Leiomyoma of the female urethra

Imaging Diagnosis of Urethral Leiomyoma, usual Tumour at an Unusual Location

Leiomyomas are benign tumours of smooth muscle origin and are the most common uterine masses in females of reproductive age group. Extrauterine leiomyomas are also encountered occassionally and most commonly they involve the genitourinary tract. Leiomyomas arising from urethral smooth muscle are exceptionally unusual which can pose a diagnostic dilemma. Patients usually present with urinary complaints and an intraluminal soft tissue mass bulging from urethral meatus. We are presenting the imaging findings of leiomyoma of distal urethra presenting as a perineal mass with histopathological correlation.

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Le léiomyome de l’urètre est une tumeur bénigne rare constituée detissus musculaires lisses. Cette tumeur se traduit par une variété designes cliniques ; le recours à l’histologie est donc nécessaire pourposer le diagnostic. Le traitement de choix est l’exérèse chirurgicale.Aucun cas de dégénérescence maligne n’a été signalé jusqu’àprésent, mais une récidive locale est possible en cas d’exérèseincomplète. Les auteurs font état d’un nouveau cas de léiomyomeintéressant à la fois le col vésical et l’urètre, et se traduisant par ladysurie chez une patiente ; ils proposent également une revue dela littérature concernant cette pathologie.

Recurrent huge leiomyoma of the urethra in a female patient: A case report

Urethral leiomyoma is an extremely rare condition that arises from the smooth muscle of the urethra. To the best of our knowledge, there is only a single reported recurrence treated by a repeat excision in the literature to date. The present study reports an exceptionally rare case of a recurrent huge leiomyoma of the female urethra. The 47-year-old female was diagnosed with a huge mass located between the urethra and vagina during a gynecological examination. The patient had no symptoms and was successfully treated with transabdominal excision. Pathological examinations revealed a leiomyoma of the urethra. The patient was followed up for one year without any sign of recurrence.

Lymphoma of the urinary bladder

Background. Lymphoma of the urinary bladder (LUB) is rare. Aims. To review the literature on LUB. Methods. Various internet databases were used. Results. LUB can be either primary or secondary. The tumour has female predominance; most cases occur in middle-age women. Secondary LUB occurs in 10% to 25% of leukemias/lymphomas and in advanced-stage systemic lymphoma. Less than 100 cases have been reported. MALT typically affects adults older than 60 years; 75% are female. Diffuse large B-cell lymphoma is also common and may arise from transformation of MALT. LUB presents with haematuria, dysuria, urinary frequency, nocturia, and abdominal or back pain. Macroscopic examination of LUBs show large discrete tumours centred in the dome or lateral walls of the bladder. Positive staining of LUB varies by the subtype of lymphoma; B-cell lymphomas are CD20 positive. MALT lymphoma is positively stained for CD20, CD19, and FMC7 and negatively stained for CD5, CD10, and CD11c. LUB stains negatively with Pan-keratin, vimentin, CK20, and CK7. MALT lymphoma exhibits t(11; 18)(q21: 21). Radiotherapy is an effective treatment for the MALT type of LUB with no recurrence. Conclusions. LUB is diagnosed by its characteristic morphology and immunohistochemical characteristics. Radiotherapy is a useful treatment.

Leiomyoma of the female urethra-a rare tumor: case report and review of the literature

Leiomyoma is a benign smooth muscle tumor which is rarely found in urethra. Only a handful of cases have been reported in the literature. We hereby report a case of urethral leiomyoma in a twenty-seven-year-old female who presented with intermittent hematuria. Mass was completely excised with a rim of normal tissue. Patient remained asymptomatic with no evidence of recurrence in followup.

Leiomyomas of the female urethra and bladder: a report of five cases and review of the literature

Through the experience of five cases of leiomyoma developed in the female bladder and urethra with a review of the literature, we have made an effort to characterize the association of symptom with the size and location of the tumor and demonstrate an appropriate treatment. The study population was composed of patients who underwent surgery for bladder or urethral leiomyoma in our hospital from March 1990 to April 2005. Their medical records were reviewed retrospectively concerning the symptom, size and location of leiomyoma, the result of cystoscope and radiological examination, surgical method, pathologic report, complications, and recurrence. Four cases were diagnosed as urethral leiomyoma and one case as bladder leiomyoma. All patients with urethral leiomyoma were admitted for the chief complaint of a palpable tumor. When the tumor size was small, if it was located on the lateral side of the urethra, it was asymptomatic, but if located in the midline, it presented irritative or obstructive symptom. When it was big, if located on the lateral side, it presented irritative rather than obstructive symptom, and if located in the midline, it presented obstructive symptom. One case of bladder leiomyoma was discovered incidentally during ultrasonic exam. In all five cases, surgical removal was performed and complications or recurrence were not detected afterwards. Bladder and urethral leiomyomas are very rare and cause diverse manifestations from asymptomatic to irritative or obstructive symptom. It is presumed that the location and size of the tumor are associated with symptom. Unless it is the case with severe hemorrhage or obstructive acute renal failure, immediate surgery is not required. However, it is desirable to distinguish leiomyoma from malignant or other benign tumors by surgical biopsy or removal.

Urologic malignancies in pregnancy

Urologic tumors during pregnancy are rare. Presenting symptoms of malignancies may be mistaken as typical symptoms in pregnancy. Evaluation and treatment of tumors of the adrenal gland, kidney, ureter, bladder, and urethra are reviewed based upon stage and type of tumor and stage of pregnancy.

A Rapidly Growing Paraurethral Myoma with Profuse Bleeding from a Mucosal Vessel: Report of a Case

Paraurethral leiomyoma is rare. This is the first reported case of a woman with a 6 x 7 x 5 cm urethral leiomyoma with profuse vaginal bleeding. The site of bleeding was identified as the anterior vaginal mucosal vein, which we subsequently electrocauterized. Enucleation of the mass was performed smoothly with a Foley catheter to avoid damage to the urethra. Profuse bleeding from a paraurethral myoma is possibly due to increased vascularity and the prolapsed nature of the tumor in this area.

Urethral and paraurethral leiomyomas in the female patient

Urethral leiomyomas in women arise from the smooth muscle of the urethra and are rare, benign urethral tumors seen primarily in women. We present three cases of urethral leiomyomas identified over a 30-year period at our institution. A 45-year old woman presented with a 1 year history of frequency, nocturia, and hesitancy and was found to have both a 2-cm proximal urethral and a 3-cm posterior bladder leiomyoma. She developed stress urinary incontinence postoperatively and was treated with a Burch colposuspension. A 33-year old woman with hematuria was found to have both a 3-cm urethral and a 3-cm paraurethral leiomyoma at the bladder neck. A 21-year old without urinary complaints was found to have a 3-cm leiomyoma at the urethral meatus. Urethral leiomyomas must be differentiated from paraurethral leiomyomas, which are often asymptomatic and may be removed without disrupting the urethral mucosa or smooth muscle. The removal of urethral myomas may be complicated by the development stress urinary incontinence or urethral stricture.

Leiomyoma of the female urethra: urodynamic changes after surgical intervention

Leiomyoma of the urethra is a relatively rare condition often presenting as an anterior vaginal wall mass or a mass that protrudes from the urethral meatus. We report on the urodynamic changes after vaginal surgery to remove a suburethral leiomyoma, which protruded from the vaginal orifice resulting in dysuria and dyspareunia. Urodynamic studies before the operation revealed a high detrusor pressure, low maximum flow rate with an elevated post-void residual urine on voluntary voiding, and high resting urethral resistance. Removal of the mass with proper reconstruction of paraurethral support restored normal detrusor pressure, maximum flow rate, and post-void residual, resulting in amelioration of her voiding difficulty and dyspareunia. The operative procedure did not affect leak point pressure and she is free from stress urinary incontinence.

Leiomyoma of the female urethra

Leiomyoma of the female urethra is an uncommon but benign condition. The authors report two additional cases of successfully operated neoplasms. The difficulties of the diagnosis, differential diagnosis, the surgical treatment and the complications are discussed.

Obstructive leiomyoma of the female urethra: report of a case

We report a case of leiomyoma of the female urethra and review the literature. A mass protruding from the urethral meatus during voiding caused dysuria. Urodynamic study showed an obstructive pattern with low maximum urine flow and high detrusor pressure in initiating voiding. Cystourethroscopy revealed a mass extending from the proximal segment of the left lateral urethral wall into the bladder. At transurethral resection of the tumor 12.2 gm. of tissue were excised. Histopathological studies confirmed urethral leiomyoma. Surgery completely resolved the original symptoms of dysuria.

Para-urethral vaginal leiomyoma

Only a few cases of para-urethral vaginal leiomyoma have been reported in literature. We describe two additional cases and discuss the differential diagnosis and management.

Leiomyoma of the female urethra--a clinical curiosity

A case of leiomyoma of the female urethra is reported. The patient, a perimenopausal, multiparous woman presented with a gradually enlarging mass per vagina for the past 6 months. A provisional diagnosis of carcinoma of skene's duct or vaginal leiomyoma was entertained and an excisional biopsy performed. To our surprise, histopathological examination revealed an urethral cellular leiomyoma.

Leiomyoma of the female urethra

Smooth muscle tumors of the female urethra are uncommon lesions. Only a few cases of leiomyoma of the female urethra have been reported in the literature. We describe 2 additional cases, review the literature on this rare neoplasm and discuss its management.

Leiomyoma of tunica albuginea of testis

Leiomyoma is an uncommon lesion which may originate anywhere within the genitourinary system where smooth muscle is present. The third case of leiomyoma of the testicular tunica albuginea is reported, and other reports of genitourinary leiomyomas are reviewed.

Retrovesical leiomyoma

Primary tumors arising in the retrovesical area are rare. We recently treated by primary excision a large retrovesical leiomyoma in a forty-five-year-old man. The smooth muscle nature of the tumor was confirmed by electron microscopy. Recognizing this entity is important, since treatment consists only of surgical removal, and the prognosis should be excellent.

Genitourinary leiomyomas

Leiomyomas may originate from any anatomic location of smooth muscle in the genitourinary system but are uncommon neoplasms. Five unusual cases of leiomyomas arising from the renal pelvis, bladder, spermatic cord, and glans penis are presented. The leiomyoma arising from the glans penis in a three-year-old boy is the first case of a leiomyoma in that location noted in the literature. A review of leiomyomas from each genitourinary structure of origin is presented.

Leiomyoma of the female urethra

Leiomyoma of the urethra is a rare condition, which is more common in female than in male subjects. There are only 14 documented cases of leiomyoma of the female urethra in the literature. A careful analysis of these cases revealed the average patient age to be 34.1 years. The site of the lesion determined the clinical features and the surgical approach. No common etiological factor could be ascertained. Two additional cases of leiomyoma of the female urethra are reported.

Nephrogenic adenoma in urethral diverticulum

A nephrogenic adenoma located within a urethral diverticulum of a female was found incidental to a diverticulectomy. Cases of this apparently benign lesion have been reported previously, but the lesions were located in the bladder, particularly in older males with a history of chronic cystitis.

Paraurethral leiomyoma--an imitator

In location and clinical appearance a paraurethral leiomyoma imitated other disease in 2 patients. Correct preoperative diagnosis of these lesions can avert therapeutic error. Diagnostic clues include a solid, noncystic mass that does not communicate with the urethra, is circumscribed, and has essentially normal overlying mucosa. A surgical approach through the anterior vaginal wall avoids urethral injury and enucleation is curative.

Leiomyoma of the female urethra: a case report

A case of leiomyoma of the female urethra arising from the anterior lip of the external urinary meatus is presented. The tumor was missed originally and, subsequently, increased in size. Although the neoplasm was suspected clinically, it was confirmed only by histopathology. The tumor was responsible for recurrent urinary tract infection, which ceased after the neoplasm was excised.