jun Yong; Han, Hyun Ho

2016-07-01

Leiomyoma is a form of benign tumor originated in hypertrophy of the smooth muscles, which is most prevalent in the uterus and gastrointestinal tract. However, Leiomyoma originating from smooth muscle at the vessels lying on deep soft tissue is very rare. Our case was a rare case of leiomyoma originating from the axillary region, which was initially diagnosed as a fibroadenoma on radiological examination. The mass was separated from surrounding tissues and totally resected. Pathologically, hematoxylin-eosin-stained biopsy tissue showed the typical findings of leiomyoma. Postoperative follow-up observation was done for 1 year, without any complications or recurrence. Notably, a leiomyoma in the axillary region is difficult to differentiate from other benign or malignant tumors on preoperative radiological examinations such as ultrasonography or computed tomgraphy. Therefore, when an indefinite asymptomatic mass that is not lymphadenopathy or common benign tumor is identified in the axillary region, leiomyoma can be considered as one of the differential diagnoses.

Comparison of Leiomyoma of Modern Medicine and Traditional Persian Medicine.

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Tansaz, Mojgan; Tajadini, Haleh

2016-04-01

Leiomyoma is the most common benign tumor of the pelvic that is associated with reproductive problems such as infertility, frequent abortions, and undesirable prenatal outcomes. High prevalence of leiomyoma and its relation with important gynecological complications, especially during reproductive ages, on the one hand, and high medical expenses and significant complications of common treatments, on the other, made us search traditional Persian medicine texts for a similar disease. In traditional Persian medicine, a condition has been introduced similar to leiomyoma (Oram-e-rahem). In this article, by collecting materials from traditional medicine texts on leiomyoma, we aim to provide theories for further studies on this topic, as there is an obvious difference between traditional Persian medicine and modern medicine with regard to leiomyoma. When modern medicine has not found a suitable response to treatment, reviewing of traditional Persian medicine for finding better treatment strategies is wise. © The Author(s) 2015.

Patients with uterine leiomyoma exhibit a high incidence but low mortality rate for breast cancer.

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Shen, Te-Chun; Hsia, Te-Chun; Hsiao, Chieh-Lun; Lin, Cheng-Li; Yang, Chih-Yi; Soh, Khay-Seng; Liu, Liang-Chih; Chang, Wen-Shin; Tsai, Chia-Wen; Bau, Da-Tian

2017-05-16

The association of uterine leiomyoma with increased risk of breast cancer is controversial. Therefore, we used the National Health Insurance Research Database of Taiwan to examine breast cancer incidence and mortality among Asian patients with and without uterine leiomyoma. We compared breast cancer incidence and mortality between 22,001 newly diagnosed uterine leiomyoma patients and 85,356 individuals without uterine leiomyoma matched by age and date of diagnosis. Adjusted hazard ratios for breast cancer were estimated using the Cox model. The incidence of breast cancer was 35% higher in the uterine leiomyoma group than the leiomyoma-free group (1.65 vs. 1.22 per 1,000 individuals, p leiomyoma group (mean followed time, 3.59 ± 2.70 years) than the leiomyoma-free group (8.78%; mean followed time, 3.54 ± 2.67 years) at the endpoint of the study (p leiomyoma than in those without it, but overall mortality from breast cancer was lower in the patients with uterine leiomyoma.

Primary ovarian leiomyoma with cystic degeneration : a case report

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Kim, Jong Chul; Suh, Kwang Sun

2000-01-01

Leiomyoma of the ovary is a very rare benign tumor which is usually found incidentally on routine pelvic examination, or during surgery of autopsy. We report a case of ovarian leiomyoma in a 46-year-old woman in whom a lower abdominal mass was detected. A multiloculated and multiseptated mainly cystic mass in the left adnexa was revealed by computed tomography, and was thought to be an ovarian mucinous cystadenoma. Surgical pathology, however, demonstrated that the mass was a vascular leiomyoma originating from the left ovary. (author)

Primary ovarian leiomyoma with cystic degeneration : a case report

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Kim, Jong Chul; Suh, Kwang Sun [School of Medicine, Chungnam National University, Taejon (Korea, Republic of)

2000-02-01

Leiomyoma of the ovary is a very rare benign tumor which is usually found incidentally on routine pelvic examination, or during surgery of autopsy. We report a case of ovarian leiomyoma in a 46-year-old woman in whom a lower abdominal mass was detected. A multiloculated and multiseptated mainly cystic mass in the left adnexa was revealed by computed tomography, and was thought to be an ovarian mucinous cystadenoma. Surgical pathology, however, demonstrated that the mass was a vascular leiomyoma originating from the left ovary. (author)

Low vascularity predicts favourable outcomes in leiomyoma patients treated with uterine artery embolization.

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Tang, Yixin; Chen, Chunlin; Duan, Hui; Ma, Ben; Liu, Ping

2016-10-01

To investigate the clinical factors predicting outcomes of leiomyoma treated with uterine artery embolization (UAE). A total of 183 uterine leiomyoma patients undergoing UAE were retrospectively analyzed. Patient age, characteristics of vascular supply in magnetic resonance imaging (MRI)/digital subtraction angiography (DSA), number, size and location of leiomyoma were recorded. Leiomyoma regrowth, new leiomyoma appearance and recurrence of any previously reported symptoms were carefully monitored over a mean follow-up of 30 months (median 32 months, range 12-80). Potential recurrence risk factors were analyzed by univariate and multivariate cox regression analysis. Twenty-three recurrences were recorded. The difference in the vascularity classification systems between MRI and DSA was not statistically significant (P = 0.059). High vascularity in MRI, high vascularity in DSA and multiple leiomyoma showed a significant risk of recurrence using univariate and multivariate analysis (P = 0.004, P leiomyoma recurrence (P > 0.05). Low vascularity and solitary leiomyoma indicated favourable outcomes in patients treated with UAE. • Low vascularity and solitary mass predicted favourable outcomes in UAE-treated patients. • MRI might provide information on vascularity in leiomyoma before UAE. • Variations in vascular supply, age, size, location were not associated with recurrence.

MR imaging findings of leiomyoma in the prevesical space: case report

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Whang, In Yong; Jung, Seung Eun; Lee, Jae Mun; Hahn, Seong Tai

2003-01-01

Leiomyomas most frequently occur in the genitourinary and gastrointestinal system. This report describes the clinical and imaging findings of a leiomyoma originating in the prevesical space, a rare location. The mass abutted the fundus of the uterus, but after the correct identification of feeding vessels from the right iliac artery, prevesical leiomyoma was diagnosed radiologically

MR imaging findings of leiomyoma in the prevesical space: case report

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Whang, In Yong; Jung, Seung Eun; Lee, Jae Mun; Hahn, Seong Tai [College of Medicine, Catholic Univ., Seoul (Korea, Republic of)

2003-10-01

Leiomyomas most frequently occur in the genitourinary and gastrointestinal system. This report describes the clinical and imaging findings of a leiomyoma originating in the prevesical space, a rare location. The mass abutted the fundus of the uterus, but after the correct identification of feeding vessels from the right iliac artery, prevesical leiomyoma was diagnosed radiologically.

Cutaneous Leiomyoma: Novel Histologic Findings for Classification and Diagnosis

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Kambiz Kamyab Hesari

2013-01-01

Full Text Available Smooth muscle tumors rather benign or malignant can arise wherever the muscular tissue presents but cutaneous leiomyoma is one of the rare benign tumors of the which even the diagnostic criteria from the malignant type of the tumor is still in doubt. This study was aimed to compare the subtypes of cutaneous leiomyoma from different histologic aspects in order to find unique criteria for better classification and diagnosis. The six year data base of our center was reviewed and 25 patients with cutaneous leiomyoma were included in this study. Of 25 patients, 5 were female and 20 were male. 5 patients had angioleiomyoma (ALM and 20 had pilar leiomyoma (PLM. ALM had following characteristics: dilated vascular canals intermingled with compact smooth muscle bundles; well circumscribe counter and myxoid and hyaline changes through the tumor. In contrast, PLMs had following histologic features: poor defined outline, entrapped hair follicles and eccrine glands, acanthosis and elongated rete ridges with hyperpigmentation and smooth muscle bundles which are interdigitated with elongated rete ridges. Here we introduced some distinct histological features for each subtype of the cutaneous leiomyoma which can lead to create novel criteria for classification and diagnosis of the lesion.

Inhibition of canonical WNT signaling attenuates human leiomyoma cell growth

Science.gov (United States)

Ono, Masanori; Yin, Ping; Navarro, Antonia; Moravek, Molly B.; Coon, John S.; Druschitz, Stacy A.; Gottardi, Cara J.; Bulun, Serdar E.

2014-01-01

Objective Dysregulation of WNT signaling plays a central role in tumor cell growth and progression. Our goal was to assess the effect of three WNT/β-catenin pathway inhibitors, Inhibitor of β-Catenin And TCF4 (ICAT), niclosamide, and XAV939 on the proliferation of primary cultures of human uterine leiomyoma cells. Design Prospective study of human leiomyoma cells obtained from myomectomy or hysterectomy. Setting University research laboratory. Patient(s) Women (n=38) aged 27–53 years undergoing surgery. Intervention(s) Adenoviral ICAT overexpression or treatment with varying concentrations of niclosamide or XAV939. Main Outcome Measure(s) Cell proliferation, cell death, WNT/β-catenin target gene expression or reporter gene regulation, β-catenin levels and cellular localization. Result(s) ICAT, niclosamide, or XAV939 inhibit WNT/β-catenin pathway activation and exert anti-proliferative effects in primary cultures of human leiomyoma cells. Conclusion(s) Three WNT/β-catenin pathway inhibitors specifically block human leiomyoma growth and proliferation, suggesting that the canonical WNT pathway may be a potential therapeutic target for the treatment of uterine leiomyoma. Our findings provide rationale for further preclinical and clinical evaluation of ICAT, niclosamide, and XAV939 as candidate anti-tumor agents for uterine leiomyoma. PMID:24534281

European Society of Urogenital Radiology (ESUR) Guidelines: MR Imaging of Leiomyomas.

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Kubik-Huch, Rahel A; Weston, Michael; Nougaret, Stephanie; Leonhardt, Henrik; Thomassin-Naggara, Isabelle; Horta, Mariana; Cunha, Teresa Margarida; Maciel, Cristina; Rockall, Andrea; Forstner, Rosemarie

2018-02-28

The aim of the Female Pelvic Imaging Working Group of the European Society of Urogenital Radiology (ESUR) was to develop imaging guidelines for MR work-up in patients with known or suspected uterine leiomyomas. Guidelines for imaging uterine leiomyomas were defined based on a survey distributed to all members of the working group, an expert consensus meeting at European Congress of Radiology (ECR) 2017 and a critical review of the literature. The 25 returned questionnaires as well as the expert consensus meeting have shown reasonable homogeneity of practice among institutions. Expert consensus and literature review lead to an optimized MRI protocol to image uterine leiomyomas. Recommendations include indications for imaging, patient preparation, MR protocols and reporting criteria. The incremental value of functional imaging (DWI, DCE) is highlighted and the role of MR angiography discussed. MRI offers an outstanding and reproducible map of the size, site and distribution of leiomyomas. A standardised imaging protocol and method of reporting ensures that the salient features are recognised. These imaging guidelines are based on the current practice among expert radiologists in the field of female pelvic imaging and also incorporate essentials of the current published MR literature of uterine leiomyomas. • MRI allows comprehensive mapping of size and distribution of leiomyomas. • Basic MRI comprise T2W and T1W sequences centered to the uterus. • Standardized reporting ensures pivotal information on leiomyomas, the uterus and differential diagnosis. • MRI aids in differentiation of leiomyomas from other benign and malignant entities, including leiomyosarcoma.

Identification of Differentially Expressed K-Ras Transcript Variants in Patients With Leiomyoma.

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Zolfaghari, Nooshin; Shahbazi, Shirin; Torfeh, Mahnaz; Khorasani, Maryam; Hashemi, Mehrdad; Mahdian, Reza

2017-10-01

Molecular studies have demonstrated a wide range of gene expression variations in uterine leiomyoma. The rat sarcoma virus/rapidly accelerated fibrosarcoma/mitogen-activated protein kinase (RAS/RAF/MAPK) is the crucial cellular pathway in transmitting external signals into nucleus. Deregulation of this pathway contributes to excessive cell proliferation and tumorigenesis. The present study aims to investigate the expression profile of the K-Ras transcripts in tissue samples from patients with leiomyoma. The patients were leiomyoma cases who had no mutation in mediator complex subunit 12 ( MED12) gene. A quantitative approach has been applied to determine the difference in the expression of the 2 main K-Ras messenger RNA (mRNA) variants. The comparison between gene expression levels in leiomyoma and normal myometrium group was performed using relative expression software tool. The expression of K-Ras4B gene was upregulated in leiomyoma group ( P = .016), suggesting the involvement of K-Ras4B in the disease pathogenesis. Pairwise comparison of the K-Ras4B expression between each leiomyoma tissue and its matched adjacent normal myometrium revealed gene upregulation in 68% of the cases. The expression of K-Ras4A mRNA was relatively upregulated in leiomyoma group ( P = .030). In addition, the mean expression of K-Ras4A gene in leiomyoma tissues relative to normal samples was 4.475 (95% confidence interval: 0.10-20.42; standard error: 0.53-12.67). In total, 58% of the cases showed more than 2-fold increase in K-Ras4A gene expression. Our results demonstrated increased expression of both K-Ras mRNA splicing variants in leiomyoma tissue. However, the ultimate result of KRAS expression on leiomyoma development depends on the overall KRAS isoform balance and, consequently, on activated signaling pathways.

Proteoglycans in Leiomyoma and Normal Myometrium: Abundance, Steroid Hormone Control, and Implications for Pathophysiology.

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Barker, Nichole M; Carrino, David A; Caplan, Arnold I; Hurd, William W; Liu, James H; Tan, Huiqing; Mesiano, Sam

2016-03-01

Uterine leiomyoma are a common benign pelvic tumors composed of modified smooth muscle cells and a large amount of extracellular matrix (ECM). The proteoglycan composition of the leiomyoma ECM is thought to affect pathophysiology of the disease. To test this hypothesis, we examined the abundance (by immunoblotting) and expression (by quantitative real-time polymerase chain reaction) of the proteoglycans biglycan, decorin, and versican in leiomyoma and normal myometrium and determined whether expression is affected by steroid hormones and menstrual phase. Leiomyoma and normal myometrium were collected from women (n = 17) undergoing hysterectomy or myomectomy. In vitro studies were performed on immortalized leiomyoma (UtLM) and normal myometrial (hTERT-HM) cells with and without exposure to estradiol and progesterone. In leiomyoma tissue, abundance of decorin messenger RNA (mRNA) and protein were 2.6-fold and 1.4-fold lower, respectively, compared with normal myometrium. Abundance of versican mRNA was not different between matched samples, whereas versican protein was increased 1.8-fold in leiomyoma compared with myometrium. Decorin mRNA was 2.4-fold lower in secretory phase leiomyoma compared with proliferative phase tissue. In UtLM cells, progesterone decreased the abundance of decorin mRNA by 1.3-fold. Lower decorin expression in leiomyoma compared with myometrium may contribute to disease growth and progression. As decorin inhibits the activity of specific growth factors, its reduced level in the leiomyoma cell microenvironment may promote cell proliferation and ECM deposition. Our data suggest that decorin expression in leiomyoma is inhibited by progesterone, which may be a mechanism by which the ovarian steroids affect leiomyoma growth and disease progression. © The Author(s) 2015.

Spontaneous subserosal venous rupture overlying a uterine leiomyoma in a young woman.

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Jenayah, Amel Achour; Saoudi, Sarah; Sferi, Nour; Skander, Rim; Marzouk, Sofiène Ben; Cherni, Abdallah; Sfar, Ezzeddine; Chelli, Dalenda; Boudaya, Fethia

2017-01-01

Uterine leiomyomas are very common tumors found in women. Rupture of veins on the surface of uterine leiomyoma is an unusual source of hemoperitoneum. It is an extremely uncommon gynaecological cause of hemoperitoneum. It is a life threatening emergency. We report a case of massive intraperitoneal hemorrhage due to rupture of vessels on the surface of subserous leiomyoma. A differential diagnosis of rupture of leiomyoma'ssurface vessel should be considered, while dealing with a case of hemoperitoneum with pelvic mass.

An unusual case of uterine cotyledonoid dissecting leiomyoma with adenomyosis.

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Shimizu, Ai; Tanaka, Hoshihito; Iwasaki, Sari; Wakui, Yukio; Ikeda, Hitoshi; Suzuki, Akira

2016-08-04

Cotyledonoid dissecting leiomyoma is a rare variant of uterine smooth muscle tumor with an unusual growth pattern that shows intramural dissection within uterine myometrium and often a placenta-like appearance in its extrauterine components. We present a unique case of cotyledonoid dissecting leiomyoma with adenomyosis. A 40-year-old Japanese female presented with prolonged menorrhagia and severe anemia. She had a pelvic mass followed-up for 6 years with a diagnosis of leiomyoma. However, increase in tumor size and cystic changes with hemorrhage were found by magnetic resonance imaging, and total abdominal hysterectomy with bilateral salpingectomy was performed. Macroscopically, the placenta-like exophytic mass protruding from the posterior uterine wall was composed of multiple nodules containing numerous hemorrhagic cysts. The mass showed continuity as a white multinodular dissecting mass infiltrating the posterolateral myometrium. Microscopically, both extra-and intrauterine portions of the mass were composed of nodules that contained swirled neoplastic smooth muscle cells with marked hyalinized degeneration, as observed in cotyledonoid dissecting leiomyomas of conventional type. In addition, numerous non-neoplastic glands of endometrial type surrounded by abundant endometrium-like stromal cells and non-neoplastic smooth muscle cells were found in the tumor, suggesting that it involved a part of concomitant adenomyosis originating from the nontumoral myometrium. Thus far, over 30 cases of cotyledonoid dissecting leiomyoma have been reported, none of which have described the presence of adenomyosis within the tumor. The present case suggested that cotyledonoid dissecting leiomyoma might have a unique clinical presentation involving concomitant uterine adenomyosis. It is critical for pathologists, gynecologists, and radiologists to be cognizant of cotyledonoid dissecting leiomyoma variants for timely and appropriate diagnosis and treatment.

Paraurethral Leiomyoma in a 20 Year-old Woman: A Case Report

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Emily Adams-Piper

2016-01-01

Full Text Available We present the case of a 20 year-old woman with a vulvar mass, found to be a paraurethral leiomyoma. She subsequently underwent supermedial-approach paraurethral mass excision, distal urethral reconstruction and cystourethroscopy. Paraurethral leiomyoma make up approximately five percent of urethral tumors. This case depicts the presentation and treatment of a paraurethral leiomyoma in one of the youngest women reported in the literature.

A large uterine leiomyoma leading to non-puerperal uterine inversion: A case report

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Batool Teimoori

2017-08-01

Full Text Available Background: Although leiomyomas are the most common gynecologic disorders, non-puerperal uterine inversion due to leiomyoma is considered as a rare clinical problem. This condition can occur as a complication of a large sub-mucous leiomyoma that leads to dilate cervix and protrude into vagina. The patient may have several symptoms such as heavy vaginal bleeding, pelvic pain and intermittent acute urinary retention. Case: We presented a 32-year-old nulliparous woman with 17 years of unexplained infertility and diagnosis of a large vaginal prolapsed non-pedunculated leiomyoma. Conclusion: Haultain’s procedure was used to reposition uterine inversion and remove leiomyoma through a posterior incision, using laparotomy

Trans-abdominal ultrasound evaluation of high-intensity focused ultrasound treatment of uterine leiomyoma

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Miao Wei; Huang Jin; Wang Junhua; Wang Yuling

2010-01-01

Objective: To determine the value of dynamic trans-abdominal ultrasound after high-intensity focused ultrasound (HIFU) treatment of uterine leiomyomas. Methods: The trans-abdominal ultrasound images of 63 patients before and after HIFU treatment of uterine leiomyomas were compared. Results: The volume and blood flow of leiomyomas were reduced after the HIFU treatment. Conclusion: Trans-abdominal ultrasound is a valuable method for evaluating the results of HIFU treatment of uterine leiomyomas. (authors)

Single benign metastasising leiomyoma of an inguinal lymph node.

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Laban, KG; Tobon-Morales, Roberto; Hodge, Janice; Schreuder, HWR

2016-01-01

Benign metastasising leiomyoma (BML) is a rare benign disease associated with uterine leiomyoma and history of uterine surgery. It most frequently occurs in premenopausal woman, with a pulmonary localisation, and consisting of multiple nodules. We present an uncommon case of a 69-year-old woman with

Cotyledonoid dissecting leiomyoma of the uterus: a case report

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Rollason Terence P

2007-06-01

Full Text Available Abstract Cotyledonoid dissecting leiomyoma of the uterus is a recently described rare variant of benign uterine leiomyoma. We report a case of cotyledonoid dissecting leiomyoma in a 52 year old woman who presented with menorrhagia and abdominal pain. An ultrasound scan showed a bulky uterus and a cystic heterogenous mass near the left ovary. At hysterectomy, the left broad ligament mass was removed. This was continuous with an ill-defined nodular area in the myometrial fundus. Microscopy revealed a benign smooth muscle proliferation in the myometrium that extended beyond the uterus and into the broad ligament. The lesion appeared to be dissecting the myometrial fibres and showed areas of oedema, hyalinisation and perinodular hydropic change. Cellular atypia, mitoses and coagulative necrosis were absent. The patient is alive and well 18 months after surgery. It is important to recognize this benign and unusual appearing variant of leiomyoma in order to prevent inappropriate treatment.

Versican Proteolysis by ADAMTS Proteases and Its Influence on Sex Steroid Receptor Expression in Uterine Leiomyoma.

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Gueye, Ndeye-Aicha; Mead, Timothy J; Koch, Christopher D; Biscotti, Charles V; Falcone, Tommaso; Apte, Suneel S

2017-05-01

Leiomyomas have abundant extracellular matrix (ECM), with upregulation of versican, a large proteoglycan. We investigated ADAMTS (a disintegrin-like and metalloprotease with thrombospondin type 1 motifs) protease-mediated versican cleavage in myometrium and leiomyoma and the effect of versican knockdown in leiomyoma cells. We used quantitative reverse transcription polymerase chain reaction (qRT-PCR), western blotting, immunohistochemistry, and RNA in situ hybridization for analysis of myometrium, leiomyoma and immortalized myometrium and leiomyoma cells. Short interfering RNA (siRNA) was used to knockdown versican in leiomyoma cells. This study was performed in an academic laboratory. Study subjects were women with symptomatic or asymptomatic leiomyoma. We quantified messenger RNAs (mRNAs) for versican splice variants. We identified ADAMTS-cleaved versican in myometrium and leiomyoma and ADAMTS messenger RNAs and examined the effect of VCAN siRNA on smooth muscle differentiation and expression of estrogen and progesterone receptors. The women in the symptomatic group (n = 7) had larger leiomyoma (P = 0.01), heavy menstrual bleeding (P leiomyomas of symptomatic versus asymptomatic women (P = 0.03 and P = 0.04, respectively). Abundant cleaved versican was detected in leiomyoma and myometrium, as well as in myometrial and leiomyoma cell lines. ADAMTS4 (P = 0.03) and ADAMTS15 (P = 0.04) were upregulated in symptomatic leiomyomas. VCAN siRNA did not effect cell proliferation, apoptosis, or smooth muscle markers, but reduced ESR1 and PR-A expression (P = 0.001 and P = 0.002, respectively). Versican in myometrium, leiomyomas and in the corresponding immortalized cells is cleaved by ADAMTS proteases. VCAN siRNA suppresses production of estrogen receptor 1 and progesterone receptor-A. These findings have implications for leiomyoma growth. Copyright © 2017 by the Endocrine Society

The expression of selenium-binding protein 1 is decreased in uterine leiomyoma

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Quddus M Ruhul

2010-12-01

Full Text Available Abstract Background Selenium has been shown to inhibit cancer development and growth through the mediation of selenium-binding proteins. Decreased expression of selenium-binding protein 1 has been reported in cancers of the prostate, stomach, colon, and lungs. No information, however, is available concerning the roles of selenium-binding protein 1 in uterine leiomyoma. Methods Using Western Blot analysis and immunohistochemistry, we examined the expression of selenium-binding protein 1 in uterine leiomyoma and normal myometrium in 20 patients who had undergone hysterectomy for uterine leiomyoma. Results and Discussion The patient age ranged from 34 to 58 years with a mean of 44.3 years. Proliferative endometrium was seen in 8 patients, secretory endometrium in 7 patients, and atrophic endometrium in 5 patients. Two patients showed solitary leiomyoma, and eighteen patients revealed 2 to 5 tumors. Tumor size ranged from 1 to 15.5 cm with a mean of 4.3 cm. Both Western Blot analysis and immunohistochemistry showed a significant lower level of selenium-binding protein 1 in leiomyoma than in normal myometrium. Larger tumors had a tendency to show a lower level of selenium-binding protein 1 than smaller ones, but the difference did not reach a statistical significance. The expression of selenium-binding protein 1 was the same among patients with proliferative, secretory, and atrophic endometrium in either leiomyoma or normal myometrium. Also, we did not find a difference of selenium-binding protein 1 level between patients younger than 45 years and older patients in either leiomyoma or normal myometrium. Conclusions Decreased expression of selenium-binding protein 1 in uterine leiomyoma may indicate a role of the protein in tumorigenesis. Our findings may provide a basis for future studies concerning the molecular mechanisms of selenium-binding protein 1 in tumorigenesis as well as the possible use of selenium in prevention and treatment of uterine

Deep soft tissue leiomyoma of the thigh

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Watson, G.M.T.; Saifuddin, A.; Sandison, A.

1999-01-01

A case of ossified leiomyoma of the deep soft tissues of the left thigh is presented. The radiographic appearance suggested a low-grade chondrosarcoma. MRI of the lesion showed signal characteristics similar to muscle on both T1- and T2-weighted spin echo sequences with linear areas of high signal intensity on T1-weighted images consistent with medullary fat in metaplastic bone. Histopathological examination of the resected specimen revealed a benign ossified soft tissue leiomyoma. (orig.)

Characterization of estrogen receptors alpha and beta in uterine leiomyoma cells.

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Valladares, Francisco; Frías, Ignacio; Báez, Delia; García, Candelaria; López, Francisco J; Fraser, James D; Rodríguez, Yurena; Reyes, Ricardo; Díaz-Flores, Lucio; Bello, Aixa R

2006-12-01

Cellular and subcellular localization of estrogen receptor alpha (ERalpha) and estrogen receptor beta (ERbeta) in uterine leiomyomas. Retrospective study. University of La Laguna (ULL) and Canary University Hospital (HUC). Premenopausal and postmenopausal women with uterine leiomyomas. Hysterectomy and myomectomy. Estrogen receptor alpha was only present in smooth muscle cells with variation in the subcellular location in different leiomyomas. Estrogen receptor beta was widely distributed in smooth muscle, endothelial, and connective tissue cells with nuclear location in all cases studied; variations were only found in the muscle cells for this receptor. Estrogens operate in leiomyoma smooth muscle cells through different receptors, alpha and beta. However they only act through the ERbeta in endothelial and connective cells.

A Case of Esophageal Leiomyoma Showing High FDG Uptake on F-18 FDG PET

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Lee, Jai Hyuen [College of Medicine, Cheonan (Korea, Republic of); Ryu, Jin Sook [Asan Medical Center, University of Ulsan College of Medicine (Korea, Republic of)

2008-08-15

An esophageal leiomyoma is the most common benign tumor of the esophagus mainly occurred in intramural portion. Occasionally, it is difficult to discriminate esophageal malignancy from large leiomyoma. Although F-18 FDG PET has been used for differentiating malignant from benign disease, false-positive cases have been reported. Recently, uterine leiomyoma has been reported to have relatively high F-18 FDG uptake in some patients but little is known about how an esophageal leiomyoma might be showed on F-18 FDG PET. We report a case of esophageal leiomyoma that showed high FDG uptake on PET images.

A Case of Esophageal Leiomyoma Showing High FDG Uptake on F-18 FDG PET

International Nuclear Information System (INIS)

Lee, Jai Hyuen; Ryu, Jin Sook

2008-01-01

An esophageal leiomyoma is the most common benign tumor of the esophagus mainly occurred in intramural portion. Occasionally, it is difficult to discriminate esophageal malignancy from large leiomyoma. Although F-18 FDG PET has been used for differentiating malignant from benign disease, false-positive cases have been reported. Recently, uterine leiomyoma has been reported to have relatively high F-18 FDG uptake in some patients but little is known about how an esophageal leiomyoma might be showed on F-18 FDG PET. We report a case of esophageal leiomyoma that showed high FDG uptake on PET images

Primary leiomyoma of the lung: an exceptional localization.

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Zidane, Abdelfettah; Elktaibi, Abderahim; Benjelloun, Amine; Arsalane, Adil; Afandi, Oussama; Bouchentouf, Rachid

2016-05-01

Leiomyoma is a benign smooth muscle tumor usually encountered in the uterus. Primary pulmonary localization is extremely rare in adults and children. However, it must be included in the differential diagnosis of any nodular lung lesion. Its treatment is surgical, with good long-term results. Here, we report a case of leiomyoma of lung parenchyma diagnosed in a 26-year-old man. © The Author(s) 2016.

Leiomyoma of the sinonasal cavity: CT and MRI findings

International Nuclear Information System (INIS)

Yang, B.T.; Wang, Z.C.; Xian, J.F.; Hao, D.P.; Chen, Q.H.

2009-01-01

Aim: To determine the computed tomography (CT) and magnetic resonance imaging (MRI) features of leiomyoma of the sinonasal cavity. Materials and methods: Six patients with histology-proven leiomyomas in the sinonasal cavity were retrospectively reviewed. All six patients underwent CT and three patients also underwent MRI. The following imaging features were reviewed: size, margin, CT attenuation, MRI signal intensity, and lesion extent. In addition, the time-intensity curve (TIC) of dynamic contrast-enhanced (DCE) MRI and diffusion-weighted imaging (DWI) were analysed in two patients. Results: All leiomyomas had well-defined margins. The mean size was 36 mm (range 20-51 mm). On unenhanced CT, the lesions appeared isodense to cerebral grey matter in four (67%) and slightly hypodense in two (33%) patients. Leiomyomas appeared isointense On T1-weighted imaging (WI) and slightly hyperintense on T2WI in three patients. The lesions showed moderate contrast enhancement. Two patients underwent DCE MRI, and the TIC showed a rapidly enhancing and slow washout pattern. The mean apparent diffusion coefficient (ADC) value were 1.66 x 10 -3 mm 2 /s and 1.78 x 10 -3 mm 2 /s for the two lesions, respectively. Conclusions: Well-defined, homogeneous, expansile masses without bony erosion are typical features of leiomyoma. Althrough rare, this entity should be included in the differential diagnosis of benign tumours in this region.

Leiomyoma of the sinonasal cavity: CT and MRI findings

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Yang, B.T., E-mail: cjr.yangbentao@vip.163.co [Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing (China); Wang, Z.C.; Xian, J.F.; Hao, D.P.; Chen, Q.H. [Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing (China)

2009-12-15

Aim: To determine the computed tomography (CT) and magnetic resonance imaging (MRI) features of leiomyoma of the sinonasal cavity. Materials and methods: Six patients with histology-proven leiomyomas in the sinonasal cavity were retrospectively reviewed. All six patients underwent CT and three patients also underwent MRI. The following imaging features were reviewed: size, margin, CT attenuation, MRI signal intensity, and lesion extent. In addition, the time-intensity curve (TIC) of dynamic contrast-enhanced (DCE) MRI and diffusion-weighted imaging (DWI) were analysed in two patients. Results: All leiomyomas had well-defined margins. The mean size was 36 mm (range 20-51 mm). On unenhanced CT, the lesions appeared isodense to cerebral grey matter in four (67%) and slightly hypodense in two (33%) patients. Leiomyomas appeared isointense On T1-weighted imaging (WI) and slightly hyperintense on T2WI in three patients. The lesions showed moderate contrast enhancement. Two patients underwent DCE MRI, and the TIC showed a rapidly enhancing and slow washout pattern. The mean apparent diffusion coefficient (ADC) value were 1.66 x 10{sup -3} mm{sup 2}/s and 1.78 x 10{sup -3} mm{sup 2}/s for the two lesions, respectively. Conclusions: Well-defined, homogeneous, expansile masses without bony erosion are typical features of leiomyoma. Althrough rare, this entity should be included in the differential diagnosis of benign tumours in this region.

Uterine Leiomyomas: An ENIGMA

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Kempula Geethamala

2016-01-01

Conclusion: Though hysterectomy is a routine procedure in the management of uterine leiomyomas, occasional cases of tumor or infective pathology may be missed. Therefore, histopathology is mandatory and conscientious quest must be done for confirmed diagnosis and ensuring optimal management.

Deep soft tissue leiomyoma of the thigh

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Watson, G.M.T.; Saifuddin, A. [Department of Radiology, The Royal National Orthopaedic Hospital Trust, Brockley Hill (United Kingdom); Sandison, A. [Department of Pathology, The Royal National Orthopaedic Hospital Trust, Stanmore, Middlesex (United Kingdom)

1999-07-01

A case of ossified leiomyoma of the deep soft tissues of the left thigh is presented. The radiographic appearance suggested a low-grade chondrosarcoma. MRI of the lesion showed signal characteristics similar to muscle on both T1- and T2-weighted spin echo sequences with linear areas of high signal intensity on T1-weighted images consistent with medullary fat in metaplastic bone. Histopathological examination of the resected specimen revealed a benign ossified soft tissue leiomyoma. (orig.) With 3 figs., 13 refs.

Extracellular matrix in uterine leiomyoma pathogenesis: a potential target for future therapeutics.

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Islam, Md Soriful; Ciavattini, Andrea; Petraglia, Felice; Castellucci, Mario; Ciarmela, Pasquapina

2018-01-01

Uterine leiomyoma (also known as fibroid or myoma) is the most common benign tumor of the uterus found in women of reproductive age. It is not usually fatal but can produce serious clinical symptoms, including excessive uterine bleeding, pelvic pain or pressure, infertility and pregnancy complications. Due to lack of effective medical treatments surgery has been a definitive choice for the management of this tumor. Extracellular matrix (ECM) accumulation and remodeling are thought to be crucial for fibrotic diseases such as uterine leiomyoma. Indeed, ECM plays important role in forming the bulk structure of leiomyoma, and the ECM-rich rigid structure within these tumors is thought to be a cause of abnormal bleeding and pelvic pain. Therefore, a better understanding of ECM accumulation and remodeling is critical for developing new therapeutics for uterine leiomyoma. PubMed and Google Scholar were searched for all original and review articles/book chapters related to ECM and medical treatments of uterine leiomyoma published in English until May 2017. This review discusses the involvement of ECM in leiomyoma pathogenesis as well as current and future medical treatments that target ECM directly or indirectly. Uterine leiomyoma is characterized by elevated levels of collagens, fibronectin, laminins and proteoglycans. They can induce the mechanotransduction process, such as activation of the integrin-Rho/p38 MAPK/ERK pathway, resulting in cellular responses that are involved in pathogenesis and altered bidirectional signaling between leiomyoma cells and the ECM. ECM accumulation is affected by growth factors (TGF-β, activin-A and PDGF), cytokines (TNF-α), steroid hormones (estrogen and progesterone) and microRNAs (miR-29 family, miR-200c and miR-93/106b). Among these, TGF-βs (1 and 3) and activin-A have been suggested as key players in the accumulation of excessive ECM (fibrosis) in leiomyoma. The presence of elevated levels of ECM and myofibroblasts in leiomyoma

Leiomyoma of the anal canal: report of two cases.

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Witz, M; Bernheim, J; Griffel, B; Dinbar, A

1986-10-01

Leiomyoma of the rectum and anal canal is an unusual clinical entity. Generally, it does not produce any clinical signs and in most cases it is discovered incidentally in the course of routine rectal examination. The clinical presentation, diagnosis, and surgical treatment are described in two presented cases of anal canal leiomyoma.

Clinical application of arterial embolization for the treatment of uterine leiomyoma

International Nuclear Information System (INIS)

Wu Wei; Cheng Zhigang; Liu Yongsheng; Xia Huihuan; Luo Fuying; Peng Fang

2003-01-01

Objective: To explore the curative effects, side effects and complications of arterial embolization for the treatment of uterine leiomyoma. Methods: Bilateral uterine arterial embolization with silk particles of 350-500 μm was performed in 16 cases of uterine leiomyomas with uterine hemorrhage as the main complaint. Results: 15 patients underwent technically successful embolization. No serious complications occurred. The patients were followed up for 3-12 months. Menses returned to regular cycle. In the patients with anemia, the hemoglobin concentration rose up to normal level. The sizes of uterine leiomyoma decreased by 52% after 6 months of the treatment. Conclusions: Uterine arterial embolization is an effective and less invasive therapy with no serious complications for patients with uterine leiomyoma, especially for presentation of the uterus

Anterior Abdominal Wall Leiomyoma Arising De Novo in a Perimenopausal Woman

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Hamed A. Al-Wadaani

2012-07-01

Full Text Available Extrauterine or extraintestinal leiomyomas are extremely uncommon especially in the pre-peritoneal area or within the anterior abdominal wall muscles. These tumors have been ascribed to intraoperative seeding during resection of a fibroid or a leiomyoma of gut, to exogenous hormone replacement therapy or a major derangement of glucose and/or lipid metabolism. So far, there is no published report of de novo origin of anterior abdominal wall pure leiomyoma in the literature. The author herein reports a case of perimenopausal multiparous woman without any listing of previous gynecological surgery or hormone therapy who presented with a large pre-peritoneal intramuscular leiomyoma of the anterior abdominal wall. The patient underwent complete primary resection with amelioration of her symptoms.

Significance of 'Bridging vessel sign' on color Doppler ultrasound in diagnosis of uterine subserosal leiomyoma

International Nuclear Information System (INIS)

Lee, Jin Hee; Lee, Jung Hee; Sohn, Chul Ho; Woo, Seung Koo; Kim, Jung Sik

2002-01-01

To evaluate the usefulness of the 'bridging vessel sign' in differentiating uterine subserosal leiomyoma from other pelvic masses mimicking leiomyoma on color Doppler ultrasound. Histologically (n=58) and clinically (n=1) proven 59 masses from 55 women were included in this study. Histologic diagnoses included leiomyoma (n=32) and various kinds of other masses (n=27). On gray scale ultrasound, the size of tumor and presence of the ovaries were recorded. On color Doppler ultrasound, the presence of 'bridging vessel sign', which was defined as a linear vessel demonstrated between the mass and the uterus was documented. Uterine subserosal leiomyoma was diagnosed on the basis of finding this sign, and the diagnostic accuracy of this sign in differentiating subserosal leiomyoma from other pelvic tumors was calculated. In addition, the diagnostic accuracy of this sign combined with the visibility of theopsilateral ovary was compared. The size of subserosal leiomyomas ranged from 4.2 to 22.1 cm (mean, 8.3 cm) while the size of other pelvic masses, from 4.6 to 21.5 cm (mean, 9.6 cm). The 'bridging vessel sign' was demonstrated in thirty of 32 leiomyomas and in three of 27 other pelvis masses. The sensitivity, specificity, accuracy, positive predictive value, and negative value of the 'bridging vessel sign' in the diagnosis of subserosal leiomyoma were 93.8%, 99.9%, 91.5%, 90.9% and 92.3%, respectively. The detection of the ipsilateral ovary was possible in 14 of 30 women with leiomyomas and in four of 25 women with other pelvic masses. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of this finding in the diagnosis of subserosal leiomyoma were 46.7%, 84.0%, 63.6%, 77.8%, and 56.8%, respectively. 'Bridging vessel sign' can be an useful finding in the differential diagnosis of subserosal leiomyomas from other pelvic masses mimicking leiomyoma.

Differential expression of caveolin-1 in human myometrial and uterine leiomyoma smooth muscle.

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Zhou, Yu; Ren, Yuanyuan; Cui, Lihua; Li, Zongjin; Zhu, Yingjun; Lin, Wanjun; Wang, Yuebing

2014-11-01

Uterine leiomyomas, the most common neoplasms of the female genital tract, are benign tumors of the uterus arising from the smooth muscle cells (SMCs) of the myometrium with an involvement of estrogen. Caveolin-1 (Cav-1), a major protein component in caveolae membrane lipid rafts, is down-regulated in several estrogen-related cancer cells, and overexpression of Cav-1 inhibits proliferation of cancer cells and vascular SMCs as well. Therefore, we hypothesize that Cav-1 is down-regulated in human uterine leiomyoma. Western blot using tissues from clinical patients showed that Cav-1 expression was significantly lower or undetectable in uterine leiomyoma compared with their matched myometrium (P leiomyomas was also significantly lower as detected by reverse transcription-quantitative polymerase chain reaction analysis (P = .001). To further study the underlying mechanism, we performed primary cell culture, and found that the expression of Cav-1 remained low in cultured leiomyoma SMCs (P = .009). Serum withdrawal did not change Cav-1 expression in leiomyoma SMCs, but increased expression in myometrial SMCs (P = .006). 17-β estradiol inhibited the expression of Cav-1 protein (P = .047) and mRNA (P = .007) in leiomyoma SMCs, whereas it stimulated expression in myometrial SMCs (P = .043). 17-β estradiol, although activating the mitogen-activated protein kinase pathway in both SMCs, did not stimulate their proliferation. We conclude that human uterine leiomyomas in vitro express low levels of Cav-1, which may result from estrogen inhibition. This effect of estrogen may contribute to the pathogenesis of uterine leiomyoma. Further studies in vivo are needed to verify these results. Copyright © 2014 Elsevier Inc. All rights reserved.

The association between uterine leiomyoma and placenta abruption: A meta-analysis.

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Jenabi, Ensiyeh; Ebrahimzadeh Zagami, Samira

2017-11-01

Some epidemiological studies have found that uterine leiomyoma can increase the risk of placenta abruption. To date, the meta-analysis has not been performed for assessing the relationship between uterine leiomyoma and placenta abruption. This meta-analysis was conducted to estimate the association between uterine leiomyoma and the risk of placenta abruption. A literature search was conducted out in major databases PubMed, Web of Science, and Scopus from the earliest possible year to October 2016. The heterogeneity across studies was explored by Q-test and I 2 statistic. The publication bias was assessed by Begg's and Egger's tests. The results were showed using odds ratio (OR) estimate with its 95% confidence intervals (CI) using a random-effects model. The literature search included 953 articles until October 2016 with 232,024 participants. Based on OR estimates obtained from case-control and cohort studies, there was significant association between uterine leiomyoma and placenta abruption (2.63; 95% CI: 1.38, 3.88). We showed based on reports in observational studies that uterine leiomyoma is a risk factor for placenta abruption.

The Rare Togetherness of Bladder Leiomyoma and Neurofibromatosis.

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Yucel, Cem; Budak, Salih; Kisa, Erdem; Celik, Orcun; Kozacioglu, Zafer

2018-01-01

Neurofibromatosis Type 1 (Von Recklinghausen disease) is a common, autosomal dominant hereditary disorder characterized by involvement of multiple tissues derived from the neural crest. Urinary system involvement in neurofibromatosis is a rare condition. Leiomyoma of the bladder is a rare benign mesenchymal tumor. In this case, our experience and approach regarding the bladder leiomyoma development in a patient diagnosed with neurofibromatosis are presented and the literature data has been reviewed.

Endoscopic Ultrasonography in the Diagnosis and Treatment Strategy Choice of Esophageal Leiomyoma

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Ling-Jia Sun

Full Text Available OBJECTIVES: Esophageal leiomyoma is the most common benign tumor of the esophagus, and it originates from mesenchymal tissue. This study analyzed the clinicopathological characteristics of esophageal leiomyoma and aimed to evaluate the role of endoscopic ultrasonography in the diagnosis and treatment selection for these lesions. METHODS: Two hundred and twenty-five patients who had suspected esophageal leiomyomas in endoscopic ultrasonography were enrolled at the Endoscopy Center of The First Affiliated Hospital, Zhejiang University from January 1st, 2009 to May 31th, 2015. The main outcomes included the demographic and morphological characteristics, symptoms, comparisons of diagnosis and treatment methods, adverse events, and prognosis. RESULTS: One hundred and sixty-seven patients were diagnosed as having an esophageal leiomyoma by pathological examination. The mean patient age was 50.57±9.983 years. In total, 62.9% of the lesions originated from the muscularis mucosa, and the others originated from the muscularis propria. The median distance to the incisors was 30±12 cm. The median diameter was 0.72±0.99 cm. As determined by endoscopic ultrasonography, most existing leiomyomas were homogeneous, endophytic, and spherical. The leiomyomas from the muscularis mucosa were smaller than those from the muscularis propria and much closer to the incisors (p<0.05. SMA (smooth muscle antibody (97.2% and desmin (94.5% were positive in the majority of patients. In terms of treatments, patients preferred endoscopic therapies, which led to less adverse events (e.g., intraoperative bleeding, local infection, pleural effusion than surgical operations (p<0.05. The superficial leiomyomas presented less adverse events and better recovery (p<0.05 than deep leiomyomas. CONCLUSION: Endoscopic ultrasonography has demonstrated high accuracy in the diagnosis of esophageal leiomyomas and provides great support in selecting treatments; however, EUS cannot completely

Partial ureterectomy for a huge primary leiomyoma of the ureter

International Nuclear Information System (INIS)

Nouralizadeh, A.; Tabib, A.; Taheri, M.; Torbati, P.M.

2010-01-01

A case of a huge primary leiomyoma of the ureter in which only partial ureterectomy was performed is presented. The benign nature of the mass was primarily confirmed with frozen section at the time of surgery and then with immunohistochemistry (IHC). To the best of our knowledge, this case is a unique form of leiomyoma of the ureter due to its large size. There have been only ten cases of primary leiomyoma of the ureter reported since 1955 and all of them were very small in size. Our case is considered to be the eleventh. (author)

Robotic Extramucosal Excision of Bladder Wall Leiomyoma

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Khalid E. Al-Othman

2014-01-01

Full Text Available Introduction: Multiple case reports and reviews have been described in the literature for bladder wall leiomyoma resection via different approaches. The minimally invasive partial cystectomy remains the most widely accepted technique; however, case reports for enucleation of bladder wall leiomyoma have also been described. The purpose of this video is to demonstrate the robotic extramucosal excision of a bladder wall leiomyoma, without cystotomy, but with complete removal of the muscular layer. Materials and Methods: A 35-year old male present with lower urinary tract symptoms and imaging showed bladder wall mass with histopathology showed leiomyoma. The patient consented for mass excision with the possibility of a partial cystectomy. The patient was placed in the supine, 30-degree Trendelenburg position during the procedure. A total of 4 ports were inserted. A 3-arm da Vinci robotic surgical system was docked, and the arms were connected. Extramucosal excision was accomplished without cystotomy and muscle approximation was achieved by 2 0 Vicryle. Result: The operative time was 90 minutes, blood loss of approximately 50mL and the patient was discharged after 72 hours with no immediate complications and a 6 months follow-up showed no recurrence. Conclusion: Such a technique results in complete excision of the tumor, without cystotomy, and also maintains an intact mucosa. These steps, in addition to decreasing the risk of local recurrence, also shorten the period of postoperative catheterization and hospitalization.

The OPPIuM technique: office hysteroscopic technique for the preparation of partially intramural leiomyomas.

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Cicinelli, Ettore; Mitsopoulos, Vasileios; Fascilla, Fabiana D; Sioutis, Dimos; Bettocchi, Stefano

2016-06-01

Uterine fibroids, also known as leiomyomas, represent the most common benign tumors of the female genital tract. Submucosal leiomyomas are classified into three grades: G0, GI, GII according to the degree of their intramural proportion. A recently developed technique enables the preparation of G1 and G2 leiomyomas for their subsequent successful resection in a second step. The OPPIuM (office preparation of partially intramural leiomyomas) technique aims to downgrade type I and II leiomyomas, in order to facilitate a subsequent easier and safer resectoscopy. Hysteroscopic resection of large GI or GII submucosal fibroids is a complex procedure. OPPIuM technique has been invented and seems to achieve the downgrading of these types of leiomyomas in approximately 93% of cases, without any significant surgical complications or the need of hormonal agents' administration. In this way, the safer and quicker subsequent complete myomectomy is facilitated.

G-protein-coupled estrogen receptor-30 gene polymorphisms are associated with uterine leiomyoma risk.

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Kasap, Burcu; Öztürk Turhan, Nilgün; Edgünlü, Tuba; Duran, Müzeyyen; Akbaba, Eren; Öner, Gökalp

2016-01-06

The G-protein-coupled estrogen receptor (GPR30, GPER-1) is a member of the G-protein-coupled receptor 1 family and is expressed significantly in uterine leiomyomas. To understand the relationship between GPR30 single nucleotide polymorphisms and the risk of leiomyoma, we measured the follicle-stimulating hormone (FSH) and estradiol (E2) levels of 78 perimenopausal healthy women and 111 perimenopausal women with leiomyomas. The participants' leiomyoma number and volume were recorded. DNA was extracted from whole blood with a GeneJET Genomic DNA Purification Kit. An amplification-refractory mutation system polymerase chain reaction approach was used for genotyping of the GPR30 gene (rs3808350, rs3808351, and rs11544331). The differences in genotype and allele frequencies between the leiomyoma and control groups were calculated using the chi-square (χ2) and Fischer's exact test. The median FSH level was higher in controls (63 vs. 10 IU/L, p=0.000), whereas the median E2 level was higher in the leiomyoma group (84 vs. 9.1 pg/mL, p=0.000). The G allele of rs3808351 and the GG genotype of both the rs3808350 and rs3808351 polymorphisms and the GGC haplotype increased the risk of developing leiomyoma. There was no significant difference in genotype frequencies or leiomyoma volume. However, the GG genotype of the GPR30 rs3808351 polymorphism and G allele of the GPR30 rs3808351 polymorphism were associated with the risk of having a single leiomyoma. Our results suggest that the presence of the GG genotype of the GPR30 rs3808351 polymorphism and the G allele of the GPR30 rs3808351 polymorphism affect the characteristics and development of leiomyomas in the Turkish population.

Uterine contractions evaluated on cine MR imaging in patients with uterine leiomyomas

International Nuclear Information System (INIS)

Nishino, Mizuki; Togashi, Kaori; Nakai, Asako; Hayakawa, Katsumi; Kanao, Shotarou; Iwasaku, Kazuhiro; Fujii, Shingo

2005-01-01

Purpose: Submucosal leiomyoma is one of the most recognized causes of infertility and habitual abortion. The purpose of this study is to evaluate uterine peristalsis, a cycle-related inherent contractility of uterus probably responsible for sperm transport and conservation of pregnancy, in patients with uterine leiomyomas using cine magnetic resonance (MR) imaging. Materials and methods: Study population consisted of 26 female patients (age range: 19-51 years, mean: 41 years), in which 16 patients had submucosal leiomyomas and 10 patients had intramural or subserosal leiomyomas. We prospectively performed MR imaging of the midsagittal plane of uterus using 1.5 T magnet (Symphony, Siemens Medical Systems) with a body array coil, and obtained 60 half-Fourier acquisition single shot turbo spin echo (HASTE) images (Echo time=80 ms, FOV=300 mm, slice thickness 5 mm, matrix 256x256) within 2 min, and displayed them on cine mode at 12x faster than real speed. Evaluated were peristaltic movements at the endometral-myometrial junction and focal myometrial movements, adjacent to leiomyomas, regarding presence, direction, frequency, and conduction. Results: The peristaltic movements were identified in 12/16 patients with submucosal lesions and 10/10 with other leiomyomas. The frequency and direction were cycle-related. Loss of peristalsis was noted adjacent to submucosal myomas in 4/12 patients, but was not in others. Focal myometrial movements were noted in 9/16 patients with submucosal myomas, but not in others. Conclusions: Uterine peristaltic movements were partly interrupted by submucosal leiomoymas, but not by myometrial or subserosal leiomyomas. Loss of peristalsis and focal myometrial movements was noted only adjacent to submucosal leiomyomas. These findings are considered to represent dysfunctional contractility, and may be related with pregnancy loss

Uterine contractions evaluated on cine MR imaging in patients with uterine leiomyomas

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Nishino, Mizuki E-mail: mizuki@mbox.kyoto-inet.or.jpnishinomizuki@hotmail.com; Togashi, Kaori; Nakai, Asako; Hayakawa, Katsumi; Kanao, Shotarou; Iwasaku, Kazuhiro; Fujii, Shingo

2005-01-01

Purpose: Submucosal leiomyoma is one of the most recognized causes of infertility and habitual abortion. The purpose of this study is to evaluate uterine peristalsis, a cycle-related inherent contractility of uterus probably responsible for sperm transport and conservation of pregnancy, in patients with uterine leiomyomas using cine magnetic resonance (MR) imaging. Materials and methods: Study population consisted of 26 female patients (age range: 19-51 years, mean: 41 years), in which 16 patients had submucosal leiomyomas and 10 patients had intramural or subserosal leiomyomas. We prospectively performed MR imaging of the midsagittal plane of uterus using 1.5 T magnet (Symphony, Siemens Medical Systems) with a body array coil, and obtained 60 half-Fourier acquisition single shot turbo spin echo (HASTE) images (Echo time=80 ms, FOV=300 mm, slice thickness 5 mm, matrix 256x256) within 2 min, and displayed them on cine mode at 12x faster than real speed. Evaluated were peristaltic movements at the endometral-myometrial junction and focal myometrial movements, adjacent to leiomyomas, regarding presence, direction, frequency, and conduction. Results: The peristaltic movements were identified in 12/16 patients with submucosal lesions and 10/10 with other leiomyomas. The frequency and direction were cycle-related. Loss of peristalsis was noted adjacent to submucosal myomas in 4/12 patients, but was not in others. Focal myometrial movements were noted in 9/16 patients with submucosal myomas, but not in others. Conclusions: Uterine peristaltic movements were partly interrupted by submucosal leiomoymas, but not by myometrial or subserosal leiomyomas. Loss of peristalsis and focal myometrial movements was noted only adjacent to submucosal leiomyomas. These findings are considered to represent dysfunctional contractility, and may be related with pregnancy loss.

The utility of diffusion-weighted MR imaging in differentiation of uterine adenomyosis and leiomyoma

International Nuclear Information System (INIS)

Yang Qiong; Zhang Lihua; Su Jing; Liu Jianyu

2011-01-01

Purpose: To investigate the value of diffusion-weighted MR imaging (DWI), especially apparent diffusion coefficient (ADC) in the differentiation of uterine adenomyosis and leiomyoma. Materials and methods: 17 patients with uterine leiomyoma and 22 patients with uterine adenomyosis underwent diffusion-weighted imaging (DWI) in addition to routine MR imaging. The ADC values, as well as ADC D-value (defined as the ADC value of high signal intensive foci minus the ADC value of lesion tissues the difference in value), were measured and compared to investigate whether they could help in the differentiation of uterine adenomyosis and leiomyoma. Histopathologic examination was conducted as the golden standard. Results: For high signal intensive foci within the lesions, uterine adenomyosis demonstrated significantly lower mean ADC value than uterine leiomyoma (1.582 vs. 2.122 x 10 -3 mm 2 /s, P = 0.001). For lesion tissues, uterine adenomyosis demonstrated significantly higher mean ADC value than uterine leiomyoma (1.214 vs. 0.967 x 10 -3 mm 2 /s, P = 0.001). However, there was overlap between uterine adenomyosis and leiomyoma in both measurements. Mean ADC D-value was significantly lower in uterine adenomyosis than in uterine leiomyoma (0.369 vs. 1.096 x 10 -3 mm 2 /s, P = 0.000). ADC D-value had no overlap between uterine adenomyosis and leiomyoma. Conclusion: DWI can be applied for the further differentiation of uterine adenomyosis and leiomyoma, in addition to routine MR imaging. ADC D-value may be a more useful tool than ADC value in the differentiation.

The utility of diffusion-weighted MR imaging in differentiation of uterine adenomyosis and leiomyoma

Energy Technology Data Exchange (ETDEWEB)

Yang Qiong, E-mail: yangq1112@126.com [Department of Radiology, Peking University Third Hospital, Beijing 100191 (China); Zhang Lihua, E-mail: zhanglh04036@yahoo.com.cn [Department of Radiology, Peking University Third Hospital, Beijing 100191 (China); Su Jing, E-mail: bjmusujing@gmail.com [Department of Pathology, Peking University Health Science Center, Beijing 100191 (China); Liu Jianyu, E-mail: jyliu5791@sina.com [Department of Radiology, Peking University Third Hospital, Beijing 100191 (China)

2011-08-15

Purpose: To investigate the value of diffusion-weighted MR imaging (DWI), especially apparent diffusion coefficient (ADC) in the differentiation of uterine adenomyosis and leiomyoma. Materials and methods: 17 patients with uterine leiomyoma and 22 patients with uterine adenomyosis underwent diffusion-weighted imaging (DWI) in addition to routine MR imaging. The ADC values, as well as ADC D-value (defined as the ADC value of high signal intensive foci minus the ADC value of lesion tissues the difference in value), were measured and compared to investigate whether they could help in the differentiation of uterine adenomyosis and leiomyoma. Histopathologic examination was conducted as the golden standard. Results: For high signal intensive foci within the lesions, uterine adenomyosis demonstrated significantly lower mean ADC value than uterine leiomyoma (1.582 vs. 2.122 x 10{sup -3} mm{sup 2}/s, P = 0.001). For lesion tissues, uterine adenomyosis demonstrated significantly higher mean ADC value than uterine leiomyoma (1.214 vs. 0.967 x 10{sup -3} mm{sup 2}/s, P = 0.001). However, there was overlap between uterine adenomyosis and leiomyoma in both measurements. Mean ADC D-value was significantly lower in uterine adenomyosis than in uterine leiomyoma (0.369 vs. 1.096 x 10{sup -3} mm{sup 2}/s, P = 0.000). ADC D-value had no overlap between uterine adenomyosis and leiomyoma. Conclusion: DWI can be applied for the further differentiation of uterine adenomyosis and leiomyoma, in addition to routine MR imaging. ADC D-value may be a more useful tool than ADC value in the differentiation.

Predictive factors for pelvic magnetic resonance in response to arterial embolization of a uterine leiomyoma

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Eduardo Zlotnik

2014-03-01

Full Text Available OBJECTIVE: Minimally invasive methods are used as alternatives to treat leiomyomas and include uterine artery embolization, which has emerged as a safe, effective method. This study aims to evaluate the magnetic resonance imaging predictors for a reduction in leiomyoma volume in patients undergoing uterine artery embolization. METHODS: This prospective longitudinal study was performed at a university hospital. We followed 50 symptomatic premenopausal women with uterine leiomyomas who underwent uterine artery embolization. We examined 179 leiomyomas among these patients. Magnetic resonance imaging was performed one month before and six months after uterine artery embolization. Two radiologists who specialized in abdominal imaging independently interpreted the images. Main Outcome Measures: The magnetic resonance imaging parameters were the uterus and leiomyomas volumes, their localizations, contrast perfusion pattern and node-to-muscle ratio. RESULTS: Six months after treatment, the average uterine volume reduction was 38.91%, and the leiomyomas were reduced by 55.23%. When the leiomyomas were submucosal and/or had a higher node-to-muscle ratio in the T2 images, the volume reduction was even greater (greater than 50%. Other parameters showed no association. CONCLUSIONS: We conclude that symptomatic uterine leiomyomas in patients undergoing uterine artery embolization exhibit volume reductions greater than 50% by magnetic resonance imaging when the leiomyomas are submucosal and/or had a high node-to-muscle ratio in the T2 images.

Ichthyosis uteri with leiomyoma.

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Kanno, Kiyoshi; Kusakabe, Takashi; Takata, Megumi; Suzuki, Kazuo; Oowada, Makoto; Suzuki, Hiroshi

2016-11-01

A 58-year-old, postmenopausal, multiparous woman presented with a chief complaint of abnormal vaginal bleeding. Endometrial cytology was evaluated twice, revealing only squamous epithelial cells both times. Degenerated leiomyoma or uterine sarcoma was suspected from imaging findings, and total abdominal hysterectomy and bilateral salpingo-oophorectomy were therefore performed. However, histopathological examination revealed no signs of malignancy, and the patient was diagnosed as having ichthyosis uteri with uterine leiomyoma. No koilocytosis was evident, and immunostaining for p16 was also negative. Ichthyosis uteri is an extremely rare disease of unknown origin in which squamous metaplasia of the endometrium occurs across a wide area. Although regarded as a benign condition, cases have been reported in which the underlying condition was squamous cell carcinoma or endometrial adenocarcinoma. If ichthyosis uteri is present, a comprehensive approach is required, and the possibility of uterine malignancy should be considered. However, there may be no direct association between the malignant lesions and ichthyosis uteri. © 2016 Japan Society of Obstetrics and Gynecology.

Genome-Wide DNA Methylation Indicates Silencing of Tumor Suppressor Genes in Uterine Leiomyoma

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Navarro, Antonia; Yin, Ping; Monsivais, Diana; Lin, Simon M.; Du, Pan; Wei, Jian-Jun; Bulun, Serdar E.

2012-01-01

Background Uterine leiomyomas, or fibroids, represent the most common benign tumor of the female reproductive tract. Fibroids become symptomatic in 30% of all women and up to 70% of African American women of reproductive age. Epigenetic dysregulation of individual genes has been demonstrated in leiomyoma cells; however, the in vivo genome-wide distribution of such epigenetic abnormalities remains unknown. Principal Findings We characterized and compared genome-wide DNA methylation and mRNA expression profiles in uterine leiomyoma and matched adjacent normal myometrial tissues from 18 African American women. We found 55 genes with differential promoter methylation and concominant differences in mRNA expression in uterine leiomyoma versus normal myometrium. Eighty percent of the identified genes showed an inverse relationship between DNA methylation status and mRNA expression in uterine leiomyoma tissues, and the majority of genes (62%) displayed hypermethylation associated with gene silencing. We selected three genes, the known tumor suppressors KLF11, DLEC1, and KRT19 and verified promoter hypermethylation, mRNA repression and protein expression using bisulfite sequencing, real-time PCR and western blot. Incubation of primary leiomyoma smooth muscle cells with a DNA methyltransferase inhibitor restored KLF11, DLEC1 and KRT19 mRNA levels. Conclusions These results suggest a possible functional role of promoter DNA methylation-mediated gene silencing in the pathogenesis of uterine leiomyoma in African American women. PMID:22428009

Endoscopic Ultrasonography in the Diagnosis and Treatment Strategy Choice of Esophageal Leiomyoma.

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Sun, Ling-Jia; Chen, Xin; Dai, Yi-Ning; Xu, Cheng-Fu; Ji, Feng; Chen, Li-Hua; Chen, Hong-Tan; Chen, Chun-Xiao

2017-04-01

Esophageal leiomyoma is the most common benign tumor of the esophagus, and it originates from mesenchymal tissue. This study analyzed the clinicopathological characteristics of esophageal leiomyoma and aimed to evaluate the role of endoscopic ultrasonography in the diagnosis and treatment selection for these lesions. Two hundred and twenty-five patients who had suspected esophageal leiomyomas in endoscopic ultrasonography were enrolled at the Endoscopy Center of The First Affiliated Hospital, Zhejiang University from January 1st, 2009 to May 31th, 2015. The main outcomes included the demographic and morphological characteristics, symptoms, comparisons of diagnosis and treatment methods, adverse events, and prognosis. One hundred and sixty-seven patients were diagnosed as having an esophageal leiomyoma by pathological examination. The mean patient age was 50.57±9.983 years. In total, 62.9% of the lesions originated from the muscularis mucosa, and the others originated from the muscularis propria. The median distance to the incisors was 30±12 cm. The median diameter was 0.72±0.99 cm. As determined by endoscopic ultrasonography, most existing leiomyomas were homogeneous, endophytic, and spherical. The leiomyomas from the muscularis mucosa were smaller than those from the muscularis propria and much closer to the incisors (pleiomyomas presented less adverse events and better recovery (pleiomyomas. Endoscopic ultrasonography has demonstrated high accuracy in the diagnosis of esophageal leiomyomas and provides great support in selecting treatments; however, EUS cannot completely avoid misdiagnosis, so combining it with other examinations may be a good strategy to solve this problem.

Microallelotyping defines novel regions of loss of heterozygosity in uterine leiomyomas

DEFF Research Database (Denmark)

Canevari, Renata de Azevedo; Pontes, Anaglória; Rogatto, Silvia Regina

2005-01-01

Uterine leiomyomas are extremely common, benign, smooth muscle tumors that represent a significant public health problem. Although there have been few molecular studies of uterine leiomyomas, most of them have reported a very low frequency of loss of heterozygosity (LOH) in different regions...... of the genome. The detection of LOH has been used to identify genomic regions that harbor tumor suppressor genes and to characterize different tumor types. We have used a set of 15 microsatellite polymorphism markers to examine the frequency of allele loss in a panel of 64 human uterine leiomyomas matched...... to normal DNAs. The markers were chosen from regions involved in losses identified by comparative genomic hybridization in a subset of uterine leiomyomas described in a previous report. DNA from tumors and normal tissue was amplified by the polymerase chain reaction and subsequently analyzed using an ABI...

FDG-PET/CT finding of benign metastasizing leiomyoma of the lung

International Nuclear Information System (INIS)

Nakajo, Masatoyo; Nakayama, Hirofumi; Sato, Masayuki; Fukukura, Yoshihiko; Nakajo, Masayuki; Kajiya, Yoriko; Yanagi, Masakazu; Tabata, Kazuhiro; Higashi, Michiyo

2012-01-01

We report a case of multiple benign metastasizing leiomyoma (BML) lung nodules showing faint or non-avid uptake of F-18 fluorodeoxyglucose (FDG) (respective 1-hour early and 2-hour delayed maximum standardized uptake values; 1.3 or less and 1.2 or less) in a 50-year-old woman with a history of hysterectomy for uterine leiomyoma at the age of 38 years. When multiple lung nodules show faint or non-avid FDG uptake in a patient with a history of hysterectomy for uterine leiomyoma, BML should be included in the differential diagnosis

Predicting the effect of gonadotropin-releasing hormone (GnRH) analogue treatment on uterine leiomyomas based on MR imaging

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Matsuno, Y.; Yamashita, Y.; Takahashi, M. [Dept. of Radiology, Kumamoto Univ. School of Medicine, Kumamoto (Japan); Katabuchi, H.; Okamura, H. [Dept. of Gynecology and Obstetrics, Kumamoto Univ. School of Medicine, Kumamoto (Japan); Kitano, Y.; Shimamura, T. [Dept. of Gynecology and Obstetrics, Amakusa Chuou General Hospital, Hondo (Japan)

1999-11-01

Purpose: To test the hypothesis that the simple assessment of signal intensity on T2-weighted MR images is predictive of the effect of hormonal treatment with gonadotropin-releasing hormone (GnRH) analogue. Material and methods: The correlation between T2-weighted MR imaging of uterine leiomyomas and histologic findings was evaluated using 85 leiomyomas from 62 females who underwent myomectomy or hysterectomy. We also correlated the pretreatment MR images features obtained in 110 women with 143 leiomyomas with the effect of GnRH analogue treatment. The size (length x width x depth) of the leiomyoma was evaluated before and at 6 months after treatment by ultrasound. Results: The proportion of leiomyoma cell fascicles and that of extracellular matrix affected signal intensities of uterine leiomyomas on T2-weighted MR images. The amount of extracellular matrix was predominant in hypointense leiomyomas on T2-weighted images, while diffuse intermediate signal leiomyomas were predominantly composed of leiomyoma cell fascicles. Marked degenerative changes were noted in leiomyomas with heterogenous hyperintensity. The homogeneously intermediate signal intensity leiomyomas showed significant size reduction after treatment (size ratio; posttreatment volume/pretreatment volume 0.29{+-}0.11). The size ratio for the hypointense tumors was 0.82{+-}0.14, and 0.82{+-}0.18 for the heterogeneously hyperintense tumors. There was a significant difference in the response to treatment between the homogeneously intermediate signal intensity leiomyomas and the hypointense or heterogeneously hyperintense leiomyomas (both p<0.01). Conclusion: Signal intensity on T2-weighted MR images depends on the amount of leiomyoma cell fascicles and extracellular matrix. Simple assessment of the MR signal intensity is useful in predicting the effect of GnRH analogue on uterine leiomyomas. (orig.)

Predicting the effect of gonadotropin-releasing hormone (GnRH) analogue treatment on uterine leiomyomas based on MR imaging

International Nuclear Information System (INIS)

Matsuno, Y.; Yamashita, Y.; Takahashi, M.; Katabuchi, H.; Okamura, H.; Kitano, Y.; Shimamura, T.

1999-01-01

Purpose: To test the hypothesis that the simple assessment of signal intensity on T2-weighted MR images is predictive of the effect of hormonal treatment with gonadotropin-releasing hormone (GnRH) analogue. Material and methods: The correlation between T2-weighted MR imaging of uterine leiomyomas and histologic findings was evaluated using 85 leiomyomas from 62 females who underwent myomectomy or hysterectomy. We also correlated the pretreatment MR images features obtained in 110 women with 143 leiomyomas with the effect of GnRH analogue treatment. The size (length x width x depth) of the leiomyoma was evaluated before and at 6 months after treatment by ultrasound. Results: The proportion of leiomyoma cell fascicles and that of extracellular matrix affected signal intensities of uterine leiomyomas on T2-weighted MR images. The amount of extracellular matrix was predominant in hypointense leiomyomas on T2-weighted images, while diffuse intermediate signal leiomyomas were predominantly composed of leiomyoma cell fascicles. Marked degenerative changes were noted in leiomyomas with heterogenous hyperintensity. The homogeneously intermediate signal intensity leiomyomas showed significant size reduction after treatment (size ratio; posttreatment volume/pretreatment volume 0.29±0.11). The size ratio for the hypointense tumors was 0.82±0.14, and 0.82±0.18 for the heterogeneously hyperintense tumors. There was a significant difference in the response to treatment between the homogeneously intermediate signal intensity leiomyomas and the hypointense or heterogeneously hyperintense leiomyomas (both p<0.01). Conclusion: Signal intensity on T2-weighted MR images depends on the amount of leiomyoma cell fascicles and extracellular matrix. Simple assessment of the MR signal intensity is useful in predicting the effect of GnRH analogue on uterine leiomyomas. (orig.)

Spatial and temporal differences in giant kidney worm, dictophyma renale, prevalence in Minnesota Mink, Mustela vison

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Mech, L.D.

2008-01-01

Examination of 110 Mink (Mustela vison) carcasses from 1998 through 2007 indicated that the giant kidney worm, Dioctophyma renale, occurred in Pine and Kanabec Counties of eastern Minnesota with annual prevalences of 0-92%. Worm prevalence increased from 20% in 1999 to 92% in 2001 and decreased to 6% in 2005. During 2000 to 2007, no worms were found in Mink from Anoka and Chisago Counties (n = 54), and in 2000, none in 107 Mink from LeSeur, Freeborn, Redwood, Brown and Watonwan Counties. Changes in kidney worm prevalence were positively related to trapping success, considered an index of Mink density.

Surgical Treatment of the Giant Leiyomyoma of the Esophagus After Fifteen Years

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Mehmet Bilgin

2015-11-01

Full Text Available Leiyomyomas are benign intramural tumors of esophagus which are rarely seen. Nearly half of the patients are asymptomatic because leiyomyomas grow slowly and intramural. Dysphagia and retrosternal pain are the most common symptoms.Osephagus leiyomyomas may appear as mediastinal mass in chest radiography and may be recognised by coincidence. It is known that they are solitary, round or oval, and their diameter may reach 15-17cm size. When it grows up to the giant diamaters, surgery is the choice of treatment. Because tumors covering distal part of esophagus and cardia are ulcerated and adhesive to mucosa resection, esophagogastric anasthomosis may be required. We are presenting the clinical and radiologic findings of this giant leiyoma case who did not accept surgical treatment fifteen years ago, and whose leiomyoma reached up to a big diamater.

Human Chorionic Gonadotrophin as a Possible Mediator of Leiomyoma Growth during Pregnancy: Molecular Mechanisms.

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Sarais, Veronica; Cermisoni, Greta Chiara; Schimberni, Matteo; Alteri, Alessandra; Papaleo, Enrico; Somigliana, Edgardo; Vigano', Paola

2017-09-20

Uterine fibroids are the most common gynecologic benign tumors. Studies supporting a strong pregnancy-related growth of leiomyomas generally claimed a crucial role of sex steroid hormones. However, sex steroids are unlikely the unique actors involved as estrogen and progesterone achieve a pick serum concentration in the last trimester while leiomyomas show a typical increase during the first trimester. Given the rapid exponential raise in serum human Chorionic Gonadotrophin (hCG) at the beginning of gestation, we conducted a review to assess the potential role of hCG in the striking growth of leiomyomas during initial pregnancy. Fibroid growth during initial pregnancy seems to correlate to the similar increase of serum hCG levels until 12 weeks of gestation. The presence of functional Luteinizing Hormone/human Chorionic Gonadotropin (LH/hCG) receptors was demonstrated on leiomyomas. In vitro treatment of leiomyoma cells with hCG determines an up to 500% increase in cell number after three days. Expression of cyclin E and cyclin-dependent kinase 1 was significantly increased in leiomyoma cells by hCG treatment. Moreover, upon binding to the receptor, hCG stimulates prolactin secretion in leiomyoma cells, promoting cell proliferation via the mitogen-activated protein kinase cascade. Fibroid enlargement during initial pregnancy may be regulated by serum hCG.

Bronchial leiomyoma, a case report and review of literature

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José Cárdenas-García, MD

2014-01-01

Full Text Available A 44 year old male former smoker from Ecuador presented with productive cough for 3 weeks, positive tuberculin skin test, 40 lbs weight loss and right lower lobe collapse. He denied wheezing or hemoptysis. He was treated with antibiotics and ruled out for tuberculosis with negative sputum smear. Bronchoscopy showed an endobronchial lesion at the distal end of bronchus intermedius as cause of the collapse. Endobronchial biopsy of the lesion revealed an endobronchial leiomyoma, a rare cause of endobronchial tumor. The patient underwent bilobectomy as definite therapy for the leiomyoma due to its large size and possible extra-luminal extension, which made it not amenable to bronchoscopic resection or bronchoplasty. Differential diagnoses of endobronchial lesions are discussed along with clinical, radiographic, pathologic characteristics and various treatment modalities for endobronchial leiomyomas.

Trigger finger presenting secondary to leiomyoma: a case report

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Harb Ziad

2009-05-01

Full Text Available Abstract Introduction We present a previously undescribed entity: trigger finger secondary to a leiomyoma. This is the first time such a case has been reported and highlights the fact that common conditions can sometimes present secondary to rare diseases. Case presentation A 39-year-old Caucasian man presented with a fairly typical presentation of trigger finger. During surgical treatment, the lesion was excised and sent for histology, which showed tissue consistent with a leiomyoma. The patient made an uneventful recovery. Conclusion Trigger finger is a common condition that is usually easily diagnosed and managed. However, it is important to appreciate that uncommon conditions, such as leiomyoma, can present with what is sometimes considered trivial disease, and one should always consider the differential diagnoses even when faced with relatively benign conditions.

GSTM1 Gene Expression Correlates to Leiomyoma Volume Regression in Response to Mifepristone Treatment

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Engman, Mikael; Varghese, Suby; Lagerstedt Robinson, Kristina; Malmgren, Helena; Hammarsjö, Anna; Byström, Birgitta; L Lalitkumar, Parameswaran Grace; Gemzell-Danielsson, Kristina

2013-01-01

Progesterone receptor modulators, such as mifepristone are useful and well tolerated in reducing leiomyoma volume although with large individual variation. The objective of this study was to investigate the molecular basis for the observed leiomyoma volume reduction, in response to mifepristone treatment and explore a possible molecular marker for the selective usage of mifepristone in leiomyoma patients. Premenopausal women (N = 14) were treated with mifepristone 50 mg, every other day for 12 weeks prior to surgery. Women were arbitrarily sub-grouped as good (N = 4), poor (N = 4) responders to treatment or intermediate respondents (N = 3). Total RNA was extracted from leiomyoma tissue, after surgical removal of the tumour and the differential expression of genes were analysed by microarray. The results were analysed using Ingenuity Pathway Analysis software. The glutathione pathway was the most significantly altered canonical pathway in which the glutathione-s transferase mu 1 (GSTM1) gene was significantly over expressed (+8.03 folds) among the good responders compared to non responders. This was further confirmed by Real time PCR (p = 0.024). Correlation of immunoreactive scores (IRS) for GSTM1 accumulation in leiomyoma tissue was seen with base line volume change of leiomyoma R = −0.8 (p = 0.011). Furthermore the accumulation of protein GSTM1 analysed by Western Blot correlated significantly with the percentual leiomyoma volume change R = −0.82 (p = 0.004). Deletion of the GSTM1 gene in leiomyoma biopsies was found in 50% of the mifepristone treated cases, with lower presence of the GSTM1 protein. The findings support a significant role for GSTM1 in leiomyoma volume reduction induced by mifepristone and explain the observed individual variation in this response. Furthermore the finding could be useful to further explore GSTM1 as a biomarker for tailoring medical treatment of uterine leiomyomas for optimizing the response

Liesegang rings in tissue. How to distinguish Liesegang rings from the giant kidney worm, Dioctophyma renale.

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Tuur, S M; Nelson, A M; Gibson, D W; Neafie, R C; Johnson, F B; Mostofi, F K; Connor, D H

1987-08-01

Liesegang rings (LRs) are periodic precipitation zones from supersaturated solutions in colloidal systems. They are formed by a process that involves an interplay of diffusion, nucleation, flocculation or precipitation, and supersaturation. Examples include LRs of calcium carbonate in oölitic limestone (in nature), LRs of silver chromate in gelatin (in vitro), and LRs of glycoprotein in pulmonary corpora amylacea (in vivo). Here we describe LRs in lesions from 29 patients--mostly lesions of the kidney, synovium, conjunctiva, and eyelid. The LRs formed in cysts, or in fibrotic, inflamed, or necrotic tissue. The LRs in this study varied greatly in shape and size, measuring 7-800 microns. Special stains and energy-dispersive radiographic analysis or scanning electron microscopy revealed that some LRs contained calcium, iron (hemosiderin), silicon, and sulfur. Some pathologists have mistaken LRs for eggs, larvae, or adults of the giant kidney worm, Dioctophyma renale. D. renale is a large blood-red nematode that infects a variety of fish-eating mammals, especially mink. Fourteen documented infections of humans have been recorded, usually with adult worms expelled from the urethra. The adult worms are probably the largest helminth to parasitize humans. Eggs of D. renale are constant in size (60-80 microns X 39-47 microns), contain an embryo, and have characteristic sculpturing of the shell. Liesegang rings should not be mistaken for eggs, larvae, or adults of D. renale, or for any other helminth.

Transcanal endoscopic resection for leiomyoma of the external auditory canal and a review of the literature.

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Ikeda, Ryoukichi; Tateda, Masaru; Okoshi, Akira; Morita, Shinkichi; Suzuki, Hiroyoshi; Hashimoto, Sho

2016-02-01

Leiomyoma usually originates from the uterus and alimentary tract, but in extremely rare cases leiomyoma can appear in the external auditory canal. Here we present a 37-year-old man with right auricular fullness. Preoperative findings suggested benign tumor or cholesteatoma in the right external auditory canal. We performed total resection using an endoauricular approach with transcanal endoscopic ear surgery. Histopathological and immunohistochemistry examination confirmed the diagnosis of leiomyoma of external auditory canal. Leiomyoma arising from soft tissue, including that in the external auditory canal, is classified into two types: that from the arrectores pilorum muscles and that from the muscle coats of blood vessels. Only four cases of leiomyoma of external auditor canal have been published in the English literature. The other four cases demonstrated vascular leiomyomas. This is the first report of leiomyoma of the EAC arising from arrectores pilorum muscles. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Subtype-Specific Tumor-Associated Fibroblasts Contribute to the Pathogenesis of Uterine Leiomyoma.

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Wu, Xin; Serna, Vanida A; Thomas, Justin; Qiang, Wenan; Blumenfeld, Michael L; Kurita, Takeshi

2017-12-15

Recent genomic studies have identified subtypes of uterine leiomyoma (LM) with distinctive genetic alterations. Here, we report the elucidation of the biological characteristics of the two most prevalent uterine leiomyoma subtypes, MED12-mutant (MED12-LM) and HMGA2-overexpressing (HMGA2-LM) uterine leiomyomas. Because each tumor carries only one genetic alteration, both subtypes are considered to be monoclonal. Approximately 90% of cells in HMGA2-uterine leiomyoma were smooth muscle cells (SMC) with HMGA2 overexpression. In contrast, MED12-LM consisted of similar numbers of SMC and non-SMC, which were mostly tumor-associated fibroblasts (TAF). Paradoxically, TAF carried no mutations in MED12, suggesting an interaction between SMC and TAF to coordinate their growth. The higher amount of extracellular matrix in MED12-LM than HMGA2-LM was partially due to the high concentration of collagen-producing TAF. SMC growth in a xenograft assay was driven by progesterone in both uterine leiomyoma subtypes. In contrast, TAF in MED12-LM proliferated in response to estradiol, whereas progesterone had no effect. The high concentration of estrogen-responsive TAF in MED12-LM explains the inconsistent discoveries between in vivo and in vitro studies on the mitogenic effect of estrogen and raises questions regarding the accuracy of previous studies utilizing MED12-LM cell culture. In addition, the differential effects of estradiol and progesterone on these uterine leiomyoma subtypes emphasize the importance of subtypes and genotypes in designing nonsurgical therapeutic strategies for uterine leiomyoma. Cancer Res; 77(24); 6891-901. ©2017 AACR . ©2017 American Association for Cancer Research.

'Bridging vascular sign' in the MR diagnosis of uterine subserosal/exophytic leiomyoma

International Nuclear Information System (INIS)

Kim, Jong Chul

1998-01-01

To evaluate the usefulness of 'bridging vascular sign' in the diagnosis of a subserosal/exophytic uterine leiomyoma and the helpfulness of this sign in the differentiation of a uterine leiomyoma from adnexal masses on pelovic magnetic resonance (MR) imaging. Of 20 women with a solitiary pelvic mass in whom pelvic MR imaging was performed during recent three years to differentiate a uterine leiomyoma from an adnexal mass, 12 with surgicopathologically proven subserosal/exophytic uterine leiomymas were included in this study. The other eight women were proved to have tubo-ovarian abscess (n=3D3), ovarian endometrioma (n=3D2), ruptured corpus luteum cyst (n=3D2), and ovarian fibroma (n=3D1). A 1.5 T unit was used to obtain axial/saittal T1- and T2-weighted and gadolinum-enhanced sagittal T1-weighted images. Positive 'bridging vascular sign' was defined through the retrospective review and analysis of MR findings as the presence of intervening curvilinear or tortuous signal-void vascular structures crossing the uterus and the pelvic mass. Using this sign in the diagnosis and differentiation of a uterine leiomyoma from adnexal masses, statistical significance was evaluated. 'Bridging vascular sign' was present in eight of 12 leiomyomas, but no in adnexal masses. Using this sign in the diagnosis and differentiation of a uterine leiomyoma from adnexal masses, sensitivity was 66.7%, specificity 100%, positive predictive value 100%, negative predictive value 66.7%, and accuracy 80%. 'Vascular bridging sign' on MR imaging may be a useful radiologic sign in the diagnosis and differentiation of a subserosal/exophytic uterine leiomyoma from adnexal masses.=20

Mechanisms underlying aberrant expression of miR-29c in uterine leiomyoma.

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Chuang, Tsai-Der; Khorram, Omid

2016-01-01

To determine the expression of miR-29c and its target genes in leiomyoma and the role of NF-κB, specific protein 1 (SP1), and DNA methylation in its regulation. Experimental study. Academic research laboratory. Women undergoing hysterectomy for leiomyoma. Over- and underexpression of miR-29c; blockade of transcription factors. MiR-29c and its target gene levels in leiomyoma and the effects of blockade of transcription factors on miR-29c expression. Leiomyoma as compared with myometrium expressed significantly lower levels of miR-29c, with an inverse relationship with expression of its targets, COL3A1 and DNMT3A. Gain of function of miR-29c inhibited the expression of COL3A1 and DNMT3A at protein and mRNA levels, secreted COL3A1, and rate of cell proliferation. Loss of function of miR-29c had the opposite effect. E2, P, and their combination inhibited miR-29c in leiomyoma smooth muscle cells (LSMC). Phosphorylated NF-κB (p65) and SP1 protein expression were significantly increased in leiomyoma. SiRNA knockdown of SP1 and DNMT3A or their specific inhibitors significantly increased the expression of miR-29c, accompanied by the inhibition of cellular and secreted COL3A1 in siRNA-treated cells. Knockdown of p65 also induced miR-29c expression but had no effect on COL3A1 expression. MiR-29c expression is suppressed in leiomyoma, resulting in an increase in expression of its targets COL3A1 and DNMT3A. The suppression of miR-29c in LSMC is primarily mediated by SP1, NF-κB signaling, and epigenetic modification. Collectively, these results indicate a significant role for miR-29c in leiomyoma pathogenesis. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Intraosseous Leiomyoma of the Jaw in an Adolescent.

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Valls-Ontañón, Adaia; Pozuelo-Arquimbau, Laura; Mateu-Esquerda, Gemma; Arranz-Obispo, Carlos; Cuscó-Albors, Sílvia; Melero-Luque, Mireia; Morla, Arnaud; Marí-Roig, Antoni

2017-05-15

Leiomyoma is a benign tumor of the smooth muscle that rarely occurs in the mouth as an intraosseous lesion. The purposes of this paper are to: (1) present a case of an intraosseous solid leiomyoma of the mandible in a 13-year-old child, who presented with a well-defined unilocular radiolucency in the right mandible incidentally discovered during a routine dental radiographic examination; and (2) conduct a review of the literature to describe clinicopathological features and management of intraosseous jaw leiomyoma (IJL). A total of 17 articles describing 18 cases of IJL satisfied the selection criteria; including the present patient, to date a total of 19 cases of IJL have been reported. IJL occurs mainly in young patients (36.8 percent), more often in boys (1:5:1 male-to-female ratio), and reaches a larger size in children than in adults. The treatment of choice for IJL is surgical excision, which should be as minimally invasive as possible, especially in children.

A case of tracheal leiomyoma misdiagnosed as asthma.

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Öztürk, Ayperi; Aktaş, Zafer; Yılmaz, Aydın; Yeşildağlı, Havva; Memiş, Leyla

2016-12-01

Primary benign tumors of trachea are rare. Of them, tracheal leiomyoma, constitutes only 1% of all benign lower respiratory tract tumors. Here, we present a case of tracheal leiomyoma who has been receiving high doses of inhaled corticosteroids and bronchodilators for a year with a misdiagnosis of asthma. As the symptoms did not resolve with an overtreatment, she has been undergone radiologic study to find a possible alternative diagnosis. The chest roentgenogram revealed an opacity in the upper mediastinum. In computed tomography, a lesion has been detected in proximal trachea, arising from the posterior wall and protruding through the lumen and almost obliterating the air column. Rigid bronchoscopy has been performed under general anesthesia due to a high risk of bleeding and the endobronchial lesion, freely moving with respiration, has been removed and cryotherapy was applied to the base of the lesion. Receiving the histopathological diagnosis of leiomyoma, the patient is now on 12th month of the follow-up without any recurrence.

Decreased expression of microRNA-29 family in leiomyoma contributes to increased major fibrillar collagen production.

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Marsh, Erica E; Steinberg, Marissa L; Parker, J Brandon; Wu, Ju; Chakravarti, Debabrata; Bulun, Serdar E

2016-09-01

To determine the expression and function of the microRNA-29 family (miRNA-29a, miRNA-29b, miRNA-29c) in human leiomyoma and myometrium. Basic science experimental design. Academic medical center. Women undergoing surgery for symptomatic uterine fibroids. Overexpression and knockdown of miRNA-29a, miRNA-29b, and miRNA-29c in primary leiomyoma and myometrial cells. [1] Expression of the miRNA-29 family members in vivo in leiomyoma versus myometrium; [2] Major fibrillar collagen (I, II, III) expression in leiomyoma and myometrial cells with manipulation of miRNA-29 species. Members of the miRNA-29 family (29a, 29b, 29c) are all down-regulated in leiomyoma versus myometrium in vivo. The expression of the miRNA-29 family can be successfully modulated in primary leiomyoma and myometrial cells. Overexpression of the miRNA-29 family in leiomyoma cells results in down-regulation of the major fibrillar collagens. Down-regulation of the miRNA-29 species in myometrium results in an increase in collagen type III deposition. The miRNA-29 family is consistently down-regulated in leiomyoma compared to matched myometrial tissue. This down-regulation contributes to the increased collagen seen in leiomyomas versus myometrium. When miRNA-29 members are overexpressed in leiomyoma cells, protein levels of all of the major fibrillar collagens decrease. The miRNA-29 members are potential therapeutic targets in this highly prevalent condition. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Regression of a vaginal leiomyoma after ovariohysterectomy in a dog: a case report.

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Sathya, Suresh; Linn, Kathleen

2014-01-01

An 11 yr old female mixed-breed Siberian husky was presented with a history of sanguineous vaginal discharge, swelling of the perineal area, decreased appetite, and lethargy. A single, large vaginal leiomyoma and multiple mammary tumors were diagnosed. Mastectomy and ovariohysterectomy were performed. The vaginal leiomyoma regressed completely after ovariohysterectomy. This is the first reported case of spontaneous regression of a vaginal leiomyoma after ovariohysterectomy in a dog.

Leiomyomas in the gastric cardia: CT findings and differentiation from gastrointestinal stromal tumors

International Nuclear Information System (INIS)

Yang, Hyun Kyung; Kim, Young Hoon; Lee, Yoon Jin; Park, Ji Hoon; Kim, Ji Young; Lee, Kyoung Ho; Lee, Hye Seung

2015-01-01

Highlights: • Gastric leiomyomas frequently involve the gastric cardia. • Gastric cardial leiomyomas and GISTs could be differentiated with CT. • Differentiation of cardial leiomyomas and GISTs can help choosing surgical procedure. - Abstract: Objective: To describe CT findings of leiomyomas and gastrointestinal stromal tumors (GISTs) in the gastric cardia and to identify their differentiating features. Materials and methods: CT images of pathologically proven leiomyomas (n = 26) and GISTs (n = 19) in the gastric cardia were retrospectively reviewed for esophagogastric junction (EGJ) involvement, contour, surface, growth pattern, enhancement pattern and degree of the tumor, and the presences of intralesional low attenuation, calcification and surface dimples or ulcers. The long (LD) and short diameters (SD), LD/SD ratio, and attenuation value of each lesion were measured. Results: EGJ involvement, homogeneous enhancement, intermediate or low enhancement, absences of intralesional low attenuation and surface dimples or ulcers, LD/SD ratio >1.2, and attenuation value ≤71.2 HU were significant findings for differentiating leiomyomas from GISTs (P < 0.05 for each finding). An LD/SD ratio of >1.2 and attenuation value of ≤71.2 HU yielded sensitivities of 84.6% and 61.5%, and specificities of 52.6% and 84.2%, respectively, on the receiver operating characteristic curve analysis. When at least five of these seven criteria were used in combination, the sensitivity and specificity for diagnosing leiomyomas were 100% (26 of 26) and 89.5% (17 of 19), respectively. When any six of these criteria were used, a specificity of 100% was achieved. Conclusions: CT features including EGJ involvement, enhancement pattern and degree, presences of intralesional low attenuation and surface dimples or ulcers, LD/SD ratio, and attenuation value could help differentiating leiomyomas from GISTs in the gastric cardia, particularly in the manner of combination

Leiomyomas in the gastric cardia: CT findings and differentiation from gastrointestinal stromal tumors

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Yang, Hyun Kyung [Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Kim, Young Hoon, E-mail: yhkrad@gmail.com [Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Lee, Yoon Jin; Park, Ji Hoon; Kim, Ji Young; Lee, Kyoung Ho [Department of Radiology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Institute of Radiation Medicine, Seoul National University Medical Research Center, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of); Lee, Hye Seung [Department of Pathology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707 (Korea, Republic of)

2015-09-15

Highlights: • Gastric leiomyomas frequently involve the gastric cardia. • Gastric cardial leiomyomas and GISTs could be differentiated with CT. • Differentiation of cardial leiomyomas and GISTs can help choosing surgical procedure. - Abstract: Objective: To describe CT findings of leiomyomas and gastrointestinal stromal tumors (GISTs) in the gastric cardia and to identify their differentiating features. Materials and methods: CT images of pathologically proven leiomyomas (n = 26) and GISTs (n = 19) in the gastric cardia were retrospectively reviewed for esophagogastric junction (EGJ) involvement, contour, surface, growth pattern, enhancement pattern and degree of the tumor, and the presences of intralesional low attenuation, calcification and surface dimples or ulcers. The long (LD) and short diameters (SD), LD/SD ratio, and attenuation value of each lesion were measured. Results: EGJ involvement, homogeneous enhancement, intermediate or low enhancement, absences of intralesional low attenuation and surface dimples or ulcers, LD/SD ratio >1.2, and attenuation value ≤71.2 HU were significant findings for differentiating leiomyomas from GISTs (P < 0.05 for each finding). An LD/SD ratio of >1.2 and attenuation value of ≤71.2 HU yielded sensitivities of 84.6% and 61.5%, and specificities of 52.6% and 84.2%, respectively, on the receiver operating characteristic curve analysis. When at least five of these seven criteria were used in combination, the sensitivity and specificity for diagnosing leiomyomas were 100% (26 of 26) and 89.5% (17 of 19), respectively. When any six of these criteria were used, a specificity of 100% was achieved. Conclusions: CT features including EGJ involvement, enhancement pattern and degree, presences of intralesional low attenuation and surface dimples or ulcers, LD/SD ratio, and attenuation value could help differentiating leiomyomas from GISTs in the gastric cardia, particularly in the manner of combination.

Xenotransplantation of uterine leiomyoma in Wistar rats: a pilot study.

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Sousa, Willane Bandeira de; Garcia, João Batista Santos; Nogueira Neto, João; Furtado, Pablo Gustavo Ribeiro; Anjos, Jonhnathan Adriano Araújo dos

2015-07-01

To evaluate whether xenografts derived from hysterectomized patients would implant successfully and lead to uterine leiomyoma in Wistar rats. This experimental study examined six female Wistar rats implanted with uterine leiomyoma obtained from patients who underwent hysterectomies at the gynecological surgery service of the HUUFMA. The rats were divided into two groups. Group I consisted of three rats in which the uterine leiomyoma had been implanted in the parietal peritoneum, and group II consisted of three rats in which the uterine leiomyoma was implanted in the subcutaneous tissue. The immunosuppressant mycophenolate mofetil (MMF) was administered orally by gavage (at a dose of 40 mg/kg of body weight) to prevent transplant rejection starting 15 days before the transplant and continuing throughout the entire experiment. After four weeks, necrosis and neovascularization were evaluated histologically in both groups and were classified as either absent or present. Lymphocytic inflammatory infiltration was also examined and classified as mild, moderate or intense (by hematoxylin and eosin staining), and fibrosis was classified as grade I-III (by Masson's trichrome staining). Necrosis was absent from all three rats in group I and was observed in only one rat from group II. Neovascularization was present in two rats from group I and in only one rat from group II. The lymphocytic inflammatory infiltrate was mild in two rats and moderate in one rat from group I, and it was moderate in two rats and intense in one rat from group II. Two rats from group 1 exhibited grade III fibrosis, and one rat presented grade I fibrosis. In group II, two rats presented grade I fibrosis and one rat had grade II fibrosis. When necrosis and neovascularization were evaluated as variables, group I demonstrated greater evidence of successful implantation when compared to group II, indicating that the peritoneal implantation technique produces better results than the subcutaneous approach (p

A Rare Case of Intra-Endometrial Leiomyoma of Uterus Simulating Degenerated Submucosal Leiomyoma Accompanied by a Large Sertoli-Leydig Cell Tumor.

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Jeong, Kyungah; Lee, Sa Ra; Park, Sanghui

2016-03-01

A 50-year-old peri-menopausal woman presented with hard palpable mass on her lower abdomen and anemia from heavy menstrual bleeding. Ultrasonography showed a 13×12 cm sized hypoechoic solid mass in pelvis and a 2.5×2 cm hypoechoic cystic mass in uterine endometrium. Abdomino-pelvic computed tomography revealed a hypodense pelvic mass without enhancement, suggesting a leiomyoma of intraligamentary type or sex cord tumor of right ovary with submucosal myoma of uterus. Laparoscopy revealed a large Sertoli-Leydig cell tumor of right ovary with a very rare entity of intra-endometrial uterine leiomyoma accompanied by adenomyosis. The final diagnosis of ovarian sex-cord tumor (Sertoli-Leydig cell), stage Ia with intra-endometrial leiomyoma with adenomyosis, was made. Considering the large size of the tumor and poorly differentiated nature, 6 cycles of chemotherapy with Taxol and Carboplatin regimen were administered. There is neither evidence of major complications nor recurrence during 20 months' follow-up.

Giant hydronephrosis mimicking progressive malignancy

Science.gov (United States)

Schrader, Andres Jan; Anderer, Georgia; von Knobloch, Rolf; Heidenreich, Axel; Hofmann, Rainer

2003-01-01

Background Cases of giant hydronephroses are rare and usually contain no more than 1–2 litres of fluid in the collecting system. We report a remarkable case of giant hydronephrosis mimicking a progressive malignant abdominal tumour. Case presentation A 78-year-old cachectic woman presented with an enormous abdominal tumour, which, according to the patient, had slowly increased in diameter. Medical history was unremarkable except for a hysterectomy >30 years before. A CT scan revealed a giant cystic tumour filling almost the entire abdominal cavity. It was analysed by two independent radiologists who suspected a tumour originating from the right kidney and additionally a cystic ovarian neoplasm. Subsequently, a diagnostic and therapeutic laparotomy was performed: the tumour presented as a cystic, 35 × 30 × 25 cm expansive structure adhesive to adjacent organs without definite signs of invasive growth. The right renal hilar vessels could finally be identified at its basis. After extirpation another tumourous structure emerged in the pelvis originating from the genital organs and was also resected. The histopathological examination revealed a >15 kg hydronephrotic right kidney, lacking hardly any residual renal cortex parenchyma. The second specimen was identified as an ovary with regressive changes and a large partially calcified cyst. There was no evidence of malignant growth. Conclusion Although both clinical symptoms and the enormous size of the tumour indicated malignant growth, it turned out to be a giant hydronephrosis. Presumably, a chronic obstruction of the distal ureter had caused this extraordinary hydronephrosis. As demonstrated in our case, an accurate diagnosis of giant hydronephrosis remains challenging due to the atrophy of the renal parenchyma associated with chronic obstruction. Therefore, any abdominal cystic mass even in the absence of other evident pathologies should include the differential diagnosis of a possible hydronephrosis. Diagnostic

Increased Urinary Phthalate Levels in Women with Uterine Leiomyoma: A Case-Control Study.

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Kim, Young Ah; Kho, Younglim; Chun, Kyoung Chul; Koh, Jae Whoan; Park, Jeong Woo; Bunderson-Schelvan, Melisa; Cho, Yoon Hee

2016-12-15

We assessed the urinary concentration of 16 phthalate metabolites in 57 women with and without uterine leiomyoma ( n = 30 and 27; respectively) to determine the association between phthalate exposure and uterine leiomyoma. To evaluate exposure to di-(2-ethylhexyl) phthalate (DEHP); we calculated the molar sum of DEHP metabolites; ∑3-DEHP (combining mono-(2-ethylhexyl) phthalate (MEHP); mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP); and mono-(2-ethyl-5-oxohexyl) phthalate); ∑4-DEHP (∑3-DEHP plus mono-(2-ethyl-5-carboxypentyl) phthalate); and ∑5-DEHP (∑4-DEHP plus mono (2-(carboxylmethyl)hexyl) phthalate (2cx-MMHP)). The log transformed urinary levels of MEHP; MEHHP; 2cx-MMHP; ∑3-DEHP; ∑4-DEHP; and ∑5-DEHP in the leiomyoma group were significantly higher than those of controls. When we adjusted for age; waist circumference; and parity using multiple logistic regression analyses; we found log ∑3-DEHP (OR = 10.82; 95% CI = 1.25; 93.46) and ∑4-DEHP (OR = 8.78; 95% CI = 1.03; 75.29) were significantly associated with uterine leiomyoma. Our findings suggest an association between phthalate exposure and uterine leiomyoma. However; larger studies are needed to investigate potential interactions between phthalate exposure and uterine leiomyoma.

Targeted Adenoviral Vector Demonstrates Enhanced Efficacy for In Vivo Gene Therapy of Uterine Leiomyoma.

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Abdelaziz, Mohamed; Sherif, Lotfy; ElKhiary, Mostafa; Nair, Sanjeeta; Shalaby, Shahinaz; Mohamed, Sara; Eziba, Noura; El-Lakany, Mohamed; Curiel, David; Ismail, Nahed; Diamond, Michael P; Al-Hendy, Ayman

2016-04-01

Gene therapy is a potentially effective non-surgical approach for the treatment of uterine leiomyoma. We demonstrated that targeted adenovirus vector, Ad-SSTR-RGD-TK/GCV, was highly effective in selectively inducing apoptosis and inhibiting proliferation of human leiomyoma cells in vitro while sparing normal myometrial cells. An in-vivo study, to compare efficacy and safety of modified adenovirus vector Ad-SSTR-RGD-TK/GCV versus untargeted vector for treatment of leiomyoma. Female nude mice were implanted with rat leiomyoma cells subcutaneously. Then mice were randomized into three groups. Group 1 received Ad-LacZ (marker gene), Group 2 received untargeted Ad-TK, and Group 3 received the targeted Ad-SSTR-RGD-TK. Tumors were measured weekly for 4 weeks. Then mice were sacrificed and tissue samples were collected. Evaluation of markers of apoptosis, proliferation, extracellular matrix, and angiogenesis was performed using Western Blot & Immunohistochemistry. Statistical analysis was done using ANOVA. Dissemination of adenovirus was assessed by PCR. In comparison with the untargeted vector, the targeted adenoviral vector significantly shrank leiomyoma size (P leiomyoma lesions with both targeted and untargeted adenovirus. Targeted adenovirus, effectively reduces tumor size in leiomyoma without dissemination to other organs. Further evaluation of this localized targeted strategy for gene therapy is needed in appropriate preclinical humanoid animal models in preparation for a future pilot human trial. © The Author(s) 2016.

Paracrine Pathways in Uterine Leiomyoma Stem Cells Involve Insulinlike Growth Factor 2 and Insulin Receptor A.

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Moravek, Molly B; Yin, Ping; Coon, John S; Ono, Masanori; Druschitz, Stacy A; Malpani, Saurabh S; Dyson, Matthew T; Rademaker, Alfred W; Robins, Jared C; Wei, Jian-Jun; Kim, J Julie; Bulun, Serdar E

2017-05-01

Uterine leiomyomas (fibroids) are the most common benign tumors in women. Recently, three populations of leiomyoma cells were discovered on the basis of CD34 and CD49b expression, but molecular differences between these populations remain unknown. To define differential gene expression and signaling pathways in leiomyoma cell populations. Cells from human leiomyoma tissue were sorted by flow cytometry into three populations: CD34+/CD49b+, CD34+/CD49b-, and CD34-/CD49b-. Microarray gene expression profiling and pathway analysis were performed. To investigate the insulinlike growth factor (IGF) pathway, real-time quantitative polymerase chain reaction, immunoblotting, and 5-ethynyl-2'-deoxyuridine incorporation studies were performed in cells isolated from fresh leiomyoma. Research laboratory. Eight African American women. None. Gene expression patterns, cell proliferation, and differentiation. A total of 1164 genes were differentially expressed in the three leiomyoma cell populations, suggesting a hierarchical differentiation order whereby CD34+/CD49b+ stem cells differentiate to CD34+/CD49b- intermediary cells, which then terminally differentiate to CD34-/CD49b- cells. Pathway analysis revealed differential expression of several IGF signaling pathway genes. IGF2 was overexpressed in CD34+/CD49b- vs CD34-/CD49b- cells (83-fold; P leiomyoma stem cell proliferation and may represent paracrine signaling between leiomyoma cell types. Therapies targeting the IGF pathway should be investigated for both treatment and prevention of leiomyomas. Copyright © 2017 by the Endocrine Society

Epidermal growth factor-containing fibulin-like extracellular matrix protein 1 expression and regulation in uterine leiomyoma.

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Marsh, Erica E; Chibber, Shani; Wu, Ju; Siegersma, Kendra; Kim, Julie; Bulun, Serdar

2016-04-01

To determine the presence, differential expression, and regulation of epidermal growth factor-containing fibulin-like extracellular matrix protein 1 (EFEMP1) in uterine leiomyomas. Laboratory in vivo and in vitro study with the use of human leiomyoma and myometrial tissue and primary cells. Academic medical center. Leiomyoma and myometrial tissue samples and cultured cells. 5-Aza-2'-deoxycytidine (5-aza-dC) treatment. Fold-change difference between EFEMP1 and fibulin-3 expression in leiomyoma tissue and cells compared with matched myometrial samples, and fold-change difference in EFEMP1 expression with 5-Aza-dC treatment. In vivo, EFEMP1 expression was 3.19-fold higher in myometrial tissue than in leiomyoma tissue. EFEMP1 expression in vitro was 5.03-fold higher in myometrial cells than in leiomyoma cells. Western blot and immunohistochemistry staining of tissue and cells confirmed similar findings in protein expression. Treatment of leiomyoma cells with 5-Aza-dC resulted in increased expression of EFEMP1 in vitro. The EFEMP1 gene and its protein product, fibulin-3, are both significantly down-regulated in leiomyoma compared with myometrium when studied both in vivo and in vitro. The increase in EFEMP1 expression in leiomyoma cells with 5-Aza-dC treatment suggest that differential methylation is responsible, in part, for the differences seen in gene expression. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Esophageal leiomyoma: radiologic findings in 12 patients

International Nuclear Information System (INIS)

Yang, Po Song; Lee, Kyung Soo; Lee, Soon Jin; Kim, Tae Sung; Choo, In Wook; Shim, Young Mog; Kim, Kwhanmien; Kim, Yoo Kyung

2001-01-01

The aim of our study was to describe and compare the radiologic findings of esophageal leiomyomas. The chest radiographic (n = 12), esophagographic (n = 12), CT (n = 12), and MR (n = 1) findings of surgically proven esophageal leiomyomas in 12 consecutive patients [ten men and two women aged 34 - 47 (mean, 39) years] were retrospectively reviewed. The tumors, surgical specimens of which ranged from 9 to 90 mm in diameter, were located in the upper (n = 1), middle (n = 5), or lower esophagus (n = 6). In ten of the 12 patients, chest radiography revealed the tumors as mediastinal masses. Esophagography showed them as eccentric, smoothly elevated filling defects in 11 patients and a multilobulated encircling filling defect in one. In 11 of the 12 patients, enhanced CT scans revealed a smooth (n = 9) or lobulated (n = 2) tumor margin, and attenuation was homogeneously low (n = 7) or iso (n 4). In one patient, the tumor signal seen on T2-weighted MR images was slightly Esophageal leiomyomas, located mainly in the middle or distal esophagus, are consistently shown by esophagography to be mainly eccentrically elevated filling defects and at CT, lesions showing homogeneous low or isoattenuation are demonstrated

Esophageal leiomyoma: radiologic findings in 12 patients

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Yang, Po Song; Lee, Kyung Soo; Lee, Soon Jin; Kim, Tae Sung; Choo, In Wook; Shim, Young Mog; Kim, Kwhanmien [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Kim, Yoo Kyung [Ewha Womans University Mokdong Hospital, Seoul (Korea, Republic of)

2001-09-01

The aim of our study was to describe and compare the radiologic findings of esophageal leiomyomas. The chest radiographic (n = 12), esophagographic (n = 12), CT (n = 12), and MR (n = 1) findings of surgically proven esophageal leiomyomas in 12 consecutive patients [ten men and two women aged 34 - 47 (mean, 39) years] were retrospectively reviewed. The tumors, surgical specimens of which ranged from 9 to 90 mm in diameter, were located in the upper (n = 1), middle (n = 5), or lower esophagus (n = 6). In ten of the 12 patients, chest radiography revealed the tumors as mediastinal masses. Esophagography showed them as eccentric, smoothly elevated filling defects in 11 patients and a multilobulated encircling filling defect in one. In 11 of the 12 patients, enhanced CT scans revealed a smooth (n = 9) or lobulated (n = 2) tumor margin, and attenuation was homogeneously low (n = 7) or iso (n 4). In one patient, the tumor signal seen on T2-weighted MR images was slightly Esophageal leiomyomas, located mainly in the middle or distal esophagus, are consistently shown by esophagography to be mainly eccentrically elevated filling defects and at CT, lesions showing homogeneous low or isoattenuation are demonstrated.

An anthocyanin rich strawberry extract induces apoptosis and ROS while decreases glycolysis and fibrosis in human uterine leiomyoma cells.

Science.gov (United States)

Islam, Md Soriful; Giampieri, Francesca; Janjusevic, Milijana; Gasparrini, Massimiliano; Forbes-Hernandez, Tamara Y; Mazzoni, Luca; Greco, Stefania; Giannubilo, Stefano Raffaele; Ciavattini, Andrea; Mezzetti, Bruno; Capocasa, Franco; Castellucci, Mario; Battino, Maurizio; Ciarmela, Pasquapina

2017-04-04

Uterine leiomyomas are highly prevalent benign tumors in reproductive aged women. Unfortunately, medical treatments are still limited and no preventive therapies have been developed. In the present study, we investigated the therapeutic effects of strawberry extract on uterine leiomyoma cells. Leiomyoma and myometrial cells were treated with strawberry (cultivar Alba) extract (250 μg/ml) for 48 h to measure apoptosis, reactive oxygen species (ROS), oxidative phosphorylation (OCR, oxygen consumption rate) and glycolysis (ECAR, extracellular acidification rate) as well as fibrosis associated gene and/or protein expression. In leiomyoma cells, strawberry increased the percentage of apoptotic and dead cells. Strawberry significantly increased ROS concentration in leiomyoma cells, while decreased it in myometrial cells. After strawberry treatment, leiomyoma cells showed a significant decreased rate of ECAR, while OCR was unchanged in both myometrial and leiomyoma cells. Strawberry significantly decreased collagen1A1, fibronectin and versican mRNA expression in leiomyoma cells. The reduced protein expression of fibronectin was observed by strawberry extract in leiomyoma cells as well. Furthermore, strawberry was able to reduce activin A induced fibronectin, collagen1A1, and versican as well as activin A and PAI-1 mRNA expression in leiomyoma cells. This study suggests that strawberry can be developed as therapeutic and/or preventive agent for uterine leiomyomas.

Leiomyomas in a naevoid distribution

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Khaitan Binod

2002-01-01

Full Text Available A 59 -year-old man developed gradually appearing and slowly progressive tender papulo-nodular lesions in a naevoid distribution on the left side of the trunk since the age of 49 years. The histopathological features were classical of leiomyoma.

Giant Urinary Bladder and Bilateral Giant Hydronephrosis due to Bladder Neck Obstruction: One Case Report and Literature Review

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Mohammed Fadl Tazi

2012-01-01

Full Text Available Bilateral hydronephrosis secondary to urinary obstruction leads to a buildup of back pressure in the urinary tract and may lead to impairment of renal function. Cases of giant hydronephrosis are rare and usually contain no more than 1-2 litres of fluid in the collecting system. Here, we report a rarely seen case with giant urinary bladder and bilateral giant hydronephrosis due to bladder neck obstruction which contains 4000 mL fluid in the collecting system of the kidney mimicking an ascites in an adult male.

A Case of Torsion of Gravid Uterus Caused by Leiomyoma

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Gururaj Deshpande

2011-01-01

Full Text Available Uterine torsion during pregnancy is only sporadically reported in the literature. Here we present a case of leiomyoma causing uterine torsion in pregnancy and review the literature on etiology, diagnosis, and management. A 25-years-old primigravida with leiomyoma complicating pregnancy was admitted in our hospital with abdominal pain and uterine tenderness. She underwent emergency LSCS (lower segment cesarean section for fetal bradycardia. Intraoperatively, the uterus was rotated 180 degrees left to right. Inadvertent incision on the posterior wall was avoided by proper delineation of anatomy. Torsion was corrected by exteriorization of leiomyoma and uterus, and lower segment cesarean was carried out safely. Prompt recognition and management of this condition is necessary for better maternal and fetal outcome.

A Comprehensive Review of the Pharmacologic Management of Uterine Leiomyoma

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Terrence D. Lewis

2018-01-01

Full Text Available Uterine leiomyomata are the most common benign tumors of the gynecologic tract impacting up to 80% of women by 50 years of age. It is well established that these tumors are the leading cause for hysterectomy with an estimated total financial burden greater than $30 billion per year in the United States. However, for the woman who desires future fertility or is a poor surgical candidate, definitive management with hysterectomy is not an optimal management plan. Typical gynecologic symptoms of leiomyoma include infertility, abnormal uterine bleeding (AUB/heavy menstrual bleeding (HMB and/or intermenstrual bleeding (IMB with resulting iron-deficiency anemia, pelvic pressure and pain, urinary incontinence, and dysmenorrhea. The morbidity caused by these tumors is directly attributable to increases in tumor burden. Interestingly, leiomyoma cells within a tumor do not rapidly proliferate, but rather the increase in tumor size is secondary to production of an excessive, stable, and aberrant extracellular matrix (ECM made of disorganized collagens and proteoglycans. As a result, medical management should induce leiomyoma cells toward dissolution of the extracellular matrix, as well as halting or inhibiting cellular proliferation. Herein, we review the current literature regarding the medical management of uterine leiomyoma.

Use of depot medroxyprogesterone acetate and prevalent leiomyoma in young African American women.

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Harmon, Q E; Baird, D D

2015-06-01

Is use of depot medroxyprogesterone acetate (DMPA) a risk factor for or a protective factor against prevalent uterine leiomyoma? Ever use of DMPA was associated with a decreased risk (adjusted risk ratio (RR): 0.8, 95% confidence interval (CI): 0.6, 0.9) of prevalent leiomyoma in young African American women. Although progesterone is associated with growth of leiomyoma, previous epidemiological studies have shown a protective association for DMPA use. These previous studies may have been biased by studying clinically diagnosed leiomyoma (DMPA may mask symptoms thus delaying diagnoses). Cross sectional analysis of baseline data from a cohort study of 1696 African American women. Community-based recruitment (e.g. letters, flyers, radio and TV announcements) were used to enroll African American women between 23 and 34 years old without a previous diagnosis of leiomyoma in the Metropolitan Detroit area. Extensive questionnaire data were used to determine DMPA use and screening ultrasound detected the presence of leiomyoma ≥0.5 cm in diameter. Relative risks with adjustment for covariates were calculated for the presence of leiomyoma based on ever use of DMPA as well as duration and recency of use. Among the 1696 volunteers who enrolled, 43% had used DMPA. Leiomyoma were detected in 17% of those who had ever used DMPA compared with 26% of those who had never used DMPA. The reduction in prevalence remained after adjustment for potential confounders and was highest among women who had used DMPA for more than 4 years (adjusted RR: 0.5, 95% CI: 0.3, 0.8). The reduction in risk was seen for women whose most recent use was up to 8 years prior to study enrollment. The use of cross-sectional data means that the timing of initial fibroid development is not known, so the temporality of the association is uncertain. However in this sample of young women, most fibroids were small, suggesting that DMPA exposure may have occurred before leiomyoma development. Our findings are in

Oxidative stress: a key regulator of leiomyoma cell survival.

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Fletcher, Nicole M; Abusamaan, Mohammed S; Memaj, Ira; Saed, Mohammed G; Al-Hendy, Ayman; Diamond, Michael P; Saed, Ghassan M

2017-06-01

To determine the effects of attenuating oxidative stress with the use of dichloroacetate (DCA) on the expression of key redox enzymes myeloperoxidase (MPO) and inducible nitric oxide synthase (iNOS) as well as on apoptosis. Prospective experimental study. University medical center. Cells established from myometrium and uterine fibroid from the same patients. Cells were exposed to normal (20% O 2 ) or hypoxic (2% O 2 ) conditions for 24 hours with or without DCA (20 μg/mL), a metabolic modulator that shifts anaerobic to aerobic metabolism. Nitrate/nitrite (iNOS activity indicator), iNOS, Bcl-2/Bax ratio, MPO, and caspase-3 activities and levels were determined by means of Greiss assay, real-time reverse-transcription polymerase chain reaction, and ELISA. Data were analyzed with the use of SPSS by means of one-way analysis of variance with Tukey post hoc analysis and independent t tests. MPO, iNOS, and nitrate/nitrite expression were higher in leiomyoma than in myometrial cells, and they were further enhanced by hypoxia in myometrial cells. Treatment with the use of DCA decreased MPO, iNOS, and nitrate/nitrite levels and negated the effect of hypoxia in both types of cells. Leiomyoma cells showed less apoptosis, as indicated by both caspase-3 activity and the Bcl-2/Bax ratio, than myometrial cells. Hypoxia further decreased apoptosis in myometrial cells with no further effect on leiomyoma cells. Treatment with DCA resulted in increased apoptosis in both types of cells, even in the presence of hypoxia. Shifting anaerobic to aerobic metabolism with the use of DCA resulted in an increase in apoptosis in leiomyoma cells and protected myometrial cells from the acquisition of the leiomyoma-like phenotype. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Iatrogenic parasitic leiomyoma and leiomyomatosis peritonealis disseminata following uterine morcellation.

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Lu, Bingjian; Xu, Jing; Pan, Zimin

2016-08-01

To assess the impact of morcellation on the spread of uterine leiomyoma. Cases of parasitic leiomyoma involving prior laparoscopy were collected between 2012 and 2015 in a tertiary women's hospital in China. Their clinicopathological features and the associated reports were reviewed. All six patients with parasitic leiomyoma had laparoscopic myomectomy or hysterectomy with power morcellation 39-132 months previously. Patient 1 had widely disseminated tumors in the peritoneum and pelvis, in keeping with leiomyomatosis peritonealis disseminata (LPD). She received debulking of peritoneal tumors and lived with disease for 22 months. The implanting sites of the other parasitic tumors (patients 2-6) included the mesentery (n = 2), intestine (n = 1), pelvic parietal (n = 1), bladder (n = 1), and musculus rectus abdominis (n = 1). The diameter varied from 1 cm to 6 cm. The patients underwent abdominal subtotal hysterectomy, cervicectomy or tumor debulking and the postoperative course was unremarkable for a period of 2-32 months. Pathologically, these disseminated or parasitic leiomyomas did not show any evidence of malignancy. There were no morphological or immunohistochemical differences between the original tumor and the following seeding tumors. On literature review, 11 iatrogenic LPD have been reported after laparoscopic surgery for uterine leiomyoma. These cases may provide an alternative pathogenic mechanism for a distinct variant of LPD. Laparoscopic hysterectomy with tumor morcellation may increase the chance of tumor implantation and dissemination. Both clinicians and pathologists should be alert to this rare complication. © 2016 Japan Society of Obstetrics and Gynecology.

Long-term follow up after uterine artery embolization for symptomatic uterine leiomyomas

DEFF Research Database (Denmark)

Poulsen, Bente; Munk, Torben; Ravn, Pernille

2011-01-01

Uterine artery embolization is one of the established treatment options for symptomatic uterine leiomyomas, with a proven effect on the size of leiomyomas and providing short-term relief of symptoms. Only few studies have addressed long-term satisfaction with the treatment. We conducted...

Significance of 'Bridging vessel sign' on color Doppler ultrasound in diagnosis of uterine subserosal leiomyoma

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Lee, Jin Hee; Lee, Jung Hee; Sohn, Chul Ho; Woo, Seung Koo [Keimyung University School of Medicine, Taegu (Korea, Republic of); Kim, Jung Sik [Radiological Clinic, Taegu (Korea, Republic of)

2002-06-15

To evaluate the usefulness of the 'bridging vessel sign' in differentiating uterine subserosal leiomyoma from other pelvic masses mimicking leiomyoma on color Doppler ultrasound. Histologically (n=58) and clinically (n=1) proven 59 masses from 55 women were included in this study. Histologic diagnoses included leiomyoma (n=32) and various kinds of other masses (n=27). On gray scale ultrasound, the size of tumor and presence of the ovaries were recorded. On color Doppler ultrasound, the presence of 'bridging vessel sign', which was defined as a linear vessel demonstrated between the mass and the uterus was documented. Uterine subserosal leiomyoma was diagnosed on the basis of finding this sign, and the diagnostic accuracy of this sign in differentiating subserosal leiomyoma from other pelvic tumors was calculated. In addition, the diagnostic accuracy of this sign combined with the visibility of theopsilateral ovary was compared. The size of subserosal leiomyomas ranged from 4.2 to 22.1 cm (mean, 8.3 cm) while the size of other pelvic masses, from 4.6 to 21.5 cm (mean, 9.6 cm). The 'bridging vessel sign' was demonstrated in thirty of 32 leiomyomas and in three of 27 other pelvis masses. The sensitivity, specificity, accuracy, positive predictive value, and negative value of the 'bridging vessel sign' in the diagnosis of subserosal leiomyoma were 93.8%, 99.9%, 91.5%, 90.9% and 92.3%, respectively. The detection of the ipsilateral ovary was possible in 14 of 30 women with leiomyomas and in four of 25 women with other pelvic masses. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of this finding in the diagnosis of subserosal leiomyoma were 46.7%, 84.0%, 63.6%, 77.8%, and 56.8%, respectively. 'Bridging vessel sign' can be an useful finding in the differential diagnosis of subserosal leiomyomas from other pelvic masses mimicking leiomyoma.

Re-intervention after uterine leiomyoma embolisation is related to incomplete infarction and presence of submucous leiomyomas

DEFF Research Database (Denmark)

Dueholm, Margit; Langfeldt, Sten; Mafi, Hossain Mohit

2014-01-01

Objective To evaluate outcome of invasive gynecological re-interventions after uterine artery embolisation (UAE) in relation to leiomyoma characteristics. Design A cohort of 114 women with symptomatic myomas underwent UAE. Myoma characteristics were determined by contrast-enhanced magnetic...

Color doppler flow imaging in evaluation of uterine arterial embolization of leiomyoma with KMG

International Nuclear Information System (INIS)

Li Furong; Guo Yunhuai; Liu Lifang; Liu Jianhua; Guo Yunhuai

2006-01-01

Objective: To explore the effectiveness of a new kind of embolization agent-sodium alginate(KMG), and to evaluate the clinical value of 2D color Doppler ultrasound in assessing the therapeutic effect of uterine arterial embolization (UAE) in leiomyomas. Methods: Forty nine patients with symptomatic leiomyomas were undertaken UAE with KMG for the treatment. Sonography was performed at 3-7 days before and, 1, 3, 6 months after UAE with 2D color Doppler for evaluating the 2D echograms and hemodynamics. Results: Forty nine leiomyomas were studied after UAE, showing a marked reduction in the size (35%-90%). No blood flow was demonstrated in the leiomyomas either 3-7 days or 1 month or 3 months after the procedure. The reappearance of blood flow could be seen in only one case. Conclusion: KMG is an efficient embolization agent for the treatment of symptomatic leiomyomas with UAE, and ultrasonography is a useful tool to assess the effectiveness. (authors)

Degeneration of uterine leiomyoma: comparison between Gd-DTPA enhanced MR imaging and pathologic findings

International Nuclear Information System (INIS)

Shin, M. J.; Kim, G. W.; No, T. Y.; Ahn, W. H.; Baik, S. K.; Kim, B. G.; Choi, H. Y.; Paik, O. J.

1995-01-01

Gonadotropin-releasing hormone(GnRH) analogues have been used as a conservative or preoperative therapy in the treatment of uterine leiomyoma. Since these drugs, which can induce a low estrogenic state, affect only undegenerative leiomyoma tissue, the aim of the present study was to differentiate degenerative leiomyoma from undegenerative one by Gd-DTPA enhanced magnetic resonance imaging(MRI). There were 40 masses in 24 patients; all were diagnosed by surgical-pathology. With superconductive 0.5T MR circuit, T1-and T2-weighted images and Gd-DTPA T1-weighted images were obtained. Based on a combination of signal intensities of T2-weighted and enhanced T1 weighted image on the same tumor section all the lesions were classified to one of four MRI patterns. Pattern I was a heterogeneous hyperintensity on the T2-weighted images that was enhancement by Gd-DTPA. Pattern II was a high signal intensity on the T2-weighted MR images but no enhancement by Gd-DTPA. Pattern III was a low to intermediate signal intensity on the T2-weighted MR images and enhancement on the Gd-DTPA T1-weighted images. Pattern IV was a low to intermediate signal intensity on the T2-weighted images and no enhancement by Gd-DTPA. Each of these 4 groups of MRI pattern were co-related to the surgical-pathology findings. Pathologically, pattern I corresponded to an edematous leiomyoma in 3 cases and a connective tissue leiomyoma in one case. Pattern II corresponded to three red degeneration, two cystic degeneration and one infected leiomyoma. Pattern III corresponded to eighteen undegenerative leiomyomas, but some of them showed focal connective tissue proliferation. All of twelve cases in pattern IV corresponded to a hyaline degeneration. MRI with Gd-DTPA enhancement may differentiate undegenerative leiomyoma from degenerated one

Degeneration of uterine leiomyoma: comparison between Gd-DTPA enhanced MR imaging and pathologic findings

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Shin, M. J.; Kim, G. W.; No, T. Y.; Ahn, W. H.; Baik, S. K.; Kim, B. G.; Choi, H. Y.; Paik, O. J. [Wallace Memorial Baptist Hospital, Busan (Korea, Republic of)

1995-05-15

Gonadotropin-releasing hormone(GnRH) analogues have been used as a conservative or preoperative therapy in the treatment of uterine leiomyoma. Since these drugs, which can induce a low estrogenic state, affect only undegenerative leiomyoma tissue, the aim of the present study was to differentiate degenerative leiomyoma from undegenerative one by Gd-DTPA enhanced magnetic resonance imaging(MRI). There were 40 masses in 24 patients; all were diagnosed by surgical-pathology. With superconductive 0.5T MR circuit, T1-and T2-weighted images and Gd-DTPA T1-weighted images were obtained. Based on a combination of signal intensities of T2-weighted and enhanced T1 weighted image on the same tumor section all the lesions were classified to one of four MRI patterns. Pattern I was a heterogeneous hyperintensity on the T2-weighted images that was enhancement by Gd-DTPA. Pattern II was a high signal intensity on the T2-weighted MR images but no enhancement by Gd-DTPA. Pattern III was a low to intermediate signal intensity on the T2-weighted MR images and enhancement on the Gd-DTPA T1-weighted images. Pattern IV was a low to intermediate signal intensity on the T2-weighted images and no enhancement by Gd-DTPA. Each of these 4 groups of MRI pattern were co-related to the surgical-pathology findings. Pathologically, pattern I corresponded to an edematous leiomyoma in 3 cases and a connective tissue leiomyoma in one case. Pattern II corresponded to three red degeneration, two cystic degeneration and one infected leiomyoma. Pattern III corresponded to eighteen undegenerative leiomyomas, but some of them showed focal connective tissue proliferation. All of twelve cases in pattern IV corresponded to a hyaline degeneration. MRI with Gd-DTPA enhancement may differentiate undegenerative leiomyoma from degenerated one.

Selective uterine artery embolization: its application in treating symptomatic uterine leiomyomas

International Nuclear Information System (INIS)

Zhang Guofu; Han Zhigang; Hu Pei'an; Wang Shijia; Tian Xiaomei; Zhou Yan; He Beiyi; Wang Jing

2010-01-01

Objective: To discuss the feasibility and safety of uterine artery embolization(UAE) for the treatment of symptomatic uterine leiomyomas. Methods: During the period of Jan. 2005-June 2009, UAE was performed in 85 patients with uterine leiomyomas in the authors' hospital. The main symptoms included hypermenorrhea, delayed menstruation and pelvic pressure symptoms. The bilateral uterine arteries were embolized with polyvinyl alcohol particles (diameter 500-710 μm) and Gelfoam. The technical success rate and the clinical results were observed. The patients were followed up for 6-36 months. Results: The technical success rate of bilateral uterine artery embolization was 100%. No serious complications occurred. During the follow-up period, menses returned to regular cycle in all patients and the hemoglobin concentration rose up to normal level in patients with anemia. The sizes of uterine leiomyomas were decreased by 57.5% after 6 months of the procedure. Conclusion: UAE is an effective and less-invasive treatment for symptomatic uterine leiomyomas with reliable results and fewer complications. This technique can greatly avoid unnecessary uterectomy and, thus, preserve the fertility of the female patients.(authors)

Primary diffuse large B cell lymphoma arising from a leiomyoma of the uterine corpus.

Science.gov (United States)

Zhao, Lianhua; Ma, Qiang; Wang, Qiushi; Zeng, Ying; Luo, Qingya; Xiao, Hualiang

2016-01-20

Primary diffuse large B cell lymphoma (DLBCL) of the uterus is rare, and primary DLBCL arising from a uterine leiomyoma (collision tumor) has not been reported in the literature. We describe the clinical, histological, immunohistochemical, and molecular features of primary DLBCL arising from a leiomyoma in the uterine corpus. A 73-year-old female patient had a uterine mass for 23 years. An ultrasound scan revealed marked enlargement of the uterus, measuring 18.2 × 13 × 16.3 cm, with a 17.6 × 10.9 × 11.6 cm hypoechoic mass in the uterine corpus. The tumors consisted of medium- to large-sized cells exhibiting a diffuse pattern of growth with a well-circumscribed leiomyoma. The neoplastic cells strongly expressed CD79α, CD20 and PAX5. Molecular analyses indicated clonal B-cell receptor gene rearrangement. To the best of our knowledge, no previous cases of primary DLBCL arising from a leiomyoma have been reported. It is necessary to differentiate a diagnosis of primary DLBCL arising from a leiomyoma from that of leiomyoma with florid reactive lymphocytic infiltration (lymphoma-like lesion). Careful analysis of clinical, histological, immunophenotypic, and genetic features is required to establish the correct diagnosis.

Increased Risk of Venous Thromboembolism in Women with Uterine Leiomyoma: A Nationwide, Population-Based Case-Control Study

Science.gov (United States)

Huang, Hung-Kai; Kor, Chew-Teng; Chen, Ching-Pei; Chen, Hung-Te; Yang, Po-Ta; Tsai, Chen-Dao; Huang, Ching-Hui

2018-01-01

Background Venous thromboembolism (VTE) is a sex-specific disease that has different presentations between men and women. Women with uterine leiomyoma can present with VTE without exhibiting the traditional risk factors. We investigated the relationship between a history of uterine leiomyoma and the risk of VTE using the National Health Insurance Research Database (NHIRD). Methods We conducted a retrospective, nationwide, population-based case-control study using the NHIRD. We identified 2,282 patients with diagnosed VTE and 392,635 subjects without VTE from 2000 to 2013. After development of an age and index diagnosis year frequency-matched model and propensity score-matched model, 2 models with a case-to-control ratio of 1 to 4 were established. Using the diagnosis of uterine leiomyoma as the exposure factor, conditional logistic regression was performed to examine the association between uterine leiomyoma and VTE. Multiple logistic regression analysis was used to investigate the joint effect of uterine leiomyoma and comorbid diseases on the risk of VTE. Results A strong association was observed between uterine leiomyoma and VTE in the overall patient model, frequency-matched model and propensity score-matched model [p leiomyoma who were ≥ 45 years old were less likely to experience VTE, but women with uterine leiomyoma and anemia, cancer, coronary artery disease or heart failure were more likely to experience VTE. Conclusions Women with uterine leiomyomas have an increased risk of developing VTE, especially during reproductive periods or in the presence of specific diseases. PMID:29375226

Antitumor Effects of Flavopiridol on Human Uterine Leiomyoma In Vitro and in a Xenograft Model

Science.gov (United States)

Lee, Hyun-Gyo; Baek, Jong-Woo; Shin, So-Jin; Kwon, Sang-Hoon; Cha, Soon-Do; Park, Won-Jin; Chung, Rosa; Choi, Eun-Som; Lee, Gun-Ho

2014-01-01

Dysregulated cyclin-dependent kinases (CDKs) are considered a potential target for cancer therapy. Flavopiridol is a potent CDK inhibitor. In this study, the antiproliferative effect of the flavonoid compound flavopiridol and its mechanism in human uterine leiomyoma cells were investigated. The present study focused on the effect of flavopiridol in cell proliferation and cell cycle progression in primary cultured human uterine leiomyoma cells. Cell viability and cell proliferation assays were conducted. Flow cytometry was performed to determine the effect of flavopiridol on cell cycle. The expression of cell cycle regulatory-related proteins was evaluated by Western blotting. Cell viability and proliferation of uterine leiomyoma cells were significantly reduced by flavopiridol treatment in a dose-dependent manner. Flow cytometry results showed that flavopiridol induced G1 phase arrest. Flavopiridol-induced growth inhibition in uterine leiomyoma cells was associated with increased expression of p21cip/wafl and p27kip1 in a dose-dependent manner. Downregulation of CDK2/4 and Cyclin A with a concomitant increase in dephosphorylation of retinoblastoma was observed. This study demonstrates that flavopiridol inhibits cell proliferation by initiating G1 cell cycle arrest in human uterine leiomyoma. We also found that flavopiridol is effective in inhibiting xenografted human uterine leiomyoma growth. These results indicate that flavopiridol could prove to be a promising chemopreventive and therapeutic agent for human uterine leiomyoma. PMID:24572052

CT and MR imaging of splenic leiomyoma in a child with ataxia telangiectasia

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Coskun, M. [Dept. of Radiology, Hacettepe University Hospital, Ankara (Turkey); Aydingoez, Ue. [Dept. of Radiology, Hacettepe University Hospital, Ankara (Turkey); Tacal, T. [Dept. of Radiology, Hacettepe University Hospital, Ankara (Turkey); Ariyuerek, M. [Dept. of Radiology, Hacettepe University Hospital, Ankara (Turkey); Demirkazik, F. [Dept. of Radiology, Hacettepe University Hospital, Ankara (Turkey); Oguzkurt, L. [Dept. of Radiology, Hacettepe University Hospital, Ankara (Turkey)

1995-02-01

Computed tomographic and magnetic resonance imaging findings of a splenic leiomyoma in an 8-year-old boy with ataxia telangiectasia are presented. This is the first reported case of a splenic leiomyoma in the literature. (orig.)

CT and MR imaging of splenic leiomyoma in a child with ataxia telangiectasia

International Nuclear Information System (INIS)

Coskun, M.; Aydingoez, Ue.; Tacal, T.; Ariyuerek, M.; Demirkazik, F.; Oguzkurt, L.

1995-01-01

Computed tomographic and magnetic resonance imaging findings of a splenic leiomyoma in an 8-year-old boy with ataxia telangiectasia are presented. This is the first reported case of a splenic leiomyoma in the literature. (orig.)

A postmenopausal woman with sciatica from broad ligament leiomyoma: a case report.

Science.gov (United States)

Tsai, Ya-Chu May

2016-10-31

Unilateral lower abdominal pain and/or sciatic nerve pain is a common presentation in the elderly population. The prevalence of broad ligament leiomyoma is leiomyomas to be clinically significant. Thus, we highlight a case of symptomatic broad ligament leiomyoma in a postmenopausal woman whose symptoms improved after definitive treatment. A 62-year-old postmenopausal Macedonian woman was referred to our gynecological department with unexplained pain in her left leg and left iliac fossa region on walking. There was minimal relief with increasing analgesia use prescribed by the family physician. Investigations revealed an ipsilateral adnexal mass and subsequent treatment with laparoscopic broad ligament myomectomy helped to alleviate her symptoms. Our case highlights the importance of staying mindful of alternate diagnoses when presented with a common presentation of iliac fossa pain and pain in the leg. Although broad ligament leiomyomas are benign tumors, the uncommon symptomatic presentation led us to report and focus some attention on this type of tumor.

Role of color Doppler US in the evaluation of uterine leiomyoma treated with gonadotrophin-releasing hormone (GnRH) agonist (Zoladex)

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Kim, Jung Sik; Sohn, Cheol Ho; Lee, Tae Sung [Keimyung University Dongsan Medical Center, Taegu (Korea, Republic of)

1999-03-15

To access the role of color Doppler US in the evaluation of uterine leiomyoma treated with GnRH agonist (Zoladex). Out of 25 patients with uterine leiomyoma treated with Zoladex, nineteen cases of leiomyoma in 18 women who had US examination before and after medication were included in this study. Zoladex was injected subcutaneously three times within three months. Both gray scale and color Doppler US were obtained before and 1-3 months after the medication. The size, volume, location and internal echoes of the leiomyoma were recorded with gray scale US. Changes in the amount of color signal within leiomyomas were recorded. Pulsatility index (PI), resistive index (RI), peak systolic velocity (PSV) of both uterine artery and arteries within leiomyomas were also recorded. The image findings of good response group and poor response group in which the volume reduction of the leiomyoma was above or below 50% respectively were compared with each other. The reduction of the volume of leiomyoma was compared between a group with decrease in the amount of color signals during follow-up US and a group with increase or no change. Mean reduction of the volume of leiomyomas was 52%. Changes in the amount of color signals of the leiomyoma, PI, RI, PSV obtained from the arteries within leiomyomas were not correlated with the change of the volume of leiomyomas. PSV of uterine artery in one month follow-up and PI of two month follow-up were correlated with the changes of the volume of leiomyomas (p<0.05). RI of uterine artery in two month follow-up was useful in prediction of the good response group and the poor response group (p<0.05). The prediction of the volume reduction of leiomyoma following Zoladex medication might be possible by obtaining RI of uterine artery in two month follow-up. Doppler US of the arteries within the leiomyoma was not useful.

Role of color Doppler US in the evaluation of uterine leiomyoma treated with gonadotrophin-releasing hormone (GnRH) agonist (Zoladex)

International Nuclear Information System (INIS)

Kim, Jung Sik; Sohn, Cheol Ho; Lee, Tae Sung

1999-01-01

To access the role of color Doppler US in the evaluation of uterine leiomyoma treated with GnRH agonist (Zoladex). Out of 25 patients with uterine leiomyoma treated with Zoladex, nineteen cases of leiomyoma in 18 women who had US examination before and after medication were included in this study. Zoladex was injected subcutaneously three times within three months. Both gray scale and color Doppler US were obtained before and 1-3 months after the medication. The size, volume, location and internal echoes of the leiomyoma were recorded with gray scale US. Changes in the amount of color signal within leiomyomas were recorded. Pulsatility index (PI), resistive index (RI), peak systolic velocity (PSV) of both uterine artery and arteries within leiomyomas were also recorded. The image findings of good response group and poor response group in which the volume reduction of the leiomyoma was above or below 50% respectively were compared with each other. The reduction of the volume of leiomyoma was compared between a group with decrease in the amount of color signals during follow-up US and a group with increase or no change. Mean reduction of the volume of leiomyomas was 52%. Changes in the amount of color signals of the leiomyoma, PI, RI, PSV obtained from the arteries within leiomyomas were not correlated with the change of the volume of leiomyomas. PSV of uterine artery in one month follow-up and PI of two month follow-up were correlated with the changes of the volume of leiomyomas (p<0.05). RI of uterine artery in two month follow-up was useful in prediction of the good response group and the poor response group (p<0.05). The prediction of the volume reduction of leiomyoma following Zoladex medication might be possible by obtaining RI of uterine artery in two month follow-up. Doppler US of the arteries within the leiomyoma was not useful.

Round Ligament of Uterus Leiomyoma: An Unusual Cause of Dyspareunia

Directory of Open Access Journals (Sweden)

Ozer Birge

2015-01-01

Full Text Available Round ligament of uterus leiomyoma is a rare, benign tumor of the vulva. Its incidence is not known exactly, and the mean age ranges from 13 to 70. Although clinical properties of benign and malignant diseases in the vulvar area are frequently similar, early diagnosis and treatment are essential. Local excision is recommended as definitive therapy. We present an 28-year-old female without any birth with a mass in anterior vaginal wall diagnosed as vulvar leiomyoma. In conclusion, a brief review of relevant literature emphasizes that leiomyomas are quite rare outside of the uterus but they might occur in any tissue or organ containing smooth muscle, spontaneously or parasitically after the spreading effect of an accident or surgical trauma. Clinicians should be alert especially for the diagnosis in a tissue with smooth muscle content.

Leiomyoma of the bladder and MRI; IRM et leiomyome vesical

Energy Technology Data Exchange (ETDEWEB)

Kabbaj, N.; Dafiri, R.; Imani, F.; Benslimane, L.; Benchekroun, A. [Hopital Avicenne, Rabat (Morocco)

1998-08-01

Unlike epithelial tumors, connective tissue tumors are uncommon, representing only 3 % of all bladder tumors. Leiomyoma of the bladder is the most frequent non-epithelial benign tumor of the bladder. Magnetic resonance imaging (MIR) is highly useful for diagnostic purposes and to determine the degree of extension. Only few reports of sonographic findings have been reported for leiomyoma of the bladder. The tumor usually develops within the bladder. Extra-vesicular formations have also been reported as well as a few intramural localizations. The characteristic feature is the absence of mucosal involvement. We analyzed the MRI findings in a case of leiomyoma of the bladder with intra and extra-vesicular development inflammatory reaction of the bladder wall and uterine adherences in a woman with a past history of chronic cystitis. The role of diagnostic MRI is discussed. (author)

Vaginal para-urethral myxoid leiomyoma: case report and review of the literature.

Science.gov (United States)

Costantini, Elisabetta; Cochetti, Giovanni; Porena, Massimo

2008-08-01

Vaginal leiomyoma is a rare solid tumour of unknown aetiology, which usually develops in women between the ages of 35 and 50. As it presents with a wide range of symptoms, diagnosis is based on histological findings. Here we present the case of a 27-year-old white woman with a painless vaginal mass associated with dyspareunia, dysmenorrhea and foul-smelling vaginal discharge. She underwent surgery by vaginal route, and the histological findings confirmed a myxoid leiomyoma. After 17 months, the patient was disease-free, and symptoms disappeared. Vaginal leiomyomas are rare, local recurrence and transformation into sarcoma are rare, and complete surgical excision as soon as possible is recommended.

1,25-Dihydroxyvitamin D3 Treatment Shrinks Uterine Leiomyoma Tumors in the Eker Rat Model1

Science.gov (United States)

Halder, Sunil K.; Sharan, Chakradhari; Al-Hendy, Ayman

2012-01-01

ABSTRACT Uterine leiomyomas (fibroids) are the most common benign tumors in women of reproductive age. These tumors are three to four times more prevalent in African American women, who also have a 10 times higher incidence of hypovitaminosis D than white women. Recent studies have demonstrated the antitumor effects of 1,25-dihydroxyvitamin D3 on several cancers, but its effects on uterine leiomyomas are still unknown. To determine the antitumor and therapeutic effects of 1,25-dihydroxyvitamin D3 on uterine leiomyomas, female Eker rats (14–16 mo old) harboring uterine leiomyomas were randomized into control and experimental groups and were given vehicle versus 1,25-dihydroxyvitamin D3 (0.5 μg/kg per day) subcutaneously for 3 wk, respectively. At the end of the experiment, the rats were euthanized, and the leiomyoma tumors were analyzed. Treatment with 1,25-dihydroxyvitamin D3 significantly reduced leiomyoma tumor size in Eker rats. It also reduced leiomyoma size by suppressing cell growth and proliferation-related genes (Pcna, cyclin D1 [Ccnd1], Myc, Cdk1, Cdk2, and Cdk4), antiapoptotic genes (Bcl2 and Bcl2l1 [Bcl-x]), and estrogen and progesterone receptors. Additionally, immunohistochemistry revealed decreased expression of PCNA and MKI67 (a marker of proliferation) and increased expression of caspase 3 in 1,25-dihydroxyvitamin D3-treated Eker rat leiomyomas. Toxicity analyses using serum samples showed similar levels of SGOT, SGPT, calcium, and total bilirubin in 1,25-dihydroxyvitamin D3-treated and vehicle-treated control Eker rats. These results support that 1,25-dihydroxyvitamin D3 is an antitumor agent that may be a potential safe, nonsurgical therapeutic option for the treatment of uterine leiomyomas. PMID:22302692

'Bridging vascular sign' in the MR diagnosis of uterine subserosal/exophytic leiomyoma

Energy Technology Data Exchange (ETDEWEB)

Kim, Jong Chul [Chungnam National Univ. School of Medicine, Taejeon (Korea, Republic of)

1998-11-01

To evaluate the usefulness of 'bridging vascular sign' in the diagnosis of a subserosal/exophytic uterine leiomyoma and the helpfulness of this sign in the differentiation of a uterine leiomyoma from adnexal masses on pelovic magnetic resonance (MR) imaging. Of 20 women with a solitiary pelvic mass in whom pelvic MR imaging was performed during recent three years to differentiate a uterine leiomyoma from an adnexal mass, 12 with surgicopathologically proven subserosal/exophytic uterine leiomymas were included in this study. The other eight women were proved to have tubo-ovarian abscess (n=3D3), ovarian endometrioma (n=3D2), ruptured corpus luteum cyst (n=3D2), and ovarian fibroma (n=3D1). A 1.5 T unit was used to obtain axial/saittal T1- and T2-weighted and gadolinum-enhanced sagittal T1-weighted images. Positive 'bridging vascular sign' was defined through the retrospective review and analysis of MR findings as the presence of intervening curvilinear or tortuous signal-void vascular structures crossing the uterus and the pelvic mass. Using this sign in the diagnosis and differentiation of a uterine leiomyoma from adnexal masses, statistical significance was evaluated. 'Bridging vascular sign' was present in eight of 12 leiomyomas, but no in adnexal masses. Using this sign in the diagnosis and differentiation of a uterine leiomyoma from adnexal masses, sensitivity was 66.7%, specificity 100%, positive predictive value 100%, negative predictive value 66.7%, and accuracy 80%. 'Vascular bridging sign' on MR imaging may be a useful radiologic sign in the diagnosis and differentiation of a subserosal/exophytic uterine leiomyoma from adnexal masses.=20.

Elastin distribution in the normal uterus, uterine leiomyomas, adenomyosis and adenomyomas: a comparison.

Science.gov (United States)

Zheng, Wei-Qiang; Ma, Rong; Zheng, Jian-Ming; Gong, Zhi-Jing

2006-04-01

To describe the histologic distribution of elastin in the nonpregnant human uterus, uterine leiomyomas, adenomyosis and adenomyomas. Uteri were obtained from women undergoing hysterectomy for benign conditions, including 26 cases of uterine leiomyomas, 24 cases of adenomyosis, 18 adenomyomas and 6 cases of autopsy specimens. Specific histochemical staining techniques were employed in order to demonstrate the distribution of elastin. The distribution of elastin components in the uterus was markedly uneven and showed a decreasing gradient from outer to inner myometrium. No elastin was present within leiomyomas, adenomyomas or adenomyosis. The distribution of elastin may help explain the normal function of the myometrium in labor. It implies that the uneven distribution of elastin components and absence of elastin within leiomyomas, adenomyomas and adenomyosis could be of some clinical significance. The altered elastin distribution in disease states may help explain such symptoms as dysmenorrhea in uterine endometriosis.

Intramural leiomyomas of the bladder in asymptomatic men

Directory of Open Access Journals (Sweden)

Roberto I. Lopes

2003-06-01

Full Text Available Bladder leiomyomas are rare benign mesenchymal tumors, which account for less than 0.43% of all bladder tumors with approximately 200 cases described in the literature. These tumors may be classified into 3 different locations: endovesical, intramural and extravesical. Endovesical is the most common form, accounting for 63-86% of the cases, while intramural occurs in 3-7% and extravesical in 11-30%. The intramural form, especially small tumors, may not produce symptoms hardening detection. We report two cases of intramural bladder leiomyomas in asymptomatic men observed incidentally by transabdominal ultrasonography during the follow-up of benign prostatic hyperplasia. We discuss the diagnosis and management of these lesions.

Polymorphisms of CYP17A1, CYP19, and androgen in Brazilian women with uterine leiomyomas

DEFF Research Database (Denmark)

Rosa, Fabíola Encinas; Canevari, Renata de Azevedo; Ambrosio, Eliane Papa

2008-01-01

BACKGROUND: Uterine leiomyomas are common, benign, smooth muscle tumors representing a significant public health problem. The aim of this study was to investigate CYP17A1, CYP19, and androgen (AR) polymorphisms, their relative risks for uterine leiomyomas and possible associations with clinical...... parameters. METHODS: Uterine leiomyoma tissues and blood samples were obtained from 87 patients, as were peripheral blood samples from 68 control women. Clinical data were recorded in both groups. The CYP17A1 (rs743572) polymorphism was analyzed by PCR-RFLP, and the CYP19 [TTTA](n) repeat and AR [CAG...... were exclusive to the leiomyoma group. The LOH assay showed allele losses at AR locus in four informative tumors and X chromosome inactivation analysis revealed that these tumors retained the active allele. CONCLUSIONS: The overall lack of association between uterine leiomyomas with polymorphisms...

Magnetic resonance imaging features of myxoid leiomyoma of the vagina: A case report

International Nuclear Information System (INIS)

Scialpi, Michele; Benagiano, Giuseppe; Frati, Sara; Piscioli, Irene; Barberini, Francesco; Lupattelli, Luciano

2009-01-01

We report a rare case of a voluminous vaginal myxoid leiomyoma in a 27-year-old nulliparous woman. Magnetic Resonance Imaging (MRI) revealed a mass arising from the vagina, with inhomogeneous signal intensity on spin-echo T1W and T2W images. MRI accurately defined the tissue planes between the lesion and the adjacent structures and suggested its benign nature. The mass was completely resected by means of transvaginal approach and the diagnosis of myxoid leiomyoma was confirmed histologically. To the best of our knowledge, this is the first report describing the MRI features of vaginal myxoid leiomyoma

Transvaginal Resection of a Bladder Leiomyoma Misdiagnosed with a Vaginal Mass: A Case Report and Literature Review

Directory of Open Access Journals (Sweden)

Fu-Fen Yin

2015-01-01

Full Text Available Bladder leiomyoma is a rare benign tumor and it could be easily misdiagnosed with many other pelvic diseases, especially obstetrical and gynecological diseases; abdominal, laparoscopic, and transurethral resection of bladder leiomyoma have been reported. Herein, we present a case of bladder leiomyoma misdiagnosed with a vaginal mass preoperatively; the mass was isolated, enucleated from the bladder neck, and removed transvaginally; to the best of our knowledge, this is the first case of intramural leiomyoma of bladder neck that has been enucleated transvaginally only without cystotomy.

Primary intracranial leiomyoma: case report

Energy Technology Data Exchange (ETDEWEB)

Lai, P.H.; Yang, C.F.; Yeh, L.R.; Pan, H.B. [Department of Radiology, Veterans General Hospital-Kaohsiung, National Yang Ming University, National Defence Medical Centre, 386 Ta-Chung First Rd., Kaohsiung 813, Taiwan (Taiwan, Province of China); Huang, C.H. [Department of Neurosurgery, Veterans General Hospital-Kashsiung, National Yang Ming University, National Defence Medical Centre, Kashsiung, Taiwan (Taiwan, Province of China); Lin, S.L. [Department of Pathology, Veterans General Hospital-Kaohsiung, National Yang Ming University, National Defence Medical Centre, Taiwan (Taiwan, Province of China)

1998-04-01

We present a case of intracranial parenchymal leiomyoma in a 20-year-old woman with a chief complaint of numbness and a painful sensation over the right limbs for several years. CT and MRI revealed an intensely enhancing calcified mass. The patient was well, without recurrence, 2 years after surgery. (orig.) With 2 figs., 13 refs.

Human Uterine Leiomyoma Stem/Progenitor Cells Expressing CD34 and CD49b Initiate Tumors In Vivo

Science.gov (United States)

Ono, Masanori; Moravek, Molly B.; Coon, John S.; Navarro, Antonia; Monsivais, Diana; Dyson, Matthew T.; Druschitz, Stacy A.; Malpani, Saurabh S.; Serna, Vanida A.; Qiang, Wenan; Chakravarti, Debabrata; Kim, J. Julie; Bulun, Serdar E.

2015-01-01

Context: Uterine leiomyoma is the most common benign tumor in reproductive-age women. Using a dye-exclusion technique, we previously identified a side population of leiomyoma cells exhibiting stem cell characteristics. However, unless mixed with mature myometrial cells, these leiomyoma side population cells did not survive or grow well in vitro or in vivo. Objective: The objective of this study was to identify cell surface markers to isolate leiomyoma stem/progenitor cells. Design: Real-time PCR screening was used to identify cell surface markers preferentially expressed in leiomyoma side population cells. In vitro colony-formation assay and in vivo tumor-regeneration assay were used to demonstrate functions of leiomyoma stem/progenitor cells. Results: We found significantly elevated CD49b and CD34 gene expression in side population cells compared with main population cells. Leiomyoma cells were sorted into three populations based on the expression of CD34 and CD49b: CD34+/CD49b+, CD34+/CD49b−, and CD34−/CD49b− cells, with the majority of the side population cells residing in the CD34+/CD49b+ fraction. Of these populations, CD34+/CD49b+ cells expressed the lowest levels of estrogen receptor-α, progesterone receptor, and α-smooth muscle actin, but the highest levels of KLF4, NANOG, SOX2, and OCT4, confirming their more undifferentiated status. The stemness of CD34+/CD49b+ cells was also demonstrated by their strongest in vitro colony-formation capacity and in vivo tumor-regeneration ability. Conclusions: CD34 and CD49b are cell surface markers that can be used to enrich a subpopulation of leiomyoma cells possessing stem/progenitor cell properties; this technique will accelerate efforts to develop new therapies for uterine leiomyoma. PMID:25658015

Value of fast dynamic enhanced MR imaging for the differential diagnosis between ovarian fibroma and subserosal leiomyoma

International Nuclear Information System (INIS)

Shan Jun; Wang Xiaomei; Xu Jianmin; Xu Hongli; Feng Xiaofeng; Gong Jingshan; Ling Rennan; Rao Zibin

2004-01-01

Objective: To study the value of dynamic enhanced MRI in the differential diagnosis between subserosal uterine leiomyoma and ovarian fibroma which were iso-signal and low signal ones on T 2 WI. Methods: Plain and dynamic enhanced MRI findings of 45 patients with histologically proved subserosal leiomyoma or ovarian fibroma were analyzed. There were 35 cases of subserosal leiomyoma and 10 cases of ovarian fibroma. The enhancement index of early phase (100 sec after the contrast medial administration) and the time to peak during 200 sec after the contrast administration (TTP 200 ) were analyzed. Results: On plain scanning, both subserosal leiomyoma and ovarian fibrioma appeared similarly as intrapelvic masses with low signal on T 2 WI. On Gadolinium dynamic enhancement, subserosal leiomyomas showed early and evident enhancement while ovarian fibroma showed delayed and moderate enhancement. The difference of the enhancement index of early phase and TTP 200 was statistically significant (P<0.001). Conclusion: Gadolinium dynamic enhanced MR imaging was helpful in the differential diagnosis between subserosal uterine leiomyoma and ovarian fibroma by the difference in the enhancement pattern

A Proteomic Approach for the Identification of Up-Regulated Proteins Involved in the Metabolic Process of the Leiomyoma.

Science.gov (United States)

Ura, Blendi; Scrimin, Federica; Arrigoni, Giorgio; Franchin, Cinzia; Monasta, Lorenzo; Ricci, Giuseppe

2016-04-09

Uterine leiomyoma is the most common benign smooth muscle cell tumor of the uterus. Proteomics is a powerful tool for the analysis of complex mixtures of proteins. In our study, we focused on proteins that were upregulated in the leiomyoma compared to the myometrium. Paired samples of eight leiomyomas and adjacent myometrium were obtained and submitted to two-dimensional gel electrophoresis (2-DE) and mass spectrometry for protein identification and to Western blotting for 2-DE data validation. The comparison between the patterns revealed 24 significantly upregulated (p leiomyoma and not with the normal myometrium. The overexpression of seven proteins involved in the metabolic processes of the leiomyoma was further validated by Western blotting and 2D Western blotting. Four of these proteins have never been associated with the leiomyoma before. The 2-DE approach coupled with mass spectrometry, which is among the methods of choice for comparative proteomic studies, identified a number of proteins overexpressed in the leiomyoma and involved in several biological processes, including metabolic processes. A better understanding of the mechanism underlying the overexpression of these proteins may be important for therapeutic purposes.

5-Hydroxymethylcytosine Promotes Proliferation of Human Uterine Leiomyoma: A Biological Link to a New Epigenetic Modification in Benign Tumors

Science.gov (United States)

Navarro, Antonia; Yin, Ping; Ono, Masanori; Monsivais, Diana; Moravek, Molly B.; Coon, John S.; Dyson, Matthew T.; Wei, Jian-Jun

2014-01-01

Context: Uterine leiomyoma, or fibroids, represent the most common benign tumors of the female reproductive tract. A newly discovered epigenetic modification, 5-hydroxymethylation (5-hmC), and its regulators, the TET (Ten Eleven Translocation) enzymes, were implicated in the pathology of malignant tumors; however, their roles in benign tumors, including uterine fibroids, remain unknown. Objective: To determine the role of 5-hmC and TET proteins in the pathogenesis of leiomyoma using human uterine leiomyoma and normal matched myometrial tissues and primary cells. Design: 5-hmC levels were determined by ELISA and immunofluorescent staining in matched myometrial and leiomyoma tissues. TET expression was analyzed by quantitative RT-PCR and immunoblotting. TET1 or TET3 were silenced or inhibited by small interfering RNA or 2-hydroxyglutarate to study their effects on 5-hmC content and cell proliferation. Results: We demonstrated significantly higher 5-hmC levels in the genomic DNA of leiomyoma tissue compared to normal myometrial tissue. The increase in 5-hmC levels was associated with the up-regulation of TET1 or TET3 mRNA and protein expression in leiomyoma tissue. TET1 or TET3 knockdown significantly reduced 5-hmC levels in leiomyoma cells and decreased cell proliferation. Treatment with 2-hydroxyglutarate, a competitive TET enzyme inhibitor, significantly decreased both 5-hmC content and cell proliferation of leiomyoma cells. Conclusion: An epigenetic imbalance in the 5-hmC content of leiomyoma tissue, caused by up-regulation of the TET1 and TET3 enzymes, might lead to discovery of new therapeutic targets in leiomyoma. PMID:25057885

Polymorphism of the p53 tumor suppressor gene is associated with susceptibility to uterine leiomyoma.

Science.gov (United States)

Denschlag, Dominik; Bettendorf, Herta; Watermann, Dirk; Keck, Christoph; Tempfer, Clemens; Pietrowski, Detlef

2005-07-01

To evaluate the association between the presence of uterine leiomyoma and two single nuclear polymorphisms of the p53 tumor suppressor and the angiopoietin-2 (ANGPT2) genes. Prospective case control study. Academic research institution. One hundred thirty-two women with clinically and surgically diagnosed uterine leiomyomas and 280 controls. Peripheral venous puncture. Genotyping was performed by polymerase chain reaction-based amplification of the Arg and Pro variants at codon 72 of the p53 gene and by restriction fragment length polymorphism analysis of the G/G and G/A alleles in exon 4 of the ANGPT2 gene. Comparing women with uterine leiomyomas and controls, no statistically significant difference with respect to allele frequency and genotype distribution were ascertained for the ANGPT2 polymorphism (P=.2 and P=.5, respectively). However, for the p53 tumor suppressor gene polymorphism, statistically significant differences in terms of a higher Pro allele frequency and a higher prevalence of the Pro/Pro genotype among women with uterine leiomyoma (32.0% vs. 16.0%, respectively, and 21.3% vs. 4.7%, respectively) were ascertained (P=.001, OR 1.74; 95% CI 1.24-2.45, P=.001; OR 3.84, 95% CI 1.81-8.14; respectively). Carriage of the p53 polymorphism at codon 72 predicts the susceptibility to leiomyoma in a Caucasian population and may contribute to the pathogenesis of uterine leiomyoma.

Pseudo-meigs syndrome due to subserosal leiomyoma diagnosed by MR imaging: case report

International Nuclear Information System (INIS)

Park, Hyun Jin; Jung, Seung Eun; Lee, Jae Mun; Lee, Kyo Young; Han, Ku Taek; Hahn, Seong Tai

2002-01-01

We report a case of pseudo-meigs syndrome due to a large subserosal leiomyoma in a patient with a high serum carcinogenic antigen 125 level. Initial clinical examination suggested disseminated malignant disease though the typical signal characteristics of leiomyoma, seen at MR imaging, led to the diagnosis of pseudo-meigs syndrome

Pseudo-meigs syndrome due to subserosal leiomyoma diagnosed by MR imaging: case report

Energy Technology Data Exchange (ETDEWEB)

Park, Hyun Jin; Jung, Seung Eun; Lee, Jae Mun; Lee, Kyo Young; Han, Ku Taek; Hahn, Seong Tai [The Catholic University of Korea, Seoul (Korea, Republic of)

2002-12-01

We reports a case of pseudo-meigs syndrome due to a large subserosal leiomyoma in a patient with a high serum carcinogenic antigen 125 level. Initial clinical examination suggested disseminated malignant disease though the typical signal characteristics of leiomyoma, seen at MR imaging, led to the diagnosis of pseudo-meigs syndrome.

Effects of miRNA-197 overexpression on proliferation, apoptosis and migration in levonorgestrel treated uterine leiomyoma cells.

Science.gov (United States)

Wu, Xiaoli; Ling, Jing; Fu, Ziyi; Ji, Chenbo; Wu, Jiangping; Xu, Qing

2015-04-01

Uterine leiomyoma is the ahead benign tumor of the female genital tract, which resulted in menstrual abnormalities, recurrent pregnancy loss, and other serious gynecological disorders in women. Recently, as the process of exploring the brief molecular mechanisms of tumorgenesis, microRNAs (miRNAs) have attracted much more attention. In this study, we first confirmed that microRNA-197 (miR-197) was down-regulated significantly in human uterus leiomyoma by quantity real-time polymerase chain reaction, compared to normal uterus myometrium. Then we observed the potential effects of miR-197 overexpression on human uterus leiomyoma cells by cell counting kit 8, wound healing assay, and flow cytometric assessment separately. The data showed that miR-197 could inhibit cell proliferation, induce cell apoptosis, and block cell migration in vitro. Coincidently, levonorgestrel (LNG), a well-known uterus leiomyoma therapy, could induce miR-197 expression in human uterus leiomyoma cells, and over-expression of miR-197 showed a synergy effect on human uterus leiomyoma cell proliferation and apoptosis with LNG. In this study, the data showed that miR-197 could play an anti-oncogenic role in human uterus leiomyoma cells, and cooperate with LNG on the cell proliferation and apoptosis, which suggested that miR-197 might be a potential target and provided database for clinical treatment. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Epidemiological and genetic clues for molecular mechanisms involved in uterine leiomyoma development and growth.

Science.gov (United States)

Commandeur, Arno E; Styer, Aaron K; Teixeira, Jose M

2015-01-01

Uterine leiomyomas (fibroids) are highly prevalent benign smooth muscle tumors of the uterus. In the USA, the lifetime risk for women developing uterine leiomyomas is estimated as up to 75%. Except for hysterectomy, most therapies or treatments often provide only partial or temporary relief and are not successful in every patient. There is a clear racial disparity in the disease; African-American women are estimated to be three times more likely to develop uterine leiomyomas and generally develop more severe symptoms. There is also familial clustering between first-degree relatives and twins, and multiple inherited syndromes in which fibroid development occurs. Leiomyomas have been described as clonal and hormonally regulated, but despite the healthcare burden imposed by the disease, the etiology of uterine leiomyomas remains largely unknown. The mechanisms involved in their growth are also essentially unknown, which has contributed to the slow progress in development of effective treatment options. A comprehensive PubMed search for and critical assessment of articles related to the epidemiological, biological and genetic clues for uterine leiomyoma development was performed. The individual functions of some of the best candidate genes are explained to provide more insight into their biological function and to interconnect and organize genes and pathways in one overarching figure that represents the current state of knowledge about uterine leiomyoma development and growth. In this review, the widely recognized roles of estrogen and progesterone in uterine leiomyoma pathobiology on the basis of clinical and experimental data are presented. This is followed by fundamental aspects and concepts including the possible cellular origin of uterine fibroids. The central themes in the subsequent parts are cytogenetic aberrations in leiomyomas and the racial/ethnic disparities in uterine fibroid biology. Then, the attributes of various in vitro and in vivo, human syndrome

Video-thoracoscopic enucleation of esophageal leiomyoma

Directory of Open Access Journals (Sweden)

Luh Shi-Ping

2012-03-01

Full Text Available Abstract Background Leiomyoma is the most common benign tumor of the esophagus. Surgical enucleation is indicated in case of symptoms or an unclear diagnosis, and open thoracotomy has long been the standard approach for this procedure. However, enucleation through video assisted thoracoscopic surgery (VATS has been developed as a preferred approach for most lesions in recent years. Method Herein we report our twelve patients (seven men and five women, with median age of 42 years from 2001 to 2009, who underwent enucleation through VATS for esophageal leiomyomas, with a size from 1 to 8 cm in diameter (median: 5, and at different locations, from the thoracic outlet to near the diaphragmatic level of the thoracic esophagus. Intraoperative fiberoptic esophagoscopy was performed in two patients for localization by illumination. A right-sided approach was performed in eight cases (upper two thirds of esophagus and the left-sided in another four cases (lower third of esophagus. Result The median operative time was 95 minutes (70 to 230 minutes. Four of them required small utility incisions (4-6 cm for better exploration and manipulation. There were no major complications, such as death or empyema due to leaks from mucosal tears, and the presenting symptoms were improved during the follow-up period, from 12 to 98 months. Conclusion VATS can be considered as an initial approach for most patients with esophageal leiomyomas, even large in size, irregular in shape, or at unfavorable location. It is a safe, minimally invasive, and effective treatment. However, conversion to open thoracotomy should be required for the sake of clinical or technical concern.

Leiomyoma of the distal oesophagus mimicking achalasia

NARCIS (Netherlands)

Idenburg, F. J.; Akkermans, L. M.; Smout, A. J.; Kooijman, C. D.; Obertop, H.

1991-01-01

An unusual case of a patient with symptoms suggestive of oesophageal achalasia is described. Most oesophageal tumour growths causing secondary achalasia are associated with malignant tumours. This patient had a large oesophageal leiomyoma closely mimicking achalasia. Treatment consisted of

Massively parallel sequencing and genome-wide copy number analysis revealed a clonal relationship in benign metastasizing leiomyoma

Science.gov (United States)

Lee, Li-Yu; Lin, Gigin; Chen, Shu-Jen; Lu, Yen-Jung; Huang, Huei-Jean; Yen, Chi-Feng; Han, Chien Min; Lee, Yun-Shien; Wang, Tzu-Hao; Chao, Angel

2017-01-01

Benign metastasizing leiomyoma (BML) is a rare disease entity typically presenting as multiple extrauterine leiomyomas associated with a uterine leiomyoma. It has been hypothesized that the extrauterine leiomyomata represent distant metastasis of the uterine leiomyoma. To date, the only molecular evidence supporting this hypothesis was derived from clonality analyses based on X-chromosome inactivation assays. Here, we sought to address this issue by examining paired specimens of synchronous pulmonary and uterine leiomyomata from three patients using targeted massively parallel sequencing and molecular inversion probe array analysis for detecting somatic mutations and copy number aberrations. We detected identical non-hot-spot somatic mutations and similar patterns of copy number aberrations (CNAs) in paired pulmonary and uterine leiomyomata from two patients, indicating the clonal relationship between pulmonary and uterine leiomyomata. In addition to loss of chromosome 22q found in the literature, we identified additional recurrent CNAs including losses of chromosome 3q and 11q. In conclusion, our findings of the clonal relationship between synchronous pulmonary and uterine leiomyomas support the hypothesis that BML represents a condition wherein a uterine leiomyoma disseminates to distant extrauterine locations. PMID:28533481

Expression Levels of Myostatin and Matrix Metalloproteinase 14 mRNAs in Uterine Leiomyoma are Correlated With Dysmenorrhea.

Science.gov (United States)

Tsigkou, Anastasia; Reis, Fernando M; Ciarmela, Pasquapina; Lee, Meng H; Jiang, Bingjie; Tosti, Claudia; Shen, Fang-Rong; Shi, Zhendan; Chen, You-Guo; Petraglia, Felice

2015-12-01

Uterine leiomyoma is the most common benign neoplasm of female reproductive system, found in about 50% of women in reproductive age. The mechanisms of leiomyoma growth include cell proliferation, which is modulated by growth factors, and deposition of extracellular matrix (ECM). Activin A and myostatin are growth factors that play a role in proliferation of leiomyoma cells. Matrix metalloproteinases (MMPs) are known for their ability to remodel the ECM in different biological systems. The aim of this study was to evaluate the expression levels of activin βA-subunit, myostatin, and MMP14 messenger RNAs (mRNAs) in uterine leiomyomas and the possible correlation of these factors with clinical features of the disease. Matrix metalloproteinase 14 was highly expressed in uterine leiomyoma and correlated with myostatin and activin A mRNA expression. Moreover, MMP14 and myostatin mRNA expression correlated significantly and directly with the intensity of dysmenorrhea. Overall, the present findings showed that MMP14 mRNA is highly expressed in uterine leiomyoma, where it correlates with the molecular expression of growth factors and is further increased in cases of intense dysmenorrhea. © The Author(s) 2015.

Massively parallel sequencing and genome-wide copy number analysis revealed a clonal relationship in benign metastasizing leiomyoma.

Science.gov (United States)

Wu, Ren-Chin; Chao, An-Shine; Lee, Li-Yu; Lin, Gigin; Chen, Shu-Jen; Lu, Yen-Jung; Huang, Huei-Jean; Yen, Chi-Feng; Han, Chien Min; Lee, Yun-Shien; Wang, Tzu-Hao; Chao, Angel

2017-07-18

Benign metastasizing leiomyoma (BML) is a rare disease entity typically presenting as multiple extrauterine leiomyomas associated with a uterine leiomyoma. It has been hypothesized that the extrauterine leiomyomata represent distant metastasis of the uterine leiomyoma. To date, the only molecular evidence supporting this hypothesis was derived from clonality analyses based on X-chromosome inactivation assays. Here, we sought to address this issue by examining paired specimens of synchronous pulmonary and uterine leiomyomata from three patients using targeted massively parallel sequencing and molecular inversion probe array analysis for detecting somatic mutations and copy number aberrations. We detected identical non-hot-spot somatic mutations and similar patterns of copy number aberrations (CNAs) in paired pulmonary and uterine leiomyomata from two patients, indicating the clonal relationship between pulmonary and uterine leiomyomata. In addition to loss of chromosome 22q found in the literature, we identified additional recurrent CNAs including losses of chromosome 3q and 11q. In conclusion, our findings of the clonal relationship between synchronous pulmonary and uterine leiomyomas support the hypothesis that BML represents a condition wherein a uterine leiomyoma disseminates to distant extrauterine locations.

Technique and methods in uterine leiomyoma embolization; Technik und Methodik der Uterusmyomembolisation

Energy Technology Data Exchange (ETDEWEB)

Helmberger, T.K.; Jakobs, T.F.; Reiser, M.F. [Institut fuer Klinische Radiologie, Klinikum der Universitaet Muenchen-Grosshadern (Germany)

2003-08-01

Uterine leiomyomas are the most common benign tumors of the female urogenital tract. Beside the classic surgical treatment options the minimal-invasive embolization therapy of the leiomyomas increasingly gains importance world-wide. Technique, complications, and results of uterine leiomyoma embolization will be presented. After careful evaluation of indications for embolization the procedure is mostly performed under conscious sedation. A single-sided femoral access route together with cross-over technique generally allows for a flow-directed embolization via both uterine arteries. After embolizing the vessels supplying the tumor, the uterine arteries should be still patent. The success rate of embolization of uterine leiomyomas ranges between 85 and 100%, whereas a reduction in size of the tumors in 42 to 83% and a relief of symptoms in up to 96% can be achieved. The total complication rate is about 10% with mainly ''minor complications''. Worldwide only three deaths following embolization of uterine leiomyomas were reported. The high technical and clinical success rate together with a low complication rate make the embolization of uterine leiomyomas a minimally-invasive alternative to the classic treatment. As long term results are not available indication to embolization of uterine leiomyomas must be carefully established in consensus with gynecologists. (orig.) [German] Uterusmyome sind die haeufigsten benignen Tumoren des weiblichen Genitaltrakts. Neben den klassischen operativ-gynaekologischen Behandlungsverfahren gewinnt die minimal-invasive Uterusmyomembolisation (UME) weltweit an Bedeutung. Technik, Komplikationen und Ergebnisse der UME werden vorgestellt. Die Indikation zur UME muss sehr sorgfaeltig und kritisch gestellt werden. Die Intervention kann meist unter Analgosedierung vorgenommen werden. Die Embolisation kann in der Regel ueber einen einseitigen femoralen Zugang erfolgen. In beide Aa. uterinae wird das Embolisat

Plasmacytoma Infiltrating Leiomyoma in Multiple Myeloma

Science.gov (United States)

2018-01-19

REPORT TYPE 3. DATES COVERED (From - To) 01/19/2018 Poster 01/19/2018-01/21/2018 4. TITLE AND SUBTITLE Sa. CONTRACT NUMBER Plasmacytoma...Infiltrating Leiomyoma in Multiple Myeloma Sb. GRANT NUMBER Sc. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Sd. PROJECT NUMBER Capt Eden, Rina Se. TASK NUMBER Sf

Epidemiological and genetic clues for molecular mechanisms involved in uterine leiomyoma development and growth

NARCIS (Netherlands)

Commandeur, Arno E.; Styer, Aaron K.; Teixeira, Jose M.

2015-01-01

Uterine leiomyomas (fibroids) are highly prevalent benign smooth muscle tumors of the uterus. In the USA, the lifetime risk for women developing uterine leiomyomas is estimated as up to 75%. Except for hysterectomy, most therapies or treatments often provide only partial or temporary relief and are

US, CT and MR imaging findings of leiomyoma of urinary bIadder: case report

International Nuclear Information System (INIS)

Kim, Hye Jung; Kim, Young Hwan; Kim, Sung Woo

2004-01-01

Leiomyomas are the most common benign tumors of the uterus, and although they can occur at any site in the genitourinary tract, they very rarely originate from the urinary bladder. We report a case in which leiomyoma occurred at that site, describing the US, CT, and MRI findings

US, CT and MR imaging findings of leiomyoma of urinary bIadder: case report

Energy Technology Data Exchange (ETDEWEB)

Kim, Hye Jung; Kim, Young Hwan; Kim, Sung Woo [School of Medicine, Kyungpook National Univ., Daegu (Korea, Republic of)

2004-03-01

Leiomyomas are the most common benign tumors of the uterus, and although they can occur at any site in the genitourinary tract, they very rarely originate from the urinary bladder. We report a case in which leiomyoma occurred at that site, describing the US, CT, and MRI findings.

Mitotically Active Leiomyoma of the Uterus in a Postmenopausal Breast Cancer Patient Receiving Tamoxifen

Directory of Open Access Journals (Sweden)

I-Feng Liu

2006-06-01

Conclusion: Endometrial cancer is rarely noted in breast cancer patients taking tamoxifen. Further, none have reported mitotically active leiomyoma of the uterus. From this case, endometrial proliferation and mitotically active leiomyoma of the uterus may be related to tamoxifen therapy, and should not be neglected in breast cancer patients.

Evaluation of life quality after arterial uterine embolization for leiomyoma

International Nuclear Information System (INIS)

Liu Zhaoyu; Shan Ming; Lu Zaiming; Zheng Jiahe; Zhang Jun; Sun Wei

2007-01-01

Objective: To evaluate the quality of life in women with uterine leiomyoma after treatment by uterine arterial embolization. Methodes: 118 patients of uterine leiomyoma were treated by uterine arterial embolization (UAE) from January 2003 to March 2005. The quality of life was measured by a fibroid specific symptom and HRQOL questionnaire pre-and post-embolization. Patients satisfaction was surveyed together with decrease of fibroids' mass measurement. Results: The decrease of fibroid size and uterine volume were 49.6% and 45.2% at 6 months after embolization with simultaneously obvious improvement of clinical symptoms. The scores of quality of life obviously improved in all follow-up subscales (P<0.001). No amenorrhea occurred during the period of observation with more than 60% of respondents acknowledging the positive improvement in fibroid-related symptoms though UAE; and 80% would probably or definitely take UAE as the first choice of treatment again. Conclusion: The treatment of symptomatic leiomyomas by UAE can improve the quality of life dramatically with a promising satisfaction. (authors)

Leiomyoma-derived transforming growth factor-β impairs bone morphogenetic protein-2-mediated endometrial receptivity.

Science.gov (United States)

Doherty, Leo F; Taylor, Hugh S

2015-03-01

To determine whether transforming growth factor (TGF)-β3 is a paracrine signal secreted by leiomyoma that inhibits bone morphogenetic protein (BMP)-mediated endometrial receptivity and decidualization. Experimental. Laboratory. Women with symptomatic leiomyomas. Endometrial stromal cells (ESCs) and leiomyoma cells were isolated from surgical specimens. Leiomyoma-conditioned media (LCM) was applied to cultured ESC. The TGF-β was blocked by two approaches: TGF-β pan-specific antibody or transfection with a mutant TGF-β receptor type II. Cells were then treated with recombinant human BMP-2 to assess BMP responsiveness. Expression of BMP receptor types 1A, 1B, 2, as well as endometrial receptivity mediators HOXA10 and leukemia inhibitory factor (LIF). Enzyme-linked immunosorbent assay showed elevated TGF-β levels in LCM. LCM treatment of ESC reduced expression of BMP receptor types 1B and 2 to approximately 60% of pretreatment levels. Preincubation of LCM with TGF-β neutralizing antibody or mutant TGF receptor, but not respective controls, prevented repression of BMP receptors. HOXA10 and LIF expression was repressed in recombinant human BMP-2 treated, LCM exposed ESC. Pretreatment of LCM with TGF-β antibody or transfection with mutant TGF receptor prevented HOXA10 and LIF repression. Leiomyoma-derived TGF-β was necessary and sufficient to alter endometrial BMP-2 responsiveness. Blockade of TGF-β prevents repression of BMP-2 receptors and restores BMP-2-stimulated expression of HOXA10 and LIF. Blockade of TGF signaling is a potential strategy to improve infertility and pregnancy loss associated with uterine leiomyoma. Copyright © 2015 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Impact of leiomyoma in pregnancy

International Nuclear Information System (INIS)

Navid, S.; Arshad, S.; Ain, Q.U.; Meo, R.A.

2012-01-01

Background: Uterine fibroids or leiomyomas are benign tumours that develop in the uterus, a female reproductive organ. These cause severe complications in females during pregnancy. This study was conducted to see the impact of leiomyoma in pregnant females to make decision for its management in future. Methods: During one year of study, total 10,842 patients presented in CMH Lahore for antenatal check-up were included in the study. Out of them, 80 patients had leiomyoma in first trimester. They were followed during antenatal period. Maternal age, parity, size of fibroid, complications during pregnancy, labour and delivery, mode of delivery and indications of caesarean section were noted. Results: The prevalence of fibroids (15 Cm) in pregnant females was 0.74%. The most common complication observed was PPH (31, 38.75%) cases. Miscarriage occurred in 8 (10%) cases, cord prolepses was observed in 6 (7.5%) cases, placental abruption in 6 (7.5%) cases, placenta previa in 2 (2.5%) cases and retained placenta was observed in 1 (1.25%) case. Breech presentation was found in 10 (12.5%) cases and abdominal hysterectomy was done in 10 (12.5%) cases. Preterm labour occurred in 8 (10%) cases and IUGR was present in 5 (6.25%) cases. No maternal was reported during the study. Among all females, 64 (80%) continue their pregnancy up to term (37 C40 weeks of gestation), out of which vaginal delivery occurred in 19 (29.69%) while 45 (70.3%) had LSCS due to failure in progress in 17 (37.8%), cord prolapsed in 6 (13.3%) cases, fibroid in lower segment in 3 (6.7%) cases, breech presentation in 10 (22.2%) cases and low lying placenta in 2 (4.4%) cases. Conclusion: Pregnancy with fibroid is associated with increase in caesarean section rate especially due to dysfunctional labour and malpresentation. There is also increase in incidence of postpartum haemorrhage and associated hysterectomy. (author)

Is a history of cesarean section a risk factor for abnormal uterine bleeding in patients with uterine leiomyoma?

Science.gov (United States)

Kinay, Tugba; Basarir, Zehra O; Tuncer, Serap F; Akpinar, Funda; Kayikcioglu, Fulya; Koc, Sevgi; Karakaya, Jale

2016-08-01

To determine whether a history of cesarean section was a risk factor for abnormal uterine bleeding in patients with uterine leiomyomas, and to identify other risk factors for this symptom. We analyzed retrospectively, the medical records of patients who underwent hysterectomies due to the presence of uterine leiomyomas during a 6-year period (2009 and 2014) at Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey. Uterine leiomyoma was diagnosed based on histopathological examination of hysterectomy specimens. Demographic characteristics, and laboratory and histopathological findings were compared between patients with uterine leiomyoma with and without abnormal uterine bleeding. In total, 501 (57.9%) patients had abnormal uterine bleeding and 364 (42.1%) patients had other symptoms. A history of cesarean section was more common in patients with abnormal uterine bleeding than in those with other symptoms (17.6% versus 9.3%, p=0.001; odds ratio [OR]: 2.1; 95% confidence interval [CI]: 1.4-3.3). The presence of a submucosal leiomyoma (OR: 2.1; 95% CI: 1.5-3.1) and coexistent adenomyosis (OR: 1.6; 95% CI: 1.1-2.4) were also associated with abnormal uterine bleeding. A history of cesarean section was an independent risk factor for abnormal uterine bleeding in patients with uterine leiomyomas; submucosal leiomyoma and coexisting adenomyosis were also independent risk factors.

Histopathological and Digital Morphometrical Evaluation of Uterine Leiomyoma in Brazilian Women

Directory of Open Access Journals (Sweden)

Ana Paula Fernandes da Silva

2016-01-01

Full Text Available The current study aims to evaluate histopathological and digital morphometrical aspects associated with uterine leiomyomas in one hundred and fifty (150 patients diagnosed with leiomyoma. Uterine tissues were subjected to the histopathological and digital morphometric analyses of the interstitial collagen distribution. The analysis of medical records indicates that most of the women diagnosed with uterine leiomyomas (68.7% are between 37 and 48 years old. As for the anatomic location of the tumors, approximately 61.4% of the patients had intramural and subserosal lesions. In 50% of the studied cases, the patients developed uterine leiomyomatosis (with more than eight tumors. As for the morphometric study, the average size of the interstitial collagen distribution held approximately 28.53% of the capture area, whereas it was of 7.43% in the normal tissue adjacent to the tumor. Another important aspect observed in the current study was the high rate of young women subjected to total hysterectomy, a fact that resulted in early and definitive sterility.

Unusual CT findings of a benign metastasizing leiomyoma presenting with multiple cavitary nodules: a case report

International Nuclear Information System (INIS)

Ahn, Ji Eun; Do, Kyung Hyun; Chae, Eun Jin; Seo, Joon Beom; Lee, Jin Seong; Song, Koun Sik; Song, Jae Wo; Kim, Kyu Rae; Lim, Tae Hwan

2007-01-01

A benign metastasizing leiomyoma is a rare condition that affects women with a history of uterine leiomyoma, usually after a myomectomy or hysterectomy. Typical radiographic findings include well-circumscribed solitary or multiple pulmonary nodules ranging from a few millimeters to several centimeters in diameter and scattered among the normal interstitium. We report a case of a benign metastasizing leiomyoma that manifested with multiple cavitary nodules in a 46-year-old woman with no previous history of a myomectomy or hysterectomy

Unusual CT findings of a benign metastasizing leiomyoma presenting with multiple cavitary nodules: a case report

Energy Technology Data Exchange (ETDEWEB)

Ahn, Ji Eun; Do, Kyung Hyun; Chae, Eun Jin; Seo, Joon Beom; Lee, Jin Seong; Song, Koun Sik; Song, Jae Wo; Kim, Kyu Rae; Lim, Tae Hwan [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

2007-09-15

A benign metastasizing leiomyoma is a rare condition that affects women with a history of uterine leiomyoma, usually after a myomectomy or hysterectomy. Typical radiographic findings include well-circumscribed solitary or multiple pulmonary nodules ranging from a few millimeters to several centimeters in diameter and scattered among the normal interstitium. We report a case of a benign metastasizing leiomyoma that manifested with multiple cavitary nodules in a 46-year-old woman with no previous history of a myomectomy or hysterectomy.

Independent clonal origin of multiple uterine leiomyomas that was determined by X chromosome inactivation and microsatellite analysis

DEFF Research Database (Denmark)

Canevari, Renata A; Pontes, Anaglória; Rosa, Fabíola E

2005-01-01

OBJECTIVE: In an attempt to clarify the clonality and genetic relationships that are involved in the tumorigenesis of uterine leiomyomas, we used a total of 43 multiple leiomyomas from 14 patients and analyzed the allelic status with 15 microsatellite markers and X chromosome inactivation analysis...... of the 9 of 12 informative patients; different inactivation patterns were observed in 3 cases. CONCLUSION: Our data support the concept that uterine leiomyomas are derived from a single cell but are generated independently in the uterus. Loss of heterozygosity findings at 7p22-15 are consistent...... with previous data that suggested the relevance of chromosomal aberrations at 7p that were involved in individual uterine leiomyomas....

Ovarian steroid hormones modulate the expression of progesterone receptors and histone acetylation patterns in uterine leiomyoma cells.

Science.gov (United States)

Sant'Anna, Gabriela Dos Santos; Brum, Ilma Simoni; Branchini, Gisele; Pizzolato, Lolita Schneider; Capp, Edison; Corleta, Helena von Eye

2017-08-01

Uterine leiomyomas are the most common benign smooth muscle cell tumors in women. Estrogen (E2), progesterone (P4) and environmental factors play important roles in the development of these tumors. New treatments, such as mifepristone, have been proposed. We evaluated the gene expression of total (PRT) and B (PRB) progesterone receptors, and the histone acetyltransferase (HAT) and deacetylase (HDAC) activity after treatment with E2, P4 and mifepristone (RU486) in primary cell cultures from uterine leiomyoma and normal myometrium. Compared to myometrium, uterine leiomyoma cells showed an increase in PRT mRNA expression when treated with E2, and increase in PRB mRNA expression when treated with E2 and P4. Treatment with mifepristone had no significant impact on mRNA expression in these cells. The HDAC activity was higher in uterine leiomyoma compared to myometrial cells after treatment with E2 and E2 + P4 + mifepristone. HAT activity was barely detectable. Our results suggest that ovarian steroid hormones modulate PR, and mifepristone was unable to decrease PRT and PRB mRNA. The higher activity of HDAC leiomyoma cells could be involved in transcriptional repression of genes implicated in normal myometrium cell function, contributing to the maintenance and growth of uterine leiomyoma.

Unusual clinical presentation of rare case of vaginal leiomyoma: a case report

OpenAIRE

Ishrat Zuber; Purnima K. Nadkarni; Aditi A. Nadkarni; Akshay Nadkarni

2016-01-01

Primary vaginal leiomyoma are rare and usually arise from anterior vaginal wall, approximately 330 cases of vaginal fibroid reported in world literature. Vaginal myoma usually presented as discharge per vaginum, abnormal bleeding, pain lower abdomen, dyspareunia etc. We report a case of primary vaginal leiomyoma arising from lateral vaginal wall which is presented clinically as pain in hip joint and radiating to ipsilateral leg which is unusual clinical presentation creating diagnostic dilemm...

Diagnostic value of progesterone receptor, p16, p53 and pHH3 expression in uterine atypical leiomyoma.

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Liang, Yun; Zhang, Xiaofei; Chen, Xiaoduan; Lü, Weiguo

2015-01-01

The differential diagnosis between atypical leiomyoma and leiomyosarcoma may be hard based on morphological criterion at times. It would be helpful to find out biomarkers that can be used to distinguish them. The aim of the study was to investigate the diagnostic value of progesterone receptor (PR), p16, p53 and pHH3 expression in a series of uterine smooth muscle tumors. Immunohistochemical expression of PR, p16, p53 and pHH3 was investigated on 32 atypical leiomyomas, 15 leiomyosarcomas and 15 usual leomyomas. The difference in expression was compared between atypical leiomyoma and other groups. The expression of PR, p16, and pHH3 was found significantly different between atypical leiomyomas and leiomyosarcomas, but lack of significant difference between atypical leiomyomas and usual leiomyomas. There was no significant difference with regard to p53 distribution among these uterine smooth muscle tumors. High p16, pHH3 expression and low PR expression preferred the diagnosis of leiomyosarcoma. The panel of antibodies used in this study is a useful complementary analysis in the assessment of problematic uterine smooth muscle tumors.

Locostatin, a disrupter of Raf kinase inhibitor protein, inhibits extracellular matrix production, proliferation, and migration in human uterine leiomyoma and myometrial cells.

Science.gov (United States)

Janjusevic, Milijana; Greco, Stefania; Islam, Md Soriful; Castellucci, Clara; Ciavattini, Andrea; Toti, Paolo; Petraglia, Felice; Ciarmela, Pasquapina

2016-11-01

To investigate the presence of Raf kinase inhibitor protein (RKIP) in human myometrium and leiomyoma as well as to determine the effect of locostatin (RKIP inhibitor) on extracellular matrix (ECM) production, proliferation, and migration in human myometrial and leiomyoma cells. Laboratory study. Human myometrium and leiomyoma. Thirty premenopausal women who were admitted to the hospital for myomectomy or hysterectomy. Myometrial and leiomyoma tissues were used to investigate the localization and the expression level of RKIP through immunohistochemistry and Western blotting. Myometrial and leiomyoma cells were treated with locostatin (10 μM) to measure ECM expression by real-time polymerase chain reaction, GSK3β expression by Western blotting, cell migration by wound-healing assay, and cell proliferation by MTT assay and immunocytochemistry. The expression of RKIP in human myometrial and leiomyoma tissue; ECM components and GSK3β expression, migration, and proliferation in myometrial and leiomyoma cells. RKIP is expressed in human myometrial and leiomyoma tissue. Locostatin treatment resulted in the activation of the mitogen-activated protein kinase (MAPK) signal pathway (ERK phosphorylation), providing a powerful validation of our targeting protocol. Further, RKIP inhibition by locostatin reduces ECM components. Moreover, the inhibition of RKIP by locostatin impaired cell proliferation and migration in both leiomyoma and myometrial cells. Finally, locostatin treatment reduced GSK3β expression. Therefore, even if the activation of MAPK pathway should increase proliferation and migration, the destabilization of GSK3β leads to the reduction of proliferation and migration of myometrial and leiomyoma cells. Our results indicate that RKIP may be involved in leiomyoma pathophysiology. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Leiomiomas uterinos e gravidez Uterine leiomyomas and pregnancy

Directory of Open Access Journals (Sweden)

Selvio Machado Simon

2005-02-01

Full Text Available OBJETIVO: avaliar a evolução da gestação e o prognóstico materno-fetal em gestantes com leiomiomas uterinos. MÉTODOS: análise retrospectiva descritiva de 75 prontuários de gestantes com leiomiomas atendidas em hospital terciário, no período de janeiro de 1992 a janeiro de 2002. RESULTADOS: foram identificadas 75 gestantes com leiomiomas numa população de 34.467 gestantes atendidas neste período (incidência de 0,2%. Dezoito pacientes (24% tiveram os diagnósticos feitos previamente à gestação, 41 (54,6% tiveram os diagnósticos durante a gestação e 16 (21,3% durante a cesariana, das quais apenas seis não haviam sido submetidas à ultra-sonografia durante o pré-natal. Foram observados 10 partos com feto pré-termo e cinco casos de rotura prematura das membranas. Quarenta e sete pacientes (75,8% foram submetidas à cesariana, sendo as indicações diretamente relacionadas aos leiomiomas em 38,3% delas (apresentação anômala, obstrução do canal de parto ou cicatriz uterina por miomectomia prévia. Foram diagnosticados quatro casos de necrose central do leiomioma, dois casos de degeneração hialina e um caso com potencial de malignidade nas pacientes submetidas à miomectomia ou histerectomia após a gestação. Sessenta e um recém-nascidos (98,4% tiveram índices de Apgar maior que 7 no 5º minuto, e a cirurgia para miomectomia, quando realizada durante a gestação, não piorou o prognóstico materno-fetal. CONCLUSÕES: a incidência de leiomiomas na gestação foi de 0,2% no período, tendo a ultra-sonografia falhado no diagnóstico em 10 pacientes. A cesariana foi freqüentemente indicada neste grupo de pacientes, mas a presença de leiomiomas na gestação não comprometeu o índice de Apgar dos recém-nascidos.PURPOSE: to evaluate the evolution of pregnancy and the maternofetal prognosis in women with uterine leiomyomas. METHODS: a descriptive retrospective analysis of the medical records of 75 pregnant women with

Laparoscopic approach in the treatment of large leiomyoma of the lower third of the esophagus.

Science.gov (United States)

Lipnickas, Vytautas; Beiša, Augustas; Makūnaitė, Gabija; Strupas, Kęstutis

2017-12-01

Leiomyoma of the lower third of the esophagus is a relatively rare disorder but the most common benign tumor of the esophagus. We present a case of an involuted esophageal leiomyoma, 11 cm in size, treated by the laparoscopic approach. The preoperative computed tomogram visualized a mass 3 × 1.5 cm in diameter in the lower esophagus without an eccentric lumen or compression of nearby organs. Resection of the tumor was indicated according to the patient's symptoms and to exclude malignancy. Laparoscopic enucleation of esophageal leiomyoma was performed. The overall operative time was 205 min. The diagnosis of leiomyoma was established on histopathology and immunohistochemistry staining. The patient resumed the intake of a normal diet on the 5 th postoperative day and was discharged from hospital 8 days after the surgery. We have found this minimally invasive operation to be an effective and well-tolerated treatment option, determined by the experience of the surgeon.

Impact of null genotypes of GSTT1 and GSTM1 with uterine leiomyoma risk in Iranian population.

Science.gov (United States)

Mostafavi, Salva Sadat; Ebrahimi, Ahmad; Sadat, Seyed Mehdi; Davari Tanha, Fatemeh; Aghasadeghi, Mohammad Reza; Bahramali, Golnaz; Abbasi Ranjbar, Parinaz; Sadeghifard, Vida; Javadi, Foozieh

2016-04-01

Few studies have investigated the role of the GSTM1 and GSTT1 genes in uterine leiomyoma. Therefore, in the current study the distribution of these genotypes in Iranian women and susceptibility to uterine leiomyoma was investigated. Blood samples of 50 patients with uterine leiomyoma and 50 healthy individual controls were collected in this cross-sectional study. Genomic DNA was extracted, and subsequently GSTM1 and GSTT1 null genotypes were detected by the Gap-polymerase chain reaction method. A total of 42% of patients appeared to lack GSTM1 enzyme activity due to the presence of an extended deletion (GSTM1 0/0 genotype), compared with 18% in a control group (odds ratio [OR], 3.56; 95% confidence interval [CI], 1.35-9.37; P leiomyoma and null GSTM1 and GSTT1 genotypes among Iranian patients. Our data support the involvement of GSTM1 and GSTT1 in uterine leiomyoma liability, and especially its role as a genetic factor in the occurrence of this disease. © 2016 Japan Society of Obstetrics and Gynecology.

Benign metastasizing leiomyoma presenting as multiple cystic pulmonary nodules: a case report.

Science.gov (United States)

Choe, Yeong Hun; Jeon, So Yeon; Lee, Yoon Chae; Chung, Myung Ja; Park, Seung Yong; Lee, Yong Chul; Kim, So Ri

2017-09-12

Benign metastatic leiomyoma (BML) is an extremely rare disease. Although uterine leiomyomas are benign histologically, they can metastasize to distant sites. While the incidence is very low, the lung is the organ most frequently affected by BML. Pulmonary BML usually presents as numerous well-defined nodules of various sizes, while the cavitary or cystic features in the nodules are rarely observed on radiologic images. A 52-year-old woman complained of cough and dyspnea for one month. She had been previously diagnosed with uterine leiomyoma and had undergone total hysterectomy about 14 years prior. High-resolution computed tomography (CT) images showed that there were multiple cystic nodules of various sizes in both lungs. Pathologic examination revealed that the pulmonary nodule had complex branching glandular structures lined by a single layer of simple cuboidal to columnar epithelium that was surrounded by abundant spindle cells. Additional immunohistochemistry data suggested that pulmonary nodule diagnosis was BML-associated uterine leiomyoma. In this report, we introduce an interesting case of pulmonary BML that presented as a combination of various kinds of nodules including simple round nodules, simple cysts, and cysts with a solid portion, which are very rare radiologic features of BML in lung. In addition, when the patient is a woman of reproductive age, physicians should meticulously review the gynecological history and suspect BML when there are various cystic pulmonary lesions.

[Leiomyoma of the bladder causing the destruction of a kidney].

Science.gov (United States)

Kehila, Mehdi; Mekni, Karima; Abouda, Hassine Saber; Chtourou, Maher; Zeghal, Dorra; Chanoufi, Mohamed Badis

2016-01-01

Leiomyoma of the bladder is a rare benign tumor deemed to have a good prognosis after surgical treatment. This is unfortunately not always true. We report the case of a 33 year-old patient who consulted for lumbar pain on right side. Exploration of patient revealed bladder floor solid tumor with non-functioning right kidney and left urinary tract dilation. Cystoscopy objectified solid tumor of the right perimeatal bladder. Tumor biopsies were performed together with the insertion of a left double J stent. Anatomo-pathologic study showed leiomyoma of the bladder. The patient underwent laparoscopic myomectomy. The postoperative course was uneventful. Pathological effect and sequelae was complete distruction of kidney.

Efficacy of ormeloxifene versus oral contraceptive in the management of abnormal uterine bleeding due to uterine leiomyoma.

Science.gov (United States)

Kriplani, Alka; Srivastava, Astha; Kulshrestha, Vidushi; Kachhawa, Garima; Agarwal, Nutan; Bhatla, Neerja; Hari, Smriti

2016-12-01

To compare ormeloxifene with combined oral contraceptive (COC) in abnormal uterine bleeding (AUB) due to leiomyoma (AUB-L). Fifty women with AUB-L were randomized after informed consent and institute ethics clearance. Group I (n = 25) was given ormeloxifene (a SERM i.e. selective estrogen receptor modulator) 60 mg twice per week and group II (n = 25) was given COC (ethinyl estradiol 30 μg with desogestrel 150 μg) on days 1-21 for 6 months. Menstrual blood loss was assessed on pictorial blood loss assessment chart (PBAC) score and leiomyoma volume was assessed on ultrasound. Fibroids were classified according to FIGO-PALM-COEIN classification for AUB where leiomyomas were further sub-classified as types 0 to 8 according to their location. Follow up was done at 1, 3, 6 and 9 months. Mean PBAC score reduced by 81% with ormeloxifene (group I) compared with 43.8% for COC (group II). After 6 months, 18 patients (72%) in group I had PBAC score in the non-menorrhagic range (leiomyoma types 2, 3, 4, 5, 6 reduced by 90.2%, 82.5%, 93.3%, 56.4% and 100%, respectively and 14 (56%) developed amenorrhea; compared with reduction of 64%, 27.5%, 25.9% in types 4, 5 and 6, respectively in group II. Dysmenorrhea visual analog scale score decreased in both groups. Mean leiomyoma volume increased in both groups: by 25.7% with ormeloxifene versus 16.9% with COC; only grade 2 leiomyoma in group I reduced by 44%. One patient in group II with grade 2 leiomyoma discontinued treatment at 3 months. Seven patients (28%) developed ovarian cyst in group I with no other major adverse effect in either group. Ormeloxifene with its convenient twice-weekly dosage schedule was effective in treating AUB-L, with 72% of patients responding to 6-month treatment compared with 8% with COC, even though leiomyoma volume increased insignificantly with both ormeloxifene and COCs. © 2016 Japan Society of Obstetrics and Gynecology.

Diagnosis of epitheliod leiomyoma

International Nuclear Information System (INIS)

Tret'yakov, A.E.; Shevyakov, V.V.

1992-01-01

Epithelioid leiomyoma (EL) is unusual and rarely met tumor of the stomach. From International histological classification it belongs to benign tumors of smooth muscular tissue. As other nonepithelial tumors EL can grow endogastral, intramural and exogastral. Exogastral type of tumor growth presents difficulties for diagnosis as changes of mucous and sometimes muscular layers of stomach wall are absent. An observation was given of a patient with mentioned disease. Primary diagnosis was mechanical jaundice, chronic cholecystitis. Tumor formation (10x8x9 sm) was revealed in the stomach during operation

Small bowel volvulus due to torsion of pedunculated uterine leiomyoma: CT findings.

Science.gov (United States)

Guglielmo, Nicola; Malgras, Brice; Place, Vinciane; Guerrache, Youcef; Pautrat, Karine; Pocard, Marc; Soyer, Philippe

Torsion of a uterine leiomyoma is a rare complication that can be life threatening because of ischemia or necrosis. This condition may also lead to gastrointestinal complications such as obstruction or, more rarely, small bowel volvulus. Its diagnosis is difficult and can be facilitated with the use of computed tomography or magnetic resonance imaging. Treatment is based on emergency surgical resection of the twisted uterine leiomyoma and detorsion of the small bowel volvulus. Copyright © 2016 Elsevier Inc. All rights reserved.

Gonadotropin-releasing hormone analogues inhibit leiomyoma extracellular matrix despite presence of gonadal hormones.

Science.gov (United States)

Malik, Minnie; Britten, Joy; Cox, Jeris; Patel, Amrita; Catherino, William H

2016-01-01

To determine the effect of GnRH analogues (GnRH-a) leuprolide acetate (LA) and cetrorelix acetate on gonadal hormone-regulated expression of extracellular matrix in uterine leiomyoma three-dimensional (3D) cultures. Laboratory study. University research laboratory. Women undergoing hysterectomy for symptomatic leiomyomas. The 3D cell cultures, protein analysis, Western blot, immunohistochemistry. Expression of extracellular matrix proteins, collagen 1, fibronectin, and versican in leiomyoma cells 3D cultures exposed to E2, P, LA, cetrorelix acetate, and combinations for 24- and 72-hour time points. The 3D leiomyoma cultures exposed to E2 for 24 hours demonstrated an increased expression of collagen-1 and fibronectin, which was maintained for up to 72 hours, a time point at which versican was up-regulated significantly. Although P up-regulated collagen-1 protein (1.29 ± 0.04) within 24 hours of exposure, significant increase in all extracellular matrix (ECM) proteins was observed when the gonadal hormones were used concomitantly. Significant decrease in the amount of ECM proteins was observed on use of GnRH-a, LA and cetrorelix, with 24-hour exposure. Both the compounds also significantly decreased ECM protein concentration despite the presence of E2 or both gonadal hormones. This study demonstrates that GnRH-a directly affect the gonadal hormone-regulated collagen-1, fibronectin, and versican production in their presence. These findings suggest that localized therapy with GnRH-a may inhibit leiomyoma growth even in the presence of endogenous gonadal hormone exposure, thereby providing a mechanism to eliminate the hypoestrogenic side effects associated with GnRH-a therapy. Published by Elsevier Inc.

Gastric leiomyoma in a child with Gorlin-Goltz syndrome: First pediatric case.

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Virgone, Calogero; Decker, Emily; Mitton, Sally G; Mansour, Sahar; Giuliani, Stefano

2016-04-01

Gorlin-Goltz syndrome (GGS), also known as nevoid basal cell carcinoma syndrome (MIM 109 400), is a rare genetic condition with a prevalence between 1/56 000 and 1/256 000. Clinical presentation is usually characterized by multiple basal cell carcinomas, odontogenic jaw keratocysts, palmar or plantar pitting and skeletal anomalies. It is furthermore associated with the development of various tumors beside basal cell carcinoma, among which medulloblastoma is the most frequent. Increased incidence of other mesenchymal neoplasms, however, is also well known: recently the first adult case of gastric leiomyoma in GGS was reported, and the inclusion of "fibromas and leiomyomas of other organs" in the minor criteria for the diagnosis was suggested. We report the first case of a pediatric patient with GGS who also developed a gastric leiomyoma: the present case illustrates the need for this change to the diagnostic criteria to encompass the highly variable presentations and phenotype in GGS. © 2015 Japan Pediatric Society.

Thoracoscopic enucleation of a large esophageal leiomyoma using a three thoracic ports technique

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Lohsiriwat Varut

2006-10-01

Full Text Available Abstract Background Video assisted thoracoscopic resection of an esophageal leiomyoma offers distinct advantages over an open approach. Many papers have described various techniques of thoracoscopic resection. Case presentation We describe a 32-year old man who presented with intermittent dysphagia. Imaging studies showed a large esophageal leiomyoma. He underwent thoracoscopic enucleation using a three thoracic-ports technique. Conclusion Thoracoscopic enucleation can be technically performed using a three thoracic-ports technique.

Role of Activin-A and Myostatin and Their Signaling Pathway in Human Myometrial and Leiomyoma Cell Function

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Islam, Md Soriful; Catherino, William H.; Protic, Olga; Janjusevic, Milijana; Gray, Peter Clarke; Giannubilo, Stefano Raffaele; Ciavattini, Andrea; Lamanna, Pasquale; Tranquilli, Andrea Luigi; Petraglia, Felice

2014-01-01

Context: Uterine leiomyomas are highly prevalent benign tumors of premenopausal women and the most common indication for hysterectomy. However, the exact etiology of this tumor is not fully understood. Objective: The objective of the study was to evaluate the role of activin-A and myostatin and their signaling pathways in human myometrial and leiomyoma cells. Design: This was a laboratory study. Setting: Myometrial and leiomyoma cells (primary and cell lines) were cultured in vitro. Patients: The study included premenopausal women who were admitted to the hospital for myomectomy or hysterectomy. Interventions: Primary myometrial and leiomyoma cells and/or cell lines were treated with activin-A (4 nM) and myostatin (4 nM) for different days of interval (to measure proliferation rate) or 30 minutes (to measure signaling molecules) or 48 hours to measure proliferating markers, extracellular matrix mRNA, and/or protein expression by real-time PCR, Western blot, and/or immunocytochemistry. Results: We found that activin-A and myostatin significantly reduce cell proliferation in primary myometrial cells but not in leiomyoma cells as measured by a CyQUANT cell proliferation assay kit. Reduced expression of proliferating cell nuclear antigen and Ki-67 were also observed in myometrial cells in response to activin-A and myostatin treatment. Activin-A also significantly increased mRNA expression of fibronectin, collagen1A1, and versican in primary leiomyoma cells. Finally, we found that activin-A and myostatin activate Smad-2/3 signaling but do not affect ERK or p38 signaling in both myometrial and leiomyoma cells. Conclusions: This study results suggest that activin-A and myostatin can exert antiproliferative and/or fibrotic effects on these cell types via Smad-2/3 signaling. PMID:24606069

Complete androgen insensitivity syndrome with paratesticular leiomyoma: A case report

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Lee, Ji Hoon; Oh, Hyung Woo; Lee, Mi Ja; Lim, Dong Hoon [Chosun University College of Medicine, Gwangju (Korea, Republic of)

2017-03-15

Complete androgen insensitivity syndrome (AIS) is a rare, X-linked recessive disorder. Patients with AIS may develop primary amenorrhea due to androgen receptor resistance, resulting in a normal female phenotype and male (XY) karyotype. We report a case of a 30-year-old woman who was diagnosed with complete AIS. Ultrasonography and magnetic resonance imaging revealed bilateral inguinal cryptorchidism and no ovaries and uterus. After gonadectomy, the inguinal mass was confirmed as testicular atrophy with hamartomatous proliferation of Leydig cells and paratesticular leiomyoma. Although these tumors have been reported in association with AIS, this is the first case of paratesticular leiomyoma with hamartomatous proliferation of Leydig cells in atrophic testes being reported in Korea.

Complete androgen insensitivity syndrome with paratesticular leiomyoma: A case report

International Nuclear Information System (INIS)

Lee, Ji Hoon; Oh, Hyung Woo; Lee, Mi Ja; Lim, Dong Hoon

2017-01-01

Complete androgen insensitivity syndrome (AIS) is a rare, X-linked recessive disorder. Patients with AIS may develop primary amenorrhea due to androgen receptor resistance, resulting in a normal female phenotype and male (XY) karyotype. We report a case of a 30-year-old woman who was diagnosed with complete AIS. Ultrasonography and magnetic resonance imaging revealed bilateral inguinal cryptorchidism and no ovaries and uterus. After gonadectomy, the inguinal mass was confirmed as testicular atrophy with hamartomatous proliferation of Leydig cells and paratesticular leiomyoma. Although these tumors have been reported in association with AIS, this is the first case of paratesticular leiomyoma with hamartomatous proliferation of Leydig cells in atrophic testes being reported in Korea

A Role for Cytosolic Fumarate Hydratase in Urea Cycle Metabolism and Renal Neoplasia

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Julie Adam

2013-05-01

Full Text Available The identification of mutated metabolic enzymes in hereditary cancer syndromes has established a direct link between metabolic dysregulation and cancer. Mutations in the Krebs cycle enzyme, fumarate hydratase (FH, predispose affected individuals to leiomyomas, renal cysts, and cancers, though the respective pathogenic roles of mitochondrial and cytosolic FH isoforms remain undefined. On the basis of comprehensive metabolomic analyses, we demonstrate that FH1-deficient cells and tissues exhibit defects in the urea cycle/arginine metabolism. Remarkably, transgenic re-expression of cytosolic FH ameliorated both renal cyst development and urea cycle defects associated with renal-specific FH1 deletion in mice. Furthermore, acute arginine depletion significantly reduced the viability of FH1-deficient cells in comparison to controls. Our findings highlight the importance of extramitochondrial metabolic pathways in FH-associated oncogenesis and the urea cycle/arginine metabolism as a potential therapeutic target.

The effect of everolimus on renal angiomyolipoma in pediatric patients with tuberous sclerosis being treated for subependymal giant cell astrocytoma.

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Bissler, John J; Franz, David N; Frost, Michael D; Belousova, Elena; Bebin, E Martina; Sparagana, Steven; Berkowitz, Noah; Ridolfi, Antonia; Kingswood, J Christopher

2018-01-01

Patients with tuberous sclerosis complex (TSC) often have multiple TSC-associated hamartomas, particularly in the brain and kidney. This was a post hoc analysis of pediatric patients being treated for subependymal giant cell astrocytomas (SEGAs) during the phase 3, randomized, double-blind, placebo-controlled EXIST-1 trial. Patients were initially randomly assigned to receive everolimus 4.5 mg/m 2 /day (target blood trough 5-15 mg/dl) or placebo and could continue in an open-label extension phase. Angiomyolipoma response rates were analyzed in patients aged 20% increase in kidney volume from nadir, and angiomyolipoma-related bleeding ≥ grade 2. Tolerability was also assessed. Overall, this analysis included 33 patients. Renal angiomyolipoma response was achieved by 75.8% of patients (95% confidence interval, 57.7-88.9%), with sustained mean reductions in renal angiomyolipoma volume over nearly 4 years of treatment. In addition, most (≥80%) achieved clinically relevant reductions in angiomyolipoma volume (≥50%), beginning at week 24 and continuing for the remainder of the study. Everolimus was generally well tolerated in this subgroup, with most adverse events being grade 1 or 2 in severity. Although everolimus is currently not indicated for this use, this analysis from EXIST-1 demonstrates its long-term efficacy and safety for the treatment of renal angiomyolipoma in pediatric patients undergoing treatment for TSC-associated SEGA.

Percutaneous nephroscopic management of an isolated giant renal hydatid cyst guided by single-incision laparoscopy using conventional instruments: the Santosh-PGI technique.

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Kumar, Santosh; Choudhary, Gautam R; Pushkarna, Arawat; Najjapa, Bhuvnesh; Ht, Vatasla

2013-11-01

Isolated renal hydatid rarely presents, but when it does occur, it requires surgical treatment. We report our experience with a novel technique involving percutaneous management of a giant renal hydatid cyst with single-incision laparoscopic assistance. First we performed retrograde ureteropyelogram, which did not show any communication between the cyst and the calyceal. A Veress needle was used for pneumoperitoneum. Three conventional laparoscopic trocars used. Under laparoscopic guidance, we punctured the cyst. The scolicidal solution used was 10% povidone-iodine. The endocyst was removed under vision with grasping forceps through the nephroscope. A Portex drain was placed into the cyst cavity. Percutaneous aspiration and instillation of scolicidal agents followed by re-aspiration have been previously reported. This is an attractive procedure because of its acceptable success rates and reduced morbidity. In our case, simple aspiration of the cyst would not have been successful because the cyst was full of daughter cysts. Also, a blind percutaneous puncture of the cyst and dilatation could have perforated the colon or the mesocolon, which is often wrapped over the surface of such giant cysts thereby making laparoscopic guidance and mobilization of the colon imperative. We devised this unique treatment method for this patient involving three conventional ports at a single umbilical site. We believe this is the first reported case of its kind in the world. Not only this technique is minimally invasive, it is also cost-effective, as only conventional laparoscopic ports and instruments are used during the procedure. © 2013 Japan Society for Endoscopic Surgery, Asia Endosurgery Task Force and Wiley Publishing Asia Pty Ltd.

Differential effects of tumor necrosis factor-α on matrix metalloproteinase-2 expression in human myometrial and uterine leiomyoma smooth muscle cells.

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Wang, Yuebing; Feng, Guowei; Wang, Jiyuan; Zhou, Yu; Liu, Yixin; Shi, Yiquan; Zhu, Yingjun; Lin, Wanjun; Xu, Yang; Li, Zongjin

2015-01-01

Does tumor necrosis factor-α (TNF-α) differentially regulate matrix metalloproteinase-2 (MMP-2) expression in leiomyomas compared with normal myometrium? TNF-α up-regulates MMP-2 expression and stimulates cell migration through the activation of extracellular signal-regulated kinase (ERK) signaling pathway in leiomyoma smooth muscle cells (SMCs), but not in normal myometrial SMCs. Uterine leiomyoma, the benign smooth muscle cell tumor, is the single most common indication for hysterectomy. High expression of MMPs or TNF-α has been reported in uterine leiomyomas; however, the molecular mechanism underlying these observations remains unknown. Samples were obtained between 2009 and 2013 from 12 women of reproductive age at the proliferative phase of the menstrual cycle by hysterectomy. Leiomyomas and matched normal myometrium from each woman were analyzed in vitro. Western blot, RT-qPCR and a wound-healing assay were used to investigate the effects of TNF-α on MMP-2 expression and intracellular signal transduction in cultured SMCs from leiomyomas and matched myometrium. Western blot and RT-qPCR analyses using tissues from clinical patients showed that the levels of MMP-2 protein (P = 0.008) and mRNA (P = 0.009) were significantly higher in uterine leiomyomas compared with their matched myometrium. Treatment with TNF-α significantly up-regulated the protein (P = 0.039) and mRNA (P = 0.037) levels of MMP-2 in cultured leiomyoma SMCs but not in matched myometrial SMCs. The extracellular signal-regulated kinase (ERK) and nuclear factor-kappa B (NF-κB) pathways were activated by TNF-α in leiomyoma SMCs. Specific inhibitors of the ERK or NF-κB pathway (PD98059 or Bay11-7082) suppressed TNF-α-induced MMP-2 expression in leiomyoma SMCs. The wound-healing assay revealed that TNF-α promoted the migration of cultured leiomyoma SMCs (P = 0.036); however, PD98059 compromised the cell migration triggered by TNF-α. This study is descriptive and although we observed clear

A Rare Prostatic Diagnosis of an Old Man: A Pure Prostatic Leiomyoma

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W. M. van Ulden-Bleumink

2013-01-01

Full Text Available A pure leiomyoma of the prostate is a rare benign tumor. An 82-year-old man was referred to our urology department with gross hematuria and complete urinary retention. Examination revealed a benign prostatic hyperplasia. Transrectal ultrasound showed a prostate of 125 mL. Serum PSA was 1.9 µg/L. A simple retropubic prostatectomy was performed. Histopathological examination showed a pure leiomyoma of the prostate, without the presence of glandular prostate tissue. The diagnosis, characteristics, and treatment of this tumor are described.

miR-139-5p regulates proliferation, apoptosis, and cell cycle of uterine leiomyoma cells by targeting TPD52

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Chen H

2016-10-01

Full Text Available Hong Chen,1 Hong Xu,1 Yu-gang Meng,1 Yun Zhang,2 Jun-ying Chen,1 Xiao-ning Wei1 1Department of Gynaecology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 2Department of Gynaecology, The People’s Hospital of Suzhou High Tech District, Suzhou, Jiangsu, People’s Republic of China Background: Uterine leiomyoma is one of the most common benign tumors in women. It dramatically decreases the quality of life in the affected women. However, there is a lack of effective treatment paradigms. Micro-RNAs are small noncoding RNA molecules that are extensively expressed in organisms, and they are interrelated with the occurrence and development of the tumor. miR-139-5p was found to be downregulated in various cancers, but its function and mechanism in uterine leiomyoma remain unknown. The aim of this study was to investigate the role of miR-139-5p and its target gene in uterine leiomyoma.Methods: By using a bioinformatic assay, it was found that TPD52 was a potential target gene of miR-139-5p. Then, expressions of miR-139-5p and TPD52 in uterine leiomyoma and adjacent myometrium tissues were evaluated by quantitative real-time polymerase chain reaction and Western blot. Proliferation, apoptosis, and cell cycle of uterine leiomyoma cells transfected by miR-139-5p mimics or TPD52 siRNA were determined.Results: It was observed that the expression of miR-139-5p in uterine leiomyoma tissues was significantly lower (P<0.001 than that in the adjacent myometrium tissues. Overexpression of miR-139-5p inhibited the growth of uterine leiomyoma cells and induced apoptosis and G1 phase arrest. Dual-luciferase reporter assay and Western blot validated that TPD52 is the target gene of miR-139-5p. Furthermore, downregulation of TPD52 by siRNA in uterine leiomyoma cells inhibited cell proliferation and induced cell apoptosis and G1 phase arrest.Conclusion: Data suggested that miR-139-5p inhibited the proliferation of uterine leiomyoma cells

Dual repressive effect of angiotensin II-type 1 receptor blocker telmisartan on angiotensin II-induced and estradiol-induced uterine leiomyoma cell proliferation.

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Isobe, Aki; Takeda, Takashi; Sakata, Masahiro; Miyake, Asako; Yamamoto, Toshiya; Minekawa, Ryoko; Nishimoto, Fumihito; Oskamoto, Yoko; Walker, Cheryl Lyn; Kimura, Tadashi

2008-02-01

Although uterine leiomyomas or fibroids are the most common gynecological benign tumor and greatly affect reproductive health and well-being, the pathophysiology and epidemiology of uterine leiomyomas are poorly understood. Elevated blood pressure has an independent, positive association with risk for clinically detected uterine leiomyoma. Angiotensin II (Ang II) is a key biological peptide in the renin-angiotensin system that regulates blood pressure. In this study, we investigated the potential role of Ang II (1-1000 nM) in the proliferation of rat ELT-3 leiomyoma cells in vitro. RT-PCR and western blot analysis with cell proliferation and DNA transfection assays were performed to determine the mechanism of action of Ang II. Ang II induced ELT-3 leiomyoma cell proliferation (P estradiol-induced cell proliferation (P < 0.01). AT(1)R, but not AT(2)R, plays a role in Ang II-induced ELT-3 cell proliferation. These experimental findings in vitro highlight the potential role of Ang II in the proliferation of leiomyoma cells.

Ethnic variations in uterine leiomyoma biology are not caused by differences in myometrial estrogen receptor alpha levels.

NARCIS (Netherlands)

Amant, F.; Huys, E.; Geurts-Moespot, A.; Lindeque, B.G.; Vergote, I.; Sweep, C.G.J.; Schoenmakers, E.F.P.M.

2003-01-01

OBJECTIVE: Uterine leiomyomas develop in women of reproductive age and regress after menopause, suggesting that they grow in a steroid hormone-dependent fashion. Furthermore, it is widely accepted that symptomatic uterine leiomyomas occur at a twofold to threefold higher frequency in black women

The clinical application of uterine arterial embolization with dextran microspheres in treating uterine leiomyomas

International Nuclear Information System (INIS)

Xu Qiang; Huang Youhua; Shi Hongjian; Shen Tao; Zhou Huaming; Wu Xiaosong; Jiang Lei; Chen Jing; Chu Jumei

2011-01-01

Objective: To prospectively investigate the clinical application of bilateral uterine arterial embolization with dextran microspheres in treating uterine leiomyomas. Methods: A total of 60 patients with uterine leiomyomas, encountered in the authors' hospital during the period from Jan. 2003 to Dec. 2010, were enrolled in this study. The patients were randomly divided into study group and control group with 30 cases in each group. Patients in the study group received bilateral uterine artery embolization by using dextran microspheres (Sephadex, g-50, 100-300 μm) as embolic agents, while patients in control group received bilateral uterine artery embolization by using KMG (500-700 μm) as embolic agents. Before and after the treatment, all patients were kept under observation for the menstrual flow, the size of the uterine and the leiomyoma and the changes in sex hormone level. The hospitalization costs were recorded. The results were compared between the two groups. Results: The technical success rate of catheterization and embolization procedure was 100% in both groups. After the therapy, the volumes of both the uterine and the leiomyoma were significantly decreased, but no significant difference in the size reduction existed between the two groups (both P.0.05). The clinical symptoms were markedly improved in all patients. The sex hormone level showed no obvious changes. No serious complications occurred. The hospitalization cost of the study group was significantly lower than that of the control group (P<0.05). Conclusion: For the treatment of uterine leiomyomas, uterine artery embolization with dextran microspheres is very effective and safe. Moreover, the hospitalization cost is lower. Therefore, it is of value to use this technique in clinical practice. (authors)

Liesegang rings in renal cyst fluid.

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Katz, L B; Ehya, H

1990-01-01

Peculiar ring-like structures identified as Liesegang rings (LRs) were found in renal cyst fluid from three patients with benign renal cysts. They ranged in size from 5 to 820 mu. Most had a double-layer outer wall with equally spaced radial cross-striations and an amorphous central nidus. Special stains were performed in one case, and the results are discussed. Reports of LRs in cystic or inflamed tissues have recently appeared in the literature. Some LRs have been mistaken for eggs or mature components of the giant kidney worm, Dioctophyma renale. We propose that cytologic assessment of renal cyst fluid in conjunction with histologic examination decreases the likelihood of misdiagnosis of LRs.

Study on the relationship between the growth of uterine leiomyoma and the level of hormone in serum and the content of ER and PR in uterus

International Nuclear Information System (INIS)

Liu Manhua; Cheng Ying; Guan Weiqun; Tao Qian; Zheng Yanli; Yang Qichang

2003-01-01

Objective: To study the relationship between expressions of estrogen receptor (ER) and progesterone receptor (PR) in uterine leiomyoma, its adjacent sites and myometrium with the uterine leiomyoma. Methods: Expressions of ER and PR in uterine leiomyoma, its adjacent site and myometrium were determined by immunohistochemical SP method in 30 patients with uterine leiomyoma and serum prolactin (PRL), follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E 2 ), progesterone (P) and testosterone (T) concentrations were measured with radioimmunoassay, with normal cycling women served as the controls. Results: (1) contents of ER and PR were significantly higher in leiomyoma than in its adjacent site and myometrium (P 0.05). Conclusion: The growth of uterine leiomyoma is associated with strong expression of ER, PR in uterine tissue. When myometrectomy is performed, the myometrium around the leiomyoma should be cut at the same time

Primary Intraventricular Leiomyoma in an Immunocompetent Patient: First Case Report and Review of the Literature.

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Garces, Juanita; Mathkour, Mansour; Valle-Giler, Edison; Scullen, Tyler; Berry, J Franklin; Smith, Roger D

2016-06-01

Primary intracranial leiomyoma is an extremely rare occurrence of a low-grade mesenchymal tumor characterized by a proliferation of smooth muscle cells. When present, these lesions predominantly occur in immunocompromised patients in the setting of infection or transplant and have not been known to involve the ventricular system of the brain. In this report, we describe a case of primary leiomyoma of the lateral ventricle in an immunocompetent patient. A 30-year-old man with no medical history presented with progressive diplopia and occipital headaches. Magnetic resonance imaging of the brain revealed a homogenously enhancing mass of the left lateral ventricle with associated cerebral edema. The patient underwent interhemispheric transcallosal craniotomy for resection for symptom alleviation and surgical diagnosis. Histopathology and immunohistochemistry was subsequently consistent with that of leiomyoma. Genetic probing for Epstein-Barr virus was negative. Computed tomography of the chest and abdomen failed to uncover a primary tumor. The patient did well postoperatively and was discharged 3 days after resection. At a two-and-a-half year follow-up, there continued to be no radiologic or clinical evidence of recurrence. To date and to our knowledge, there are fewer than 25 reported cases of primary intracranial leiomyoma, with only 13 occurring in immunocompetent individuals. We believe this is the first report of this tumor type occurring within the ventricular system of the brain. As such, leiomyoma should be considered as a rare etiology in the differential diagnosis of intraventricular lesions. Copyright © 2016 Elsevier Inc. All rights reserved.

Ultrasonographic findings of uterine leiomyosarcoma: Differentiation from leiomyoma

International Nuclear Information System (INIS)

Song, Mi Jin; Kim, Jeong Ah

2003-01-01

To analyze the ultrasonographic findings of uterine leiomyosarcoma and to differentiate them from leiomyoma. From January 1998 to December 2001, a retrospective review of ultrasonographic findings of 7 patients with pathologically proven uterine leiomyosarcoma and 30 patients with leiomyoma was done. The mean size of leiomyosarcoma was 72 X 59 X 74 mm while the echogenicity, mixed. The shape of masses was round in five cases and ovoid in two. The margins of the mass were well-defined in five cases and partially indistinct in two. The locations of the mass were intramural in four cases, submucosal in two cases and indetermined in one case. The masses abutted the endometrium in four cases while invasion into the endometrium was seen in three. All masses were single. On the other hand, the mean size of leiomyoma was 52 X 45 X 49 mm. The echogenicities were homogenously hypoechoic in eighteen cases and mixed in twelve. The shape of masses was round in nineteen cases and ovoid in eleven cases. The margins of the mass were well-defined in twenty nine cases and partially indistinct in one case. The locations of the mass were intramural in twenty five cases, subserosal in four cases, and indetermined in one case. Separation between the masses and endometrium was definite in twenty two cases while the masses abutted the endometrium in seven cases. The invasion of the masses into the endometrium was noted in one case. Twenty five cases showed multiple masses while the remaining five cases were single mass. The possibility of leiomyosarcoma should be taken in to consideration when there is a single uterine mass larger than 7 cm that abutted the endometrium.

Ultrasonographic findings of uterine leiomyosarcoma: Differentiation from leiomyoma

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Song, Mi Jin; Kim, Jeong Ah [Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2003-12-15

To analyze the ultrasonographic findings of uterine leiomyosarcoma and to differentiate them from leiomyoma. From January 1998 to December 2001, a retrospective review of ultrasonographic findings of 7 patients with pathologically proven uterine leiomyosarcoma and 30 patients with leiomyoma was done. The mean size of leiomyosarcoma was 72 X 59 X 74 mm while the echogenicity, mixed. The shape of masses was round in five cases and ovoid in two. The margins of the mass were well-defined in five cases and partially indistinct in two. The locations of the mass were intramural in four cases, submucosal in two cases and indetermined in one case. The masses abutted the endometrium in four cases while invasion into the endometrium was seen in three. All masses were single. On the other hand, the mean size of leiomyoma was 52 X 45 X 49 mm. The echogenicities were homogenously hypoechoic in eighteen cases and mixed in twelve. The shape of masses was round in nineteen cases and ovoid in eleven cases. The margins of the mass were well-defined in twenty nine cases and partially indistinct in one case. The locations of the mass were intramural in twenty five cases, subserosal in four cases, and indetermined in one case. Separation between the masses and endometrium was definite in twenty two cases while the masses abutted the endometrium in seven cases. The invasion of the masses into the endometrium was noted in one case. Twenty five cases showed multiple masses while the remaining five cases were single mass. The possibility of leiomyosarcoma should be taken in to consideration when there is a single uterine mass larger than 7 cm that abutted the endometrium.

Primary Ovarian Leiomyoma: An Uncommon Entity ‑ Case Report ...

African Journals Online (AJOL)

Journal of Basic and Clinical Reproductive Sciences · January - June 2013 · Vol 2 · Issue 1. 54 ... case report of primary ovarian leiomyoma, which is a rare entity, in a postmenopausal female with ... There were extensive areas of edema.

Screening of potential biomarkers in uterine leiomyomas disease via gene expression profiling analysis.

Science.gov (United States)

Liu, Xuhui; Liu, Yanfei; Zhao, Jingrong; Liu, Yan

2018-05-01

The present study aimed to screen potential biomarkers for uterine leiomyomas disease, particularly target genes associated with the mediator of RNA polymerase II transcription subunit 12 (MED12) mutation. The microarray data of GSE30673, including 10 MED12 wild-type myometrium, 8 MED12 mutation leiomyoma and 2 MED12 wild-type leiomyoma samples, were downloaded from the Gene Expression Omnibus database. Compared with myometrium samples, differently-expressed genes (DEGs) in the MED12 mutation and wild-type leiomyoma samples were identified using the Limma package. The two sets of DEGs obtained were intersected to screen common DEGs. The DEGs in the MED12 mutation and wild-type leiomyoma samples, and common DEGs were defined as group A, B and C. Gene Ontology (GO) and pathway enrichment analyses were performed using the Database for Annotation, Visualization and Integrated Discovery online tool. Based on the Kyoto Encyclopedia of Genes and Genomes database, pathway relation networks were constructed. DEGs in GO terms and pathways were intersected to screen important DEGs. Subsequently, a gene co‑expression network was constructed and visualized using Cytoscape software. Reverse transcription‑quantitative polymerase chain reaction was used to detect the expression levels of important DEGs. A total of 1,258 DEGs in group A were screened, and enriched for extracellular matrix (ECM) organization and ECM‑receptor interaction. In addition, a total of 1,571 DEGs in group B were enriched for cell adhesion. Furthermore, 391 DEGs were involved in extracellular matrix organization. Pathway relation networks of group A, B and C were constructed with nodes of 48, 39, and 28, respectively. Finally, 135 important DEGs were obtained, including Acyl‑CoA synthetase medium‑chain family member 3, protein S (α) (PROS1) and F11 receptor. A gene co‑expression network with 68 nodes was constructed. The expression of caspase 1 (CASP1) and aldehyde dehydrogenase 1 family member

The evaluation of quality of life associated with uterine artery embolization in the treatment of leiomyomas

International Nuclear Information System (INIS)

Huang Mingsheng; Shan Hong; Jiang Zaibo; Guan Shouhai; Zhu Kangshun; Li Zhengran; Ma Zhuang; Li Yanhao; Li Bing

2002-01-01

Objective: To evaluate the change in quality of life associated with uterine leiomyoma embolization in comparison with surgical treatment. Methods: In a consecutive prospective, randomized and controlled study, the patients with symptomatic uterine leiomyomas in hospital were randomly assigned to uterine artery embolization group (UAEG) and surgical treatment group (STG) from January 2000 to February 2001. Quality of life of patients was investigated with the uterine leiomyomas symptom questionnaire and SF-36 Chinese questionnaire before and 6 months after the procedure in two groups. The changes of quality of life scores from baseline to 6 months were analyzed. Results: There were 279 patients (140 of STG, 139 of UAEG) with symptomatic uterine leiomyomas who entered the study. 218 (118 of UAEG, 100 of STG) cases completed the 6-month questionnaires. In UAEG, the scores of quality of life in all instances improved at follow-up (P<0.001). In STG, the mean scores of quality of life also improved at follow-up assessment except the scores of sexual function items (P<0.001). The mean change scores from baseline to 6 months in sexual function, general health, vitality, role-emotional, mental health, and reported health transition were statistically significant between UAEG and STG (P<0.001), and the former were higher than the latter. Conclusion: The treatment of uterine artery embolization for uterine leiomyomas is better than surgical therapy on the improvement of quality of life

Hypointensity on postcontrast MR imaging from compression of the sacral promontory in enlarged uterus with huge leiomyoma and adenomyosis

International Nuclear Information System (INIS)

Uotani, Kensuke; Monzawa, Shuichi; Adachi, Shuji; Takemori, Masayuki; Kaji, Yasushi; Sugimura, Kazuro

2007-01-01

In patients with huge leiomyoma and with adenomyosis of the uterus, a peculiar area of hypointensity was occasionally observed on postcontrast magnetic resonance (MR) imaging in the dorsal portion of the enlarged uterus near the sacral promontory. We describe the imaging characteristics of these MR findings and correlate them with histopathological findings to examine whether the areas represent specific pathological changes. Ten patients with huge leiomyomas and two with huge adenomyotic lesions whose imaging revealed the hypointensity were enrolled. All had enlarged uteri that extended beyond the sacral promontory. MR findings of the hypointense areas were evaluated and correlated with histopathological findings in 5 patients with leiomyoma and two with adenomyosis who had hysterectomy. The ten patients with leiomyoma showed flare-shaped hypointensity arising from the dorsal surface of the uterine body that extended deep into the tumor. The base of the hypointense areas was narrow in 5 patients with intramural leiomyoma and broad in five with subserosal leiomyoma. Two patients with adenomyosis showed nodular-shaped areas of hypointensity in front of the sacral promontory. Precontrast T 1 - and T 2 -weighted MR images showed no signal abnormalities in the portions corresponding to the hypointensity in any of the 12 patients. Pathological examinations showed no specific findings in the portions corresponding to the hypointensity in the 7 patients who had hysterectomy. The areas of hypointensity may represent functional changes, such as decreased localized blood flow caused by compression of the sacral promontory. (author)

Dyspareunia in a Teenager Reveals a Rare Occurrence: Retroperitoneal Cervical Leiomyoma of the Left Pararectal Space.

Science.gov (United States)

Giannella, Luca; Mfuta, Kabala; Tuzio, Antonella; Cerami, Lillo Bruno

2016-02-01

Retroperitoneal uterine leiomyoma is a very rare occurrence and to discover it as a cause of female sexual dysfunction in a teen is unusual. An 18-year-old black woman reported deep dyspareunia, resulting in severe distress. Gynecological and instrumental examinations showed a pelvic mass of 7 cm in diameter. The preoperative diagnosis was uterine fibroid, but the exact location of the leiomyoma was uncertain. Laparoscopic examination showed a pedunculated retroperitoneal cervical leiomyoma in the left pararectal space. After surgical excision of the mass, normal sexual activity was restored. When a teen experiences pain with intercourse, pelvic masses should be part of differential diagnosis of dyspareunia. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Cytochrome P2A13 and P1A1 gene polymorphisms are associated with the occurrence of uterine leiomyoma.

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Herr, D; Bettendorf, H; Denschlag, D; Keck, C; Pietrowski, D

2006-10-01

To investigate the association between the occurrence of uterine leiomyoma and two SNPs of the CYP 2A13 and CYP 1A1 genes. Prospective case control study with 132 women with clinically and surgically diagnosed uterine leiomyoma and 260 controls. Genotyping was performed by polymerase chain reaction (PCR) based amplification of CYP 2A13 and CYP 1A1 genes, and restriction fragment length polymorphism (RFLP) analysis. Comparing women with uterine leiomyoma and controls, we demonstrate statistical significant differences of allele frequency and genotype distribution for the CYP 1A1 polymorphism (P = 0.025 and P = 0.046, respectively). Furthermore, for the CYP 2A13 polymorphism we found a significant difference concerning allele frequency (P = 0.033). However, for the genotype distribution, only borderline significance was observed (P = 0.064). The CYP 2A13 and CYP 1A1 SNPs are associated with uterine leiomyoma in a Caucasian population and may contribute to the understanding of the pathogenic mechanisms of uterine leiomyoma.

Laparoscopic management of a twisted ovarian leiomyoma in a woman with 10 weeks' gestation: Case report and literature review.

Science.gov (United States)

Kim, Myounghwan

2016-11-01

Primary leiomyoma of the ovary is a rare benign ovarian tumor that only seldom causes acute abdomen. A 35-year-old gravida 1, para 0 woman presented with a history of acute lower abdominal pain, and 10 weeks of amenorrhea. The patient's physical examination revealed abdominal tenderness, defense, and rebound. On ultrasonographic examination, a solid mass measuring 9.3 × 7.8 cm was detected adjacent to the uterine fundus. The mass was preoperatively diagnosed as a twisted pedunculated subserosal uterine myoma. Upon entering the pelvic cavity, the mass in the right adnexa appeared twisted clockwise. Therefore, a laparoscopic salpingo-oophorectomy was performed. The tumor was pathologically diagnosed as ovarian leiomyoma. The patient delivered a healthy girl at 40 1/7 weeks of pregnancy. Despite its low incidence, torsion of ovarian leiomyoma should be considered in the differential diagnosis of acute abdomen. Furthermore, laparoscopic exploration should be the preferred way of removing twisted ovarian leiomyoma, even during pregnancy. It seems that primary ovarian leiomyomata have a tendency to grow rapidly during early pregnancy. However, because of the low incidence of ovarian leiomyoma, the effects of estrogen and pregnancy on this condition remain unclear.

A primary leiomyoma in the neural foramen of the lumbar spine: a case report

Energy Technology Data Exchange (ETDEWEB)

Jang, Jong Chang; Kang, Byeong Seong; Kim, Young Min; Park, Moon Soo; Jeong, Ae Kyung; Yang, Myeon Jun; Hwang, Jae Cheol [University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan (Korea, Republic of)

2007-12-15

A primary leiomyoma in the neural foramen of the lumbar spine is a very rare condition. We examined a 23-year-old female presented with back and right flank pain. A plain radiography showed a well-defined, osteolytic lesion in the L3 body. In addition, MR images showed a mass lesion with intense enhancement, after intravenous injection with contrast material, in the right neural foramen at the L2/3 level. A histopathologic examination of the resected specimen revealed a benign leiomyoma.

Identification of CUX1 as the recurrent chromosomal band 7q22 target gene in human uterine leiomyoma

NARCIS (Netherlands)

Schoenmakers, E.F.P.M.; Bunt, J.; Hermers, L.; Schepens, M.; Merkx, G.; Janssen, B.; Kersten, M.; Huys, E.; Pauwels, P.; Debiec-Rychter, M.; Geurts van Kessel, A.

2013-01-01

Uterine leiomyomas are benign solid tumors of mesenchymal origin which occur with an estimated incidence of up to 77% of all women of reproductive age. The majority of these tumors remains symptomless, but in about a quarter of cases they cause leiomyoma-associated symptoms including chronic pelvic

Combined use of T2-weighted and diffusion-weighted 3-T MR imaging for differentiating uterine sarcomas from benign leiomyomas

International Nuclear Information System (INIS)

Namimoto, Tomohiro; Yamashita, Yasuyuki; Awai, Kazuo; Nakaura, Takeshi; Yanaga, Yumi; Hirai, Toshinori; Saito, Tetsuo; Katabuchi, Hidetaka

2009-01-01

The objective of our study was to compare diffusion-weighted imaging (DWI) alone and DWI combined with T2-weighted MRI for the differentiation of uterine sarcomas from benign leiomyomas. T2-weighted imaging and DWI were performed in 103 patients with 103 myometrial tumours, including 8 uterine sarcomas and 95 benign leiomyomas on 3-T MR imaging. The signal intensity (SI) of the tumour on T2-weighted images was quantified as the tumour-myometrium contrast ratio (TCR) by using the following formula: (SI tumour - SI myometrium )/SI myometrium . The TCR or apparent diffusion coefficient (ADC) value alone and then the ADC value combined with T2-weighted imaging were evaluated for differentiation between sarcomas and leiomyomas. The mean ADC value of sarcomas was 0.86 ± 0.11 x 10 -3 m 2 /s, which was significantly lower than that of leiomyomas 1.18 ± 0.24 x 10 -3 m 2 /s; however, there was a substantial overlap. The mean TCR of sarcomas was 0.66 ± 0.71, which was significantly higher than that of the leiomyomas, -0.37 ± 0.34; however, again, there was a considerable overlap. When ADC was less than 1.05 x 10 -3 mm 2 /s and TCR was greater than 0 this condition was considered to confirm a sarcoma; a combination of ADC and TCR achieved a significant improvement without any overlap between sarcomas and leiomyomas (sensitivity 100%, specificity 100%). Our preliminary results indicate that combined DWI and T2-weighted MR imaging is better than DWI alone in the differentiation of uterine sarcomas from benign leiomyomas. (orig.)

Uterine artery embolization for uterine leiomyomas: impact on serum level of sex hormones

International Nuclear Information System (INIS)

Fu Shouzhong; Dai Feng; Zhang Lihua; Ding Wei; Wang Xiaowei; Wang Xiaoyan; Wang Jianhua

2007-01-01

Objective: To investigate the impact of uterine artery embolization (UAE) for leiomyomas of uterus on serum level of sex hormones. Methods: UAE were performed on 31 patients with leiomyomas of uterus. Changes of menses were followed up within 3-6 months after UAE. Serum levels of sex hormones, including FSH, LH, Prog, E2 were tested before and 3 months or 6 months after UAE; and simultaneously with recording the tumor size and the changes of blood dynamics by color Doppler. Results: Twenty-five patients (80.6%)with menorrhagia resumed normal after UAE, and a transient menstrual disorder occurred in 4 patients (12.9%). Only 2 patients (0.06%)aged 45 years and 49 years became menopausal following the procedure. Serum levels of sex hormones showed no significant difference before and 3 months or 6 months after UAE (P>0.05)in 31 patients. Conclusion: UAE is an effective treatment for uterine leiomyomas and possesses no influence on serum levels of sex hormones. However, for patients aged 45 or older, there is possibility of menopause. (authors)

Leiomyoma Cells in 3-Dimensional Cultures Demonstrate an Attenuated Response to Fasudil, a Rho-Kinase Inhibitor, When Compared to 2-Dimensional Cultures

Science.gov (United States)

Malik, Minnie; Britten, Joy; Segars, James

2014-01-01

Uterine leiomyomata are common benign tumors in women of reproductive age and demonstrate an attenuated response to mechanical signaling that involves Rho and integrins. To further characterize the impairment in Rho signaling, we studied the effect of Rho-kinase inhibitor, fasudil, on extracellular matrix production, in 2-dimensional (2D) and 3-dimensional (3D) cultures of leiomyoma and myometrial cells. Leiomyoma 2D cultures demonstrated a rapid decrease in gene transcripts and protein for fibronectin, procollagen 1A, and versican. In 3D cultures, fibronectin and procollagen 1A proteins demonstrated increased levels at lower concentrations of fasudil, followed by a concentration-dependent decrease. Versican protein increased up to 3-fold, whereas fibromodulin demonstrated a significant decrease of 1.92-fold. Myometrial 2D or 3D cultures demonstrated a decrease in all proteins after 72 hours of treatment. The 3D leiomyoma cultures demonstrated a significant increase in active RhoA, followed by a concentration-dependent decrease at higher concentrations. A concentration-dependent increase in phospho-extracellular regulated signal kinase and proapoptotic protein Bax was observed in 3D leiomyoma cultures. Fasudil relaxed the contraction of the 3D collagen gels caused by myometrium and leiomyoma cell growth. These findings indicate that the altered state of Rho signaling in leiomyoma was more clearly observed in 3D cultures. The results also suggest that fasudil may have clinical applicability for treatment of uterine leiomyoma. PMID:25084783

Role of magnetic resonance imaging (MRI) establishing the indication for, planning, and following up uterine artery embolization (UAE) for treating symptomatic leiomyomas of the uterus

International Nuclear Information System (INIS)

Kroencke, T.J.; Hamm, B.

2003-01-01

To describe the role of magnetic resonance imaging (MRI) in establishing the indication for, planning, and following up uterine artery embolization (UAE) for treating symptomatic leiomyomas of the uterus on the basis of the current literature and our results. Retrospective analysis of the MRI findings obtained in 130 patients before and after UAE. Presentation of characteristic MRI features and their relevance in establishing the indication for, performing, and following up of UAE. Discussion of the results in conjunction with published data. The intermediate results of UAE reported in the literature show a successful improvement of leiomyoma-related symptoms in 82-94% of cases and an average reduction of leiomyoma size by 36-64%. The typical MRI appearance of degenerating leiomyomas is presented together with that of relevant differential diagnoses. MRI findings allow for establishing the indication for UAE by providing reliable information on the location, size, and number of uterine leiomyomas. Analysis of 60 patients of our study population showed solitary leiomyoma in 16% of cases, 2-10 leiomyomas in 47%, and over 10 in 37%. Subserosal, pedunculated leiomyomas cannot be treated by UAE; these were present in 5% of the patients. MR angiography is useful in assessing pelvic vascular anatomy before the intervention and identifies collateral vascular supply to the uterus. Contrast-enhanced imaging is suitable for monitoring successful devascularization following embolization and evaluating complications. (orig.) [de

Inactivation of AKT Induces Cellular Senescence in Uterine Leiomyoma

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Xu, Xiaofei; Lu, Zhenxiao; Qiang, Wenan; Vidimar, Vania; Kong, Beihua

2014-01-01

Uterine leiomyomas (fibroids) are a major public health problem. Current medical treatments with GnRH analogs do not provide long-term benefit. Thus, permanent shrinkage or inhibition of fibroid growth via medical means remains a challenge. The AKT pathway is a major growth and survival pathway for fibroids. We propose that AKT inhibition results in a transient regulation of specific mechanisms that ultimately drive cells into cellular senescence or cell death. In this study, we investigated specific mechanisms of AKT inhibition that resulted in senescence. We observed that administration of MK-2206, an allosteric AKT inhibitor, increased levels of reactive oxygen species, up-regulated the microRNA miR-182 and several senescence-associated genes (including p16, p53, p21, and β-galactosidase), and drove leiomyoma cells into stress-induced premature senescence (SIPS). Moreover, induction of SIPS was mediated by HMGA2, which colocalized to senescence-associated heterochromatin foci. This study provides a conceivable molecular mechanism of SIPS by AKT inhibition in fibroids. PMID:24476133

Experimental study on ablation of leiomyoma by combination high-intensity focused ultrasound and iodized oil in vitro.

Science.gov (United States)

Liang, Zhi-Gang; Gao, Yi; Ren, Xiao-Yan; Sun, Cui; Gu, Heng-Fang; Mou, Meng; Xiao, Yan-Bing

2017-10-01

The aim of the current study was to investigate whether iodized oil (IO) enhances high-intensity focused ultrasound (HIFU) ablation of uterine leiomyoma and to determine the features of hyperechoic changes in the target region. Forty samples of uterine leiomyoma were randomly divided into an experimental group and a control group. In the experimental group, the leiomyoma was ablated by HIFU 30 min after 1 mL of iodized oil had been injected into the center of the myoma. The hyperechoic values and areas in the target region were observed by B-modal ultrasound after HIFU ablation. The samples were cut successively into slices and stained by triphenyltetrazolium chloride (TTC) solution within 1 h after HIFU ablation. The diameters of TTC-non-stained areas were measured and tissues in the borderline of the TTC-stained and -non-stained areas were observed pathologically. All procedures in the control group were the same as those in the experimental group except IO was replaced by physiological saline. The hyperechoic value in the target region in the experimental group was higher than that in the control group 4 min after HIFU ablation (P leiomyoma occurred in the target region in both groups. IO causes coagulation necrosis, enlarges tissue damage, and postpones the attenuation of hyperechoic changes in the target region when HIFU ablation is carried out for leiomyoma in vitro. © 2017 Japan Society of Obstetrics and Gynecology.

Evaluation of the antiproliferative, proapoptotic, and antiangiogenic effects of a double-stranded RNA mimic complexed with polycations in an experimental mouse model of leiomyoma.

Science.gov (United States)

García-Pascual, Carmen Maria; Ferrero, Hortensia; Juarez, Irene; Martínez, Jessica; Villanueva, Ana; Pozuelo-Rubio, Mercedes; Soengas, Marisol; Tormo, Damiá; Simón, Carlos; Gómez, Raúl; Pellicer, Antonio

2016-02-01

To assess the antiproliferative, proapoptotic, and antiangiogenic effects of the double-stranded RNA mimic polyinosine-polycytidylic acid (pIC) complexed with polyethylenimine [pIC(PEI)] in xenografted human leiomyomas. Heterologous leiomyoma mouse model. University-affiliated infertility center. Ovariectomized and hormone-replaced nude mice (n = 16) who received human leiomyoma fragment transplantation. Leiomyoma fragments placed in the peritoneum of 5-week-old nude female mice and treated with the vehicle (n = 8) or 0.6 mg/kg [pIC(PEI)] (n = 8) for 4 weeks. The size of the leiomyoma implants, and cellular proliferation (Ki67), vascularization (PECAM), and apoptosis (OH-ends) assessed by quantitative immunohistochemical/immunofluorescent analysis of the recovered implants. No significant differences were observed in the size of the leiomyoma implants between groups. Vascularization and proliferation were significantly decreased, and apoptosis was increased in the [pIC(PEI)]-treated group versus control. We hypothesize that the antiangiogenic and apoptotic effects exerted by [pIC(PEI)] might lead to a decrease in lesion size in this animal model if the compound is administered for longer periods of time. This study provides promising data on [pIC(PEI)] as a potential novel therapeutic agent against human leiomyoma. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Systematic analysis of gene expression pattern in has-miR-197 over-expressed human uterine leiomyoma cells.

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Ling, Jing; Wu, Xiaoli; Fu, Ziyi; Tan, Jie; Xu, Qing

2015-10-01

Our previous study showed that the expression of miR-197 in leiomyoma was down-regulated compared with myometrium. Further, miR-197 has been identified to affect uterine leiomyoma cell proliferation, apoptosis, and metastasis ability, though the responsible molecular mechanism has not been well elucidated. In this study, we sought to determine the expression patterns of miR-197 targeted genes and to explore their potential functions, participating Pathways and the networks that are involved in the biological behavior of human uterine leiomyoma. After transfection of human uterine leiomyoma cells with miR-197, we confirmed the expression level of miR-197 using quantitative real-time PCR (qRT-PCR), and we detected the gene expression profiles after miR-197 over-expression through DNA microarray analysis. Further, we performed GO and Pathway analysis. The dominantly dys-regulated genes, which were up- or down-regulated by more than 10-fold, compared with parental cells, were confirmed using qRT-PCR technology. Compared with the control group, miR-197 was up-regulated by 30-fold after miR-197 lentiviral transfection. The microarray data showed that 872 genes were dys-regulated by more than 2-fold in human uterine leiomyoma cells after miR-197 overexpression, including 537 up-regulated and 335 down-regulated genes. The GO analysis indicated that the dys-regulated genes were primarily involved in response to stimuli, multicellular organ processes, and the signaling of biological progression. Further, Pathway analysis data showed that these genes participated in regulating several signaling Pathways, including the JAK/STAT signaling Pathway, the Toll-like receptor signaling Pathway, and cytokine-cytokine receptor interaction. The qRT-PCR results confirmed that 17 of the 66 selected genes, which were up- or down-regulated more than 10-fold by miR-197, were consistent with the microarray results, including tumorigenesis-related genes, such as DRT7, SLC549, SFMBT2, FLJ37956

Treatment of uterine leiomyoma with magnetic resonance-guided focused ultrasound surgery (MRgFUS)

International Nuclear Information System (INIS)

Fukunishi, Hidenobu

2007-01-01

Uterine leiomyoma is the most common pelvic tumor in women. Although hysterectomy has long been the standard treatment for uterine myoma, some uterus-preserving alternatives are available today. Among these, magnetic resonance-guided focused ultrasound surgery (MRgFUS) is a minimally-invasive procedure that uses high intensity ultrasound waves to ablate tissue. The present study investigates the efficacy of MRgFUS in the treatment of uterine myoma and the histopathological features on extirpated myoma tissue, when alternative surgical treatment is requisite. The Ethics Committee of Shinsuma Hospital approved the treatment of uterine myoma by MRgFUS, and written informed consent was obtained from all of the patients in compliance with the principles of good clinical practice. Between June 2004 and March 2007, 81 premenopausal patients with 125 myomas confirmed by T2-weighted MRI were treated by MRgFUS. The myomas were classified into 3 types based on signal intensity of T2-weighted images type I, low intensity; type II, intermediate intensity and type III, high intensity. The ablation (the non-perfused ratio of gadolinium injection) was about 55% in type I and type II, and 38% in type III. There was no correlation between the ablation ratio and the location or the size of the myoma. The uterine muscle was spared ablation when 2 combined myomas were treated as one tumor, suggesting that the vascularity was richer in the uterine muscle layer than in the myoma Sufficient ablation of the myoma near the Os sacrum is not able to attain immediately after the treatment; however, in several cases a complete non-perfusion margin was observed 3 or 6 months after the treatment. These cases yield very satisfactory results and it is meaningful to search for the reason why such good results were induced. Alternative treatment such as hysterectomy, myomectomy, trans cervical resection (TCR) or uterine artery embolization (UAE) was indicated for 13.6% of the patients. Here, we

Contribution of X-Ray Repair Complementing Defective Repair in Chinese Hamster Cells 3 (XRCC3) Genotype to Leiomyoma Risk.

Science.gov (United States)

Chang, Wen-Shin; Tsai, Chia-Wen; Wang, Ju-Yu; Ying, Tsung-Ho; Hsiao, Tsan-Seng; Chuang, Chin-Liang; Yueh, Te-Cheng; Liao, Cheng-Hsi; Hsu, Chin-Mu; Liu, Shih-Ping; Gong, Chi-Li; Tsai, Chang-Hai; Bau, Da-Tian

2015-09-01

The present study aimed at investigating whether X-ray repair cross complementing protein 3 (XRCC3) genotype may serve as a useful marker for detecting leiomyoma and predicting risk. A total of 640 women (166 patients with leiomyoma and 474 healthy controls) were examined for their XRCC3 rs1799794, rs45603942, rs861530, rs3212057, rs1799796, rs861539, rs28903081 genotype. The distributions of genotypic and allelic frequencies between the two groups were compared. The results showed that the CT and TT genotypes of XRCC3 rs861539 were associated with increased leiomyoma risk (odds ratio=2.19, 95% confidence interval=1.23-3.90; odds ratio=3.72, 95% confidence interval=1.23-11.26, respectively). On allelic frequency analysis, we found a significant difference in the distribution of the T allelic frequency of the XRCC3 rs861539 (p=5.88 × 10(-5)). None of the other six single nucleotide polymorphisms were associated with altered leiomyoma susceptibility. The T allele (CT and TT genotypes) of XRCC3 rs861539 contributes to increased risk of leiomyoma among Taiwanese women and may serve as a early detection and predictive marker. Copyright© 2015 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Expression study of CYP19A1 gene in a cohort of Iranian leiomyoma patients

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Leila Emrahi

2018-07-01

Full Text Available Background: CYP19A1 gene encodes aromatase, a microsomal key enzyme that catalyzes the synthesis of estrogens from androgens. Accumulating evidence has revealed that aromatase plays an important role in the pathogenesis of leiomyoma through increasing local concentration of estrogens. In this study, we examined the levels of CYP19A1 mRNA to determine the impact of aromatase overexpression in uterine leiomyoma growth. Subjects and methods: Tissues were obtained via myomectomy or hysterectomy from 30 patients. Total RNA was extracted and cDNA was synthesized from each frozen sample. Using SYBR Green dye, Real-time PCR assay was performed by sequence-specific primers. Relative mRNA expression was normalized to the mean of the Ct values determined for HPRT1. Gene expression ratio in each sample was determined relative to the mean ΔCt value of tumor-free margin samples. Results: PCR efficiencies for amplification reactions of HPRT1, and CYP19A genes were calculated as 0.93 and 0.96, respectively. Regression coefficients (R for standard curves were above 0.90. The obtained data revealed that the mean fold increase of CYP19A1 gene expression in leiomyoma samples relative to normal samples was 3.551 (95% CI: 0.04–6.64, S.E., 0.29–5.35. Conclusions: Our results were in accordance with previous studies and imply that up-regulation of CYP19A1 is correlated with the pathogenesis of leiomyoma tumors. We also observed that expression level of CYP19A1 was not linked to the tumor size or localization. It can be concluded that; up-regulation of aromatase is a key factor in the initiation of tumor development as well as tumor growth. Keywords: Leiomyoma, CYP19A1, Real-time PCR, Gene expression study

Echography and computed tomography in the diagnosis of gastric leiomyoma

International Nuclear Information System (INIS)

Bujlov, V.M.; Borisanov, A.V.; Bessarab, A.V.

1998-01-01

Case of the diagnosis of gastric leiomyoma identified by ultrasonic scanning (USS) and computerized tomography (CT) (X-ray and endoscopic data are negative) is described. Presented observation shows the high efficiency of transabdominal USS and CT in revealing exogastric neoplasm

Radiological appearances of degenerative uterine leiomyomas

International Nuclear Information System (INIS)

Tzvetankov, K.; Hadjidekov, G.; Plachkov, I.; Yankova, M.

2013-01-01

Uterine fibroids, also known as leiomyomas, are the most common uterine neoplasms. Although benign, they can be associated with significant morbidity and are the commonest indication for hysterectomy. They are often discovered incidentally when performing imaging for other reasons. Usually first identified with US, they can be further characterized with MRI. They are usually easily recognizable, but degenerate fibroids can have unusual appearances. Knowledge of the different appearances of fibroids on imaging is important as it enables prompt diagnosis and thereby guides treatment. (authors)

1 Bizarre presentation of bilateral ovarian leiomyoma: a case report

African Journals Online (AJOL)

ovarian leiomyoma. Challenges remain in the management of bilateral primary ovarian tumours, especially for young and nulliparous women. Pre-laparotomy diagnostic ... normal external genitalia, vaginal mucosa appeared to be smooth, cervix was healthy and ... Both masses had irregular surface with some cystic areas.

Disease: H00804 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available H00804 Multiple cutaneous and uterine leiomyomata Multiple cutaneous and uterine leiomyoma...patients with MCUL develop renal cancer and this condition is called hereditary leiomyoma... mutations in multiple cutaneous and uterine leiomyomatosis, hereditary leiomyomatosis and renal cancer, and...th a diffuse variant of cutaneous leiomyomatosis (Reed's syndrome). ... JOURNAL ... Dermatology 221:378-80 (2010) DOI:10.1159/000321336

Racial and Ethnic Differences in the Pathogenesis and Clinical Manifestations of Uterine Leiomyoma

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Catherino, William H.; Eltoukhi, Heba M.; Al-Hendy, Ayman

2014-01-01

Uterine leiomyomas are the most common benign gynecologic condition. The prevalence is three times more common among women of African ethnicity. Disparity in this disease is evidenced by earlier age of onset, greater severity of symptoms, and different response to treatment. Although the pathogenesis of disease development is not completely known, growing evidence focuses on investigating the molecular mechanisms in disease development and the influence of ethnicity. Variation in the expression levels or function of estrogen and progesterone receptors, polymorphism of genes involved in estrogen synthesis and/or metabolism (COMT, CYP17), retinoic acid nuclear receptors (retinoid acid receptor-α, retinoid X receptor-α), and aberrant expression of micro-RNAs (miRNAs) are some of the molecular mechanisms that may be involved. Nutritional factors, such as vitamin D deficiency, might also contribute to the higher incidence in dark skinned populations who are also commonly suffer from hypovitaminosis D. Culture and environmental difference might have a role in disease development. Further analysis and better understanding of these mechanisms will provide insight into the molecular basis of racial disparities in leiomyoma formation and will help to develop new innovations in leiomyoma treatment. PMID:23934698

Recent scientific advances in leiomyoma (uterine fibroids) research facilitates better understanding and management.

Science.gov (United States)

Taylor, Darlene K; Holthouser, Kristine; Segars, James H; Leppert, Phyllis C

2015-01-01

Uterine leiomyomas (fibroids) are the most prevalent medical problem of the female reproductive tract, but there are few non-surgical treatment options. Although many advances in the understanding of the molecular components of these tumors have occurred over the past five years, an effective pharmaceutical approach remains elusive. Further, there is currently no clinical method to distinguish a benign uterine leiomyoma from a malignant leiomyosarcoma prior to treatment, a pressing need given concerns about the use of the power morcellator for minimally invasive surgery. This paper reviews current studies regarding the molecular biology of uterine fibroids, discusses non-surgical approaches and suggests new cutting-edge therapeutic and diagnostic approaches.

Hypovolemic Shock and Hemoperitoneum from Spontaneous Avulsion of a Large Pedunculated Uterine Leiomyoma.

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Mizrahi, Daniel J; Kaushik, Chhavi; Adamo, Robert

2017-03-01

Hemoperitoneum with hypovolemic shock from avulsion of a pedunculated leiomyoma is a rare but highly fatal condition that can occur spontaneously or as a result of trauma. We report a case of hemoperitoneum and hypovolemic shock secondary to a bleeding leiomyoma detected via computed tomography (CT) scan in a 39 year old premenopausal, gravida 0 female that presented with abdominal pain and became hemodynamically unstable in the emergency department. A preoperative bimanual exam revealed a mass consistent with a 20 week gestational uterus. Following fluid resuscitation, the patient underwent emergent myomectomy and ligation of the right uterine artery and was discharged home in good condition.

Benign metastasizing leiomyoma in triple location: lungs, parametria and appendix

Directory of Open Access Journals (Sweden)

Renata Raś

2016-07-01

Full Text Available Benign metastasizing leiomyoma (BML usually are situated in one organ, most often in lungs. BML patients typically have a history of uterine leiomyoma treated with hysterectomy, myomectomy or subtotal hysterectomy. The aim of the study was to present the case of a 53-year-old woman with triple location in the lungs, parametria and appendix. She had undergone a myomectomy 26 years earlier. In 2015, she was admitted to the surgical department because of abdominal pain, whereupon a cholecystectomy was performed. CT scans showed pelvic mass with pulmonary metastasis. Upon discharge the patient was referred to the Gynecology Clinic, where a laparotomy was performed. The intraoperative findings were: 1 uterus with multiple leiomyomas, 2 four tumors in the parametria, 3 tumor connected to the appendix. A subtotal hysterectomy, with a bilateral salpingo-oophorectomy, removal of the tumors from the parametria and appendectomy was performed. Pathology confirmed the diagnosis based on morphology and immunohistochemical staining (strongly positive for estrogen receptors and SMA, while Ki67 was very low, below 1%. Upon postoperative recovery, the patient was referred to the Thoracic Surgery Department. During the thoracotomy, multiple nodes, surrounded by lung parenchyma, were revealed. Wedge resection was performed, for localized pulmonary lesions, and sent for pathological examination. The final pathological diagnosis was benign metastasizing leiomyomatosis. In conclusion, the triple location of BML could possibly be a result of a parallel different metastasizing mechanism, although it is impossible to exclude one mechanism, which may be the cause of the metastases in three locations.

Pathological findings of uterine tumors preoperatively diagnosed as red degeneration of leiomyoma by MRI.

Science.gov (United States)

Nakai, Go; Yamada, Takashi; Hamada, Takamitsu; Atsukawa, Natsuko; Tanaka, Yoshikazu; Yamamoto, Kiyohito; Higashiyama, Akira; Juri, Hiroshi; Nakamoto, Atsushi; Yamamoto, Kazuhiro; Hirose, Yoshinobu; Ohmichi, Masahide; Narumi, Yoshifumi

2017-07-01

Venous infarction of a leiomyoma is known as red degeneration of leiomyoma (RDL) and can be a cause of acute abdomen. Although magnetic resonance imaging (MRI) is the only modality that can depict the inner condition of a leiomyoma, the typical MR findings of RDL are sometimes identified incidentally even in asymptomatic patients. The purpose of this study is to clarify common pathological findings of uterine tumors preoperatively diagnosed as RDL by MRI. We diagnosed 28 cases of RDL by MRI from March 2007 to April 2015. The ten lesions subjected to pathological analysis after resection were included in the study and reviewed by a gynecological pathologist. The average time from MRI to operation was 4.7 months. The typical beefy-red color was not observed on the cut surface of the tumor except in one tumor resected during the acute phase. All lesions diagnosed as RDL by MRI had common pathological findings consistent with red degeneration of leiomyoma, including coagulative necrosis. Other common pathological features of RDL besides extensive coagulative necrosis appear to be a lack of inflammatory cell infiltrate or hemorrhage in the entire lesion. Although RDL is known to cause acute abdomen, its typical MR findings can be observed even in asymptomatic patients in a condition that manifests long after red degeneration. The characteristic pathological findings in both the acute phase and the chronic phase that we found in this study, along with radiology reports, will be helpful references for gynecologists and pathologists in suspecting a history of red degeneration and confirming the diagnosis.

The construction of digital 3D arterial vascular network of uterine leiomyomas and its clinical significance

International Nuclear Information System (INIS)

Chen Chunlin; Xu Yujing; Liu Ping

2012-01-01

Objective: To discuss the method of constructing digital 3D arterial vascular network of uterine leiomyomas based on the CTA data, by which to lay the fundamental work for the observation of the origin and distribution of hysteromyoma blood supply. Methods: A total of 64 cases of uterine leiomyomas were enrolled in this study. Dual-source CT angiography was performed in all the patients, and the CTA original images were obtained. By using Mimics 10.01 software the digital 3D arterial vascular network of uterine was reconstructed. The reconstructed models were analyzed. Results: (1) The constructing process of arterial vascular network was successfully accomplished in all 64 patients. The pelvic main arteries, the uterine arteries and tumor-feeding arteries as well as the blood distribution type were clearly demonstrated on the reconstructed images. (2) The origins of hysteromyoma blood supply included uterine artery (81.25%), uterine artery and unilateral ovarian artery (10.94%), uterine artery and bilateral ovarian artery (4.69%) and ovarian artery (3.12%). (3) Distribution pattern of blood supply of uterine leiomyomas could be divided into 4 types: (1) Type Ⅰ. The unilateral arterial blood supply dominant type (unilateral uterine artery with or without ipsilateral ovarian arterial, providing more than 1/2 blood supply of hysteromyoma), which accounted for 35.94% of all patients (23/26); (2) Type Ⅱ. The bilateral arterial blood supply balanced type (bilateral uterine artery with or without ipsilateral ovarian artery, providing about 1/2 blood supply of hysteromyoma), which accounted for 53.13% of all patients (34/64); (3) Type Ⅲ. The unilateral uterine artery was the main blood supply of uterine leiomyomas, which accounted for 7.81% of all patients (5/64); (4) Type Ⅳ. The ovarian artery was the main blood supply of uterine leiomyomas, which accounted for 3.13% of all patients (3/64). Conclusion: Based on CTA data and with the help of reconstruction

Renal alterations in feline immunodeficiency virus (FIV)-infected cats: a natural model of lentivirus-induced renal disease changes.

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Poli, Alessandro; Tozon, Natasa; Guidi, Grazia; Pistello, Mauro

2012-09-01

Human immunodeficiency virus (HIV) is associated with several renal syndromes including acute and chronic renal failures, but the underlying pathogenic mechanisms are unclear. HIV and feline immunodeficiency virus (FIV) share numerous biological and pathological features, including renal alterations. We investigated and compared the morphological changes of renal tissue of 51 experimentally and 21 naturally infected cats. Compared to the latter, the experimentally infected cats exhibited some mesangial widening and glomerulonephritis, milder proteinuria, and lower tubular and interstitial alterations. The numbers of giant protein tubular casts and tubular microcysts were also lower. In contrast, diffuse interstitial infiltrates and glomerular and interstitial amyloidosis were detected only in naturally infected cats. Similar alterations are found in HIV infected patients, thus supporting the idea of a causative role of FIV infection in renal disease, and underlining the relevance of the FIV and its natural host as an animal model for investigating lentivirus-associated nephropathy.

Anterior abdominal wall leiomyoma arising de novo in a fertile women: A case report

International Nuclear Information System (INIS)

Cho, Je Young; Woo, Ji Young; Hong, Hye Suk; Yang, Ik; Lee, Yul; Hwang, Ji Young; Kim, Han Myun; Shin, Mi Kyung

2016-01-01

Abdominal wall leiomyoma arising de novo is very rare, hence the reported imaging findings of this disease are also rare. We reported the case of a 33-year-old woman who presented with an abdominal wall mass without antecedent gynecological surgeries. The initial abdominal computed tomography (CT) showed thickening of the left rectus abdominis and the loss of intervening fat between the rectus abdominis and the lateral abdominal muscles. After 8 months, the follow-up contrast-enhanced CT and ultrasonography (US) showed a lentiform-shaped mass with isodensity to the adjacent muscles. The US-guided biopsy was consistent with leiomyoma

Anterior abdominal wall leiomyoma arising de novo in a fertile women: A case report

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Cho, Je Young; Woo, Ji Young; Hong, Hye Suk; Yang, Ik; Lee, Yul; Hwang, Ji Young; Kim, Han Myun; Shin, Mi Kyung [Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul (Korea, Republic of)

2016-01-15

Abdominal wall leiomyoma arising de novo is very rare, hence the reported imaging findings of this disease are also rare. We reported the case of a 33-year-old woman who presented with an abdominal wall mass without antecedent gynecological surgeries. The initial abdominal computed tomography (CT) showed thickening of the left rectus abdominis and the loss of intervening fat between the rectus abdominis and the lateral abdominal muscles. After 8 months, the follow-up contrast-enhanced CT and ultrasonography (US) showed a lentiform-shaped mass with isodensity to the adjacent muscles. The US-guided biopsy was consistent with leiomyoma.

Canine Uterine Leiomyoma with Epithelial Tissue Foci, Adenomyosis, and Cystic Endometrial Hyperplasia

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George S. Karagiannis

2011-01-01

Full Text Available An 11-year-old Labrador Retriever bitch with a history of intermittent, sanguineous vaginal discharge of a six-month duration was presented. During exploratory laparotomy, two well-delineated, intramural masses were identified bilaterally in the uterine horns. Histopathologic examination of the mass on the left horn showed that it was a typical leiomyoma. However, the second mass appeared with an unusual coexistence of histological lesions, involving epithelial tissue foci, mild focal adenomyosis, and cystic endometrial hyperplasia. Interestingly, such combination was never encountered before in dogs. Although uterine leiomyoma is quite usual in the reproductive system of female dogs, this case resembled relevant cases of human uterine adenomyomas in morphology, and thus it was offered a similar tentative diagnosis.

The Heart as a Site of Metastasis of Benign Metastasizing Leiomyoma: Case Report and Review of the Literature

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Mariam Meddeb

2018-01-01

Full Text Available Uterine leiomyomas are the most common gynecological tumors in premenopausal women. While the lung is the most common extrauterine organ afflicted, benign metastasizing leiomyomas (BML of the heart are rarities. We report an incidental finding of a cardiac mass in a 36-year-old woman who presented to the Emergency Department after a motor vehicle accident. CT scan of the chest revealed 2 well-circumscribed pulmonary nodules and a filling defect in the right ventricle. Echocardiogram showed a 4 cm mass attached to the right ventricular (RV septum. The cardiac tumor was resected and showed benign histologic features. Immunohistochemical staining was positive for smooth muscle α-actin and desmin, as well as estrogen and progesterone receptors, consistent with the diagnosis of uterine leiomyoma.

Lesions in mink (Mustela vison) infected with giant kidney worm (Dioctophyma renale).

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Mace, T F

1976-01-01

Adult Dioctophyma renale occupied the enlarged renal pelvis of the right kidney of naturally infected mink. Lesions in the kidney parenchyma consisted of connective tissue proliferation in the interstitial tissue, tubular atrophy and fibrosis, and periglomerular fibrosis. The luminal surface of the renal pelvis wall was formed of numerous papillae covered with transitional epithelium. The nematodes in the lumen were bathed in an albuminous fluid containing red blood cells, epithelial cells and D. renale eggs. The left (uninfected) kidney was 60% larger than the left kidney of normal mink.

Molecular analyses of 6 different types of uterine smooth muscle tumors: Emphasis in atypical leiomyoma.

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Zhang, Qing; Ubago, Julianne; Li, Li; Guo, Haiyang; Liu, Yugang; Qiang, Wenan; Kim, J Julie; Kong, Beihua; Wei, Jian-Jun

2014-10-15

Uterine smooth muscle tumors (USMTs) constitute a group of histologic, genetic, and clinical heterogeneous tumors that include at least 6 major histologically defined tumor types: leiomyoma (ULM), mitotically active leiomyoma (MALM), cellular leiomyoma (CLM), atypical leiomyoma (ALM), uncertain malignant potential (STUMP), and leiomyosarcoma (LMS). Apart from ULM and LMS, the nature of these variants is not well defined. A total of 167 cases of different USMT variants were collected, reviewed, and diagnostically confirmed based on the World Health Organization and Stanford schemes. These included 38 cases of LMS, 18 cases of STUMP, 42 cases of ALM, 22 cases of CLM, 7 cases of MALM, and 40 cases of ULM. Molecular analysis included selected microRNAs (miRNAs), oncogenes, and tumor suppressors that are highly relevant to USMT. Overall, 49% (17/35) of LMS cases and 7% (1/14) of STUMP cases died due to their USMT, but no deaths were attributed to ALM. miRNA profiling revealed that ALM and LMS shared similar miRNA signatures. P53 mutations and PTEN deletions were significantly higher in LMS, ALM, and STUMP compared with other USMT variants (P 74%) but were significantly less common (< 15%) in CLM, ALM, STUMP, and LMS (P < .01). Six types of USMT have different gene mutation fingerprints. ALM shares many molecular alterations with LMS. Our findings suggest that ALM may be a precursor lesion of LMS or have similar genetic changes during its early stage. © 2014 American Cancer Society.

Color Doppler Ultrasonographic Findings of Vascular Leiomyoma: Pathologic Correlation

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Ko, Ji Young; Koh, Sung Hye; Min, Soo Kee; Choi, A Lam; Jang, Kyung Mi; Lee, Yul; Lee, Kwan Seop; Lee, Hyun; Sohn, Jeong Hee [Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of); Kim, Sam Soo [Kangwon National University College of Medicine, Chuncheon (Korea, Republic of)

2009-12-15

To evaluate the distribution of color flow signals on color Doppler ultrasonography of vascular leiomyomas and to correlate them with pathologic findings. We retrospectively analyzed color Doppler ultrasonographic images and pathologic slides of six vascular leiomyomas. We classified the patterns of distribution of color flow signals into localized compact cluster types and non-cluster types, and the pathologic findings into three subtypes: solid, venous and cavernous. All cases showed well-defined homogenous hypoechoic subcutaneous masses on gray-scale ultrasonography. Three cases showed localized compact cluster types on color Doppler ultrasonography, one in each subtype (solid, venous and cavernous). For the three non-cluster types, again there was on in each subtype. In addition, on pathologic analysis the zone of the localized compact cluster of color flow signals coincided with a cluster of larger, vascular caliber masses. Localized compact clusters of color flow signals on color Doppler ultrasonography were seen in 50% of our cases and correlated with a cluster of larger vascular caliber in the mass. But the pattern of distribution of color flows didn't show a correlation with pathologic type

Color Doppler Ultrasonographic Findings of Vascular Leiomyoma: Pathologic Correlation

International Nuclear Information System (INIS)

Ko, Ji Young; Koh, Sung Hye; Min, Soo Kee; Choi, A Lam; Jang, Kyung Mi; Lee, Yul; Lee, Kwan Seop; Lee, Hyun; Sohn, Jeong Hee; Kim, Sam Soo

2009-01-01

To evaluate the distribution of color flow signals on color Doppler ultrasonography of vascular leiomyomas and to correlate them with pathologic findings. We retrospectively analyzed color Doppler ultrasonographic images and pathologic slides of six vascular leiomyomas. We classified the patterns of distribution of color flow signals into localized compact cluster types and non-cluster types, and the pathologic findings into three subtypes: solid, venous and cavernous. All cases showed well-defined homogenous hypoechoic subcutaneous masses on gray-scale ultrasonography. Three cases showed localized compact cluster types on color Doppler ultrasonography, one in each subtype (solid, venous and cavernous). For the three non-cluster types, again there was on in each subtype. In addition, on pathologic analysis the zone of the localized compact cluster of color flow signals coincided with a cluster of larger, vascular caliber masses. Localized compact clusters of color flow signals on color Doppler ultrasonography were seen in 50% of our cases and correlated with a cluster of larger vascular caliber in the mass. But the pattern of distribution of color flows didn't show a correlation with pathologic type

[The clinical characteristics of pulmonary benign metastasizing leiomyoma].

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Wang, H P; Shi, J H; Zhang, L

2017-07-01

Objective: Pulmonary benign metastasizing leiomyoma (PBML) is a rare entity that leiomyoma of uterus metastasized to the lung. The clinical characteristics of this rare disease were analyzed in this article. Methods: The detailed clinical records of 7 patients diagnosed as PBML at Peking Union Medical College Hospital between January 2001 and June 2015 were reviewed. Results: All patients were women with median age of 44 years (range 28-62). Symptoms included dyspnea (2/7), chest pain (1/7), cyanosis (1/7), cough (1/7) and bloody sputum (1/7), while 4/7 cases were asymptomatic. Six patients had the past-history of leiomyoma of uterus 20 months to 14 years ago among whom 5 patients received hysterectomy. Chest CT showed bilateral, random-distributed multiple round solid nodules, or diffuse-distributed miliary nodules, or single solid nodule, even some small cavities. Extra-pulmonary metastasis was found in left superclavicular lymph node (1 case) and right heart (1 case). Histological tissues were obtained by video-assisted thoracic surgery lung biopsy (4/7), mass resection on tricuspid valve (1/7), transbronchil lung biopsy (1/7), and CT-guided percutaneous lung biopsy (1/7). Pathology showed an interlacing pattern by spindle cells having elongated nuclei without cellular atypia. Ki-67 index was less than 1%. Molecules such as smooth muscle antibody, estrogen receptor (ER) and progestrone receptor (PR) were positive in immunohistochemistry staining. Neither letrozole nor zoladex was effective. Two patients responded to bilateral adnexectomy, presenting as shrunk nodules. No relapsed disease was seen in one patient with single nodule after resection. There was only one patient with disease-related mortality, whose chest CT showed milliary nodules. Conclusion: Although CT findings of PBML are similar to malignancies, the clinical outcome is good. Despite the positive expression of ER and PR, the effectiveness of hormone related treatment is limited. And periodical

Uterine arterial embolization for uterine leiomyoma: efficacy and clinical outcome

International Nuclear Information System (INIS)

Park, Jeong Seon; Lee, Do Yon; Kim, Yong Tae; Park, Ki Hyun; Park, Yong Won; Cho, Jae Sung; Kim, Myung Jun; Won, Je Hwan; Kang, Byung Chul

1999-01-01

To determine the efficacy and clinical outcome of uterine arterial embolization as a new approach to the management of uterine leiomyomas. Uterine arterial embolization was performed in 21 patients aged 26-62(mean, 42) years. Twenty of these had menorrhagia, dysmenorrhea, and mass-related symptoms (low abdominal discomfort, backache, urinary frequency, etc.) and one was diagnosed incidentally. Bilateral uterine arteries were selected individually and polyvinyl alcohol and/or gelfoam was used as an embolic material. Nineteen patients were followed up after embolization. Seventeen (89.5 %)reported satisfactory improvement of symptoms and follow-up sonography three months later showed a 58.5 % reduction in mean myoma volume. In 17 patients (89.5 %), the menstrual cycle returned to normal. All patients experienced pain after the procedure and other complications were vaginal bleeding (26.3 %) and fever (23.8 %). Uterine arterial embolization represents a new approach to the management of uterine leiomyoma-related symptoms. Further investigations and long-term follow-up are, however, enquired

Uterine arterial embolization for uterine leiomyoma: efficacy and clinical outcome

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Park, Jeong Seon; Lee, Do Yon; Kim, Yong Tae; Park, Ki Hyun; Park, Yong Won; Cho, Jae Sung; Kim, Myung Jun [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of); Won, Je Hwan [Ajou Univ. College of Medicine, Suwon (Korea, Republic of); Kang, Byung Chul [Ewha Womans Univ. College of Medicine, Seoul (Korea, Republic of)

1999-09-01

To determine the efficacy and clinical outcome of uterine arterial embolization as a new approach to the management of uterine leiomyomas. Uterine arterial embolization was performed in 21 patients aged 26-62(mean, 42) years. Twenty of these had menorrhagia, dysmenorrhea, and mass-related symptoms (low abdominal discomfort, backache, urinary frequency, etc.) and one was diagnosed incidentally. Bilateral uterine arteries were selected individually and polyvinyl alcohol and/or gelfoam was used as an embolic material. Nineteen patients were followed up after embolization. Seventeen (89.5 %)reported satisfactory improvement of symptoms and follow-up sonography three months later showed a 58.5 % reduction in mean myoma volume. In 17 patients (89.5 %), the menstrual cycle returned to normal. All patients experienced pain after the procedure and other complications were vaginal bleeding (26.3 %) and fever (23.8 %). Uterine arterial embolization represents a new approach to the management of uterine leiomyoma-related symptoms. Further investigations and long-term follow-up are, however, enquired.

A systematic review on efficacy and safety of gasless laparoscopy in the management of uterine leiomyoma.

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Liu, Qi-wei; Han, Tong; Yang, Min; Tong, Xiao-wen; Wang, Jian-jun

2016-02-01

Uterine leiomyoma causes considerable morbidity in women. This study systematically reviewed the efficacy and safety of gasless laparoscopic myomectomy (GLM) in the management of uterine leiomyoma by comparing GLM with other minimally invasive procedures. Cochrane Library, Pub- Med, EMBASE, Web of Science, WANFANG database and China National Knowledge Infrastructure (CNKI) were searched for studies published in English or Chinese between January 1995 and May 2015, and related references were traced. Study outcomes from randomized controlled trials and retrospective cohort studies were presented as mean difference (MD) or odds ratio (OR) with a 95% confidence interval (CI). Seventeen studies (including 1862 patients) meeting the inclusion criteria, including 934 treated with GLM and 928 treated with other minimally invasive procedures were reviewed. The results of meta-analysis revealed that GLM resulted in significantly shorter operating time [MD=-10.34, 95% CI (-18.12,-2.56), Ppost-operative fever [MD=-0.52, 95% CI (-1.46, 0.42)] between the two groups. Additionally, GLM was associated with lower febrile morbidity, lower postoperative abdominal pain, and higher postoperative hemoglobin than other minimally invasive procedures for the treatment of uterine leiomyoma. In conclusion, GLM and other minimally invasive procedures are feasible, safe, and reliable for uterine leiomyoma treatment. However, available studies show that GLM is more effective and safer than other minimally invasive approaches.

A Rare Combination of Ovarian and Uterine Leiomyomas with Goblet Cell Carcinoid of the Appendix

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Abdulrahman F. Al-Shaikh

2015-01-01

Full Text Available We present a case of the rare combination of unilateral ovarian leiomyoma, uterine leiomyoma, and goblet cell carcinoid tumor of the appendix in a premenopausal woman who presented with right iliac pain. Immunohistochemistry study for desmin (muscle marker and chromogranin and synaptophysin (neuroendocrine markers confirmed immunophenotyping origin. Interestingly, both tumors showed positive reaction for estrogen receptor. To our knowledge, such a combination has not been reported previously in the literature. In this paper, the pathogenesis and differential diagnosis of both types of tumors are discussed.

A subserosal, pedunculated, multilocular uterine leiomyoma with ovarian tumor-like morphology and histological architecture of adenomatoid tumors: a case report and review of the literature.

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Yorita, Kenji; Tanaka, Yu; Hirano, Koki; Kai, Yuka; Arii, Kaoru; Nakatani, Kimiko; Ito, Satoshi; Imai, Toshiya; Fukunaga, Masaharu; Kuroda, Naoto

2016-12-20

Uterine leiomyomas are common uterine tumors, and typical cases of leiomyoma are easily diagnosed by imaging study. However, uterine leiomyomas are often altered by degenerative changes, which can cause difficulty and confusion in their clinical diagnosis. We describe the 17th reported case of a uterine leiomyoma clinically diagnosed as an ovarian tumor; however, the present case shows the most detailed radiological evaluation, including contrast-enhanced magnetic resonance imaging. We first show that a uterine leiomyoma can histologically mimic an adenomatoid tumor. A 47-year-old premenopausal, nulliparous Japanese woman with a history of type 2 diabetes mellitus, hypertension, and hyperlipidemia had lower abdominal pain. Ultrasonography confirmed a 6-cm mass in the right-sided space of the pelvic cavity. Magnetic resonance imaging evaluation showed that a multilocular mass was present near the uterus, and a mucinous ovarian tumor was considered. Emergency surgery due to acute abdomen was performed under the diagnosis of pedicle torsion of the ovarian tumor. During surgery, a pedunculated uterine mass without stalk torsion was seen. The mass grossly contained serous and hemorrhagic fluids in the cavities, and pathology examination confirmed that the mass was a leiomyoma with hydropic and cystic degeneration. Anastomosing thin cord-like arrangements of the leiomyoma cells mimicked the architecture of adenomatoid tumors. The tumor cells were positive for the microphthalmia transcription factor but negative for other melanoma markers. Three days postoperatively, she was discharged without sequelae. Marked intratumoral deposition of fluids may induce the multilocular morphology of a tumor, and the cellular arrangement of the tumor cells with hydropic degeneration mimicked an adenomatoid tumor in this case. Clinicians need to be aware that a subserosal leiomyoma with cystic and hydropic degeneration can mimic an ovarian tumor, and pathologists should be aware that such

Renal Alterations in Feline Immunodeficiency Virus (FIV-Infected Cats: A Natural Model of Lentivirus-Induced Renal Disease Changes

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Mauro Pistello

2012-08-01

Full Text Available Human immunodeficiency virus (HIV is associated with several renal syndromes including acute and chronic renal failures, but the underlying pathogenic mechanisms are unclear. HIV and feline immunodeficiency virus (FIV share numerous biological and pathological features, including renal alterations. We investigated and compared the morphological changes of renal tissue of 51 experimentally and 21 naturally infected cats. Compared to the latter, the experimentally infected cats exhibited some mesangial widening and glomerulonephritis, milder proteinuria, and lower tubular and interstitial alterations. The numbers of giant protein tubular casts and tubular microcysts were also lower. In contrast, diffuse interstitial infiltrates and glomerular and interstitial amyloidosis were detected only in naturally infected cats. Similar alterations are found in HIV infected patients, thus supporting the idea of a causative role of FIV infection in renal disease, and underlining the relevance of the FIV and its natural host as an animal model for investigating lentivirus-associated nephropathy.

Estimate of X-ray radiation for patient during uterine artery embolization to uterine leiomyomas

International Nuclear Information System (INIS)

Chen Shengli; Zhu Dongliang; Huang Qihao; Chen Guodong; Huang Zicheng; Zou Rongzhu

2005-01-01

Objective: To evaluate the X-ray radiation of patients during uterine artery embolization (UAE) for leiomyomas. Methods: Radiation dose was measured in 90 patients who underwent UAE for leiomyomas. Measurements were obtained by a dosimeters system (Diamentor K1 and Diamentor ED) equipped in DSA setting Angiostar-Plus (Siemens, Germany), dose-area product (DAP) and entrance surface dose (ESD) were recorded on line, effect dose (ED) was estimated by Monte-Carlo conversion coefficient from DAP. Results: the mean fluoroscopic time was 28.60 ± 23.73 minutes, and the mean number of angiographic exposures was 87 ± 38. The mean DAP dose was (6178 ± 3802) cGycm 2 , and the mean ESD was 378 ± 245) mGy, ED was (9.89 ± 6.08) mSv. The contribution of pulsed fluoroscopy (PF) dose to the total DAP (34.05% ± 10.65%) was smaller than that of radiography (R) (65.94% ± 10.65%), and the contribution of PF for total ESD (61.09% ± 12.88%) was bigger than that of R(65.94% ± 10.65%). Conclusion: The leiomyoma patient suffered a large dose X-ray exposure from a UAE procedure. (authors)

MVP immunohistochemistry is a useful adjunct in distinguishing leiomyosarcoma from leiomyoma and leiomyoma with bizarre nuclei.

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Lintel, Nicholas J; Luebker, Stephen A; Lele, Subodh M; Koepsell, Scott A

2018-03-01

Morphologically, distinguishing between leiomyoma (LM) and leiomyosarcoma (LMS) is not always straightforward, especially with benign variants such as bizarre leiomyoma (BLM). To identify potential markers of malignancy in uterine smooth muscle tumors, proteomic studies were performed followed by assessment of protein expression by immunohistochemistry. Archival formalin-fixed, paraffin-embedded tissues from tumors (n = 23) diagnosed as LM, BLM, and LMS (using published criteria) were selected for the study. Sequential window acquisition of all theoretical fragment ion spectra mass spectrometry was applied to pooled samples of formalin-fixed, paraffin-embedded LM and LMS tumor tissue to assay the relative protein quantities and look for expression patterns differentiating the 2 tumor types. A total of 592 proteins were quantified, and 10 proteins were differentially expressed between LM and LMS. Select proteins were chosen for evaluation by immunohistochemistry (IHC) based on antibody availability and biologic relevance in the literature. IHC was performed on a tissue microarray, and intensity was evaluated using imaging software. Major vault protein (MVP) and catechol O-methyltransferase had 3.05 and 13.94 times higher expression in LMS relative to LM by sequential window acquisition of all theoretical fragment ion spectra mass spectrometry, respectively. By IHC, MVP (clone 1014; Santa Cruz Biotechnology, Dallas, TX) was found to be 50% sensitive and 100% specific when comparing LMS to LM. Catechol O-methyltransferase (clone FL-271; Santa Cruz Biotechnology) had a sensitivity of 38% and a specificity of 88%. Six of 7 BLM had expression of MVP similar to LM. Immunohistochemical staining for MVP is a useful adjunct in distinguishing LMS from LM and BLM in difficult cases. Copyright © 2018. Published by Elsevier Inc.

Retroperitoneal unicentric Castleman's disease (giant lymph node hyperplasia: case report

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Jaques Waisberg

Full Text Available CONTEXT AND OBJECTIVE: Castleman's disease, or giant lymph node hyperplasia, is a rare disorder of the lymphoid tissue that causes lymph node enlargement. It is considered benign in its localized form, but aggressive in the multicentric type. The definitive diagnosis is based on postoperative pathological findings. The aim here was to describe a case of retroperitoneal unicentric Castleman's disease in the retroperitoneum. CASE REPORT: A 61-year old white male with weight loss and listlessness presented with moderate arterial hypertension and leukopenia. Abdominal tomography revealed a 5 x 4 x 5 cm oval mass of low attenuation, with inner calcification and intense enhancement on intravenous contrast, located in the retroperitoneal region, between the left kidney and the aorta, at the renal hilus. Exploratory laparotomy revealed a non-pulsatile solid oval mass situated in the retroperitoneum, adjacent to the left renal hilus. The retroperitoneal lesion was removed in its entirety. Examination of frozen samples revealed benign lymph node tissue and histopathological examination of the surgical sample revealed hyaline-vascular giant lymph node hyperplasia (Castleman's disease. The patient was discharged on the 12th day without significant events. Two months after the operation, the patient was readmitted with severe cardiac insufficiency, acute renal failure and bronchopneumonia, which progressed to acute respiratory insufficiency, sepsis and death.

Pilot study: safety and effectiveness of simple ultrasound-guided high-intensity focused ultrasound ablating uterine leiomyoma with a diameter greater than 10 cm.

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Hou, Ruijie; Wang, Liwei; Li, Shaoping; Rong, Fengmin; Wang, Yuanyuan; Qin, Xuena; Wang, Shijin

2018-02-01

The study aimed to prospectively investigate whether uterine leiomyoma greater than 10 cm in diameter could be treated with simple ultrasound-guided high-intensity focused ultrasound (USgHIFU) in one-time treatment. A total of 36 patients with 36 symptomatic uterine leiomyoma greater than 10 cm in diameter who underwent simple USgHIFU treatment alone were analysed. Enhanced MRI was performed before and after HIFU treatment, and all patients had follow-up for 6 months after treatment. Symptom severity scores, treatment time, treatment speed, ablation rate, energy effect ratio, uterine leiomyoma regression rate, adverse events, liver and kidney functions, coagulation function and routine blood count were included in the study endpoints. The mean diameter of uterine leiomyoma was 11.2 ± 1.3 cm (10.0-14.3 cm). The median treatment time and treatment speed were 104.0 min (90.0-140.0 min) and 118.8 cm 3  h -1  (86.2-247.1 cm 3  h -1 ), respectively. The ablation rate of uterine leiomyoma was 71.9 ± 20.4% (32.1-100.0%), and the regression rate of uterine leiomyoma was 40.8 ± 7.5% (25.6-59.9%) at 6 months after treatment. The mean symptom severity scores decreased by an average of approximately 8.6 ± 2.3 (5-14) points. There were no significant changes in haemogram and blood chemical indexes of patients, except for the transient elevation of aspartate aminotransferase, total bilirubin and white blood cells after treatment. No serious adverse reactions occurred. According to our preliminary results, simple USgHIFU is a safe and effective single-treatment method of treating uterine leiomyoma greater than 10 cm in diameter and is an almost innocuous alternative therapeutic strategy. Advances in knowledge: The conclusions indicate simple USgHIFU is safe and effective as one-time treatment of uterine leiomyoma greater than 10 cm in diameter, it could be a promising therapeutic strategy.

Uterine arterial embolization with PVA particles as a the treatment of uterine leiomyomas (with the analysis of 16 cases)

International Nuclear Information System (INIS)

Zhou Ruming; Liu Minhua; Qiu Shuibo; Zhuang Shaoyu; Yang Huijun

2003-01-01

Objective: To investigate the technic and the clinical effect of uterine arterial embolization as the treatment of uterine leiomyoma. Methods: Bilateral uterine arterial embolization was performed in 16 patients with uterine leiomyomas. The embolic agents were polyvinyl alcohol (PVA) particles sided 350 μm-500 μm in diameter and gelfoam. The clinical manifestations and the size of tumors were investigated in a 6-month post-procedure follow-up. Results: In all patients with hypermenorrhea was relieved, in average the uterine size was reduced by 48.9% and the size of tumor was reduced by 49.2% after the intervention. No serious complication occurred. Conclusion: Uterine arterial embolization is effective in relieving the clinical symptoms and debulking the leiomyoma. it is a valuable technique, and easily accepted by patients

Uterine leiomyoma in a spayed poodle bitch: a case report.

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Sontas, B H; Ozyogurtcu, H; Turna, O; Arun, S; Ekici, H

2010-06-01

A 16-year-old, spayed, female poodle dog was presented for evaluation of tenesmus, with the ability to attract male dogs and a willingness to mate. The dog had undergone an ovariohysterectomy when it was 7 years old. Haematological and serum biochemistry analyses demonstrated leucocytosis and a mild uraemia. A vaginal smear was predominantly made up of superficial cells, accounting for at least 80% of the cells. Abdominal ultrasonography revealed a heterogeneous multicystic mass at the caudal abdomen and two masses with anechoic areas adjacent to the caudal pole of each kidney. A midline exploratory laparotomy identified a uterine mass and residual ovaries that were surgically excised. Histopathological examination of the mass demonstrated that it was a leiomyoma. The left ovary had a cystic structure and the right ovary had a papillary cystic adenoma. Seven months after the surgery, the owner reported that the dog was clinically normal. To the authors' knowledge, this is the first reported case of a uterine leiomyoma after an incomplete ovariohysterectomy in the dog.

Argon-plasma treatment in benign metastasizing leiomyoma of the lung: A case report

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A. Bugalho

2010-11-01

Full Text Available Benign metastasizing leiomyomas of the lung are rare smooth muscle cells tumours. We report the case of a 48 year-old female who was evaluated due to persistent cough, progressive dyspnoea and constitutional symptoms. Chest computed tomography revealed a left endobronchial mass, multiple parenchyma nodules and a pleural effusion. Bronchial biopsy histological features were consistent with benign metastasizing leiomyoma. The patient was successfully treated with argon-plasma and mechanical debulking. There was no disease relapse in the last four years. Resumo: Os leiomiomas benignos metastizantes pulmonares são tumores raros de células musculares lisas. Uma doente de 48 anos foi avaliada devido a tosse persistente, dispneia progressiva e sintomas constitucionais. A tomografia computorizada do tórax revelou uma massa endobrônquica à esquerda, múltiplos nódulos do parênquima pulmonar e derrame pleural. As características histológicas da biopsia brônquica foram consistentes com o diagnóstico de leiomioma benigno metastizante. A doente foi submetida a coagulação árgon-plasma e desobstrução mecânica com eficácia terapêutica. Verificou-se estabilidade clínica nos últimos quatro anos. Keywords: Benign metastasizing leiomyoma, Lung neoplasms, Diagnosis, Bronchoscopy, Management, Argon-plasma treatment, Palavras-chave: Leiomioma benigno metastizante, Neoplasias pulmonares, Diagnóstico, Broncoscopia, Tratamento, Tratamento árgon-plasma

Genome-Wide Progesterone Receptor Binding: Cell Type-Specific and Shared Mechanisms in T47D Breast Cancer Cells and Primary Leiomyoma Cells

Science.gov (United States)

Huang, Lei; Owen, Jonas K.; Xie, Anna; Navarro, Antonia; Monsivais, Diana; Coon V, John S.; Kim, J. Julie; Dai, Yang; Bulun, Serdar E.

2012-01-01

Background Progesterone, via its nuclear receptor (PR), exerts an overall tumorigenic effect on both uterine fibroid (leiomyoma) and breast cancer tissues, whereas the antiprogestin RU486 inhibits growth of these tissues through an unknown mechanism. Here, we determined the interaction between common or cell-specific genome-wide binding sites of PR and mRNA expression in RU486-treated uterine leiomyoma and breast cancer cells. Principal Findings ChIP-sequencing revealed 31,457 and 7,034 PR-binding sites in breast cancer and uterine leiomyoma cells, respectively; 1,035 sites overlapped in both cell types. Based on the chromatin-PR interaction in both cell types, we statistically refined the consensus progesterone response element to G•ACA• • •TGT•C. We identified two striking differences between uterine leiomyoma and breast cancer cells. First, the cis-regulatory elements for HSF, TEF-1, and C/EBPα and β were statistically enriched at genomic RU486/PR-targets in uterine leiomyoma, whereas E2F, FOXO1, FOXA1, and FOXF sites were preferentially enriched in breast cancer cells. Second, 51.5% of RU486-regulated genes in breast cancer cells but only 6.6% of RU486-regulated genes in uterine leiomyoma cells contained a PR-binding site within 5 kb from their transcription start sites (TSSs), whereas 75.4% of RU486-regulated genes contained a PR-binding site farther than 50 kb from their TSSs in uterine leiomyoma cells. RU486 regulated only seven mRNAs in both cell types. Among these, adipophilin (PLIN2), a pro-differentiation gene, was induced via RU486 and PR via the same regulatory region in both cell types. Conclusions Our studies have identified molecular components in a RU486/PR-controlled gene network involved in the regulation of cell growth, cell migration, and extracellular matrix function. Tissue-specific and common patterns of genome-wide PR binding and gene regulation may determine the therapeutic effects of antiprogestins in uterine fibroids and

The stepchild of intestinal diagnostics. Evaluation of radiological methods to diagnose leiomyomas of the small bowel

International Nuclear Information System (INIS)

Keberle, M.; Wittenberg, G.; Jenett, M.; Hahn, D.; Mueller, J.G.

1998-01-01

Purpose: Various radiological methods to diagnose small bowel neoplasmas and problems of differential diagnosis specially considerating leiomyomas are discussed. Patients and methods: Two patients with leiomyoma of the ileum underwent enteroclysis, computed tomography of the abdomen, intra-arterial DSA and colour Doppler sonography. Another patient with leiomyosarcoma just underwent CT of the abdomen with CT-guided biopsy. Results: Due to the homogenous density and the smooth surface of the tumors in computed tomography and respectively enteroclysis and the presentation of the tumor vascularisation in the angiography and Colour Doppler sonography in both patients a leiomyoma of the small bowel was diagnosed. Postoperatively this diagnosis was histologically confirmed. The CT-findings of the patient with leiomyosarcoma were not suspicious of a malignant tumor. Conclusion: Radiologically it is not possible to determine the dignity of smooth muscle cell tumors safely. That is the reason why the diagnosis has to be achieved operatively. But the histopathological diagnosis based on the mitotic rate may be difficult. Therefore the after care has to be carried out thoroughly. (orig.) [de

Vesical Leiomyoma: Presentation of a clinical case

International Nuclear Information System (INIS)

Rodriguez Carballo, Michel; Gonzalez Gonzalez, Gonzalo Antonio; Sanchez Falcon Ania

2009-01-01

The vesical leiomyoma is a tumor of mesenchymal origin, and extremely rare. Most of them are diagnosed casually after the pathologic study of samples collected after surgery. Few cases were found in the reviewed literature, leading us to think of the scarce incidence of this kind of tumors. We present a case treated in our service, of an 18-years-old female patient, assisting to our consultation presenting a polaquiuria, ardor and mictional effort. The complementary exams led to the surgical treatment and follow up of the patient

Giant kidney worm (Dioctophyma renale) infection mimicking retroperitoneal neoplasm.

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Sun, T; Turnbull, A; Lieberman, P H; Sternberg, S S

1986-07-01

A 50-year-old Chinese man was found by ultrasound and computed tomography to have a retroperitoneal mass in the right upper quadrant of the abdomen. At operation, a hemorrhagic cyst was detected at the upper pole of the right kidney adjacent to the adrenal gland. Microscopic examination revealed that the cyst wall was composed of granulomatous tissue loaded with eggs and cross-sections of parasites, identified as Dioctophyma renale. The eggs were characterized by a birefringent striated double wall. The presence of cross sections of adult worms of D. renale in human tissue has not been previously described. Another unique feature of this case was that the right kidney was intact, as examined grossly at laparotomy and by intravenous pyelography. Eggs were not detected in the urine.

Giant Asian honeybee stings induced acute myocarditis: a case report

OpenAIRE

NP Dinamithra; S Sivansuthan

2013-01-01

Hymenopterid stings and subsequent allergic reactions including fatal anaphylaxis are a common indication for emergency department visits worldwide. Less commonly, multiple wasp stings can result in multi-system involvement ranging from intravascular hemolysis, rhabdomyolysis, acute renal failure, cardiac involvement, hepatic dysfunction and occasionally thrombocytopenia and coagulopathy. Here we report one case of multiple Giant Asian honey bee stings induced myocarditis.

Giant Asian honeybee stings induced acute myocarditis: a case report

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NP Dinamithra

2013-10-01

Full Text Available Hymenopterid stings and subsequent allergic reactions including fatal anaphylaxis are a common indication for emergency department visits worldwide. Less commonly, multiple wasp stings can result in multi-system involvement ranging from intravascular hemolysis, rhabdomyolysis, acute renal failure, cardiac involvement, hepatic dysfunction and occasionally thrombocytopenia and coagulopathy. Here we report one case of multiple Giant Asian honey bee stings induced myocarditis.

Diagnostic Accuracy of Ultrasound, Contrast-enhanced CT, and Conventional MRI for Differentiating Leiomyoma From Leiomyosarcoma.

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Gaetke-Udager, Kara; McLean, Karen; Sciallis, Andrew P; Alves, Timothy; Maturen, Katherine E; Mervak, Benjamin M; Moore, Andreea G; Wasnik, Ashish P; Erba, Jake; Davenport, Matthew S

2016-10-01

This study aimed to determine whether uterine leiomyoma can be distinguished from uterine leiomyosarcoma on ultrasound (US), computed tomography (CT), and/or magnetic resonance imaging (MRI) without diffusion-weighted imaging. Institutional review board approval was obtained and informed consent was waived for this Health Insurance Portability and Accountability Act-compliant retrospective case-control diagnostic accuracy study. All subjects with resected uterine leiomyosarcoma diagnosed over a 17-year period (1998-2014) at a single institution for whom pre-resection US (n = 10), CT (n = 11), or MRI (n = 7) was available were matched by tumor size and imaging modality with 28 subjects with resected uterine leiomyoma. Six blinded radiologists (three attendings, three residents) assigned 5-point Likert scores for the following features: (1) margins, (2) necrosis, (3) hemorrhage, (4) vascularity, (5) calcifications, (6) heterogeneity, and (7) likelihood of malignancy (primary end point). Mean suspicion scores were calculated and receiver operating characteristic curves were generated. The ability of individual morphologic features to predict malignancy was assessed with logistic regression. Mean suspicion scores were 2.5 ± 1.2 (attendings) and 2.4 ± 1.3 (residents) for leiomyoma, and 2.7 ± 1.3 (attendings) and 2.7 ± 1.4 (residents) for leiomyosarcoma. The areas under the receiver operating characteristic curves (range: 0.330-0.685) were not significantly different from chance, either overall (P = .36-.88) or by any modality (P = .28-.96), for any reader. Reader experience had no effect on diagnostic accuracy. No morphologic parameter was significantly predictive of malignancy (P = .10-.97). Uterine leiomyoma cannot be differentiated accurately from leiomyosarcoma on US, CT, or MRI without diffusion-weighted imaging. Copyright © 2016 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

Congenital giant megaureter associated with ipsilateral multicystic dysplastic kidney in newborn

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Rajendran Ramaswamy

2016-01-01

Full Text Available Congenital giant megaureter presents as abdominal mass and impose diagnostic difficulties. It can be associated with other upper urinary tract anomalies. A female newborn with antenatal diagnosis of polycystic kidneys was admitted at birth due to lower abdominal mass. Ultrasound and CT scans diagnosed a multiloculated cystic lesion in the mid and lower abdomen along with right side multicystic kidney. At laparotomy, an extaperitoneal, lobulated cystic swelling was found due to rightside giant megaureter. Its lower end was of normal caliber and orthotopic. End cutaneous ureterostomy was done. Intravenous urogram and isotope renograms showed nonfunctioning right kidney. She also had grade II vesicoureteral reflux on left side. Child suffered urinary infection twice. At 9m age, right nephroureterectomy was done. Histopathologic examination was consistent with cystic renal dysplasia and dilated ureter. This is the first case report of giant megaureter associated with ipsilateral multicystic dysplastic kidney in newborn.

Successful en bloc venous resection with reconstruction and subsequent radiotherapy for 2 consecutive recurrences of intravenous leiomyoma?a case report

OpenAIRE

Zhang, Ying; Clark, Leslie H.; Sheng, Xiugui; Zhou, Chunxiao

2016-01-01

Background Intravenous leiomyomas are a rare variant of uterine leiomyoma. Although histologically benign, these tumors are associated with a poor prognosis due to propensity for metastasis, high recurrence rate, difficulty of obtaining complete resection, and frequent extension into and along major veins. Case presentation We describe a 43-year-old patient initially presenting with lower abdominal pain. Clinical examination revealed a large right pelvic mass that was shown by computed tomogr...

Primary cervical leiomyoma: A rare cause of a posterior neck mass in a pediatric patient.

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Oliver, Jeremie D; Anzalone, C Lane; Balakrishnan, Karthik

2018-01-01

A 13-year-old male presents for evaluation of a right-sided posterolateral neck mass, first noted four years prior to presentation; incisional biopsy two years ago suggested a benign lymph node. Recent growth and increased pain prompted referral to our tertiary care center. MR imaging revealed a densely calcified mass in the right posterior paraspinous muscles with intense enhancement with gadolinium contrast, approximately 5 cm × 2.8 cm x 4.6 cm. Incisional biopsy showed leiomyoma with extensive dystrophic calcifications. This case describes a rare finding of extraesophageal leiomyoma of the neck; this is only the second such case reported in a pediatric patient. Copyright © 2017 Elsevier B.V. All rights reserved.

Analysis of the long and middle term effect of uterine artery embolization for uterine leiomyomas

International Nuclear Information System (INIS)

Shi Limin; Luo Pengfei; Chen Xiaoming

2006-01-01

Uterine artery embolization (UAE) is a safe and effective method for uterine leiomyomas but its long and middle term effects are definite. Furthermore it bears some exquisite comparison with the conventional therapy but not as a radical one, with a tendency. However, to develop new leiomyomas and recurrence after UAE, there for all patients should be monitored with clinical and imaging examinations for more than 2 years after the procedure. At present, a few literatures involving the factors that could influence the effects of UAE have been issued. It is necessary to carry on large-scale clinical research of the related factors influencing the results of UAE in order to guide clinical practice correctly and swiftly. (authors)

Genotype distribution of estrogen receptor-alpha, catechol-O-methyltransferase, and cytochrome P450 17 gene polymorphisms in Caucasian women with uterine leiomyomas.

Science.gov (United States)

Denschlag, Dominik; Bentz, Eva-Katrin; Hefler, Lukas; Pietrowski, Detlef; Zeillinger, Robert; Tempfer, Clemens; Tong, Dan

2006-02-01

To evaluate the association between the presence of uterine leiomyomas and three functional single nucleotide polymorphisms (SNPs) of the estrogen receptor alpha (ESR1), catechol-O-methyltransferase (COMT), and cytochrom P450 17 (CYP17A) genes, which have been described to modify the estrogen metabolism. Prospective case control study. Academic research institution. One hundred thirty women with clinically and surgically diagnosed uterine leiomyomas and 139 population controls. Peripheral venous puncture. Polymerase chain reaction and pyrosequencing were performed to genotype women with respect to the ESR1 IVS1-397 T/C (PvuII), COMT G158A, and the CYP17A 34T-->C SNPs. Comparing women with uterine leiomyomas and controls, no statistically significant differences with respect to allele frequency and genotype distribution were ascertained for ESR1 IVS 1-397 T/C (PvuII) (P=0.9 and P=0.6, respectively), COMT G158A (P=0.3 and P=0.6, respectively), and CYP17A 34T-->C (P=0.1 and P=0.5, respectively). When all two-way interactions of investigated SNPs were ascertained, no significant interactions were observed. In a multivariate model, no SNP was significantly associated with leiomyomas. Carriage of the ESR1 IVS1-397 T/C (PvuII), COMT G158A, and the CYP17A 34T-->C SNPs is not associated with the susceptibility to uterine leiomyoma in a Caucasian population.

Comparison between submucosal tunneling endoscopic resection and video-assisted thoracoscopic surgery for large esophageal leiomyoma originating from the muscularis propria layer.

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Tan, Yuyong; Lv, Liang; Duan, Tianying; Zhou, Junfeng; Peng, Dongzi; Tang, Yao; Liu, Deliang

2016-07-01

Submucosal tunneling endoscopic resection (STER) has been proved to be safe and effective for removal of esophageal leiomyoma originating from the muscularis propria (MP) layer. However, there are still technical challenges for tumors ≥35 mm due to the limited space of the submucosal tunnel. The aim of the study was to estimate the safety and efficacy of STER for large esophageal leiomyoma originating from the MP layer as well as compare its efficacy with video-assisted thoracoscopic surgery (VATS), which is a standard procedure for treating esophageal leiomyoma. We retrospectively collected the clinical data of the patients with esophageal leiomyoma of 35-55 mm who underwent STER or VATS at our hospital between January 2010 and December 2014. Epidemiological data (gender, age), tumor location, tumor size, procedure-related parameters, complications, length of stay and cost were compared between STER and VATS. A total of 31 patients were enrolled, and 18 patients underwent STER and the other 13 received VATS. There was no significant difference between the two groups in gender, age, tumor location, tumor size, complications and rate of en bloc resection (P > 0.05). However, patients in the STER groups had a shorter operation time, a less decrease in hemoglobin level, a shorter length of hospital stay and a decreased cost (P leiomyoma of 35-55 mm. However, STER is superior to VATS in a shorter operation time, a less decrease in hemoglobin level, a shorter length of hospital stay and a decreased cost.

A 35-year-old woman presenting with an unusual post-traumatic leiomyoma of the nipple: a case report.

Science.gov (United States)

Pavlidis, Leonidas; Vakirlis, Efstratios; Spyropoulou, Georgia-Alexandra; Pramateftakis, Manousos Georgios; Dionyssiou, Dimitris; Demiri, Efterpi

2013-02-19

Leiomyoma of the mammary papilla is one of the most uncommon nipple tumors with only 50 cases reported in the literature until now. To the best of our knowledge we present the first report of a nipple leiomyoma that originated from a traumatic abrasion caused by breastfeeding. A 35-year-old healthy Caucasian female with a cauliflower-like tender and pink nodular mass that was approximately 10mm in diameter presented to our out-patients department. The patient suggested that the mass originated from a traumatic abrasion caused by breastfeeding three years ago and it has been slowly growing ever since.An excision biopsy was performed. The histological and immunohistochemical examination confirmed the diagnosis of leiomyoma. There were no postoperative complications or any sign of local recurrence four years postoperatively. Leiomyoma of the mammary papilla is a rare benign neoplasm that usually appears as a solid tender nodule. Differential diagnosis comprises breast carcinoma, leiomyosarcoma and myoid hamartoma. The recommended treatment is complete excision of the tumor with histologically confirmed tumor-free margins otherwise recurrence is possible. A detailed history of the patient's disease can reveal the original etiology. This is an original case report that will have particular interest to plastic surgeons, dermatologists, and pathologists. The pathogenetic mechanism was trauma of the nipple. According to our review of the literature this particular information has never been reported and we think that it may advance our knowledge of this very infrequent tumor.

Liarozole inhibits transforming growth factor-β3–mediated extracellular matrix formation in human three-dimensional leiomyoma cultures

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Levy, Gary; Malik, Minnie; Britten, Joy; Gilden, Melissa; Segars, James; Catherino, William H.

2014-01-01

Objective To investigate the impact of liarozole on transforming growth factor-β3 (TGF-β3) expression, TGF-β3 controlled profibrotic cytokines, and extracellular matrix formation in a three-dimensional (3D) leiomyoma model system. Design Molecular and immunohistochemical analysis in a cell line evaluated in a three-dimensional culture. Setting Laboratory study. Patient(s) None. Intervention(s) Treatment of leiomyoma and myometrial cells with liarozole and TGF-β3 in a three-dimensional culture system. Main Outcome Measure(s) Quantitative real-time reverse-transcriptase polymerase chain reaction and Western blotting to assess fold gene and protein expression of TGF-β3 and TGF-β3 regulated fibrotic cytokines: collagen 1A1 (COL1A1), fibronectin, and versican before and after treatment with liarozole, and confirmatory immunohistochemical stains of treated three-dimensional cultures. Result(s) Both TGF-β3 gene and protein expression were elevated in leiomyoma cells compared with myometrium in two-dimensional and 3D cultures. Treatment with liarozole decreased TGF-β3 gene and protein expression. Extracellular matrix components versican, COL1A1, and fibronectin were also decreased by liarozole treatment in 3D cultures. Treatment of 3D cultures with TGF-β3 increased gene expression and protein production of COL1A1, fibronectin, and versican. Conclusion(s) Liarozole decreased TGF-β3 and TGF-β3–mediated extracellular matrix expression in a 3D uterine leiomyoma culture system. PMID:24825427

Usual Tumor at an Unusual Site - A Leiomyoma Masquerading as a Urethral Polyp.

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Shilpa MN

2013-01-01

Full Text Available Polyps and papillomas encompass the most common benign tumors of the urethra.Leiomyoma of urethra is a rare clinical entity which can be diagnosed only with histopathological examination and only around 35 such cases have been reported worldwide.

Neuroeffector connections of giant multimodal neurons in the African snail Achatina fulica.

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Bugai, V V; Zhuravlev, V L; Safonova, T A

2005-07-01

A new method of making preparations was used to analyse the neuroeffector connections of the paired giant neurons of the African snail Achatina fulica. These neurons were found to induce postsynaptic potentials in the muscles of the mantle, heart, the wall of the pulmonary cavity, and the muscular elements of the renal complex, the pericardium, the sexual apparatus, the walls of the cerebral arteries, the filaments of the columellar muscles, the wall of the abdomen, and the tentacle retractor muscles. Rhythmic neuron activity led to the development of marked facilitation and long-term potentiation of synaptic potentials. The possible significance of the multiple neuroeffector connections of giant neurons is discussed.

Primary urethral leiomyoma in a female patient: A case report and ...

African Journals Online (AJOL)

R. Sharma

www.ees.elsevier.com/afju · www.sciencedirect.com. Case report. Primary urethral leiomyoma in a female patient: A case report and review of the literature. R. Sharma. ∗. , S.K. Mitra, R.K. Dey, S. Basu, R.K. Das. Urology Department, R.G. Kar Medical College, Kolkata, India. Received 14 July 2014; received in revised form ...

Incidental multiple pulmonary nodules: benign metastasizing leiomyoma and 18F-FDG PET/CT

International Nuclear Information System (INIS)

Lee, Seok Mo

2007-01-01

Benign metastasizing leiomyoma(BML) is a rare condition affecting women with a history of having undergone hysterectomy or myomectomy for a benign uterine fibroid, that is found to have metastasized to extrauterine sites, usually many years after hysterectomy. 1,2) Patient with BML almost always asymptomatic, although if the lesions are large enough, they can cause compressive symptoms. Among several hypothesis of pathogenesis, most plausible theory is that these tumors represent a true metastatic lesion but are very low-grade sarcoma. 3) Because the tumor is responsive to estrogen, menopause and pregnancy have slowed the growth of these lesion 4) and it seems reasonable to perform hysterectomy in patients with a uterine mass and, at the same time, perform oophorectomy for hormonal control. BML is an unusual cause of diffuse pulmonary nodules which should be considered in females with unexplained nodules and a history of surgery for uterine leiomyoma

The giant kidney worm (Dioctophyma renale) infection in man in Australia.

Science.gov (United States)

Fernando, S S

1983-04-01

A 47-year-old, previously healthy farmer from Grafton, N.S.W. in Australia, developed loin pain and hematuria 2 months after minor trauma to his loin. A renal cyst was found by ultrasound and arteriography. At operation, a thick-walled cyst containing 800 ml of clotted blood was excised together with a small wedge of kidney. Ring-like structures measuring 70 X 45 mu were found in the fibrous cyst wall and in the surrounding fat. These birefringent double-walled "rings" with equally spaced radial striations were identified as the eggs of Dioctophyma renale.

A rare prostatic diagnosis of an old man: a pure prostatic leiomyoma

NARCIS (Netherlands)

Ulden-Bleumink, W.M. van; Dom, P.G.; Ramakers, B.P.C.; Adrichem, N.P. van

2013-01-01

A pure leiomyoma of the prostate is a rare benign tumor. An 82-year-old man was referred to our urology department with gross hematuria and complete urinary retention. Examination revealed a benign prostatic hyperplasia. Transrectal ultrasound showed a prostate of 125 mL. Serum PSA was 1.9 microg/L.

ENDOVASCULAR HEMOSTASIS IN UTERINE BLEEDING IN PATIENTS WITH UTERINE LEIOMYOMA

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M. M. Damirov

2017-01-01

Full Text Available We report results of treatment for 72 patients with uterine leiomyoma (LM of various sizes and location, who had arrived with excessive uterine bleeding. All patients underwent urgent or urgently-delayed endovascular hemostasis by performing uterine arteries embolization (UAE. We analyzed clinical features of the disease after UAE in various sizes of tumors and studied immediate and long-term results of UAE in patients with LM.

SMARCB1 involvement in the development of leiomyoma in a patient with schwannomatosis

NARCIS (Netherlands)

Hulsebos, Theo J. M.; Kenter, Susan; Siebers-Renelt, Ulrike; Hans, Volkmar; Wesseling, Pieter; Flucke, Uta

2014-01-01

Germline SMARCB1 mutations predispose in schwannomatosis patients to the development of multiple benign schwannomas and, in some cases, meningiomas. Here, we report on a 34-year-old female patient who developed multiple schwannomas at various locations and in addition a leiomyoma of the cervix

SMARCB1 Involvement in the Development of Leiomyoma in a Patient With Schwannomatosis

NARCIS (Netherlands)

Hulsebos, T.J.M.; Kenter, S.; Siebers-Renelt, U.; Hans, V.; Wesseling, P.; Flucke, U.E.

2014-01-01

Germline SMARCB1 mutations predispose in schwannomatosis patients to the development of multiple benign schwannomas and, in some cases, meningiomas. Here, we report on a 34-year-old female patient who developed multiple schwannomas at various locations and in addition a leiomyoma of the cervix

Carpal tunnel syndrome due to an atypical deep soft tissue leiomyoma: The risk of misdiagnosis and mismanagement

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Dimitriou Christos G

2007-08-01

Full Text Available Abstract Background Leiomyomas of the deep soft tissue are quite uncommon and occur even more rarely in upper extremity. Case presentation A 32-year old manual laborer man presented with a two-year history of numbness, tingling and burning pain in the palmar surface of the left hand and fingers. His medical history was unremarkable and no trauma episode was reported. According to the clinical examination and the result of median nerve conduction study (NCS the diagnosis of carpal tunnel syndrome was established. Operative release of the transverse carpal ligament was subsequently performed but the patient experienced only temporary relief of his symptoms. MRI examination revealed a deep palmary located mass with well-defined margins and ovoid shape. Intraoperatively, the tumor was in continuity with the flexor digitorum superficialis tendon of the middle finger causing substantial compression to median nerve. Histopathological findings of the resected mass were consistent with leiomyoma. After two years the patient was pain-free without signs of tumor recurrence. Conclusion Despite the fact that reports on deep soft tissue leiomyoma are exceptional, this tumor had to be considered as differential diagnosis in painful non-traumatic hand syndromes especially in young patients.

Expression and imprinting of insulin-like growth factor II (IGF2) and H19 genes in uterine leiomyomas

DEFF Research Database (Denmark)

Rainho, C A; Pontes, A; Rogatto, S R

1999-01-01

status of IGF2 and H19 genes in 47 uterine leiomyomas. Using allelic transcription assay, we detected the expression of the IGF2 gene in 10 of a total of 15 informative cases. No loss of imprinting, as determined by the finding of biallelic expression, was detected in any case. The expression of H19 gene...... was detected in 10 of 20 informative cases and the imprinting pattern was also maintained in all of them. Our data suggest that alterations in IGF2 and H19 genes expression by loss of imprinting do not occur in uterine leiomyomas....

Signaling Pathways in Leiomyoma: Understanding Pathobiology and Implications for Therapy

Science.gov (United States)

Borahay, Mostafa A; Al-Hendy, Ayman; Kilic, Gokhan S; Boehning, Darren

2015-01-01

Uterine leiomyomas are the most common tumors of the female genital tract, affecting 50% to 70% of females by the age of 50. Despite their prevalence and enormous medical and economic impact, no effective medical treatment is currently available. This is, in part, due to the poor understanding of their underlying pathobiology. Although they are thought to start as a clonal proliferation of a single myometrial smooth muscle cell, these early cytogenetic alterations are considered insufficient for tumor development and additional complex signaling pathway alterations are crucial. These include steroids, growth factors, transforming growth factor-beta (TGF-β)/Smad; wingless-type (Wnt)/β-catenin, retinoic acid, vitamin D, and peroxisome proliferator-activated receptor γ (PPARγ). An important finding is that several of these pathways converge in a summative way. For example, mitogen-activated protein kinase (MAPK) and Akt pathways seem to act as signal integrators, incorporating input from several signaling pathways, including growth factors, estrogen and vitamin D. This underlines the multifactorial origin and complex nature of these tumors. In this review, we aim to dissect these pathways and discuss their interconnections, aberrations and role in leiomyoma pathobiology. We also aim to identify potential targets for development of novel therapeutics. PMID:25879625

Robot-assisted "Santosh-Post Graduate Institute tubularized flap pyelovesicostomy" in a solitary functioning kidney with giant hydronephrosis: A minimally invasive salvage procedure.

Science.gov (United States)

Kumar, Santosh; Singh, Shivanshu; Kumar, Navneet

2016-03-01

We describe a case of a solitary functioning kidney with giant hydronephrosis secondary to ureteropelvic junction obstruction in a young girl who underwent successful robot-assisted tubularized flap pyelovesicostomy. The aim of this report was to highlight the feasibility and efficacy of this technique in salvaging such renal moieties and to present a brief review of the surgical options available for the management of giant hydronephrosis.

Strong association of HMB-45 expression with renal angiomyolipoma.

Science.gov (United States)

Yaldiz, Mehmet; Kilinc, Nihal; Ozdemir, Enver

2004-08-01

Angiomyolipoma (AML) is a benign neoplasm consisting of varying mixtures of smooth muscle, blood vessels and fat. Although, most of these tumors are easy to recognize, some may pose a diagnostic dilemma due to unusual histologic features. Recently, it was suggested that melanosome-associated protein (HMB-45) immunoreactivity may be used for diagnostic confirmation of several neoplasm. The aim of this study is to analyze the diagnostic efficacy of HMB-45 in patients with AML. This study was carried out at the Faculty of Medicine, Department of Pathology, Dicle University, Diyarbakir, Turkey, during the period January 2000 to September 2003. HMB-45 immunoreactivity was analyzed in 6 patients with AML and in 34 patients with other renal and retroperitoneal pathologies, including 10 nephrectomized patients for non-neoplastic reasons by means of immunohistochemistry. Patients with AML were positive for HMB-45. Whereas, HMB-45 immunoreactivity was negative in all of the histologic specimens from the patients with renal cell carcinoma, retroperitoneal sarcomas, Wilms' tumor, lipoma, leiomyoma, and nephrectomized kidneys of non-neoplastic reason. The association of AML with HMB-45 immunoreactivity was highly significant (pHMB-45 may not be a melanocyte-restricted marker, and can be useful in differential diagnosis between AML and other tumors seen in kidney and retroperitoneal region.

Preoperative embolization of a giant neurofibroma of the chest in a patient with neurofibromatosis type II: A case report

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Bae, Suk Hyun [Dept. of Radiology, Inje University College of Medicine, Ilsan Paik Hospital, Goyang (Korea, Republic of); Shin, Jong Soo [Dept. of Radiology, Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Seoul (Korea, Republic of)

2017-01-15

Giant plexiform neurofibromas, which are rare in patients with neurofibromatosis type II (NFII), are difficult to manage surgically, as they are extensively infiltrative and highly vascularized. Preoperative embolization is performed to reduce intraoperative blood loss and operative time, increase resectability of lesions, and improve visualization of the operative field during surgery of hypervascular tumors such as renal cell carcinoma and intracranial meningioma. Preoperative intravascular embolization of a giant chest wall neurofibroma has not been reported in the English literature. We report successful treatment of a giant chest wall neurofibroma in a 45-year-old male with NFII by preoperative intravascular embolization followed by surgical resection.

Unilateral leiomyoma in the mesosalpinx of a dog.

Science.gov (United States)

Eker, Kemal; Salmanoğlu, Mehmet Rifat; Vural, Sevil Atalay

2006-01-01

Routine ultrasonographic evaluation of the genital organs of a 3-year-old terrier bitch revealed a mass at the level of the left ovary. The mass was located next to the caudal pole of the left kidney and ventrocaudal to the left ovary. Ultrasonographically, the uterus was not enlarged and had no luminal contents. Exploratory laparotomy revealed a mass attached to the left ovarian bursa with a small and thin pedicle. The mass had smooth margins, was whitish in color, and was lobulated on cut surface. The histopathological diagnosis of the mass was leiomyoma associated with the mesosalpinx.

MRI induced second-degree burn in a patient with extremely large uterine leiomyomas: A case report

International Nuclear Information System (INIS)

Lee, Chul Min; Kang, Bo Kyeong; Song, Soon Young; Koh, Byung Hee; Choi, Joong Sub; Lee, Won Moo

2015-01-01

Burns and thermal injuries related with magnetic resonance imaging (MRI) are rare. Previous literature indicates that medical devices with cable, cosmetics or tattoo are known as risk factors for burns and thermal injuries. However, there is no report of MRI-related burns in Korea. Herein, we reported a case of deep second degree burn after MRI in a 38-year-old female patient with multiple uterine leiomyomas including some that were large and degenerated. The large uterine leiomyoma-induced protruded anterior abdominal wall in direct contact with the body coil during MRI was suspected as the cause of injury, by retrospective analysis. Therefore, awareness of MRI related thermal injury is necessary to prevent this hazard, together with extreme care during MRI

MRI induced second-degree burn in a patient with extremely large uterine leiomyomas: A case report

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Lee, Chul Min; Kang, Bo Kyeong; Song, Soon Young; Koh, Byung Hee; Choi, Joong Sub; Lee, Won Moo [Hanyang University Medical Center, Hanyang University College of Medicine, Seoul (Korea, Republic of)

2015-12-15

Burns and thermal injuries related with magnetic resonance imaging (MRI) are rare. Previous literature indicates that medical devices with cable, cosmetics or tattoo are known as risk factors for burns and thermal injuries. However, there is no report of MRI-related burns in Korea. Herein, we reported a case of deep second degree burn after MRI in a 38-year-old female patient with multiple uterine leiomyomas including some that were large and degenerated. The large uterine leiomyoma-induced protruded anterior abdominal wall in direct contact with the body coil during MRI was suspected as the cause of injury, by retrospective analysis. Therefore, awareness of MRI related thermal injury is necessary to prevent this hazard, together with extreme care during MRI.

Germline fumarate hydratase mutations in patients with ovarian mucinous cystadenoma

DEFF Research Database (Denmark)

Ylisaukko-oja, Sanna K.; Cybulski, Cezary; Lehtonen, Rainer

2006-01-01

Germline mutations in the fumarate hydratase (FH) gene were recently shown to predispose to the dominantly inherited syndrome, hereditary leiomyomatosis and renal cell cancer (HLRCC). HLRCC is characterized by benign leiomyomas of the skin and the uterus, renal cell carcinoma, and uterine...... leiomyosarcoma. The aim of this study was to identify new families with FH mutations, and to further examine the tumor spectrum associated with FH mutations. FH germline mutations were screened from 89 patients with RCC, skin leiomyomas or ovarian tumors. Subsequently, 13 ovarian and 48 bladder carcinomas were...

Efficacy of PET/CT to exclude leiomyoma in patients with lesions suspicious for uterine sarcoma on MRI.

Science.gov (United States)

Kusunoki, Soshi; Terao, Yasuhisa; Ujihira, Takafumi; Fujino, Kazunari; Kaneda, Hiroshi; Kimura, Miki; Ota, Tsuyoshi; Takeda, Satoru

2017-08-01

To analyze the efficacy of positron emission tomography/computed tomography (PET/CT) for the diagnosis of uterine sarcoma. Thirty-four patients evaluated between January 2010 and March 2015 were retrospectively enrolled. All patients in whom uterine sarcoma was suspected based on contrast-enhanced magnetic resonance imaging (MRI) findings (heterogeneous, high signal intensity on T2-weighted images and/or high intensity on T1-weighted images) underwent PET/CT for further assessment. Patients were divided into 2 groups based on postoperative pathological findings: uterine sarcoma (n = 15) and leiomyoma (n = 19). The maximum standardized uptake value (SUVmax) of all lesions was measured using PET/CT; we calculated the optimal cutoff value for diagnosing sarcoma. The median SUVmax for uterine sarcoma and leiomyoma was 12 and 4.1, respectively; these values were significantly different. An SUVmax of greater than 7.5 was able to exclude leiomyoma with 80.8% sensitivity and 100% specificity (area under the curve, 95.3%). A cutoff SUVmax of 7.5 yields 100% specificity, and a cutoff SUVmax of 4.4 yields a 100% negative predictive value (NPV). The combination of PET/CT and lactate dehydrogenase (LDH) levels had a sensitivity of 86.6%, specificity of 100%, positive predictive value of 100%, and an NPV of 90.4%. No relation between histopathology or International Federation of Gynecology and Obstetrics (FIGO) stage and 18-fluoro-2-deoxy-d-glucose uptake value on PET/CT was seen. The surgical outcome trended toward a correlation with the SUVmax, although this was not statistically significant. In patients with MRI findings consistent with either uterine sarcoma or leiomyoma, PET/CT can decrease the false-positive rate by setting an optimal cutoff SUVmax of 7.5. Using this cutoff can avoid unnecessary surgery. Copyright © 2017. Published by Elsevier B.V.

Incidental multiple pulmonary nodules: benign metastasizing leiomyoma and {sup 18}F-FDG PET/CT

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Lee, Seok Mo [Kosin University Medical School, Busan (Korea, Republic of)

2007-06-15

Benign metastasizing leiomyoma(BML) is a rare condition affecting women with a history of having undergone hysterectomy or myomectomy for a benign uterine fibroid, that is found to have metastasized to extrauterine sites, usually many years after hysterectomy. 1,2) Patient with BML almost always asymptomatic, although if the lesions are large enough, they can cause compressive symptoms. Among several hypothesis of pathogenesis, most plausible theory is that these tumors represent a true metastatic lesion but are very low-grade sarcoma. 3) Because the tumor is responsive to estrogen, menopause and pregnancy have slowed the growth of these lesion 4) and it seems reasonable to perform hysterectomy in patients with a uterine mass and, at the same time, perform oophorectomy for hormonal control. BML is an unusual cause of diffuse pulmonary nodules which should be considered in females with unexplained nodules and a history of surgery for uterine leiomyoma.

Endoscopic-assisted resection of a pedunculated uterine leiomyoma with maximal tissue preservation in a cow and a mare.

Science.gov (United States)

Schneeweiss, Wilfried; Krump, Lea; Metcalfe, Lucy; Ryan, Eoin; Beltman, Marijke; Jahns, Hanne; David, Florent

2015-02-01

To report successful minimally invasive treatment of a uterine leiomyoma in a cow and a mare. Clinical report. Limousine cow (n = 1), Thoroughbred mare (n = 1). A 10-year-old cow and an 18-year-old mare were presented for difficulties in breeding and infertility, respectively. Examination of the reproductive tract revealed the presence of a large mass attached to the uterine wall via a wide and short peduncle in both cases. The mass expanded into the uterine lumen in the mare and into the abdomen in the cow. Both masses were removed using a minimally invasive endoscopic approach and a vessel-sealing and dividing device. Minimally invasive surgical resection of a subserosal and a submucosal leiomyoma with maximal sparing of uterine tissue resulted in a short convalescence period and apparent return to breeding function in a cow and a mare. Use of a vessel-sealing and dividing device provided excellent hemostasis and decreased tissue handling. Leiomyoma with short, wide, and thick peduncles were treated successfully in a cow and a mare with minimally invasive endoscopic approaches aiming at maximal uterine tissue preservation. © Copyright 2014 by The American College of Veterinary Surgeons.

Multiple cutaneous leiomyomas: Pain relief with pulsed hysocine butyl bromide

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Kaliyadan Feroze

2009-01-01

Full Text Available A 35-year-old male patient presented to our outpatient department, complaining of multiple, raised skin lesions on the forehead and back, associated with intermittent pain, especially on exposure to cold. A diagnosis of cutaneous leiomyoma (type 2 segmental was made, which was confirmed by skin biopsy. The patient was started on a trial of pulsed Hyoscine Butyl bromide tablets, following which the patient had significant relief from pain associated with the lesions.

Pedunculated uterine leiomyoma associated with pseudo-Meigs' syndrome and elevated CA-125 level: CT features

International Nuclear Information System (INIS)

Kebapci, Mahmut; Aslan, Ozgur; Kaya, Tamer; Yalcin, Omer T.; Ozalp, Sinan

2002-01-01

A 38-year-old woman presented with a 1-week history of low back pain, distension, weakness, and loss of appetite. Laboratory studies showed a serum CA-125 level of 281 U/ml (normal value 1.2-32 U/ml). Abdominopelvic sonography revealed massive ascites, left pleural effusion, and a heterogeneous, hypoechogenic, and smoothly outlined solid mass. The mass had a close proximity and to the anterior side of the right ovary. Doppler sonography showed that the mass was hypervascularized. Computed tomography demonstrated numerous, tortuous vascular structures around the mass and along the omentum indicating its auxiliary vascularization from the omentum. Exploratory laparotomy and histopathological examination revealed pedunculated leiomyoma with parasitized blood supply from the omentum. Ascites and pleural effusion disappeared 6 months after surgery. We present the clinical and CT features of a parasitic leiomyoma adhering to the omentum. (orig.)

Gene Expression in Uterine Leiomyoma from Tumors Likely to Be Growing (from Black Women over 35) and Tumors Likely to Be Non-Growing (from White Women over 35)

Science.gov (United States)

Davis, Barbara J.; Risinger, John I.; Chandramouli, Gadisetti V. R.; Bushel, Pierre R.; Baird, Donna Day; Peddada, Shyamal D.

2013-01-01

The study of uterine leiomyomata (fibroids) provides a unique opportunity to investigate the physiological and molecular determinants of hormone dependent tumor growth and spontaneous tumor regression. We conducted a longitudinal clinical study of premenopausal women with leiomyoma that showed significantly different growth rates between white and black women depending on their age. Growth rates for leiomyoma were on average much higher from older black women than for older white women, and we now report gene expression pattern differences in tumors from these two groups of study participants. Total RNA from 52 leiomyoma and 8 myometrial samples were analyzed using Affymetrix Gene Chip expression arrays. Gene expression data was first compared between all leiomyoma and normal myometrium and then between leiomyoma from older black women (age 35 or older) and from older white women. Genes that were found significant in pairwise comparisons were further analyzed for canonical pathways, networks and biological functions using the Ingenuity Pathway Analysis (IPA) software. Whereas our comparison of leiomyoma to myometrium produced a very large list of genes highly similar to numerous previous studies, distinct sets of genes and signaling pathways were identified in comparisons of older black and white women whose tumors were likely to be growing and non-growing, respectively. Key among these were genes associated with regulation of apoptosis. To our knowledge, this is the first study to compare two groups of tumors that are likely to have different growth rates in order to reveal molecular signals likely to be influential in tumor growth. PMID:23785396

Parasitic leiomyoma after laparoscopic myomectomy

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Srithean Lertvikool

2015-08-01

Full Text Available A 31-year-old nulligravid underwent laparoscopic myomectomy and the masses were removed by an electric morcellator. Five years later, this patient suffered from acute pelvic pain and received an operation. During laparoscopic surgery, an 8-cm right-sided multiloculated ovarian cyst with chocolate-like content was seen. After adhesiolysis, two parasitic myomas (each ∼2 cm in diameter were found attached to the right ovarian cyst and the other two parasitic myomas (each ∼1 cm in diameter were found at the right infundibulopelvic ligament and omentum respectively. These tumors were successfully removed by laparoscopic procedure. Histopathological examination confirmed that all masses were leiomyomas and the right ovarian cyst was confirmed to be endometriosis. The formation of parasitic myomas was assumed that myomatous fragments during morcellation at the time of myomectomy may have been left behind unintentionally. Thus, morcellator should be used carefully. With that being said, all of the myomatous fragment should be removed after morcellation.

Primary Human Uterine Leiomyoma Cell Culture Quality Control: Some Properties of Myometrial Cells Cultured under Serum Deprivation Conditions in the Presence of Ovarian Steroids.

Science.gov (United States)

Bonazza, Camila; Andrade, Sheila Siqueira; Sumikawa, Joana Tomomi; Batista, Fabrício Pereira; Paredes-Gamero, Edgar J; Girão, Manoel J B C; Oliva, Maria Luiza V; Castro, Rodrigo Aquino

2016-01-01

Cell culture is considered the standard media used in research to emulate the in vivo cell environment. Crucial in vivo experiments cannot be conducted in humans and depend on in vitro methodologies such as cell culture systems. However, some procedures involving the quality control of cells in culture have been gradually neglected by failing to acknowledge that primary cells and cell lines change over time in culture. Thus, we report methods based on our experience for monitoring primary cell culture of human myometrial cells derived from uterine leiomyoma. We standardized the best procedure of tissue dissociation required for the study of multiple genetic marker systems that include species-specific antigens, expression of myofibroblast or myoblast markers, growth curve, serum deprivation, starvation by cell cycle synchronization, culture on collagen coated plates, and 17 β-estradiol (E2) and progesterone (P4) effects. The results showed that primary myometrial cells from patients with uterine leiomyoma displayed myoblast phenotypes before and after in vitro cultivation, and leiomyoma cells differentiated into mature myocyte cells under the appropriate differentiation-inducing conditions (serum deprivation). These cells grew well on collagen coated plates and responded to E2 and P4, which may drive myometrial and leiomyoma cells to proliferate and adhere into a focal adhesion complex involvement in a paracrine manner. The establishment of these techniques as routine procedures will improve the understanding of the myometrial physiology and pathogenesis of myometrium-derived diseases such as leiomyoma. Mimicking the in vivo environment of fibrotic conditions can prevent false results and enhance results that are based on cell culture integrity.

Uterine leiomyoma is associated with a polymorphism in the interleukin 1-beta gene.

Science.gov (United States)

Pietrowski, Detlef; Thewes, Roberta; Sator, Michael; Denschlag, Dominik; Keck, Christoph; Tempfer, Clemens

2009-08-01

To investigate whether polymorphisms in the interleukin-1beta (IL-1beta) gene are associated with uterine leiomyoma. Case-control study in a collective of 131 patients and 280 controls. Genotyping of the IL-1beta-511 and IL-1beta-3954 polymorphism was performed by PCR amplification and subsequent RFLP analysis. A significant difference in the allele frequencies of the IL-1beta-511 Cleiomyoma, suggesting that this polymorphism does contribute to the development of this disease.

The co-existence of a myxoid liposarcoma and leiomyoma in the same ovarian mass of a dog.

Science.gov (United States)

Shiwa, Nozomi; Boonsriroj, Hassadin; Kimitsuki, Kazunori; Shimatsu, Taichi; Park, Chun-Ho

2016-03-01

A 15-year-old, female mixed-breed dog presented with abdominal distention. An exploratory laparotomy revealed a large left ovarian mass (20 × 15 × 12 cm). Histopathological examination of the mass revealed a mixed myxoid liposarcoma and a well-differentiated leiomyoma. Four months after surgical removal of the mass, the dog died due to multiorgan metastasis. The metastasis was composed solely of the liposarcoma component. The liposarcoma component was Alcian Blue- and Oil red O-positive, and demonstrated immunoreactivity with S-100, adipophilin and vimentin. Electron microscopy revealed that the tumor cell cytoplasms were packed with lipid vacuoles and dilated rough endoplasmic reticulum. To our knowledge, this is the first report of myxoid liposarcoma and leiomyoma co-existing in a canine ovary.

Lipoleiomyoma of the Uterus and Primary Ovarian Leiomyoma in a Postmenopausal Woman: Two Rare Entities in the Same Individual

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Sefa Kelekci

2015-01-01

Full Text Available Uterine lipoleiomyomas are rare benign tumours that are composed of various mixtures of smooth muscle and mature fat tissue. Leiomyomas, which arise primarily in the ovary, are extremely rare tumours that account for 0.5–1% of all benign ovarian tumours. To the best of our knowledge, we present the first case of an ovarian leiomyoma coexisting with a uterine lipoleiomyoma in the postmenopausal period. A 59-year-old, gravida 4, para 3, postmenopausal woman exhibited pelvic discomfort and increased frequency of micturition. A pelvic examination revealed a solid, tender mass on the left side that could not be clearly separated from the uterus. She underwent a laparotomy with an initial diagnosis of a left ovarian mass. She had previously undergone a total abdominal hysterectomy and bilateral salpingo-oophorectomy. A histopathological examination revealed a uterine lipoleiomyoma, composed of variable amounts of smooth muscle cells and mature adipocytes and a right ovarian leiomyoma composed of interlacing bundles and fascicles of spindle cells. The coexistence of these two rare entities in the same individual may represent a common pathway as a stimulating agent. This case may help to clarify the pathogenesis of these lesions.

Sudden Death by Pulmonary Thromboembolism due to a Large Uterine Leiomyoma with a Parasitic Vein to the Mesentery

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Varsha Podduturi

2014-01-01

Full Text Available The pathophysiology of venous thrombosis is classically attributed to alterations in one or more components of Virchow’s triad: hypercoagulability, stasis, and damage to the vascular endothelium. Deep vein thrombosis (DVT may lead to pulmonary thromboembolism (PE, and the latter is culpable for many deaths annually in the United States; however, DVT as a complication of uterine leiomyoma has rarely been reported. We report a case of a 57-year-old woman whose death was due to a large pedunculated subserosal leiomyoma externally compressing the pelvic veins resulting in stasis and venous thrombosis leading to fatal PE. The association of large pelvic masses with venous thrombosis has clinical implications, since prophylactic surgery could be life-saving.

MK-2206, an AKT Inhibitor, Promotes Caspase-Independent Cell Death and Inhibits Leiomyoma Growth

Science.gov (United States)

Sefton, Elizabeth C.; Qiang, Wenan; Serna, Vanida; Kurita, Takeshi; Wei, Jian-Jun; Chakravarti, Debabrata

2013-01-01

Uterine leiomyomas (ULs), benign tumors of the myometrium, are the number one indication for hysterectomies in the United States due to a lack of an effective alternative therapy. ULs show activation of the pro-survival AKT pathway compared with normal myometrium; however, substantial data directly linking AKT to UL cell survival are lacking. We hypothesized that AKT promotes UL cell survival and that it is a viable target for inhibiting UL growth. We used the investigational AKT inhibitor MK-2206, currently in phase II trials, on cultured primary human UL and myometrial cells, immortalized leiomyoma cells, and in leiomyoma grafts grown under the kidney capsule in mice. MK-2206 inhibited AKT and PRAS40 phosphorylation but did not regulate serum- and glucocorticoid-induced kinase and ERK1/2, demonstrating its specificity for AKT. MK-2206 reduced UL cell viability and decreased UL tumor volumes. UL cells exhibited disruption of mitochondrial structures and underwent cell death that was independent of caspases. Additionally, mammalian target of rapamycin and p70S6K phosphorylation were reduced, indicating that mammalian target of rapamycin complex 1 signaling was compromised by AKT inhibition in UL cells. MK-2206 also induced autophagy in UL cells. Pretreatment of primary UL cells with 3-methyladenine enhanced MK-2206-mediated UL cell death, whereas knockdown of ATG5 and/or ATG7 did not significantly influence UL cell viability in the presence of MK-2206. Our data provide molecular evidence for the involvement of AKT in UL cell survival and suggest that AKT inhibition by MK-2206 may be a viable option to consider for the treatment of ULs. PMID:24002033

Dioctophyma renale in a dog: clinical diagnosis and surgical treatment.

Science.gov (United States)

Ferreira, Vivian Lindmayer; Medeiros, Fábio Pestana; July, José Roberto; Raso, Tânia Freitas

2010-02-26

This study reports a case of parasitism by the giant kidney worm, Dioctophyma renale, diagnosed in the right kidney of a domestic dog. An adult female German Shepherd was attended with clinical history of prostration and hyporexia. The hemogram showed changes compatible with an inflammatory process, for that reason, an abdominal ultrasound was requested. Ultrasound image suggested the presence of D. renale in the right kidney. The diagnosis was confirmed after urinalysis due to the presence of dioctophymas ova in the urinary sediment. Surgical treatment was made and the animal had an excellent recovery after the nephrectomy was performed. Generally, in almost all cases, parasitism by D. renale in domestic dogs is a necropsy finding, nevertheless imaging techniques as sonography and laboratorial exams as urinalysis have been proven to be important tools to achieve diagnosis. The purpose of this study is to report a case of parasitism by D. renale where diagnosis and treatment were made in time to allow the patient's recovery.

Primary Human Uterine Leiomyoma Cell Culture Quality Control: Some Properties of Myometrial Cells Cultured under Serum Deprivation Conditions in the Presence of Ovarian Steroids.

Directory of Open Access Journals (Sweden)

Camila Bonazza

Full Text Available Cell culture is considered the standard media used in research to emulate the in vivo cell environment. Crucial in vivo experiments cannot be conducted in humans and depend on in vitro methodologies such as cell culture systems. However, some procedures involving the quality control of cells in culture have been gradually neglected by failing to acknowledge that primary cells and cell lines change over time in culture. Thus, we report methods based on our experience for monitoring primary cell culture of human myometrial cells derived from uterine leiomyoma. We standardized the best procedure of tissue dissociation required for the study of multiple genetic marker systems that include species-specific antigens, expression of myofibroblast or myoblast markers, growth curve, serum deprivation, starvation by cell cycle synchronization, culture on collagen coated plates, and 17 β-estradiol (E2 and progesterone (P4 effects. The results showed that primary myometrial cells from patients with uterine leiomyoma displayed myoblast phenotypes before and after in vitro cultivation, and leiomyoma cells differentiated into mature myocyte cells under the appropriate differentiation-inducing conditions (serum deprivation. These cells grew well on collagen coated plates and responded to E2 and P4, which may drive myometrial and leiomyoma cells to proliferate and adhere into a focal adhesion complex involvement in a paracrine manner. The establishment of these techniques as routine procedures will improve the understanding of the myometrial physiology and pathogenesis of myometrium-derived diseases such as leiomyoma. Mimicking the in vivo environment of fibrotic conditions can prevent false results and enhance results that are based on cell culture integrity.

Pedunculated uterine leiomyoma associated with pseudo-Meigs' syndrome and elevated CA-125 level: CT features

Energy Technology Data Exchange (ETDEWEB)

Kebapci, Mahmut; Aslan, Ozgur; Kaya, Tamer [Department of Radiology, Osmangazi University School of Medicine, Meselik, 26480 Eskisehir (Turkey); Yalcin, Omer T.; Ozalp, Sinan [Department of Obstetrics and Gynecology, Osmangazi University School of Medicine, Meselik, 26480 Eskisehir (Turkey)

2002-07-01

A 38-year-old woman presented with a 1-week history of low back pain, distension, weakness, and loss of appetite. Laboratory studies showed a serum CA-125 level of 281 U/ml (normal value 1.2-32 U/ml). Abdominopelvic sonography revealed massive ascites, left pleural effusion, and a heterogeneous, hypoechogenic, and smoothly outlined solid mass. The mass had a close proximity and to the anterior side of the right ovary. Doppler sonography showed that the mass was hypervascularized. Computed tomography demonstrated numerous, tortuous vascular structures around the mass and along the omentum indicating its auxiliary vascularization from the omentum. Exploratory laparotomy and histopathological examination revealed pedunculated leiomyoma with parasitized blood supply from the omentum. Ascites and pleural effusion disappeared 6 months after surgery. We present the clinical and CT features of a parasitic leiomyoma adhering to the omentum. (orig.)

Abnormal uterine bleeding as a presenting symptom is related to multiple uterine leiomyoma: an ultrasound-based study

Directory of Open Access Journals (Sweden)

Fonseca-Moutinho JA

2013-10-01

Full Text Available José Alberto Fonseca-Moutinho,1,2 Lígia Silva Barbosa,1 Daniel Gonçalves Torres,1 Sara Morgado Nunes31Faculty of Health Sciences, School of Medicine, Beira Interior University, Covilhã, Portugal; 2Child and Women Department, Cova da Beira Academic Medical Center, Covilhã, Portugal; 3Polytechnic Institute of Castelo Branco, Castelo Branco, PortugalPurpose: To determine the prevalence of uterine leiomyomas, diagnosed by ultrasound, in a private health care setting located in the central eastern region of Portugal, and to explore the demographic and clinical factors related to diagnosis and symptomatology.Patients and methods: The files of 624 patients attending a private clinic in Covilhã, Portugal, from January 2 to December 31, 2010 were retrieved for evaluation. Pelvic ultrasound record, age, weight, height, age at menarche, number of pregnancies and deliveries, marital status, menstrual cycles characteristic, and contraceptive method at consultation were included in the analysis.Results: Uterine leiomyoma (UL was diagnosed by ultrasonography in 161 (25.8% patients. A single UL was diagnosed in 80 (49.7% patients. In 79 (49.1% patients, the largest leiomyoma had a dimension <20 mm. Prevalence of UL was age dependent: at 11.0% for women 20–39 years old; 45.4% for those aged 40–59 years; and 19.5% for women 60 years or older. Metrorrhagia was the most distressing presenting symptom. When menorrhagia was the presenting symptom, the probability of having an ultrasound diagnosis of UL was 73.3%. Metrorrhagia or menorrhagia, as presenting symptom, was significantly related to the ultrasound diagnosis of multiple ULs.Conclusion: UL was especially prevalent in women aged between 40 and 59 years. Patients with multiple ULs had significantly more abnormal uterine bleeding. In patients with menorrhagia or metrorrhagia, special attention should be taken in searching for the presence of multiple ULs during ultrasound.Keywords: fibroid, leiomyoma

Strong association of HMB-45 expression with renal angiomyolipoma

International Nuclear Information System (INIS)

Yaldiz, Mehmet; Kilinc, Niha; Ozdemir, Enver

2004-01-01

Angiomyolipoma (AML) is a benign neoplasm consisting of varying mixtures of smooth muscle, blood vessels and fat. Although, most of these tumors are easy to recognize, some may pose a diagnostic dilemma due to unusual histologic features. Recently, it was suggested that melanosome-associated protein (HMB-45) immunoreactivity may be used for diagnostic confirmation of several neoplasm. The aim of this study is to analyze the diagnostic efficacy of HMB-45 in patients with AML. This study was carried out at the Faculty of Medicine, Department of Pathology, Dicle University, Diyarbakir, Turkey, during the period January 2000 to September 2003. HMB-45 immunoreactivity was analyzed in 6 patients with AML and in 34 patients with other renal and retroperitoneal pathologies, including 10 nephrectomized patients for non-neoplastic reasons by means of immunohistochemistry. Patients with AML were positive for HMB-45. Whereas, HMB-45 immunoreactivity was negative in all of the histologic specimens from the patients with renal cell carcinoma, retroperitoneal sarcomas, Wilms tumor, lipoma, leiomyoma, and nephrectomized kidneys of non-neoplastic reason. The association of AML with HMB-45 immunoreactivity was highly significant (p<0.001). Our findings suggest that HMB-45 may not be a melanocyte-restricted marker, and can be useful in differential diagnosis between AML and other tumors seen in kidney and retroperitoneal region. (author)

The relation between histological, tumor-biological and clinical parameters in deep and superficial leiomyosarcoma and leiomyoma.

NARCIS (Netherlands)

Pijpe, Justin; Broers, Gerben H Torn; Plaat, Boudewijn E Ch; Hundeiker, M; Otto, F; Mastik, Mirjam F; Hoekstra, Harald J; Graaf, Winette T A van der; van den Berg, Eva; Molenaar, Willemina M

2002-01-01

Purpose: Leiomyosarcomas (LMS) of deep and superficial tissues were examined to identify prognostic markers explaining their different biological behaviour and to define differences between cutaneous and subcutaneous LMS. LMS and leiomyomas (LM) of the skin were compared to and consistent

Effect of Direct Marketing for Uterine Artery Embolization on Rates of Leiomyomas, Incidental Findings, and Management After Pelvic MRI.

Science.gov (United States)

Gurwara, Sheena; Allen, Brian C; Kouri, Brian; Clingan, M Jennings; Picard, Melissa; Leyendecker, John R

2016-07-01

The aim of this study was to determine whether a self-referred population screened by an interventional radiology (IR) clinic and a non-IR, physician-referred population differed with regard to suitability for uterine artery embolization (UAE) for symptomatic leiomyomas on the basis of preprocedure MRI. This was an institutional review board-approved, HIPAA-compliant retrospective study of 301 women evaluated in an IR clinic for possible UAE from January 2009 to September 2012. Subjects were retrospectively divided into two groups: self-referred via direct marketing (group A, n = 203; mean age, 41.8 years; range, 22-58 years) and physician referred (group B, n = 98; mean age, 42.9 years; range, 30-65 years). There was no significant difference between groups in presenting symptoms (multiple symptoms, bleeding, bulk-related symptoms, pain). After initial screening, 73.4% of group A (149 of 203) and 79.6% of group B (78 of 98) underwent MRI (P = .242). On the basis of MRI findings, 91.3% of group A (136 of 149) and 94.9% of group B (74 of 78) had uterine leiomyomas (P = .328). Adenomyosis without leiomyoma was present in 4.0% of group A (6 of 149) and 3.8% of group B (3 of 78) (P = .947). Incidental findings requiring further clinical or imaging evaluation were found in 20.8% of group A (31 of 149) and 24.4% of group B (19 of 78) (P = .539). After MRI, 41.6% of group A (62 of 149) and 48.7% of group B (38 of 78) proceeded to UAE (P = .306). After initial screening, similar proportions of self-referred and physician-referred patients were candidates for UAE. The rates of confirmed leiomyomas and incidental findings on MRI were similar between groups. Copyright © 2016 American College of Radiology. All rights reserved.

Leiomyoma of uterus in a patient with ring chromosome 12: Case presentation and literature review

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Hajianpour, M.J.; Habibian, R.; Hajianpour, A.K. [Children`s Hospital, Los Angeles, CA (United States)] [and others

1996-05-17

We report on a 30-year-old woman with de novo ring chromosome 12 mosaicism, 46,XX,r(12)(p13.3q24.3)/46,XX. In addition to the clinical manifestations generally observed in {open_quotes}ring syndrome{close_quotes} cases such as growth retardation, short stature, microcephaly, and mental deficiency, she had a broad nasal bridge, micrognathia with overbite, underdeveloped breasts, mild dorsal scoliosis, clinodactyly of the fifth fingers with a single interdigital crease, symphalangism of thumbs, tapering fingers, mild cutaneous syndactyly between the second and third toes, multiple cafe-au-lait spots, sebaceous acne on the face and back, and mild dystrophic toenails. She developed a large, pedunculated uterine leiomyoma at age 28 years. To our knowledge, uterine leiomyoma in association with r(12) has not been reported previously. However, a gain of chromosome 12 and translocations involving 12q14-15 have been described. 12 refs., 5 figs., 2 tabs.

Does life-course socioeconomic position influence racial inequalities in the occurrence of uterine leiomyoma? Evidence from the Pro-Saude Study

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Karine de Limas Irio Boclin

2014-02-01

Full Text Available We aimed to investigate whether life-course socioeconomic position mediates the association between skin color/race and occurrence of uterine leiomyomas. We analyzed 1,475 female civil servants with baseline data (1999-2001 of the Pró-Saúde Study in Rio de Janeiro State, Brazil. Life-course socioeconomic position was determined by parental education (early life socioeconomic position, participant education (socioeconomic position in early adulthood and their combination (cumulative socioeconomic position. Gynecological/breast exams and health insurance status were considered markers of access to health care. Hazard ratios (HR and 95% confidence intervals (95%CI were estimated using Cox proportional hazards models. Compared with white women, black and parda (“brown” women had higher risk of reporting uterine leiomyomas, respectively HR: 1.6, 95%CI: 1.2-2.1; HR: 1.4, 95%CI: 0.8-2.5. Estimates were virtually identical in models including different variables related to life-course socioeconomic position. This study corroborated previous evidence of higher uterine leiomyomas risk in women with darker skin color, and further suggest that life-course socioeconomic position adversity does not influence this association.

Efficacy of PET/CT to exclude leiomyoma in patients with lesions suspicious for uterine sarcoma on MRI

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Soshi Kusunoki

2017-08-01

Conclusions: In patients with MRI findings consistent with either uterine sarcoma or leiomyoma, PET/CT can decrease the false-positive rate by setting an optimal cutoff SUVmax of 7.5. Using this cutoff can avoid unnecessary surgery.

Atypical leiomyoma arising in a hepatic vein with extension into the inferior vena cava and right atrium

International Nuclear Information System (INIS)

Dunlap, H.J.; Udjus, K.

1990-01-01

We report an atypical leiomyoma arising in a hepatic vein and extending into the inferior vena cava and right atrium in a fourteen year old boy. US, CT and MRI facilitated diagnosis and removal of this tumor. (orig.)

Canine Uterine Leiomyoma with Epithelial Tissue Foci, Adenomyosis, and Cystic Endometrial Hyperplasia

OpenAIRE

Karagiannis, George S.; Pelekanis, Mihalis; Loukopoulos, Panayiotis; Ververidis, Haris N.; Kaldrymidou, Eleni

2011-01-01

An 11-year-old Labrador Retriever bitch with a history of intermittent, sanguineous vaginal discharge of a six-month duration was presented. During exploratory laparotomy, two well-delineated, intramural masses were identified bilaterally in the uterine horns. Histopathologic examination of the mass on the left horn showed that it was a typical leiomyoma. However, the second mass appeared with an unusual coexistence of histological lesions, involving epithelial tissue foci, mild focal adenomy...

[Leiomyoma of the small bowel with hypercalcaemia: presence of a substance with parathormone activity (author's transl)].

Science.gov (United States)

Rathaus, M; Bernheim, J L; Griffel, B; Bernheim, J; Taragan, R; Gutman, A

1979-10-22

A leiomyoma of the small bowel produced laboratory features of hyperparathyroidism which disappeared promptly after tumour resection. Hypercalcaemia, hypophosphatemia, hyperchloremia, elevated chloride/phosphorus ratio, increased urinary cyclic AMP, and blood levels of immunoreactive parathormone were present. Electron microscopy showed dense round granules in the tumour cells.

Benign Metastasizing Leiomyoma of the Lung: Clinicopathologic, Immunohistochemical, and Micro-RNA Analyses

OpenAIRE

Nuovo, Gerard J.; Schmittgen, Thomas D.

2008-01-01

Benign metastasizing leiomyomas are rare tumors, which are typically found in the lungs and, thus, might be confused with leiomyosarcomas. Further, it is not clear whether the term “benign metastasizing leiomyoma” is a misnomer and whether these lesions actually represent low-grade malignant tumors that have a low proliferation index. Micro-RNAs (miRNAs) are small noncoding RNAs, which repress translation. The altered expression of miRNAs has been strongly correlated with the malignant phenot...

[The molecular mechanisms and morphological manifestations of leiomyoma reduction induced by selective progesterone receptor modulators].

Science.gov (United States)

Demura, T A; Revazova, Z V; Kogan, E A; Adamyan, L V

to investigate the molecular mechanisms and morphological substrate of reduced uterine leiomyoma in patients receiving the selective progesterone receptor modulator (SPRM) ulipristal acetate for 3 months, by estimating the immunohistochemical expression of the markers steroid receptor coactivator 1 (SRC-1), nuclear receptor corepressor 1 (NCoR-1), ER, PgR, Ki-67, p16, TGF-β, and VEGF in tumor tissue. The investigation enrolled 75 women with uterine leiomyoma, menorrhagias, and anemia. Group 1 included 40 patients who were treated with ulipristal for 3 months, followed by laparoscopic myomectomy. Group 2 consisted of 35 patients who underwent surgery without previous preparation. The intra- and postoperative parameters and molecular and morphological changes in the myomatous nodules were comparatively analyzed in both groups. After 3 months of therapy initiation, menorrhagia completely ceased, myomatous nodules decreased in size (pleiomyoma reduction was leiomyocyte apoptosis and dystrophy, tumor stroma sclerosis and hyalinosis with diminished Ki-67 expression and elevated p16 in the smooth muscle cells, trophic nodular tissue disorders exhibited by vascular wall sclerosis and lower VEGF and TGF-β expression, and leiomyocyte hormonal reception dysregulation that made itself evident through the reduced expression of SRC-1 with the unchanged expression of PR and ER and the maintained level of NCoR-1. The molecular mechanisms of tumor reduction involved the reduced Ki-67 expression and elevated p16, lower VEGF and TGF-β, diminished SRC-1 expression with the maintained level of PR, ER, and NCoR-1. Overall, this is suggestive of enhanced apoptosis and reduced leiomyoma proliferation and angiogenesis induced by SPRM and indicative of the expediency of using ulipristal acetate as a preoperative agent for organ-sparing surgery in reproductive-aged patients with uterine myoma, menorrhagias, and anemia.

Characterization of a recurrent t(1;2)(p36;p24) in human uterine leiomyoma.

NARCIS (Netherlands)

Rijk, A. van; Sweers, M.A.; Huys, E.; Kersten, M.; Merkx, G.F.M.; Geurts van Kessel, A.H.M.; Debiec-Rychter, M.; Schoenmakers, E.F.P.M.

2009-01-01

Uterine leiomyomas are the most common neoplasms in women of reproductive age. Approximately 40% of these neoplasms show recurring structural cytogenetic anomalies, including del(7)(q22), t(12;14)(q15;q24), t(1;2)(p36;p24), and anomalies affecting 6p21 or 10q22. Using positional cloning strategies,

Transvaginal expulsion of intramural leiomyoma after uterine artery embolization: case report

Energy Technology Data Exchange (ETDEWEB)

Lee, Seung Woo; Cho, Jae Ho; Park, Won Kyu; Lee, Doo Jin [College of Medicine, Yeungnam Univ., Daegu (Korea, Republic of)

2004-03-01

We report a case in which an intramural uterine Ieiomyoma was transvaginally expelled after uterine arterial embolization (UAE). A 29-year-old unmarried female presented with vaginal bleeding, and at pre-treatment MRI an intramural leiomyoma was diagnosed. UAE was performed and after 13 days the tumor was transvaginally expelled. Follow-up MRI performed seven days later depicted a large myometrial defect in the anterior uterine wall; subsequent follow-up MRI showed that the defect became gradually smaller, and the size and configuration of the uterus progressively normalized.

Giant grains

International Nuclear Information System (INIS)

Leitch-Devlin, M.A.; Millar, T.J.; Williams, D.A.

1976-01-01

Infrared observations of the Orion nebula have been interpreted by Rowan-Robinson (1975) to imply the existence of 'giant' grains, radius approximately 10 -2 cm, throughout a volume about a parsec in diameter. Although Rowan-Robinson's model of the nebula has been criticized and the presence of such grains in Orion is disputed, the proposition is accepted, that they exist, and in this paper situations in which giant grains could arise are examined. It is found that, while a giant-grain component to the interstellar grain density may exist, it is difficult to understand how giant grains arise to the extent apparently required by the Orion nebula model. (Auth.)

Bilateral renal dysplasia, nephroblastomatosis, and bronchial stenosis. A new syndrome?

Science.gov (United States)

Rodriguez, Maria Matilde; Correa-Medina, Mayrin; Whittington, Elizabeth E

2015-06-01

Bilateral nephroblastomatosis (NB) is an uncommon renal anomaly characterized by multiple confluent nephrogenic rests scattered through both kidneys, with only a limited number of cases reported in the medical literature. Some of these children may have associated either Perlman or Beckwith-Wiedemann syndrome and others do not demonstrate syndromic features. We report a full-term boy with anteverted nose, bilateral bronchial stenosis due to lack of cartilage, bilateral obstructive renal dysplasia and NB with glomeruloid features. The infant had visceromegaly, but neither gigantism nor hemihypertrophy. Immunohistochemistry for PAX2 (Paired box gene-2) and WT-1 (Wilms Tumor 1) were strongly positive in the areas of NB. GLEPP-1 (Glomerular Epithelial Protein) did not stain the areas of NB with a glomeruloid appearance, but was positive in the renal glomeruli as expected. We found neither associated bronchial stenosis nor the histology of NB resembling giant glomeruli in any of the reported cases of NB.

Esophageal Leiomyoma with intense FDG uptake on {sup 18}F-FDG PET/CT

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Lee, Seok Mo; Bae, Sang Kyun [Inje university Medical School, Busan (Korea, Republic of)

2008-10-15

A 56 years old woman referred to our hospital with dysphagia and epigastric soreness. Gastroendoscopy revealed huge submucosal tumor with ulceration extending from distal esophagus to lesser curvature of stomach. Subsequent computed tomography (CT) demonstrated soft tissue mass encircling distal esophagus, and 18F-FDG PET/CT demonstrated intense {sup 18}F-FDG accumulation in it. Finally this case was diagnosed as esophageal leiomyoma based on pathologic evaluation of the surgical specimen.

Ultrasound guided high-intensity focused ultrasound combined with gonadotropin releasing hormone analogue (GnRHa) ablating uterine leiomyoma with homogeneous hyperintensity on T2 weighted MR imaging.

Science.gov (United States)

Yang, Shenghua; Kong, Fanjing; Hou, Ruijie; Rong, Fengmei; Ma, Nana; Li, Shaoping; Yang, Jun

2017-05-01

The study aimed to evaluate the safety and efficiency of ultrasound-guided high-intensity focused ultrasound (USgHIFU) combined with gonadotropin-releasing hormone analogue (GnRHa)-ablating symptomatic uterine leiomyoma with homogeneous hyperintensity on T 2 weighted MRI prospectively. A total of 34 patients with 42 symptomatic uterine leiomyomas with homogeneous hyperintensity on T 2 weighted MRI were enrolled in our study. In the patient who had multiple uterine leiomyomas, only one dominant leiomyoma was treated. According to the principles of voluntariness, 18 patients underwent a 3-month therapy of GnRHa (once a month) before the high-intensity focused ultrasound (HIFU) treatment, while 16 patients received only HIFU treatment. Enhanced MRI was performed before and after GnRHa and HIFU treatment. Evaluation of the main indicators included treatment time, sonication time, treatment efficiency, non-perfused volume (NPV) (indicative of successful ablation) ratio and energy effect ratio; adverse events were also recorded. The treatment time and sonication time of the combination group were 102.0 min (55.8-152.2 min) and 25.4 min (12.2-34.1 min); however, they were 149.0 min (87.0-210.0 min) and 38.9 min (14.0-46.7 min) in the simple USgHIFU group. The treatment and sonication time for the combination group was significantly shorter than that for the simple USgHIFU group. Treatment efficiency, NPV ratio and energy effect ratio were 46.7 mm 3  s -1 (28.5-95.8 mm 3  s -1 ), 69.2 ± 29.8% (35.5-97.4%) and 9.9 KJ mm -3 (4.5-15.7 KJ mm -3 ) in the combination group, respectively; but, the lowest treatment efficiency, lowest NPV ratio and more energy effect ratio were observed in the simple HIFU group, which were 16.8 mm 3  s -1 (8.9-32.9 mm 3  s -1 ), 50.2 ± 27.3% (0-78.6%) and 23.8 KJ mm -3 (12.4-46.2 KJ mm -3 ), respectively. Pain scores in the combination group were 3.0 ± 0.5 points (2-4 points

MiRNA-TF-gene network analysis through ranking of biomolecules for multi-informative uterine leiomyoma dataset.

Science.gov (United States)

Mallik, Saurav; Maulik, Ujjwal

2015-10-01

Gene ranking is an important problem in bioinformatics. Here, we propose a new framework for ranking biomolecules (viz., miRNAs, transcription-factors/TFs and genes) in a multi-informative uterine leiomyoma dataset having both gene expression and methylation data using (statistical) eigenvector centrality based approach. At first, genes that are both differentially expressed and methylated, are identified using Limma statistical test. A network, comprising these genes, corresponding TFs from TRANSFAC and ITFP databases, and targeter miRNAs from miRWalk database, is then built. The biomolecules are then ranked based on eigenvector centrality. Our proposed method provides better average accuracy in hub gene and non-hub gene classifications than other methods. Furthermore, pre-ranked Gene set enrichment analysis is applied on the pathway database as well as GO-term databases of Molecular Signatures Database with providing a pre-ranked gene-list based on different centrality values for comparing among the ranking methods. Finally, top novel potential gene-markers for the uterine leiomyoma are provided. Copyright © 2015 Elsevier Inc. All rights reserved.

Letter to Editor: Carpal tunnel syndrome due to an atypical deep soft tissue leiomyoma: The risk of misdiagnosis and mismanagement

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Caliandro Pietro

2008-02-01

Full Text Available Abstract A response to Chalidis et al: Carpal tunnel syndrome due to an atypical deep soft tissue leiomyoma: The risk of misdiagnosis and mismanagement. World J Surg Oncol 2007, 5:92.

Allometry indicates giant eyes of giant squid are not exceptional.

Science.gov (United States)

Schmitz, Lars; Motani, Ryosuke; Oufiero, Christopher E; Martin, Christopher H; McGee, Matthew D; Gamarra, Ashlee R; Lee, Johanna J; Wainwright, Peter C

2013-02-18

The eyes of giant and colossal squid are among the largest eyes in the history of life. It was recently proposed that sperm whale predation is the main driver of eye size evolution in giant squid, on the basis of an optical model that suggested optimal performance in detecting large luminous visual targets such as whales in the deep sea. However, it is poorly understood how the eye size of giant and colossal squid compares to that of other aquatic organisms when scaling effects are considered. We performed a large-scale comparative study that included 87 squid species and 237 species of acanthomorph fish. While squid have larger eyes than most acanthomorphs, a comparison of relative eye size among squid suggests that giant and colossal squid do not have unusually large eyes. After revising constants used in a previous model we found that large eyes perform equally well in detecting point targets and large luminous targets in the deep sea. The eyes of giant and colossal squid do not appear exceptionally large when allometric effects are considered. It is probable that the giant eyes of giant squid result from a phylogenetically conserved developmental pattern manifested in very large animals. Whatever the cause of large eyes, they appear to have several advantages for vision in the reduced light of the deep mesopelagic zone.

Gorlin syndrome with an ovarian leiomyoma associated with a PTCH1 second hit.

Science.gov (United States)

Akizawa, Yoshika; Miyashita, Toshiyuki; Sasaki, Ryo; Nagata, Reiko; Aoki, Ryoko; Ishitani, Ken; Nagashima, Yoji; Matsui, Hideo; Saito, Kayoko

2016-04-01

We describe a Gorlin syndrome (GS) case with two different second hit mutations of PTCH1, one in a keratocystic odontogenic tumor (KCOT) and the other in an ovarian leiomyoma. GS is a rare genetic condition manifesting as multiple basal cell nevi associated with other features such as medulloblastomas, skeletal abnormalities, and ovarian fibromas. A 21-year-old Japanese woman with a history of two KCOTs was diagnosed with GS according to clinical criteria. A PTCH1 mutation, c.1427del T, was detected in peripheral blood. A novel PTCH1 mutation, c.264_265insAATA, had been found in the maxillary KCOT as a second hit mutation. More recently, the ovarian tumor was detected during a gynecological examination. Laparoscopic adnexectomy was performed, and the pathological diagnosis of the ovarian tumor was leiomyoma. Interestingly, another novel mutation, loss of heterozygosity spanning from 9q22.32 to 9q31.2, including PTCH1 and 89 other genes, was detected in this ovarian tumor, providing evidence of a second hit mutation. This is the first report describing a GS-associated ovarian tumor carrying a second hit in the PTCH1 region. We anticipate that accumulation of more cases will clarify the importance of second hit mutations in ovarian tumor formation in GS. © 2016 Wiley Periodicals, Inc.

Low-Grade Uterine Epithelioid Hemangioendothelioma Presented as a Submucosal Leiomyoma during Labor

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Anastasios V. Koutsopoulos

2013-01-01

Full Text Available With the exception of leiomyomas, soft tissue tumors of the uterine corpus are not common. This is particularly true for vascular neoplasms, with the epithelioid hemangioendothelioma being a curiosity; not more than twenty-two cases of malignant hemangioendotheliomas have been reported in the literature so far, all of which were high-grade hemangioendotheliomas (hemangiosarcomas. We present herewith a unique case of low-grade epithelioid hemangioendothelioma of the uterus in a pregnant woman aged 29 years. The clinical, histological, and immunohistochemical characteristics of this entity, together with its differential diagnosis, are discussed.

The management of uterine leiomyomas.

Science.gov (United States)

Vilos, George A; Allaire, Catherine; Laberge, Philippe-Yves; Leyland, Nicholas

2015-02-01

The aim of this guideline is to provide clinicians with an understanding of the pathophysiology, prevalence, and clinical significance of myomata and the best evidence available on treatment modalities. The areas of clinical practice considered in formulating this guideline were assessment, medical treatments, conservative treatments of myolysis, selective uterine artery occlusion, and surgical alternatives including myomectomy and hysterectomy. The risk-to-benefit ratio must be examined individually by the woman and her health care provider. Implementation of this guideline should optimize the decision-making process of women and their health care providers in proceeding with further investigation or therapy for uterine leiomyomas, having considered the disease process and available treatment options, and reviewed the risks and anticipated benefits. Published literature was retrieved through searches of PubMed, CINAHL, and Cochrane Systematic Reviews in February 2013, using appropriate controlled vocabulary (uterine fibroids, myoma, leiomyoma, myomectomy, myolysis, heavy menstrual bleeding, and menorrhagia) and key words (myoma, leiomyoma, fibroid, myomectomy, uterine artery embolization, hysterectomy, heavy menstrual bleeding, menorrhagia). The reference lists of articles identified were also searched for other relevant publications. Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date limits but results were limited to English or French language materials. Searches were updated on a regular basis and incorporated in the guideline to January 2014. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, and national and international medical specialty societies. The majority of fibroids are asymptomatic and require no intervention or further

Centrarchid fish as paratenic hosts of the giant kidney worm, Dioctophyma renale (Goeze, 1782), in Ontario, Canada.

Science.gov (United States)

Measures, L N; Anderson, R C

1985-01-01

Infective larvae of Dioctophyma renale were found in the hypaxial musculature of pumpkinseed (Lepomis gibbosus L.) from three lakes in Algonquin Provincial Park, Ontario, Canada. This represents the first report of D. renale in centrarchid fish. In the three lakes surveyed prevalence and mean intensity ranged from 5 to 23% and one to two larvae respectively. Larvae elicited a mild granulomatous reaction in pumpkinseed. Two ferrets were each given five larvae from pumpkinseed. Adult D. renale were recovered from the right kidney capsule of ferrets 108 and 134 days post-infection. An opening in the ventral surface of the right kidney capsule was present in one ferret. Chronic peritonitis was associated with eggs of D. renale and cellular debris which probably entered the abdominal cavity from the right kidney capsule.

Leiomioma vascular bucal: relato de dois casos, revisão da literatura e estudo imuno-histoquímico Oral vascular leiomyoma: report of two cases, review of literature and immunohistochemistry study

Directory of Open Access Journals (Sweden)

Vanessa Ávila Sarmento Silveira

2007-06-01

Full Text Available INTRODUÇÃO: Os leiomiomas são neoplasias benignas do músculo liso que ocorrem mais comumente nos tratos geniturinário e gastrintestinal, entretanto são raros na cavidade bucal, na qual provavelmente a maioria desses tumores tem sua origem a partir de músculo liso vascular. OBJETIVOS: Relatar dois casos com história clínica semelhante, confrontando seus aspectos com aqueles encontrados na literatura. RELATO DOS CASOS: Dois casos de mulheres na quinta e sexta décadas de vida apresentando nódulo submucoso em ventre lingual. Após exame microscópico que revelou numerosos vasos sangüíneos entremeados a células fusiformes, com núcleos ovalados ou alongados, e exame imuno-histoquímico com positividade para actina de músculo liso nos dois casos, o diagnóstico final foi leiomioma vascular. CONCLUSÃO: O estudo do leiomioma vascular bucal é de extrema importância devido à raridade e semelhança desse com outras lesões da cavidade bucal. A análise imuno-histoquímica é importante para o diagnóstico final do leiomioma.INTRODUCTION: The leiomyomas are benign tumors of smooth muscle origin, which are more frequently found in genitourinary and gastrointestinal tracts. However, leiomyomas rarely arise in the oral cavity, and when it happens, the majority of them is originated by smooth muscle of blood vessels. AIMS: Report two cases of oral vascular leiomyoma with similar clinical characteristics, and discuss their aspects with the literature. CASE REPORT: Two cases of vascular leiomyoma in women that presented a nodular mass in the tongue ventral surface were described. The microscopic analysis revealed numerous blood vessels surrounded by spindle cells with ovoid or elongated nuclei. The two cases presented immunopositivity for smooth muscle actin, confirming the diagnosis. CONCLUSION: The study of vascular leiomyoma is required due to its rarity and similar aspects with other oral common lesions. The immunohistochemical analysis is

Third-stage larvae of the enoplid nematode Dioctophyme renale (Goeze, 1782) in the freshwater turtle Trachemys dorbigni from southern Brazil.

Science.gov (United States)

Mascarenhas, C S; Müller, G

2015-09-01

The giant kidney worm Dioctophyme renale is normally found in wild carnivores and domestic dogs, with aquatic oligochaetes acting as intermediate hosts. In the present study a prevalence of 50% of third-stage larvae of D. renale was recorded in 60 specimens of the freshwater turtle Trachemys dorbigni from southern Brazil. Larvae were encysted in muscles, the coelomic cavity and mesentery, the serous lining of the stomach and on the surfaces of the lung, heart, liver, pancreas, spleen and intestines. There are no previous records of reptiles being part of the life cycle of D. renale, although fish and amphibians normally act as paratenic hosts. This is the first report of third-stage D. renale larvae in the freshwater turtle, T. dorbigni.

Prevalence and clinical significance of mediator complex subunit 12 mutations in 362 Han Chinese samples with uterine leiomyoma.

Science.gov (United States)

Wu, Juan; Zou, Yang; Luo, Yong; Guo, Jiu-Bai; Liu, Fa-Ying; Zhou, Jiang-Yan; Zhang, Zi-Yu; Wan, Lei; Huang, Ou-Ping

2017-07-01

Uterine leiomyomas (ULs) are the most common gynecological benign tumors originating from the myometrium. Prevalent mutations in the mediator complex subunit 12 (MED12) gene have been identified in ULs, and functional evidence has revealed that these mutations may promote the development of ULs. However, whether MED12 mutations are associated with certain clinical characteristics in ULs remains largely unknown. In the present study, the potential mutations of MED12 and its paralogous gene, mediator complex subunit 12-like (MED12L), were screened in 362 UL tumors from Han Chinese patients. A total of 158 out of 362 UL tumors (43.6%) were identified as harboring MED12 somatic mutations, and the majority of these mutations were restricted to the 44th residue. MED12 mutations were also observed in 2 out of 145 (1.4%) adjacent control myometrium. Furthermore, the mutation spectrum of MED12 in the concurrent leiomyomas was noticeably different. Correlation analysis of MED12 mutations with the available clinical features indicated that patients with mutated MED12 tended to have smaller cervical diameters. By contrast, no MED12L mutation was identified in the present samples. In summary, the present study demonstrated the presence of prevalent MED12 somatic mutations in UL samples, and the MED12 mutation was associated with smaller cervical diameters. The low mutation frequency of MED12 in adjacent control myometrium indicated that MED12 mutation may be an early event in the pathogenesis of ULs. Furthermore, MED12 mutation status in concurrent tumors from multiple leiomyomas supported several prior observations that the majority of these tumors arose independently.

A Case of Placenta Increta Mimicking Submucous Leiomyoma

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Ali Ekiz

2014-01-01

Full Text Available In recent years with the increase in cesarean section rates, the frequency of placenta accreta cases rises. It causes 33–50% of all emergency peripartum hysterectomies. We present a 42-year-old case who was caught with early postpartum hemorrhage due to retained placental products. The ultrasonography showed a 65 × 84 mm mass in the uterine cavity after the delivery. Due to presence of early postpartum hemorrhage which needs transfusion, an intervention decision was made. The patient underwent curettage but the mass could not be removed so that placental retention was ruled out. Submucous leiomyoma was made as first-prediagnosis. Hysterectomy operation was performed as a curative treatment. Placenta increta diagnosis was made as a final diagnosis with pathological examination. As a result, placental attachment disorders may be overlooked if it is not a placenta previa case.

Leiomioma uretral durante a gravidez: relato de caso Urethral leiomyoma during pregnancy: a case report

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Arlon Breno Figueiredo Nunes da Silveira

2012-12-01

Full Text Available The authors report a case of urethral leiomyoma diagnosed during pregnancy, which was conservatively treated up to the 38th week, when the pregnancy was interrupted. Thirty days after delivery, exeresis of the lesion was performed from the upper border of the urethral meatus and sutured with interrupted delayed-absorbable suture. The patient evolved favorably and presented no lesion recurrence during three months of follow up.

Comparison of the Efficacy of the Embolic Agents Acrylamido Polyvinyl Alcohol Microspheres and Tris-Acryl Gelatin Microspheres for Uterine Artery Embolization for Leiomyomas: A Prospective Randomized Controlled Trial

International Nuclear Information System (INIS)

Worthington-Kirsch, Robert L.; Siskin, Gary P.; Hegener, Paul; Chesnick, Richard

2011-01-01

Objective: To evaluate the efficacy of acrylamido polyvinyl alcohol microspheres (a-PVAM) as an embolic agent for uterine artery embolization (UAE) compared with Tris-acryl gelatin microspheres (TAGM).Design, Setting, ParticipantsProspective randomized double-blind noninferiority trial. Conducted at two sites both with regional UAE practices. Forty-six women with symptomatic leiomyomas.InterventionUAE procedure was performed with either of the two embolic agents. Either 700–900-μm a-PVAM or 500–700-μm TAGM was used.Main Outcome MeasuresChanges in leiomyoma perfusion, overall uterine volume, and dominant leiomyomas volume measured by contrast-enhanced magnetic resonance imaging at 1 week, 3 months, and 6 months after UAE by a reader blinded to the embolic agent used. Changes in Uterine Fibroid Symptoms and Quality of Life questionnaire scores were measured at 3, 6, and 12 months after UAE. Results: Forty-six patients were randomized and treated under the study protocol (a-PVAM n = 22, TAGM n = 24). There were no procedure-related complications. Two patients were excluded from analysis (one technical failure of the procedure, one withdrawal from study). Successful (>90%) leiomyoma devascularization was observed in 81% of subjects at 1 week after UAE, 97% at 3 months after UAE, and 95% at 6 months after UAE. No significant differences were observed in 14 of 15 outcome measurements, consistent with noninferiority. TAGM was slightly superior to a-PVAM on one comparison (overall quality of life at 3 months after UAE).

Cell cultures in uterine leiomyomas: rapid disappearance of cells carrying MED12 mutations.

Science.gov (United States)

Nadine Markowski, Dominique; Tadayyon, Mahboobeh; Bartnitzke, Sabine; Belge, Gazanfer; Maria Helmke, Burkhard; Bullerdiek, Jörn

2014-04-01

Uterine leiomyomas (UL) are the most frequent symptomatic human tumors. Nevertheless, their molecular pathogenesis is not yet fully understood. To learn more about the biology of these common neoplasms and their response to treatment, cell cultures derived from UL are a frequently used model system, but until recently appropriate genetic markers confirming their origin from the tumor cell population were lacking for most UL, i.e., those not displaying karyotypic abnormalities. The identification of MED12 mutations in the majority of UL makes it possible to trace the tumor cell population during in vitro passaging in the absence of cytogenetic abnormalities. The present study is addressing the in vitro survival of cells carrying MED12 mutations and its association with karyotypic alterations. The results challenge numerous in vitro studies into the biology and behavior of leiomyomas. Cells of one genetic subtype of UL, i.e., those with rearrangements of the high mobility AT-hook 2 protein gene (HMGA2), seem to be able to proliferate in vitro for many passages whereas tumor cells from the much more frequent MED12-mutated lesions barely survive even the first passages. Apparently, for the most frequent type of human UL no good in vitro model seems to exist because cells do not survive culturing. On the other hand, this inability may point to an Achilles' heel of this type of UL. Copyright © 2014 Wiley Periodicals, Inc.

Imaging for Polyps and Leiomyomas in Women With Abnormal Uterine Bleeding: A Systematic Review.

Science.gov (United States)

Maheux-Lacroix, Sarah; Li, Fiona; Laberge, Philippe Y; Abbott, Jason

2016-12-01

To evaluate the accuracy of saline infusion sonohysterography in comparison with transvaginal ultrasonography for diagnosing polyps and submucosal leiomyomas in women with abnormal uterine bleeding. We searched the databases MEDLINE, EMBASE, CENTRAL, and ClinicalTrials.gov as well as citations and reference lists to the end of November 2015. Two authors screened 5,347 citations for eligibility. We included randomized controlled trials or prospective cohort studies published in English, assessing the accuracy of saline infusion sonohysterography and transvaginal ultrasonography for diagnosing polyps and submucosal leiomyomas in women with abnormal uterine bleeding. We considered studies using histopathologic specimens obtained at either hysteroscopy or hysterectomy as criterion standard. Twenty-five studies were eligible. Two authors extracted data and assessed the quality of included studies. Bivariate random-effects models were used to compare the different tests and evaluate sources of heterogeneity. Saline infusion sonohysterography was superior to transvaginal ultrasonography with pooled sensitivity and specificity of 0.92 and 0.89 compared with 0.64 and 0.90, respectively (Pabnormal uterine bleeding. Although less specific than hysteroscopy, saline infusion sonohysterography offers a similar detection rate and permits concomitant visualization of the ovaries and myometrium. Cost, convenience, and tolerability of different imaging techniques require further evaluation. PROSPERO International prospective register of systematic reviews, http://www.crd.york.ac.uk/PROSPERO, CRD42016034005.

Biological and Mechanistic Characterization of Novel Prodrugs of Green Tea Polyphenol Epigallocatechin Gallate Analogs in Human Leiomyoma Cell Lines.

Science.gov (United States)

Ahmed, Reda Saber Ibrahim; Liu, Gang; Renzetti, Andrea; Farshi, Pershang; Yang, Huanjie; Soave, Claire; Saed, Ghassan; El-Ghoneimy, Ashraf Ahmed; El-Banna, Hossny Awad; Foldes, Robert; Chan, Tak-Hang; Dou, Q Ping

2016-10-01

Uterine fibroids (leiomyomas) are very common benign tumors grown on the smooth muscle layer of the uterus, present in up to 75% of reproductive-age women and causing significant morbidity in a subset of this population. Although the etiology and biology of uterine fibroids are unclear, strong evidence supports that cell proliferation, angiogenesis and fibrosis are involved in their formation and growth. Currently the only cure for uterine fibroids is hysterectomy; the available alternative therapies have limitations. Thus, there is an urgent need for developing a novel strategy for treating this condition. The green tea polyphenol epigallocatechin gallate (EGCG) inhibits the growth of uterine leiomyoma cells in vitro and in vivo, and the use of a green tea extract (containing 45% EGCG) has demonstrated clinical activity without side effects in women with symptomatic uterine fibroids. However, EGCG has a number of shortcomings, including low stability, poor bioavailability, and high metabolic transformations under physiological conditions, presenting challenges for its development as a therapeutic agent. We developed a prodrug of EGCG (Pro-EGCG or 1) which shows increased stability, bioavailability and biological activity in vivo as compared to EGCG. We also synthesized prodrugs of EGCG analogs, compounds 2a and 4a, in order to potentially reduce their susceptibility to methylation/inhibition by catechol-O-methyltransferase. Here, we determined the effect of EGCG, Pro-EGCG, and 2a and 4a on cultured human uterine leiomyoma cells, and found that 2a and 4a have potent antiproliferative, antiangiogenic, and antifibrotic activities. J. Cell. Biochem. 117: 2357-2369, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Duodenal leiomyoma. A case report. Leiomyome duodenal. Apports de l'imagerie a propos d'un cas

Energy Technology Data Exchange (ETDEWEB)

Benziane, K.; Ballorain, X.; Kalfon, M. (Hopital Camille Guerin, 86 -Chatellerault (France)); Vandermarcq, P. (Hopital Jean-Bernard, 86 - Poitiers (France))

1994-05-01

A leiomyoma of the duodenum was revealed by chronic anaemia. Radiography, echography and computed tomography provided images leading to the diagnosis of a 11 cm regular, homogenous sub-serous tumour of the duodenum without loco-regional or distant extension. The radiographic images suggested a benign tumour confirmed by the pathology examination. (authors). 22 refs.

THE REDSHIFT DISTRIBUTION OF GIANT ARCS IN THE SLOAN GIANT ARCS SURVEY

International Nuclear Information System (INIS)

Bayliss, Matthew B.; Gladders, Michael D.; Koester, Benjamin P.; Oguri, Masamune; Hennawi, Joseph F.; Sharon, Keren; Dahle, Haakon

2011-01-01

We measure the redshift distribution of a sample of 28 giant arcs discovered as a part of the Sloan Giant Arcs Survey. Gemini/GMOS-North spectroscopy provides precise redshifts for 24 arcs, and 'redshift desert' constrains for the remaining 4 arcs. This is a direct measurement of the redshift distribution of a uniformly selected sample of bright giant arcs, which is an observable that can be used to inform efforts to predict giant arc statistics. Our primary giant arc sample has a median redshift z = 1.821 and nearly two-thirds of the arcs, 64%, are sources at z ∼> 1.4, indicating that the population of background sources that are strongly lensed into bright giant arcs resides primarily at high redshift. We also analyze the distribution of redshifts for 19 secondary strongly lensed background sources that are not visually apparent in Sloan Digital Sky Survey imaging, but were identified in deeper follow-up imaging of the lensing cluster fields. Our redshift sample for the secondary sources is not spectroscopically complete, but combining it with our primary giant arc sample suggests that a large fraction of all background galaxies that are strongly lensed by foreground clusters reside at z ∼> 1.4. Kolmogorov-Smirnov tests indicate that our well-selected, spectroscopically complete primary giant arc redshift sample can be reproduced with a model distribution that is constructed from a combination of results from studies of strong-lensing clusters in numerical simulations and observational constraints on the galaxy luminosity function.

Giant CP stars

International Nuclear Information System (INIS)

Loden, L.O.; Sundman, A.

1989-01-01

This study is part of an investigation of the possibility of using chemically peculiar (CP) stars to map local galactic structure. Correct luminosities of these stars are therefore crucial. CP stars are generally regarded as main-sequence or near-main-sequence objects. However, some CP stars have been classified as giants. A selection of stars, classified in literature as CP giants, are compared to normal stars in the same effective temperature interval and to ordinary 'non giant' CP stars. There is no clear confirmation of a higher luminosity for 'CP giants', than for CP stars in general. In addition, CP characteristics seem to be individual properties not repeated in a component star or other cluster members. (author). 50 refs., 5 tabs., 3 figs

The diagnostic and therapeutic approach of a primary bilateral leiomyoma of the ovaries: a case report and a literature review.

NARCIS (Netherlands)

Esch, E.M. van; Wijngaarden, S.E. van; Schaafsma, H.E.; Smeets, M.J.; Rhemrev, J.P.

2011-01-01

INTRODUCTION: A primary fibroid (leiomyoma) arising from both ovaries is rare and can be difficult to diagnose as a result of the low incidence and its indistinctive presentation. A literature review on the diagnostic and therapeutic approach of this rare benign tumour is presented. We describe a

Recent scientific advances in leiomyoma (uterine fibroids research facilitates better understanding and management [v1; ref status: indexed, http://f1000r.es/54a

Directory of Open Access Journals (Sweden)

Darlene K. Taylor

2015-07-01

Full Text Available Uterine leiomyomas (fibroids are the most prevalent medical problem of the female reproductive tract, but there are few non-surgical treatment options. Although many advances in the understanding of the molecular components of these tumors have occurred over the past five years, an effective pharmaceutical approach remains elusive. Further, there is currently no clinical method to distinguish a benign uterine leiomyoma from a malignant leiomyosarcoma prior to treatment, a pressing need given concerns about the use of the power morcellator for minimally invasive surgery. This paper reviews current studies regarding the molecular biology of uterine fibroids, discusses non-surgical approaches and suggests new cutting-edge therapeutic and diagnostic approaches.

Factors affecting the loss of MED12-mutated leiomyoma cells during in vitro growth

OpenAIRE

Bloch, Jeannine; Holzmann, Carsten; Koczan, Dirk; Helmke, Burkhard Maria; Bullerdiek, J?rn

2017-01-01

Uterine leiomyomas (UL) are the most prevalent symptomatic human tumors at all and somatic mutations of the gene encoding mediator subcomplex 12 (MED12) constitute the most frequent driver mutations in UL. Recently, a rapid loss of mutated cells during in vitro growth of UL-derived cell cultures was reported, resulting in doubts about the benefits of UL-derived cell cultures. To evaluate if the rapid loss of MED12-mutated cells in UL cell cultures depends on in vitro passaging, we set up cell...

Rapid formation of gas giants, ice giants and super-Earths

Energy Technology Data Exchange (ETDEWEB)

Boss, A P [DTM, Carnegie Institution of Washington, 5241 Broad Branch Road, NW, Washington, DC 20015 (United States)], E-mail: boss@dtm.ciw.edu

2008-08-15

Giant planets might have been formed by either of the two basic mechanisms, top-down (disk instability) or bottom-up (core accretion). The latter mechanism is the most generally accepted mechanism and it begins with the collisional accumulation of solid cores that may then accrete sufficient gas to become gas giants. The former mechanism is more heretical and begins with the gravitational instability of the protoplanetary disk gas, leading to the formation of self-gravitating protoplanets, within which the dust settles to form a solid core. The disk instability mechanism has been thought of primarily as a mechanism for the formation of gas giants, but if it occurs in a disk that is being photoevaporated by the ultraviolet radiation from nearby massive stars, then the outer gaseous protoplanets can be photoevaporated as well and stripped of their gaseous envelopes. The result would then be ice giants (cold super-Earths), such as the objects discovered recently by microlensing orbiting two presumed M dwarf stars. M dwarfs that form in regions of future high-mass star formation would be expected to produce cold super-Earths orbiting at distances of several astronomical units (AU) and beyond, while M dwarfs that form in regions of low-mass star formation would be expected to have gas giants at those distances. Given that most stars are born in the former rather than in the latter regions, M dwarfs should have significantly more super-Earths than gas giants on orbits of several AU or more.

Rapid formation of gas giants, ice giants and super-Earths

International Nuclear Information System (INIS)

Boss, A P

2008-01-01

Giant planets might have been formed by either of the two basic mechanisms, top-down (disk instability) or bottom-up (core accretion). The latter mechanism is the most generally accepted mechanism and it begins with the collisional accumulation of solid cores that may then accrete sufficient gas to become gas giants. The former mechanism is more heretical and begins with the gravitational instability of the protoplanetary disk gas, leading to the formation of self-gravitating protoplanets, within which the dust settles to form a solid core. The disk instability mechanism has been thought of primarily as a mechanism for the formation of gas giants, but if it occurs in a disk that is being photoevaporated by the ultraviolet radiation from nearby massive stars, then the outer gaseous protoplanets can be photoevaporated as well and stripped of their gaseous envelopes. The result would then be ice giants (cold super-Earths), such as the objects discovered recently by microlensing orbiting two presumed M dwarf stars. M dwarfs that form in regions of future high-mass star formation would be expected to produce cold super-Earths orbiting at distances of several astronomical units (AU) and beyond, while M dwarfs that form in regions of low-mass star formation would be expected to have gas giants at those distances. Given that most stars are born in the former rather than in the latter regions, M dwarfs should have significantly more super-Earths than gas giants on orbits of several AU or more

Giant Cell Arteritis

Science.gov (United States)

Giant cell arteritis is a disorder that causes inflammation of your arteries, usually in the scalp, neck, and arms. ... arteries, which keeps blood from flowing well. Giant cell arteritis often occurs with another disorder called polymyalgia ...

A Giant Case of Pyonephrosis Resulting from Nephrolithiasis

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Ali Erol

2014-01-01

Full Text Available Pyonephrosis is an uncommon disease that is associated with suppurative destruction of the renal parenchyma in adults. Upper urinary tract infection and obstruction play a role in its etiology. Immunosuppression from medications (steroids, diseases (diabetes mellitus, AIDS, and anatomic variations (pelvic kidney, horseshoe kidney may also be risk factors for pyonephrosis. Fever, shivering, and flank pain are frequent clinical symptoms. On physical examination, a palpable abdominal mass may be associated with the hydronephrotic kidney. Septic shock and death can occur if the disorder is not treated with urgent surgery. After the acute phase, most patients are treated with nephrectomy. In this paper, we share the etiology, clinical features, diagnosis and treatment of pyonephrosis using the background of a case with giant pyonephrosis developing due to a kidney stone, the most common cause of upper urinary tract obstruction.

Role of magnetic resonance imaging (MRI) establishing the indication for, planning, and following up uterine artery embolization (UAE) for treating symptomatic leiomyomas of the uterus; Stellenwert der Magnetresonanztomographie fuer Indikationsstellung, Interventionsplanung und Nachsorge bei transarterieller Embolisationsbehandlung des Uterus myomatosus

Energy Technology Data Exchange (ETDEWEB)

Kroencke, T.J. [Institut fuer Radiologie, Universitaetsklinikum Charite, Campus Mitte, Humboldt-Universitaet zu Berlin (Germany); Institut fuer Radiologie, Universitaetsklinikum Charite, Campus Mitte, Humboldt-Universitaet zu Berlin, Schumannstrasse 20/21, 10117, Berlin (Germany); Hamm, B. [Institut fuer Radiologie, Universitaetsklinikum Charite, Campus Mitte, Humboldt-Universitaet zu Berlin (Germany)

2003-08-01

To describe the role of magnetic resonance imaging (MRI) in establishing the indication for, planning, and following up uterine artery embolization (UAE) for treating symptomatic leiomyomas of the uterus on the basis of the current literature and our results. Retrospective analysis of the MRI findings obtained in 130 patients before and after UAE. Presentation of characteristic MRI features and their relevance in establishing the indication for, performing, and following up of UAE. Discussion of the results in conjunction with published data. The intermediate results of UAE reported in the literature show a successful improvement of leiomyoma-related symptoms in 82-94% of cases and an average reduction of leiomyoma size by 36-64%. The typical MRI appearance of degenerating leiomyomas is presented together with that of relevant differential diagnoses. MRI findings allow for establishing the indication for UAE by providing reliable information on the location, size, and number of uterine leiomyomas. Analysis of 60 patients of our study population showed solitary leiomyoma in 16% of cases, 2-10 leiomyomas in 47%, and over 10 in 37%. Subserosal, pedunculated leiomyomas cannot be treated by UAE; these were present in 5% of the patients. MR angiography is useful in assessing pelvic vascular anatomy before the intervention and identifies collateral vascular supply to the uterus. Contrast-enhanced imaging is suitable for monitoring successful devascularization following embolization and evaluating complications. (orig.) [German] Darstellung des Stellenwerts der Magnetresonanztomographie fuer die Indikationsstellung, Interventionsplanung und Nachsorge bei der transarteriellen Embolisationsbehandlung des symptomatischen Uterus myomatosus unter Beruecksichtigung der aktuellen Literatur sowie eigener Ergebnisse. Retrospektive Auswertung der MRT-Untersuchungen vor und nach Myomembolisation eines Kollektivs von 130 Patientinnen. Darlegung charakteristischer

Immunohistochemical and morphological features of a small bowel leiomyoma in a black crested macaque (Macaca nigra

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Aristizabal-Arbelaez Mónica

2012-06-01

Full Text Available Abstract Background Spontaneous gastrointestinal neoplasms in non-human primates are commonly seen in aged individuals. Due to genetic similarities between human and non-human primates, scientists have shown increasing interest in terms of comparative oncology studies. Case presentation The present study is related to a case of an intestinal leiomyoma in a black crested macaque (Macaca nigra, kept on captivity by Matecaña Zoo, Pereira City, Colombia. The animal had abdominal distension, anorexia, vomiting, diarrhea and behavioral changes. Clinical examination showed an increased volume in the upper right abdominal quadrant caused by a neoplastic mass. The patient died during the surgical procedure. Necropsy revealed several small nodules in the peritoneum with adhesion to different portions of the small and large intestines, liver, stomach and diaphragm. Tissue samples were collected, routinely processed and stained by H&E. Microscopic examination revealed a mesenchymal tumor limited to tunica muscularis, resembling normal smooth muscle cells. Neoplastic cells were positive for alpha-smooth muscle actin and vimentin, and negative for cytokeratin AE1/AE3 by immunohistochemistry. Those morphological and immunohistochemical findings allowed to diagnose the intestinal leiomyoma referred above. Conclusion Neoplastic diseases in primates have multifaceted causes. Their manifestations are understudied, leading to a greater difficulty in detection and measurement of the real impact provides by this disease.

MicroRNA-15b regulates reversion-inducing cysteine-rich protein with Kazal motifs (RECK) expression in human uterine leiomyoma.

Science.gov (United States)

Guan, Yichun; Guo, Lankai; Zukerberg, Lawrence; Rueda, Bo R; Styer, Aaron K

2016-08-17

Human uterine leiomyoma (fibroids; LYO) are the most common benign neoplasms in reproductive-aged women. Dysregulated extracellular matrix and irregular LYO reversion-inducing cysteine-rich protein with Kazal motifs (RECK) expression are thought to be mediated by aberrant microRNA (miR) expression. The relationship of miR-15b and RECK expression in LYO has not been studied. The expression levels of miR-15b and RECK were determined by quantitative RT-PCR, Western blot, and immunohistochemistry in cultures derived from commercial primary leiomyoma (cpLYO) and myometrial (cpMYO) cell lines and leiomyoma (pLYO) and myometrium (pMYO) tissue from surgical samples respectively. The relationship between miR-15b and RECK expression in cpLYO and pLYO (compared to their respective myometrial controls) was evaluated following transfection of cell cultures with either miR-15b mimic or inhibitor. Elevated levels of miR-15b were observed in cpLYO (2.82-fold; p = 0.04) and pLYO cell (1.30-fold; p = 0.0001) cultures respectively compared to corresponding MYO cell controls. Following transfection with miR-15b mimic, cpLYO cells (0.62-fold; p < 0.0001) and pLYO cells (0.68-fold; p < 0.0001) demonstrated reduced RECK protein expression. Following transfection with miR-15b inhibitor, cpLYO cells (1.20-fold; p < 0.0001) and pLYO cells (1.31-fold; p = 0.0007) demonstrated elevated RECK protein expression. RECK protein expression was reduced in pLYO tissues (0.73-fold; p < 0.0001) and pLYO (0.47-fold; p = 0.047) cells when compared to the corresponding MYO tissue controls. Our findings suggest that miR-15b negatively regulates RECK expression in LYO, and increased miR-15b and decreased RECK expression may contribute to the pathobiology of LYO. The functional significance of miR-15b and RECK expression warrants further investigation as potential therapeutic targets for the treatment of human LYO.

Exploring the Link between ACE Insertion/Deletion (I/D Polymorphism and Uterine Leiomyomas

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Shirin Shahbazi

2017-03-01

Full Text Available Introduction: Uterine leiomyomas arise from the proliferation of smooth muscle cells. ACE gene encodes a convertase enzyme mainly secreted in vascular endothelial cells which is involved in the renin–angiotensin system and blood pressure controlling. This gene has an insertion/deletion (I/D polymorphism correlates to serum and tissue ACE levels. The aim of this study is to elucidate the relationship between ACE gene variation and the development of myom. Methods: The samples of 55 uterine leiomyoma patients and 78 healthy women were studied. After obtaining informed consent, blood samples were collected and DNA extraction was performed by Salting-out method. Genotyping was performed using PCR reaction. The amplified products were two bands of 190 and 490 bp, which represents D allele and I allele, respectively. Statistical analysis was done using Chi-square test. Results: The D allele frequency was 0.55 in the patient group and 0.51 in the control group. The I allele frequencies in the two groups were 0.45 and 0.49, respectively. The results showed that taking the II genotype into account as reference genotype; homozygous DD individuals were at increased risk of uterine myoma (Odds ratio: 1.37. However, heterozygous ID showed a similar risk with the II genotype as the reference group. Conclusion: High blood pressure is significantly associated with uterine fibroids. It has been shown that atherosclerotic damage of uterine blood vessels and the inflammatory process caused by it may play an important role in the development of uterine myoma. This study indicates a positive relationship between the ACE (I/D polymorphism and the risk of uterine myoma. This finding is evidence of the important role of the renin–angiotensin system in the pathogenesis of myoma

Prevalence of giant kidney worm (Dioctophyma renale) in wild mink (Mustela vison) in Minnesota

Science.gov (United States)

Mech, L. David; Tracy, Shawn P.

2001-01-01

Of 138 wild mink (Mustela vison) from eastern Minnesota, 27% contained Dioctophyma renale, primarily in the right kidney. No significant difference between prevalence in adult male and immature male mink was found, nor between the prevalence in males versus female mink. Thirteen worms were found in one male mink, representing the highest documented infection intensity of a single wild mink.

Giant pulses of pulsar radio emission

OpenAIRE

Kuzmin, A. D.

2007-01-01

Review report of giant pulses of pulsar radio emission, based on our detections of four new pulsars with giant pulses, and the comparative analysis of the previously known pulsars with giant pulses, including the Crab pulsar and millisecond pulsar PSR B1937+21.

Vascular leiomyoma of the oral cavity. Clinical, histopathological and immunohistochemical characteristics. Presentation of five cases and review of the literature.

Science.gov (United States)

Gaitan Cepeda, Luis Alberto; Quezada Rivera, Daniel; Tenorio Rocha, Fernando; Leyva Huerta, Elba Rosa; Mendez Sánchez, Edgar Ramiro

2008-08-01

Leiomyoma, a benign neoplasia arising from smooth muscle is an uncommon neoplasia of the oral cavity. The most common histological subtype in the oral cavity is the vascular one. To supplement information on vascular leiomyoma of the oral cavity (VLOC), we present cases of VLOC describing their clinical, histological, and immunohistochemical characteristics. Case reports. Five cases of VLOC (3 females; 2 males) from the Clinical and Experimental Pathology Laboratory, Dental School, National Autonomous University of México, are included. The most frequent clinical characteristic of VLOC was a single, asymptomatic, slow growing nodule. The age average of the cases was 40.6, however 3 out of our 5 cases were < or = 40 years old at the moment of their diagnosis. The lesions were composed of fusiform cells arranged in bundles or fascicles. The neoplastic cells were characterized by eosinophilic cytoplasm and tapered nuclei. The presence of vascular spaces was prominent in all cases. The immunocharacteristics of VLOC neoplastic cells were: alpha smooth muscle (+); vimentin (+), desmin (+), CD34 (-) and S-100 protein (-). The endothelial cells of vascular spaces were CD34 (+). Differential diagnosis of VLOC with fusocellular neoplasm is discussed.

Giant Oil Fields - The Highway to Oil: Giant Oil Fields and their Importance for Future Oil Production

International Nuclear Information System (INIS)

Robelius, Fredrik

2007-01-01

Since the 1950s, oil has been the dominant source of energy in the world. The cheap supply of oil has been the engine for economic growth in the western world. Since future oil demand is expected to increase, the question to what extent future production will be available is important. The belief in a soon peak production of oil is fueled by increasing oil prices. However, the reliability of the oil price as a single parameter can be questioned, as earlier times of high prices have occurred without having anything to do with a lack of oil. Instead, giant oil fields, the largest oil fields in the world, can be used as a parameter. A giant oil field contains at least 500 million barrels of recoverable oil. Only 507, or 1 % of the total number of fields, are giants. Their contribution is striking: over 60 % of the 2005 production and about 65 % of the global ultimate recoverable reserve (URR). However, giant fields are something of the past since a majority of the largest giant fields are over 50 years old and the discovery trend of less giant fields with smaller volumes is clear. A large number of the largest giant fields are found in the countries surrounding the Persian Gulf. The domination of giant fields in global oil production confirms a concept where they govern future production. A model, based on past annual production and URR, has been developed to forecast future production from giant fields. The results, in combination with forecasts on new field developments, heavy oil and oil sand, are used to predict future oil production. In all scenarios, peak oil occurs at about the same time as the giant fields peak. The worst-case scenario sees a peak in 2008 and the best-case scenario, following a 1.4 % demand growth, peaks in 2018

Excitation of giant resonances in heavy ion collisions

International Nuclear Information System (INIS)

Kuehn, W.

1991-01-01

Introduction: What are Giant Resonances? General Features of Giant Resonances, Macroscopic Description and Classification, Basic Excitation Mechanisms, Decay Modes, Giant Resonances Built on Excited States, Relativistic Coulomb Excitation of Giant Resonances, Experimental Situation. (orig.)

Floret-like multinucleated giant cells in neurofibroma

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Golka Dariusz

2007-12-01

Full Text Available Abstract This short report discusses a case of neurofibroma containing floret-like multinucleated giant cells. This being the second such case in the literature. Floret-like multinucleated giant cells have been reported in gynaecomastia and neurofibroma in neurofibromatosis type 1. These cells have been reported in uncommon soft tissue tumours including pleomorphic lipoma, giant cell collagenoma, giant cell fibroblastoma and giant cell angiofibroma. We recommend these cells to be interpreted carefully keeping in mind the rare malignant change in neurofibromas. Immunohistochemistry would help in defining the nature of such cells.

Additional value of 16{alpha}-[{sup 18}F]fluoro-17{beta}-oestradiol PET for differential diagnosis between uterine sarcoma and leiomyoma in patients with positive or equivocal findings on [{sup 18}F]fluorodeoxyglucose PET

Energy Technology Data Exchange (ETDEWEB)

Yoshida, Yoshio; Kurokawa, Tetsuji; Kotsuji, Fumikazu [University of Fukui, Department of Gynecology, Faculty of Medical Sciences, Fukui (Japan); Kiyono, Yasushi; Tsujikawa, Tetsuya; Okazawa, Hidehiko [University of Fukui, Biomedical Imaging Research Center, Fukui (Japan)

2011-10-15

Pathological data suggest that the rate of oestrogen receptor (ER) expression in uterine sarcoma is significantly lower than in leiomyoma. The present study aimed to investigate whether ER expression using ER imaging agents for positron emission tomography (PET), of which the most successful has been 16{alpha}-[{sup 18}F]-fluoro-17{beta}-oestradiol (FES), is able to add useful information to the differential diagnosis of uterine sarcoma and leiomyoma in patients with positive or equivocal findings on [{sup 18}F]fluorodeoxyglucose (FDG) PET. A total of 76 patients with suspected uterine sarcoma based on ultrasound and magnetic resonance imaging findings from 2007 to 2010 were enrolled. Twenty-four of the present patients were referred for FES PET because of FDG PET findings that showed equivocal or positive FDG uptake. PET images were quantitatively evaluated with reference to histopathological findings. Receiver-operating characteristic analysis was performed to determine the optimal cutoff value to differentiate uterine sarcoma and leiomyoma. Of the 24 patients, 11 had a final diagnosis of uterine sarcoma, while 13 had leiomyoma. The sensitivity, specificity and accuracy of an FDG to FES standardized uptake value (SUV) ratio greater than 2.0 were significantly higher using Cochran's Q test (p = 0.024) when compared with FDG PET greater than 3.0 alone (90.9 vs 81.8%, 92.3 vs 84.6% and 91.3 vs 83.3%, respectively). Additional FES PET findings confirmed uterine sarcoma in 91.3% of a selected group of patients with equivocal or positive FDG uptake. (orig.)

Nanodielectrics with giant permittivity

Indian Academy of Sciences (India)

Following the prediction, during the last couple of years we have investigated the effect of giant permittivity in one-dimensional systems of conventional metals and conjugated polymer chains. In this article, we have tried to summarize the works on giant permittivity and finally the fabrication of nanocapacitor using metal ...

From red giants to planetary nebulae

International Nuclear Information System (INIS)

Kwok, S.

1982-01-01

The transition from red giants to planetary nebulae is studied by comparing the spectral characteristics of red giant envelopes and planetary nebulae. Observational and theoretical evidence both suggest that remnants of red giant envelopes may still be present in planetary nebula systems and should have significant effects on their formation. The dynamical effects of the interaction of stellar winds from central stars of planetary nebulae with the remnant red giant envelopes are evaluated and the mechanism found to be capable of producing the observed masses and momenta of planetary nebulae. The observed mass-radii relation of planetary nebulae may also be best explained by the interacting winds model. The possibility that red giant mass loss, and therefore the production of planetary nebulae, is different between Population I and II systems is also discussed

Incidentally Detected Primary Giant Renal Cystic Enchinococcosis in a Young Patient: An Underestimated Entity?

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Emre Urer

2015-01-01

Full Text Available Echinococcosis is a parasitic infestation caused by Echinococcus granulosus and is an endemic disease in many parts of world. The symptoms and signs depend on the location and size of the cyst. Renal cystic echinococcosis or hydatid cyst (HC disease of the kidney is extremely rare and constitutes only 2-4% of all cases of hydatid disease (HD. We present a 39-year-old male patient who was referred to our outpatient clinic with cystic right kidney mass that was incidentally diagnosed during hepatobiliary ultrasound for chronic hepatitis B evaluation. Routine blood tests were normal without eosinophilia. Indirect haemagglutination test was negative. Abdominal kidneys, ureters, and bladder X-ray showed an 83×95 mm sized curvilinear calcification in the right upper abdominal quadrant. Abdominal computed tomography scan and magnetic resonance imaging demonstrated a 10x9x10 cm sized cystic mass arising from the middle pole of the right kidney, destructing the whole upper pole and extending into the liver. Daughter vesicles were present in the cystic lesion suggesting renal HD. Right retroperitoneal exploration with flank approach and right radical nephrectomy was performed without any complications. Pathology confirmed HC lesion. Following surgery, albendazole 400 mg per os twice daily for 4 weeks was suggested.

Bisphenol A Concentrates Preferentially in Human Uterine Leiomyoma and Induces Proliferation in Rat Myometrium.

Science.gov (United States)

Othman, Essam R; Al-Adly, Dina M M; Elgamal, Dalia A; Ghandour, Nagwa; El-Sharkawy, Sawsan

2016-04-01

To measure tissue levels of bisphenol A (BPA) in uterine leiomyoma (ULM), adjacent myometrium (Myo-F), and normal myometrium (Myo-N). Also, we tested the effect of BPA treatment on rat myometrium. Uterine leiomyomas and Myo-F tissues were isolated from hysterectomy specimens done to treat symptomatic ULMs (N = 30). Normal myometrium is isolated from hysterectomies done on ULM-free uteri for other benign indications (N = 25). Bisphenol A was measured in 1 g of tissue using solid-phase extraction and high-performance liquid chromatography, with fluorescence detectors. Experimentally, adult female rats were fed BPA orally at a dose of 50 mg/kg/d for 90 days. Animals were killed, and their myometrial thickness and proliferating cell nuclear antigen (PCNA) immunostaining were evaluated. Tissue concentration of BPA in each of ULM (12.3 ± 2.8 µg/g) and Myo-F (10.1 ± 0.2 µg/g) was significantly higher than that of Myo-N (0.58 ± 0.2 µg/g). There was no statistically significant difference in BPA level between ULM and Myo-F within submucous or interstitial/subserous fibroid groups. Compared to control rats, BPA-treated animals showed significantly higher myometrial thickness (168.67 ± 5.7 µm and 281.6 ± 20.32 µm, respectively, P = .003) and increased myometrial PCNA immunoscores (1.5 ± 0.37 and 10.38 ± 0.67, respectively, P ≤ .001). Bisphenol A concentrates in human ULM tissue and its adjacent Myo-F compared to Myo-N. No significant difference is detected in BPA content of ULM tissue of different subtypes. Bisphenol A increases thickness and induces cellular proliferation in rat myometrium. Taken together, our results support a role of BPA in ULM development/growth. © The Author(s) 2015.

Giant multipole resonances: an experimental review

International Nuclear Information System (INIS)

Bertrand, F.E.

1979-01-01

During the past several years experimental evidence has been published for the existance of nondipole giant resonances. These giant multipole resonances, the so-called new giant resonances were first observed through inelastic hadron and electron scattering and such measurements have continued to provide most of the information in this field. A summary is provided of the experimental evidence for these new resonances. The discussion deals only with results from inelastic scattering and only with the electric multipoles. Emphasis is placed on the recent observations of the giant monopole resonance. Results from recent heavy-ion and pion inelastic scattering are discussed. 38 references

Giant dipole resonance in hot nuclei

International Nuclear Information System (INIS)

Mau, N.V.

1993-01-01

Giant resonances built on an excited state of the nucleus at a finite temperature T are studied. The following questions are investigated: how long such collective effects occur in a nucleus when T increases. How the properties of the giant resonances vary when the temperature increases. How the study of giant resonances in hot nuclei can give information on the structure of the nucleus in a highly excited state. The special case of the giant dipole resonance is studied. Some of the experimental results are reviewed and in their theoretical interpretation is discussed. (K.A.). 56 refs., 20 figs., 4 tabs

Electrified BPS giants: BPS configurations on giant gravitons with static electric field

International Nuclear Information System (INIS)

Ali-Akbari, Mohammad; Sheikh-Jabbari, Mohammad Mahdi

2007-01-01

We consider D3-brane action in the maximally supersymmetric type IIB plane-wave background. Upon fixing the light-cone gauge, we obtain the light-cone Hamiltonian which is manifestly supersymmetric. The 1/2 BPS solutions of this theory (solutions which preserve 16 supercharges) are either of the form of spherical three branes, the giant gravitons, or zero size point like branes. We then construct specific classes of 1/4 BPS solutions of this theory in which static electric field on the brane is turned on. These solutions are deformations about either of the two 1/2 BPS solutions. In particular, we study in some detail 1/4 BPS configurations with electric dipole on the three sphere giant, i.e. BIons on the giant gravitons, which we hence call BIGGons. We also study BPS configurations corresponding to turning on a background uniform constant electric field. As a result of this background electric field the three sphere giant is deformed to squashed sphere, while the zero size point like branes turn into circular or straight fundamental strings in the plane-wave background, with their tension equal to the background electric field

Giant cells around bone biomaterials: Osteoclasts or multi-nucleated giant cells?

Science.gov (United States)

Miron, Richard J; Zohdi, Hamoon; Fujioka-Kobayashi, Masako; Bosshardt, Dieter D

2016-12-01

Recently accumulating evidence has put into question the role of large multinucleated giant cells (MNGCs) around bone biomaterials. While cells derived from the monocyte/macrophage lineage are one of the first cell types in contact with implanted biomaterials, it was originally thought that specifically in bone tissues, all giant cells were bone-resorbing osteoclasts whereas foreign body giant cells (FBGCs) were found associated with a connective tissue foreign body reaction resulting in fibrous encapsulation and/or material rejection. Despite the great majority of bone grafting materials routinely found with large osteoclasts, a special subclass of bone biomaterials has more recently been found surrounded by large giant cells virtually incapable of resorbing bone grafts even years after their implantation. While original hypotheses believed that a 'foreign body reaction' may be taking place, histological data retrieved from human samples years after their implantation have put these original hypotheses into question by demonstrating better and more stable long-term bone volume around certain bone grafts. Exactly how or why this 'special' subclass of giant cells is capable of maintaining long-term bone volume, or methods to scientifically distinguish them from osteoclasts remains extremely poorly studied. The aim of this review article was to gather the current available literature on giant cell markers and differences in expression patterns between osteoclasts and MNGCs utilizing 19 specific markers including an array of CD-cell surface markers. Furthermore, the concept of now distinguishing between pro-inflammatory M1-MNGCs (previously referred to as FBGCs) as well as wound-healing M2-MNGCs is introduced and discussed. This review article presents 19 specific cell-surface markers to distinguish between osteoclasts and MNGCs including an array of CD-cell surface markers. Furthermore, the concept of now distinguishing between pro-inflammatory M1-MNGCs (often

Changes in proliferating and apoptotic markers of leiomyoma following treatment with a selective progesterone receptor modulator or gonadotropin-releasing hormone agonist.

Science.gov (United States)

Yun, Bo Seong; Seong, Seok Ju; Cha, Dong Hyun; Kim, Ji Yeon; Kim, Mi-La; Shim, Jeong Yun; Park, Ji Eun

2015-08-01

To evaluate changes in proliferating and apoptotic markers of myoma tissue from patients treated with a selective progesterone receptor modulator (SPRM) or GnRH agonist by measuring expression of PDGF-A mRNA, IGF-1 mRNA, bcl-2 mRNA, and PCNA and caspase-3 protein. Between December 2013 and July 2014, women with symptomatic leiomyoma were divided into control (no treatment before surgery), SPRM (treatment with ulipristal acetate [SPRM] for 3 months before surgery), and GnRHa (treatment with leuprolide acetate [GnRH agonist] for 3 months before surgery) groups. Tissue specimens were collected from the myoma core and normal myometrium of all patients. The expression of mRNA and protein was assessed by quantitative real-time reverse transcriptase-polymerase chain reaction and Western blot. A total of 38 patients were enrolled (control group, n=14; SPRM group, n=13; GnRHa group, n=11). PDGF-A mRNA expression was lower in both the myoma core and normal myometrium tissues of the SPRM compared with the control group, but there was no difference between the control and GnRHa group. There were also no group differences in bcl-2 mRNA or IGF-1 mRNA expression. Both PCNA and caspase-3 protein expression were higher in the leiomyoma tissue of the SPRM compared with the control group, but there was no difference between the control and GnRHa groups in the expression of either protein. Both proliferation and apoptosis were increased in the leiomyoma of patients after SPRM treatment, but there was no change following GnRH agonist treatment, in vivo. However, PDGF-A mRNA was decreased after SPRM treatment, indicating a dual effect of progesterone on the regulation of growth factors. Furthermore, there was an increase in caspase-3 protein, but not bcl-2 mRNA, expression in the SPRM group suggesting that SPRM may exert its effects in pathways other than the bcl-2 apoptotic pathway. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Giant Planets: Good Neighbors for Habitable Worlds?

Science.gov (United States)

Georgakarakos, Nikolaos; Eggl, Siegfried; Dobbs-Dixon, Ian

2018-04-01

The presence of giant planets influences potentially habitable worlds in numerous ways. Massive celestial neighbors can facilitate the formation of planetary cores and modify the influx of asteroids and comets toward Earth analogs later on. Furthermore, giant planets can indirectly change the climate of terrestrial worlds by gravitationally altering their orbits. Investigating 147 well-characterized exoplanetary systems known to date that host a main-sequence star and a giant planet, we show that the presence of “giant neighbors” can reduce a terrestrial planet’s chances to remain habitable, even if both planets have stable orbits. In a small fraction of systems, however, giant planets slightly increase the extent of habitable zones provided that the terrestrial world has a high climate inertia. In providing constraints on where giant planets cease to affect the habitable zone size in a detrimental fashion, we identify prime targets in the search for habitable worlds.

sup(99m)Tc-DMSA renal scintigraphy in renal failure due to various renal diseases

Energy Technology Data Exchange (ETDEWEB)

Hosokawa, S; Daijo, K; Okabe, T; Kawamura, J; Hara, A [Kyoto Univ. (Japan). Hospital

1979-08-01

Renal contours in renal failure were studied by means of sup(99m)Tc-dimercaptosuccinic acid (DMSA) renoscintigraphy. Renal cortical images were obtained even in renal failure cases. Causes of renal failure were chronic glomerulonephritis in 7, bilateral renal tuberculosis in 2, chronic pyelonephritis in 3, bilateral renal calculi in 3, diabetic nephropathy in 2, polycystic kidney disease in 2 and stomach cancer in 1.

sup(99m)Tc-DMSA renal scintigraphy in renal failure due to various renal diseases

International Nuclear Information System (INIS)

Hosokawa, Shin-ichi; Daijo, Kazuyuki; Okabe, Tatsushiro; Kawamura, Juichi; Hara, Akira

1979-01-01

Renal contours in renal failure were studied by means of sup(99m)Tc-dimercaptosuccinic acid (DMSA) renoscintigraphy. Renal cortical images were obtained even in renal failure cases. Causes of renal failure were chronic glomerulonephritis in 7, bilateral renal tuberculosis in 2, chronic pyelonephritis in 3, bilateral renal calculi in 3, diabetic nephropathy in 2, polycystic kidney disease in 2 and stomach cancer in 1. (author)

Should the Endangered Status of the Giant Panda Really Be Reduced? The Case of Giant Panda Conservation in Sichuan, China.

Science.gov (United States)

Ma, Ben; Lei, Shuo; Qing, Qin; Wen, Yali

2018-05-03

The International Union for Conservation of Nature (IUCN) reduced the threat status of the giant panda from “endangered” to “vulnerable” in September 2016. In this study, we analyzed current practices for giant panda conservation at regional and local environmental scales, based on recent reports of giant panda protection efforts in Sichuan Province, China, combined with the survey results from 927 households within and adjacent to the giant panda reserves in this area. The results showed that household attitudes were very positive regarding giant panda protection efforts. Over the last 10 years, farmers’ dependence on the natural resources provided by giant panda reserves significantly decreased. However, socio-economic development increased resource consumption, and led to climate change, habitat fragmentation, environmental pollution, and other issues that placed increased pressure on giant panda populations. This difference between local and regional scales must be considered when evaluating the IUCN status of giant pandas. While the status of this species has improved in the short-term due to positive local attitudes, large-scale socio-economic development pressure could have long-term negative impacts. Consequently, the IUCN assessment leading to the classification of giant panda as “vulnerable” instead of “endangered”, should not affect its conservation intensity and effort, as such actions could negatively impact population recovery efforts, leading to the extinction of this charismatic species.

Should the Endangered Status of the Giant Panda Really Be Reduced? The Case of Giant Panda Conservation in Sichuan, China

Directory of Open Access Journals (Sweden)

Ben Ma

2018-05-01

Full Text Available The International Union for Conservation of Nature (IUCN reduced the threat status of the giant panda from “endangered” to “vulnerable” in September 2016. In this study, we analyzed current practices for giant panda conservation at regional and local environmental scales, based on recent reports of giant panda protection efforts in Sichuan Province, China, combined with the survey results from 927 households within and adjacent to the giant panda reserves in this area. The results showed that household attitudes were very positive regarding giant panda protection efforts. Over the last 10 years, farmers’ dependence on the natural resources provided by giant panda reserves significantly decreased. However, socio-economic development increased resource consumption, and led to climate change, habitat fragmentation, environmental pollution, and other issues that placed increased pressure on giant panda populations. This difference between local and regional scales must be considered when evaluating the IUCN status of giant pandas. While the status of this species has improved in the short-term due to positive local attitudes, large-scale socio-economic development pressure could have long-term negative impacts. Consequently, the IUCN assessment leading to the classification of giant panda as “vulnerable” instead of “endangered”, should not affect its conservation intensity and effort, as such actions could negatively impact population recovery efforts, leading to the extinction of this charismatic species.

A search for lithium-rich giant stars

International Nuclear Information System (INIS)

Brown, J.A.; Sneden, C.; Lambert, D.L.; Dutchover, E. Jr.

1989-01-01

Lithium abundances or upper limits have been determined for 644 bright G-K giant stars selected from the DDO photometric catalog. Two of these giants possess surface lithium abundances approaching the cosmic value of the interstellar medium and young main-sequence stars, and eight more giants have Li contents far in excess of standard predictions. At least some of these Li-rich giants are shown to be evolved to the stage of having convectively mixed envelopes, either from the direct evidence of low surface carbon isotope ratios, or from the indirect evidence of their H-R diagram positions. Suggestions are given for the unique conditions that might have allowed these stars to produce or accrete new lithium for their surface layers, or simply to preserve from destruction their initial lithium contents. The lithium abundance of the remaining stars demonstrates that giants only very rarely meet the expectations of standard first dredge-up theories; the average extra Li destruction required is about 1.5 dex. The evolutionary states of these giants and their average masses are discussed briefly, and the Li distribution of the giants is compared to predictions of Galactic chemical evolution. 110 refs

Mini-laparotomic Colpotomy for a Cervicovaginal Leiomyoma: Preservation of hymenal integrity

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Ibrahim Yalçin

2016-03-01

Full Text Available Background: Leiomyomas are the most common benign tumors of the uterus. Removal of the prolapsed pedunculated submucous myoma represents a distinct entity. Evaluation and treatment of such cases may need intervention via the hymen.Mini-laparotomic management of a pedunculated submucous myoma while preserving hymen integrity in a virginal patient is described as a safe alternative.. Case: A 30-year old, nulliparous virgin woman admitted to the outpatient- clinic with the complaint of irregular menstrual bleeding ongoing for three months. Pelvic ultrasound revealed a 5×6 cm solid mass in the cervico-vaginal location that filled the vaginal margins. Due to the patient’s consistent desire for preserving hymenal integrity, mini-laparotomic colpotomy was performed and the mass was removed successfully. Conclusion: Mini-laparotomic colpotomy, preserving hymen integrity, provides excellent visualization and it is a convenient and effective tool in the management of a cervicovaginal pedunculated submucous myoma

Macroscopic description of isoscalar giant multipole resonances

International Nuclear Information System (INIS)

Nix, J.R.; Sierk, A.J.

1980-01-01

On the basis of a simple macroscopic model, we calculate the isoscalar giant-resonance energy as a function of mass number and multipole degree. The restoring force is determined from the distortion of the Fermi surface, and the inertia is determined for the incompressible, irrotational flow of nucleons with unit effective mass. With no adjustable parameters, the resulting closed expression reproduces correctly the available experimental data, namely the magnitude and dependence upon mass number of the giant quadrupole energy and the magnitude of the giant octupole energy for 208 Pb. We also calculate the isoscalar giant-resonance width as a function of mass number and multipole degree for various macroscopic damping mechanisms, including two-body viscosity, one-body dissipation, and modified one-body dissipation. None of these damping mechanisms reproduces correctly all features of the available experimental data, namely the magnitude and dependence upon mass number of the giant quadrupole width and the magnitude of the giant octupole width for 208 Pb

Tests of the Giant Impact Hypothesis

Science.gov (United States)

Jones, J. H.

1998-01-01

The giant impact hypothesis has gained popularity as a means of explaining a volatile-depleted Moon that still has a chemical affinity to the Earth. As Taylor's Axiom decrees, the best models of lunar origin are testable, but this is difficult with the giant impact model. The energy associated with the impact would be sufficient to totally melt and partially vaporize the Earth. And this means that there should he no geological vestige of Barber times. Accordingly, it is important to devise tests that may be used to evaluate the giant impact hypothesis. Three such tests are discussed here. None of these is supportive of the giant impact model, but neither do they disprove it.

Renal computed angiography. Part I: Renal CT phlebography. Renal veins variants

International Nuclear Information System (INIS)

Al-Amin, M.; Krupev, M.; Hadjidekov, V.; Plachkov, I.

2012-01-01

The changing trend in renal surgery, transplantation and minimal invasive urology implies preprocedure evaluation of renal veins. Development of imaging methods offers new possibilities for venographic visualization. The goal of this study is to present authors experience in visualization of renal veins using 64 MDCT and to evaluate the utility in assessments of their variants. 128 patients (68 females and 60 males, mean age 53,3) with urological complaints underwent 64MDCT examination including CT angiography. Contrast enhancement includes 3-4ml/sec injection flow of 90 ml contrast medium followed by 20 ml saline at the same rate. In 23 out of 128 examined patients some of the common variants of the renal vein is found. 64 MDCT angiography visualize very well renal veins and becomes method of choice in preoperative assessment of renal vein anatomy. (authors)

Hadron excitation of giant resonances

International Nuclear Information System (INIS)

Morsch, H.-P.

1985-01-01

A review is given on giant resonance studies in heavy nuclei using scattering of different hadronic probes. Concerning isoscalar giant resonances compression modes are discussed with the possibility to obtain more detailed structure information. From detailed studies of α scattering the distribution of isoscalar strengths of multipolarity up to L=6 was obtained. Some recent aspects of heavy ion excitation of collective modes are mentioned. The possibility to study isovector giant resonances in hadron charge exchange reactions is discussed. Finally, a comparison is made between α and 200 MeV proton scattering from which isoscalar and spin-isospin continuum response are extracted. (orig.)

YOUNG SOLAR SYSTEM's FIFTH GIANT PLANET?

International Nuclear Information System (INIS)

Nesvorný, David

2011-01-01

Studies of solar system formation suggest that the solar system's giant planets formed and migrated in the protoplanetary disk to reach the resonant orbits with all planets inside ∼15 AU from the Sun. After the gas disk's dispersal, Uranus and Neptune were likely scattered by the gas giants, and approached their current orbits while dispersing the transplanetary disk of planetesimals, whose remains survived to this time in the region known as the Kuiper Belt. Here we performed N-body integrations of the scattering phase between giant planets in an attempt to determine which initial states are plausible. We found that the dynamical simulations starting with a resonant system of four giant planets have a low success rate in matching the present orbits of giant planets and various other constraints (e.g., survival of the terrestrial planets). The dynamical evolution is typically too violent, if Jupiter and Saturn start in the 3:2 resonance, and leads to final systems with fewer than four planets. Several initial states stand out in that they show a relatively large likelihood of success in matching the constraints. Some of the statistically best results were obtained when assuming that the solar system initially had five giant planets and one ice giant, with the mass comparable to that of Uranus and Neptune, and which was ejected to interstellar space by Jupiter. This possibility appears to be conceivable in view of the recent discovery of a large number of free-floating planets in interstellar space, which indicates that planet ejection should be common.

Young Solar System's Fifth Giant Planet?

Science.gov (United States)

Nesvorný, David

2011-12-01

Studies of solar system formation suggest that the solar system's giant planets formed and migrated in the protoplanetary disk to reach the resonant orbits with all planets inside ~15 AU from the Sun. After the gas disk's dispersal, Uranus and Neptune were likely scattered by the gas giants, and approached their current orbits while dispersing the transplanetary disk of planetesimals, whose remains survived to this time in the region known as the Kuiper Belt. Here we performed N-body integrations of the scattering phase between giant planets in an attempt to determine which initial states are plausible. We found that the dynamical simulations starting with a resonant system of four giant planets have a low success rate in matching the present orbits of giant planets and various other constraints (e.g., survival of the terrestrial planets). The dynamical evolution is typically too violent, if Jupiter and Saturn start in the 3:2 resonance, and leads to final systems with fewer than four planets. Several initial states stand out in that they show a relatively large likelihood of success in matching the constraints. Some of the statistically best results were obtained when assuming that the solar system initially had five giant planets and one ice giant, with the mass comparable to that of Uranus and Neptune, and which was ejected to interstellar space by Jupiter. This possibility appears to be conceivable in view of the recent discovery of a large number of free-floating planets in interstellar space, which indicates that planet ejection should be common.

miR-139-5p regulates proliferation, apoptosis, and cell cycle of uterine leiomyoma cells by targeting TPD52

OpenAIRE

Chen,Hong; Xu,Hong; Meng,Yugang; Zhang,Yun; Chen,Junying; Wei,Xiaoning

2016-01-01

Hong Chen,1 Hong Xu,1 Yu-gang Meng,1 Yun Zhang,2 Jun-ying Chen,1 Xiao-ning Wei1 1Department of Gynaecology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 2Department of Gynaecology, The People’s Hospital of Suzhou High Tech District, Suzhou, Jiangsu, People’s Republic of China Background: Uterine leiomyoma is one of the most common benign tumors in women. It dramatically decreases the quality of life in the affected women. However, there ...

CYTOKINE EXPRESSION PROFILES OF PERITONEAL FLUID IN THE PATIENTS WITH UTERINE LEIOMYOMA

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K. A. Syssoev

2006-01-01

Full Text Available Abstract. Uterine leiomyoma (UL is a hormone-dependent benign tumor of uterus. Social significance of UL is stipulated by its high rate among fertile females. Scarce data exist about the impact of cytokines in UL progression. Th1/Th2 paradigm is one of crucial points in modern immunology. Evaluation of cytokines involved into either type of immune response is of special significance for studying the diseases accompanied by the changes of extracellular matrix, e.g., leiomyomas. In present study, we analyzed peritoneal fluids from UL patients, with multiplex detection of IL-2, IL-4, IL-5, IL-10, IL-12, IL-13, GM-CSF, IFN-γ and TNF-α (Th1/Th2 panel, by means of a Bio-Plex® instrument (Bio-Rad, USA. Twenty-seven patients were observed in our study (20 patients with UL, and 7 myoma-free women (a group of comparison. The mean age of the patients was 43.5±0.6 years. The duration of UL ranged from 0 to 18 years. As a result, the levels of IL-10, GM-CSF, IFN-γ and TNF-α in patients with long-existing UL (over 5 years were significantly higher (p<0,05 than in group with a disease story of <5 years. IFN-γ values in peritoneal fluid patients with UL did inversely correlate with uterine size. Moreover, the levels of IFN-γ in patients with smaller uterine volume (<8 weeks of pregnancy were increased in relation to the group with larger tumor size. IL-10 contents were increased in the patients with adenomyosis, rapid and slow growth of UL, and in both types of tumor (simple and proliferative. Increased IL-5 levels were observed in the patients with single tumor nodules (as related to the patients bearing multiple nodes, and comparison group. Furthermore, intramural and subserosal location of nodes was characterized by increased levels of IL-5. In the patients free of adenomyosis, IL-5 value was increased against the comparison group. The changes in IL-2, IL-4, IL-12 and IL-13 levels in patients with UL were not statistically significant.

Giant multipole resonances: perspectives after ten years