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González-Díaz E, Cengotitabengoa BG, Carbajo ABD, Fernández CF, Corona AF. Imaging Diagnosis of Perianal Leiomyoma: A Case Report. Ann Coloproctol 2021; 37:S58-S62. [PMID: 34107598 PMCID: PMC8359697 DOI: 10.3393/ac.2020.10.13.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/13/2020] [Indexed: 11/24/2022] Open
Abstract
A leiomyoma is a benign mesenchymal neoplasm that usually develops where smooth muscle is present. In this report, we present the case of a 75-year-old woman who sought medical attention due to pelvic organ prolapse and urinary incontinence, and without defecatory symptoms. Both pelvic floor ultrasound and magnetic resonance imaging (MRI) examination showed a well-defined mass in the ischioanal fossa, eventually diagnosed as a perianal leiomyoma. It is considered a rare entity because of its location involving the anal sphincter and clinical features. We describe the ultrasonographic and MRI findings of this perianal leiomyoma, together with differential diagnoses and immunohistochemical characterization.
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Affiliation(s)
- Enrique González-Díaz
- Pelvic Floor Unit, Department of Obstetrics and Gynaecology, Complejo Asistencial Universitario de León (CAULE), León, Spain
| | | | | | - Camino Fernández Fernández
- Department of Obstetrics and Gynaecology, Complejo Asistencial Universitario de León (CAULE), León, Spain
| | - A Fernández Corona
- Department of Obstetrics and Gynaecology, Complejo Asistencial Universitario de León (CAULE), León, Spain
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Wu YT, Wu Y, Chen SC, Zhou F, Yang CB, Xie ZW, Xu CM, Jin HM. A Novel Molecular Cytogenetic Finding of Leiomyomatosis Peritonealis Disseminata. Gynecol Obstet Invest 2015; 81:000381262. [PMID: 25925998 DOI: 10.1159/000381262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 02/26/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Leiomyomatosis peritonealis disseminata (LPD) is a rare disease characterised by the subperitoneal proliferation of smooth muscle cells that form benign nodules. A few studies have aimed to reveal the pathogenesis of LPD without reaching a clear explanation. METHODS Karyotype analysis and array-comparative genomic hybridization (aCGH) of a human LPD case were performed to evaluate the role of chromosomal abnormalities in LPD pathogenesis. RESULTS The LPD nodules showed a 45, XX, del(7p), t(11; 17) (q23;q25),-22 de novo karyotype, and the aCGH analysis confirmed these deletions at 7p22.3-p12.1 (1,862,362-52,766,911 bp) and 22q11.23-q13.33 (21,973,915-49,265,116 bp) with lengths of 50.9 Mb and 27.3 Mb, respectively. CONCLUSION In this study, we described two large novel aberrations - deletions in chromosome 7 and 22 - that might play an important role in LPD disease. These findings might contribute to new insights to unravel the pathogenesis of LPD and develop further clinical treatments. © 2015 S. Karger AG, Basel.
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Affiliation(s)
- Yan-Ting Wu
- Departments of Gynaecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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García-Santos EP, Ruescas-García FJ, Estaire-Gómez M, Martín-Fernández J, González-López L. [Anorectal leiomyoma: a case report and literature review]. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2014; 79:58-60. [PMID: 24629571 DOI: 10.1016/j.rgmx.2013.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Revised: 05/01/2013] [Accepted: 05/29/2013] [Indexed: 10/25/2022]
Affiliation(s)
- E P García-Santos
- Servicio de Cirugía General y de Aparato Digestivo, Hospital General Universitario de Ciudad Real, Ciudad Real, España.
| | - F J Ruescas-García
- Servicio de Cirugía General y de Aparato Digestivo, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - M Estaire-Gómez
- Servicio de Cirugía General y de Aparato Digestivo, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - J Martín-Fernández
- Servicio de Cirugía General y de Aparato Digestivo, Hospital General Universitario de Ciudad Real, Ciudad Real, España
| | - L González-López
- Servicio de Anatomía Patológica, Hospital General Universitario de Ciudad Real, Ciudad Real, España
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García-Santos E, Ruescas-García F, Estaire-Gómez M, Martín-Fernández J, González-López L. Anorectal leiomyoma: A case report and literature review. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2014. [DOI: 10.1016/j.rgmxen.2014.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Acar M, Tatlı S, Silverman SG. Leiomyomatosis Peritonealis Disseminata: MRI Features Before and After Treatment with GnRH Agonist. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2013. [DOI: 10.29333/ejgm/82222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Dim CC, Akogu SP, Ezegwui HU, Olusina DB. Leiomyomatosis peritonealis disseminata in a Nigerian woman. Niger Med J 2013; 53:172-4. [PMID: 23293420 PMCID: PMC3531039 DOI: 10.4103/0300-1652.104390] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Leiomyomatosis peritonealis disseminata (LPD) is a rare condition. A 48-year-old multiparous woman was referred because of an incidental ultrasound finding suggestive of LPD. She had a 6-year past history of use of combined oral contraceptive pills. LPD was also suspected at laparotomy and confirmed by histology. She had total abdominal hysterectomy, bilateral salpingo ophorectomy and infracolic omentectomy. Patient was being followed-up. LSD is a rare gynecological condition which can pose a diagnostic challenge. Removal of estrogen sources as was done for the patient is the mainstay of treatment. Patient follow-up is very important because of the risk of malignant transformation.
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Affiliation(s)
- Cyril C Dim
- Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital (UNTH), Enugu, Nigeria
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Young-onset peri-anorectal leiomyomatosis: report of a case. Surg Today 2012; 43:329-34. [PMID: 22610456 DOI: 10.1007/s00595-012-0201-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Accepted: 11/23/2011] [Indexed: 10/28/2022]
Abstract
A 23-year-old female was referred with constipation that lasted for 2 years. Preoperative examinations revealed multiple submucosal tumors beside the anorectum, along with subcutaneous tumors in the left buttock. The pathological diagnosis was leiomyoma. Low anterior resection of the rectum with regional lymph node dissection, along with the resection of the subcutaneous tumors in the left buttock through the transdermal approach, was performed, since multiple tumor formation indicated a high malignant potential. The tumors were diagnosed as multiple leiomyomas with no malignancy. Disease categories such as intravenous leiomyomatosis, leiomyomatosis peritonealis disseminata, Alport syndrome, and Currarino syndrome have been reported to be associated with leiomyomatosis; however, the current case of "peri-anorectal leiomyomatosis" was not classified into any of these. The patient was monitored with careful checkups, and the postoperative course was satisfactory for over 5 years without any sign of recurrence or metastasis. Although the clinicopathological features of this case are quite rare and no therapeutic guidelines for such a disease have yet been established, radical resection should be considered, and the elucidation of the histogenesis of this disease will help establish future therapeutic guidelines.
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Ciotti P, Mandich P, Bellone E, Ceppa P, Bovio M, Ameri P, Torre G, Fiocca R, Murialdo G. Currarino syndrome with pelvic neuroendocrine tumor diagnosed by post-mortem genetic analysis of tissue specimens. Am J Med Genet A 2011; 155A:2750-3. [PMID: 21915987 DOI: 10.1002/ajmg.a.34031] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2010] [Accepted: 02/10/2011] [Indexed: 12/12/2022]
Abstract
Currarino syndrome (CS) is an autosomal dominant disorder of embryonic development characterized by the triad of anorectal abnormalities, partial sacral agenesis, and presacral mass. Mutations of the HLXB9 gene have been identified in most CS cases, but a precise genotype-phenotype correlation has not been described so far. We report the clinical case of a 44-year-old Caucasian woman with malignant neuroendocrine transformation of a pre-sacrococcygeal mass combined with bicornuate uterus, dermoid cyst of the ovaries, and chronic constipation. After the patient died, a sacrococcygeal malformation and anterior meningocele were diagnosed in her 22-year-old son. CS diagnosis was then retrospectively confirmed by molecular analysis of normal and pathological tissue specimens of the mother, with identification of a HLXB9 mutation (c.727C>T; p.R243W). CS should be considered, and genetic counseling recommended, to all patients with presacral masses. Since malignant neuroendocrine transformation of presacral mass in CS is a possible complication, even thought rare, close follow up in these patients is advisable.
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Affiliation(s)
- Paola Ciotti
- Department of Neuroscience, Ophthalmology and Genetics-Section of Medical Genetics, University of Genova, Genova, Italy.
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Disseminated leiomyomatosis peritonei. Incidental finding in laparoscopy: a case report. Surg Laparosc Endosc Percutan Tech 2010; 20:e123-4. [PMID: 20551791 DOI: 10.1097/sle.0b013e3181e10c8e] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Disseminated leiomyomatosis peritonei is a rare condition characterized by multiple smooth muscle, myofibroblastic, and fibroblastic nodules. The appearance often mimics carcinomatosis or tuberculosis. We describe a 33-year-old woman with disseminated leiomyomatosis peritonei and recurrent multiple uterine leiomyomas who underwent laparoscopic myomectomy. The images obtained from laparoscopy are presented.
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Fasih N, Galwa RP, Macdonald DB, Fraser-Hill MA, McInnes M, Khalili K. Thinking beyond peritoneal carcinomatosis: imaging spectrum of unusual disseminated peritoneal entities. Can Assoc Radiol J 2010; 62:125-34. [PMID: 20452173 DOI: 10.1016/j.carj.2010.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2009] [Revised: 03/07/2010] [Accepted: 03/08/2010] [Indexed: 11/16/2022] Open
Abstract
Although peritoneal carcinomatosis is the most common entity involving the peritoneum diffusely, a vast array of unusual diseases may affect the peritoneal surfaces. These entities can be further categorized into infectious, neoplastic, and miscellaneous, and miscellaneous conditions. Cross-sectional imaging, including computed tomography and magnetic resonance imaging are excellent modalities for further characterization of these unusual diseases. For some of the conditions, imaging-specific is achievable. For others, the diagnosis can be favored when clinical and/or cross-sectional features coexist.
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Affiliation(s)
- Najla Fasih
- Division of Abdominal Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, Canada.
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Al-Talib A, Al-Farsi AR, Stanimir G. Leiomyomatosis Peritonealis Disseminata with Features of Carcinomatosis on Laparoscopy: A case report. Sultan Qaboos Univ Med J 2009; 9:315-318. [PMID: 21509316 PMCID: PMC3074792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2009] [Revised: 06/30/2009] [Accepted: 08/24/2009] [Indexed: 05/30/2023] Open
Abstract
Leiomyomatosis peritonealis disseminata (LPD), also known as diffuse peritoneal leiomyomatosis, is a rare disease characterised by subperitoneal proliferation of benign nodules mainly composed of benign smooth muscle cells, macroscopically mimicking peritoneal carcinomatosis. We report a 43 year-old woman who presented with menorrhagia, pelvic pressure and pain. Ultrasound of the pelvis showed uterine fibroids and an ovarian cyst. She was scheduled to have a laparoscopic hysterectomy and left salpingo-oophorectomy for symptomatic relief. A picture of carcinomatosis was seen on laparoscopy so multiple biopsies were taken and the patient was referred to the gynaecological oncology team. Definitive surgery was performed and final pathology was consistent with LPD with no evidence of malignancy. No hormone replacement therapy was offered after surgery. Macroscopically, LPD has features of malignancy; it usually pursues a benign course. To review current management of LPD and the risk of malignant transformation, we conducted a search in Medline, EMBASE, and the Cochrane Database of systematic reviews using the keywords: leiomyomatosis peritonealis disseminata, management and malignant transformation. LPD is a diagnostic challenge. Although rare, malignant transformation can occur since hormones play an important role in the pathogenesis of LPD, following surgery, patients should be followed carefully if they are on hormone replacement as these tumours could re-grow and cause symptoms or transform to malignancy.
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Kotru M, Gupta R, Aggarwal S, Sharma S, Bhatia A. Cartilaginous metaplasia in uterine leiomyoma. Arch Gynecol Obstet 2009; 280:671-3. [DOI: 10.1007/s00404-009-0970-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2008] [Accepted: 01/29/2009] [Indexed: 10/21/2022]
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Fasih N, Prasad Shanbhogue AK, Macdonald DB, Fraser-Hill MA, Papadatos D, Kielar AZ, Doherty GP, Walsh C, McInnes M, Atri M. Leiomyomas beyond the Uterus: Unusual Locations, Rare Manifestations. Radiographics 2008; 28:1931-48. [PMID: 19001649 DOI: 10.1148/rg.287085095] [Citation(s) in RCA: 264] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Najla Fasih
- Department of Diagnostic Imaging, Ottawa Hospital, Ottawa, ON, Canada.
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Castro-Boix S, Dopazo-Taboada C, Nadal-Guinard A, Boqué-Genovard R, Zanón-Navarro V, Armengol-Carrasco M. Leiomiomatosis peritoneal diseminada. Cir Esp 2007; 82:125-7. [PMID: 17785148 DOI: 10.1016/s0009-739x(07)71680-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Leiomyomatosis peritonealis disseminata is an uncommon condition characterized by subperitoneal proliferation of benign nodules mainly composed of benign smooth muscle cells. This entity generally appears in premenopausal women and hormonal influences may play a role in its pathogenesis. The macroscopic appearance mimics peritoneal carcinomatosis. The characteristic clinical course is asymptomatic and diagnosis is only feasible after microscopic examination. To date, less than 100 cases have been reported in the literature. We report the case of a 40-year-old woman who underwent surgery in our department.
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Affiliation(s)
- Sandra Castro-Boix
- Servicio de Cirugía General. Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Passeig Vall d'Hebron, 08035 Barcelona, Spain.
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