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ERBAY G, YALÇIN Ç. Peritoneal karsinomatozisi taklit eden dissemine peritoneal leiomyomatozis. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1090438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Dissemine peritoneal leiomyomatozis (DPL) genellikle premenopozal kadınları etkileyen iyi huylu ve çok nadir bir hastalıktır. 39 yaşında intramural leiomyomu ve dissemine peritoneal leiomyomatozisi olan bir kadın hastayı sunuyoruz. DPL'in kesin tedavisi hastalığın derecesine göre değişen derecede cerrahi olarak yapılmaktadır. Agresif tedavi kararı verilmeden önce peritoneal fibroidlerin malign peritoneal tümörleri taklit edebileceği akılda tutulmalıdır.
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Proteomic Profiling Identifies Co-Regulated Expression of Splicing Factors as a Characteristic Feature of Intravenous Leiomyomatosis. Cancers (Basel) 2022; 14:cancers14122907. [PMID: 35740573 PMCID: PMC9221257 DOI: 10.3390/cancers14122907] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 06/07/2022] [Indexed: 11/17/2022] Open
Abstract
Intravenous leiomyomatosis (IVLM) is a rare benign smooth muscle tumour that is characterised by intravenous growth in the uterine and pelvic veins. Previous DNA copy number and transcriptomic studies have shown that IVLM harbors unique genomic and transcriptomic alterations when compared to uterine leiomyoma (uLM), which may account for their distinct clinical behaviour. Here we undertake the first comparative proteomic analysis of IVLM and other smooth muscle tumours (comprising uLM, soft tissue leiomyoma and benign metastasizing leiomyoma) utilising data-independent acquisition mass spectrometry. We show that, at the protein level, IVLM is defined by the unique co-regulated expression of splicing factors. In particular, IVLM is enriched in two clusters composed of co-regulated proteins from the hnRNP, LSm, SR and Sm classes of the spliceosome complex. One of these clusters (Cluster 3) is associated with key biological processes including nascent protein translocation and cell signalling by small GTPases. Taken together, our study provides evidence of co-regulated expression of splicing factors in IVLM compared to other smooth muscle tumours, which suggests a possible role for alternative splicing in the pathogenesis of IVLM.
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Khangar B, Mallya V, Khurana N, Sachdeva P, Kashyap S. Coexisting leiomyomata peritonealis disseminata and ovarian leiomyoma. J Midlife Health 2017; 8:45-47. [PMID: 28458480 PMCID: PMC5367224 DOI: 10.4103/jmh.jmh_96_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Leiomyoma is the most common tumor seen affecting women mostly of reproductive age groups. It is composed of smooth muscle cells that are positive for smooth muscle actin on immunohistochemistry. Leiomyomata peritonealis disseminata (LPD) is characterized by nodules that stud the peritoneum. It is seen in association with hormone-producing ovarian tumors and coexisting leiomyomas of the uterus. Association with mesenteric leiomyomas has been reported. Ovarian leiomyomas are very rare tumors of the ovary and coexisting LPD with ovarian leiomyomas has not been reported before. We present this rare case of LPD and ovarian leiomyoma.
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Affiliation(s)
- Babita Khangar
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Varuna Mallya
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Nita Khurana
- Department of Pathology, Maulana Azad Medical College, New Delhi, India
| | - Poonam Sachdeva
- Department of Obstetrics and Gynecology, Lok Nayak Jai Prakash Hospital, MAMC, New Delhi, India
| | - Swati Kashyap
- Department of Obstetrics and Gynecology, Lok Nayak Jai Prakash Hospital, MAMC, New Delhi, India
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Lete I, González J, Ugarte L, Barbadillo N, Lapuente O, Álvarez-Sala J. Parasitic leiomyomas: a systematic review. Eur J Obstet Gynecol Reprod Biol 2016; 203:250-9. [PMID: 27359081 DOI: 10.1016/j.ejogrb.2016.05.025] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 04/27/2016] [Accepted: 05/13/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND Parasitic leiomyomas were first described as early as 1909 but are a rare condition. In recent years, due to the rise of laparoscopic surgery and power morcellation, several cases of parasitic leiomyomas associated with this surgical procedure have been reported. METHODS A literature search was performed using PubMed, Embase and Google Scholar with the following combination of keywords: leiomyoma OR uterine neoplasms OR uterine myomectomy OR laparoscopy OR hysterectomy OR peritoneal neoplasms AND parasitic. Papers describing parasitic leiomyomas were included. The results of these studies are summarized herein. RESULTS We retrieved abstracts of 756 papers. Of these, 591 were excluded for not fulfilling the inclusion criteria and 54 were removed as duplicates; after full-text assessment, 8 were rejected for presenting cases of malignancy and finally 103 were included in our systematic review. From these, we present information about 274 patients with parasitic leiomyomas. The mean age of women was 40 years (range 18-79 years); and 154 (56%) had no history of uterine surgery, the others (120, 44%) having had a previous myomectomy or hysterectomy. Of the total, 106 (39%) women had a history of power morcellation. The most frequent clinical symptom was abdominal pain (49%) and the most frequent presentation was disseminated peritoneal leiomyomatosis. CONCLUSIONS While parasitic leiomyoma was first described a century ago, the recent introduction of laparoscopic power morcellation has increased the number of reported cases.
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Affiliation(s)
- Iñaki Lete
- Department of Obstetrics and Gynecology, University Hospital Araba, Vitoria, Spain; School of Medicine, Basque Country University, Vitoria, Spain; BioAraba Research Unit, Vitoria, Spain.
| | - Janire González
- Department of Obstetrics and Gynecology, University Hospital Araba, Vitoria, Spain
| | - Lorea Ugarte
- Department of Obstetrics and Gynecology, University Hospital Araba, Vitoria, Spain
| | - Nagore Barbadillo
- Department of Obstetrics and Gynecology, University Hospital Araba, Vitoria, Spain
| | - Oihane Lapuente
- Department of Obstetrics and Gynecology, University Hospital Araba, Vitoria, Spain
| | - Javier Álvarez-Sala
- Department of Obstetrics and Gynecology, University Hospital Araba, Vitoria, Spain
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Shwayder J, Sakhel K. Imaging for Uterine Myomas and Adenomyosis. J Minim Invasive Gynecol 2014; 21:362-76. [DOI: 10.1016/j.jmig.2013.11.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 11/16/2013] [Accepted: 11/18/2013] [Indexed: 10/25/2022]
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Bayrak S, Pasaoglu E, Cakar E, Bektas H, Colak S, Sevinc MM, Kinaci E. Disseminated peritoneal leiomyomatosis with chronic constipation: a case report. J Med Case Rep 2014; 8:114. [PMID: 24708548 PMCID: PMC3977977 DOI: 10.1186/1752-1947-8-114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 02/17/2014] [Indexed: 11/10/2022] Open
Abstract
Introduction Disseminated peritoneal leiomyomatosis is a rare disease. Almost all disseminated peritoneal leiomyomatosis cases described in the literature are associated with a gynecological disorder or a mass in the abdominal cavity. Disseminated peritoneal leiomyomatosis with only chronic constipation has not been reported in the English literature. We present a case of a patient with disseminated peritoneal leiomyomatosis who manifested solely with chronic constipation. Case presentation A 49-year-old premenopausal nulliparous Caucasian woman was admitted with complaints of abdominal distention and chronic constipation. Open subtotal colectomy with ileorectal anastomosis was performed. There were diffuse nodular and polypoid tumor formations in her colonic mesoderm. Based on morphological and pathological evaluation of the resection material, she was diagnosed with disseminated peritoneal leiomyomatosis. Conclusions In general, disseminated peritoneal leiomyomatosis is seen in women who are of childbearing age with estrogen hypersecretion. Preoperative diagnosis of disseminated peritoneal leiomyomatosis is almost impossible and it can be confused with disseminated intra-abdominal malignancies. There are no specific methods to diagnose disseminated peritoneal leiomyomatosis in a preoperative period.
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Affiliation(s)
- Savas Bayrak
- Department of General Surgery, Istanbul Training and Research Hospital, Kasap İlyas Mah, Org, Abdurrahman Nafiz Gürman Cd, PK: 34098,, Istanbul (212) 4596000, Turkey.
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Leiomyomatosis peritonealis disseminata as a possible result of laparoscopic myomectomy—report of four cases. ACTA ACUST UNITED AC 2013. [DOI: 10.1007/s10397-013-0806-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Keskin G, Bastu E, Gungor-Ugurlucan F, Comba C, Iyibozkurt C, Topuz S. Diffuse peritoneal leiomyomatosis. J OBSTET GYNAECOL 2013; 33:535-6. [DOI: 10.3109/01443615.2013.783003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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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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Thian YL, Tan KH, Kwek JW, Wang J, Chern B, Yam KL. Leiomyomatosis peritonealis disseminata and subcutaneous myoma--a rare complication of laparoscopic myomectomy. ACTA ACUST UNITED AC 2009; 34:235-8. [PMID: 18311496 DOI: 10.1007/s00261-008-9379-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
We present a case of leiomyomatosis peritonealis disseminata (LPD) after laparoscopic myomectomy with imaging features corroborating laparoscopic tract dissemination of the tumor. This would suggest a subset cases of LPD may be secondary to transcoelomic dissemination of a primary uterine leiomyoma rather than de novo peritoneal metaplasia. To our knowledge, this is the first case report of LPD and subcutaneous leiomyoma complicating laparoscopic surgery. The imaging features of LPD are reviewed. Radiologists as well as clinicians should consider LPD as a potential complication of laparoscopic myomectomy.
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Affiliation(s)
- Yee Liang Thian
- Department of Diagnostic Radiology, KK Women's and Children Hospital, 100 Bukit Timah Road, Singapore, 229899, Singapore.
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Karaşahin KE, Gezginç K, Ulubay M, Başer I. Disseminated Peritoneal Leiomyomatosis. Taiwan J Obstet Gynecol 2008. [DOI: 10.1016/s1028-4559(19)30085-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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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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Cohen DT, Oliva E, Hahn PF, Fuller AF, Lee SI. Uterine smooth-muscle tumors with unusual growth patterns: imaging with pathologic correlation. AJR Am J Roentgenol 2007; 188:246-55. [PMID: 17179374 DOI: 10.2214/ajr.05.1070] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This essay illustrates the salient features of variant smooth-muscle tumors on multiple imaging techniques with correlative pathology. We describe how recognition of these features allows the radiologist to distinguish a uterine leiomyoma variant from the classic fibroid or a leiomyosarcoma. Finally, we highlight the role of the radiologist in triaging these patients to surgical versus medical management and in surgical planning. CONCLUSION Parasitic leiomyoma, intravenous leiomyomatosis, disseminated peritoneal leiomyomatosis, and benign metastasizing leiomyoma show key features on multiple imaging techniques that correlate with pathology findings. In the appropriate clinical setting, the radiologist should include these unusual lesions in the broader differential diagnosis of smooth-muscle tumors and, in certain cases, aid in surgical planning.
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Affiliation(s)
- Daniel T Cohen
- Department of Radiology, Massachusetts General Hospital, 55 Fruit St., White 270, Boston, MA 02114, USA
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Bucher M, Pusztaszeri M, Bouzourene H. La léiomyomatose péritonéale disséminée : profil immunohistochimique et origine. Ann Pathol 2006; 26:207-10. [PMID: 17127852 DOI: 10.1016/s0242-6498(06)70705-2] [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: 11/29/2022]
Abstract
Leiomyomatosis peritonealis disseminata (LPD) is a rare disease presenting as multiple peritoneal nodules of smooth muscle cells, mimicking peritoneal carcinomatosis. This disease usually pursues a benign course. We report one case of LPD in a 32-year-old woman, G2P1, without gynecological history. At term, she had an elective caesarean section during which several firm peritoneal nodules, ranging from 0.2 to 0.4 mm, were found. Microscopic examination showed a smooth-muscle cell proliferation with no mitosis, no atypia and no necrosis. Immunohistochemical analysis showed diffuse and strong staining for progesterone receptors and partial expression of estrogen receptors. The cells coexpressed smooth muscle actin, desmin, h-caldesmon, calretinin, WT1, and CD117 (KIT). They were weakly positive for EMA but negative for CD34. Proliferation index was low with 5% of cells being positive for MIB-1. This case of LPD proved to have an unusual immunohistochemistry profile raising the question of its real origin.
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Affiliation(s)
- Maya Bucher
- Institut Universitaire de Pathologie, Centre Hospitalier Universitaire de Lausanne (CHUV), 1011 Lausanne, Suisse
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Surmacki P, Sporny S, Tosiak A, Lasota J. Disseminated peritoneal leiomyomatosis coexisting with leiomyoma of the uterine body. Arch Gynecol Obstet 2006; 273:301-3. [PMID: 16341539 DOI: 10.1007/s00404-005-0086-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2004] [Accepted: 02/01/2005] [Indexed: 11/24/2022]
Abstract
The authors present an extremely rare case of disseminated peritoneal leiomyomatosis (DPL) coexisting with leiomyoma of the uterine body in a 32-year-old woman. The patient had undergone a caesarean section 12 years ago and used oral contraceptives since then. Before the present surgery leiomyoma of the left corner of the uterine body was diagnosed. DPL was found on the uterine serous membrane, Douglas's cavity, vesicouterine recess, the great omentum and abdominal peritoneum. There were no DPL nodules on the surface of the liver, kidneys and bowels. Saving operation was performed and only leiomyoma and the great omentum were resected. Immunohistochemical analysis using smooth muscle actin and HHF-35 antibodies showed the same reactivity of leiomyoma and DPL cells and proved the intra-operative diagnosis. Our case corroborates that DPL may occur in women of reproductive age and in patients who use oral contraceptives over a long span of time. That both leiomyoma and DPL are hormonally dependent could also be proved.
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Affiliation(s)
- Piotr Surmacki
- Department of Cytophysiology, Histology and Embryology, Medical University of Łódź, 90-136 Łódź, ul., Narutowicza 60, Łódź, Poland.
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Advincula AP, Hernandez JC, Lieberman R. Disseminated leiomyomatosis peritonei. Fertil Steril 2005; 84:1505-7. [PMID: 16275251 DOI: 10.1016/j.fertnstert.2005.04.063] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2005] [Revised: 04/01/2005] [Accepted: 04/01/2005] [Indexed: 11/21/2022]
Abstract
We describe a 41-year-old woman with disseminated leiomyomatosis peritonei who underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Images obtained from laparoscopy and histopathology are presented.
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Affiliation(s)
- Arnold P Advincula
- Department of Obstetrics and Gynecology, University of Michigan Medical Center, Ann Arbor, Michigan 48109, USA.
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Yamaguchi T, Imamura Y, Yamamoto T, Fukuda M. Leiomyomatosis peritonealis disseminata with malignant change in a man. Pathol Int 2003; 53:179-85. [PMID: 12608900 DOI: 10.1046/j.1440-1827.2003.01452.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Leiomyomatosis peritonealis disseminata (LPD) is a rare clinicopathological entity typically observed in women of reproductive age. We report a case of LPD with malignant change in a man. A 77-year-old man presented with a mass measuring 10 cm in diameter at the terminal ileum and numerous peritoneal small nodules that were revealed by abdominal computed tomography. Right hemicolectomy with lymph node dissection was performed. Macroscopically, a tumor of the terminal ileum consisted of aggregates of small nodular lesions with calcification and necrosis. The wall of the ileum and colon was intact. Microscopically, some of the nodular lesions consisted of neoplastic growths of atypical spindle cells with cellular atypism and abnormal mitoses. A few of these lesions were completely surrounded by smooth muscle bundles. Hemorrhages and necroses were found within the tumor nodules. Immunohistochemically, the tumor cells were positive for vimentin, desmin, muscle actin, alpha-smooth muscle actin, cytokeratin and p53. The remaining nodular lesions, including small peritoneal lesions, were composed of hypocellular hyalinizing nodules. This case was thought to be LPD with malignant change, although the pathogenesis was uncertain because the tumor cells were negative for estrogen and progesterone receptors.
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Affiliation(s)
- Tadanori Yamaguchi
- Department of Cytopathology, Maizuru Kyosai Hospital, Kyoto, Department of Surgical Pathology, Fukui Medical University Hospital, Fukui, Japan
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