1
|
Gupta Y, Agrawal M, Mehta V. Renal Leiomyoma - A Surprise Diagnosis!! Indian J Nephrol 2023; 33:488-489. [PMID: 38174307 PMCID: PMC10752398 DOI: 10.4103/ijn.ijn_200_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 05/26/2023] [Accepted: 05/28/2023] [Indexed: 01/05/2024] Open
Affiliation(s)
- Yashita Gupta
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences (AIIMS), Raipur, Chhattisgarh, India
| | - Mousmi Agrawal
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences (AIIMS), Raipur, Chhattisgarh, India
| | - Vats Mehta
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences (AIIMS), Raipur, Chhattisgarh, India
| |
Collapse
|
2
|
Costa C, Barba M, Cola A, Frigerio M. Transvaginal excision of vaginal paraurethral leiomyoma: A video case report. Eur J Obstet Gynecol Reprod Biol 2023; 290:11-13. [PMID: 37708657 DOI: 10.1016/j.ejogrb.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 08/22/2023] [Accepted: 09/09/2023] [Indexed: 09/16/2023]
Abstract
INTRODUCTION AND HYPOTHESIS Vaginal leiomyomas are uncommon benign tumors of the genital district that appear as a circumscribed, mobile, and nontender mass along the vaginal tube. The gold standard of vaginal leiomyoma management is surgical treatment. We aimed to present a clinical case of vaginal leiomyoma successfully treated throughout a transvaginal excision and layered repair. METHODS A 44-year-old woman was referred to our division for vaginal bulging symptoms and dyspareunia. Clinical examination revealed a 4-5 cm hard bulging mass in the anterior vaginal wall, below the urethra, compatible with vaginal leiomyoma. After proper counseling, the patient was admitted to transvaginal leiomyoma excision plus primary layered repair. RESULTS No surgical complications were observed. The indwelling catheter was removed the day after the surgery. The patient was successfully discharged home on postoperative day 1. The patient is currently asymptomatic and there are no signs of recurrence. CONCLUSION The procedure was successful in obtaining anatomical repair and relieving symptoms. This approach represents a valid procedure for the surgical management of this uncommon condition.
Collapse
Affiliation(s)
- Clarissa Costa
- Obstetrics and Gynecology Department, University of Milano-Bicocca, Monza, Italy.
| | - Marta Barba
- Obstetrics and Gynecology Department, University of Milano-Bicocca, Monza, Italy
| | - Alice Cola
- Department of Gynecology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Matteo Frigerio
- Department of Gynecology, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| |
Collapse
|
3
|
Gama J, Oliveira RC, Jarimba R, Sousa V. Leiomyoma with bizarre nuclei of the scrotum: a rare entity. BMJ Case Rep 2022; 15:e248423. [PMID: 35264392 PMCID: PMC8915319 DOI: 10.1136/bcr-2021-248423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2022] [Indexed: 11/04/2022] Open
Abstract
Leiomyomas of the paratesticular region are a rare entity. A subtype of leiomyomas called bizarre nuclei leiomyoma is even rarer and histologically present some interesting features that are important to recognise to make the differential diagnosis with its malignant counterpart-leiomyosarcoma. We present a case of a man in his 60s, who presented with a painless mass on the right testicle. The clinical diagnosis was of an epidermoid cyst. The mass was excised and a diagnosis of leiomyoma of bizarre nuclei was made.
Collapse
Affiliation(s)
- João Gama
- Pathology Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Rui Caetano Oliveira
- Pathology Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| | - Roberto Jarimba
- Urology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Vítor Sousa
- Pathology Department, Centro Hospitalar e Universitário de Coimbra EPE, Coimbra, Portugal
| |
Collapse
|
4
|
Aldughiman AW, Alzahrani A, Alzahrani T. Renal Leiomyoma: Case Report and Literature Review. J Endourol Case Rep 2020; 5:181-183. [PMID: 32775659 DOI: 10.1089/cren.2019.0049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Renal leiomyomas are rare benign tumors of the kidney originating from muscle cells. They are usually found by an autopsy, whether the patient is asymptomatic or has symptoms (i.e., abdominal/flank pain, hematuria, and palpable mass). Today the widespread use of ultrasonography and CT has increased the detection of clinically asymptomatic renal leiomyomas. The differential diagnosis between leiomyomas and other malignant lesions (above all renal cell carcinoma or leiomyosarcoma) is still possible by histologic examination. Radiologic examinations are not sufficient for the differential diagnosis. Renal leiomyomas have no aggressive behavior and they usually do not metastasize. The prognosis, after surgery, is excellent without recurrence. We report a case of leiomyoma in a 78-year-old man who presented with hematuria and flank pain. We also review the literature and provide a summary of clinical, radiologic, and histologic features of renal leiomyomas.
Collapse
Affiliation(s)
| | - Ahmed Alzahrani
- Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Tarek Alzahrani
- Department of Urology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| |
Collapse
|
5
|
The Rare Togetherness of Bladder Leiomyoma and Neurofibromatosis. Case Rep Urol 2018; 2018:2302918. [PMID: 29736289 PMCID: PMC5904780 DOI: 10.1155/2018/2302918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 10/19/2017] [Accepted: 11/06/2017] [Indexed: 11/17/2022] Open
Abstract
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.
Collapse
|
6
|
Winton C. A peri-urethral mass - what are the possible diagnoses? J OBSTET GYNAECOL 2017; 38:427-428. [PMID: 29017386 DOI: 10.1080/01443615.2017.1357167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Claire Winton
- a Obstetric and Gynaecology Department , Pinderfields Hospital, Mid Yorkshire Hospital Trust , Wakefield , UK
| |
Collapse
|
7
|
Leiomyoma of the deferens: a curious and extremely rare disease. Urologia 2017; 84:206-207. [PMID: 28665455 DOI: 10.5301/uj.5000252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2017] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Leiomyomas are rare benign tumors that can occur in the male urinary tract. We present a unique case of leiomyoma of the vas deferens. CASE DESCRIPTION We present the clinical case of a 69-year-old patient with a suspected bulk close to the right epididymis, which turned out to be a leiomyoma of the vas deferens. To our knowledge, it is the fourth case in literature. CONCLUSIONS A proper identification and the knowledge of this pathology, even if it is a very unusual event, is necessary to avoid a surgical over treatment and preserve the testicle, by removing only the tumor.
Collapse
|
8
|
Renal leiomyoma: a contemporary multi-institution study of an infrequent and frequently misclassified neoplasm. Am J Surg Pathol 2015; 39:349-56. [PMID: 25517956 DOI: 10.1097/pas.0000000000000354] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Renal leiomyoma is an exceptionally rare benign mesenchymal tumor of the kidney predominantly arising in proximity of the renal capsule or pelvis. Its rarity and nonspecific clinical and imaging features may lead to radical or partial nephrectomy on the basis of preoperative suspicion of renal cell carcinoma. The diagnosis of renal leiomyoma is challenging because of the histologic overlap with lipid-poor angiomyolipoma (AML). We conducted a multi-institution study to characterize renal leiomyoma in greater detail. We collected and reviewed 24 cases diagnosed initially as renal leiomyoma in 10 institutions from North America, Canada, and Europe. Immunohistochemical expression of desmin, HMB-45, estrogen receptor (ER), progesterone receptor (PR), and cathepsin K was evaluated. Upon central review, 9 tumors were classified as renal leiomyoma, whereas the remaining were reclassified as AML (n=13), myolipoma (n=1), and medullary fibroma (n=1). All renal leiomyomas were solitary and occurred in female patients (mean age 63 y; range, 44 to 74 y). Tumor size ranged from 0.6 to 7.0 cm (mean 2.9 cm); 7 originated from the renal capsule or the subcapsular area and 1 from a large vessel in the renal sinus. All leiomyomas were diffusely positive for desmin and negative for HMB-45 and cathepsin K; 6/9 (67%) showed diffuse ER and PR expression, and 1 case showed focal ER positivity only. Renal leiomyoma should be included in the histologic differential diagnosis of solid renal masses, particularly in perimenopausal women. The main differential diagnosis is with lipid-poor AML, and cathepsin K plays a key role in distinguishing these 2 lesions.
Collapse
|
9
|
Khetrapal S, Bhargava A, Jetley S, Rana S, Jairajpuri Z. Renal leiomyoma: an uncommon differential diagnosis of renal masses with a clinical relevance. J Clin Diagn Res 2014; 8:FD08-9. [PMID: 25478354 DOI: 10.7860/jcdr/2014/9434.4993] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 06/30/2014] [Indexed: 11/24/2022]
Abstract
Renal leiomyomas are an extremely rare neoplasm which account for 1.5% of the benign lesions and 0.29% of all treated renal tumours, with autopsy evidence of 4.2% to 5.2%. Given their exceptional incidence, they are rarely included in the differential diagnosis of renal masses, despite their capacity to grow to a considerable size. The definitive diagnosis of a leiomyoma is only possible after histopathological examination, most of the times of a nephrectomy specimen. However, due to the rising number of diagnosis resulting from improved medical imaging and interventions, renal leiomyomas should gain importance in the differential diagnosis of renal masses, specialy with respect to kidney sparing surgery. Hereby, we report a case of 60-year-old male patient with a large well circumscribed left renal mass, diagnosed as Renal cell carcinoma on imaging.
Collapse
Affiliation(s)
- Shaan Khetrapal
- Demonstrator, Department of Pathology, Hamdard Institute of Medical Sciences and Research , Jamia Hamdard, New Delhi, India
| | - Anupam Bhargava
- Senior Consultant, Department of Urology, Adiva Superspeciality Care Hospitals , Green Park Extension, New Delhi, India
| | - Sujata Jetley
- Professor, Department of Pathology, Hamdard Institute of Medical Sciences and Research , Jamia Hamdard, New Delhi, India
| | - Safia Rana
- Lecturer, Department of Pathology, Hamdard Institute of Medical Sciences and Research , Jamia Hamdard, New Delhi, India
| | - Zeeba Jairajpuri
- Associate Professor, Department of Pathology, Hamdard Institute of Medical Sciences and Research , Jamia Hamdard, New Delhi, India
| |
Collapse
|
10
|
Lymphoma of the urinary bladder. Adv Urol 2014; 2014:327917. [PMID: 24511310 PMCID: PMC3912819 DOI: 10.1155/2014/327917] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2013] [Revised: 10/02/2013] [Accepted: 10/08/2013] [Indexed: 12/27/2022] Open
Abstract
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.
Collapse
|
11
|
Oderda M, Mondaini N, Bartoletti R, Vigna D, Fiorito C, Marson F, Peraldo F, Bosio A, Maletta F, Pacchioni D, Gontero P. Leiomyomata of the genitourinary tract: A case series from the “rare urological neoplasm” registry. Scand J Urol 2012; 47:158-62. [DOI: 10.3109/00365599.2012.727466] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
12
|
Le O, Roy A, Silverman PM, Kundra V. Common and uncommon adult unilateral renal masses other than renal cell carcinoma. Cancer Imaging 2012; 12:194-204. [PMID: 22752221 PMCID: PMC3392784 DOI: 10.1102/1470-7330.2012.0019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Many different masses can involve the kidney other than the commonly encountered renal cell carcinoma (RCC). The purpose of this article is to review the characteristic clinical and imaging findings of common and uncommon masses that predominantly present unilaterally in the adult patient, other than RCC. Awareness of such lesions and knowing the clinical scenario is important for appropriate diagnosis and management, especially in a multidisciplinary care setting.
Collapse
Affiliation(s)
- Ott Le
- University of Texas MD Anderson Cancer Center, Houston, 77230-1439, USA.
| | | | | | | |
Collapse
|
13
|
Brunocilla E, Pultrone CV, Schiavina R, Vagnoni V, Caprara G, Martorana G. Renal leiomyoma: Case report and literature review. Can Urol Assoc J 2012; 6:E87-90. [PMID: 22511443 DOI: 10.5489/cuaj.11159] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Renal leiomyomas are rare benign tumours of the kidney originating from muscle cells. They are usually found by an autopsy, whether the patient is asymptomatic or has symptoms (i.e., abdominal/flank pain, hematuria, palpable mass). Today the widespread use of ultrasonography and computed tomography has increased the detection of clinically asymptomatic renal leiomyomas. The differential diagnosis between leiomyomas and other malignant lesions (above all renal cell carcinoma or leiomyosarcoma) is still possible by histological examination. Radiological examinations are not sufficient for the differential diagnosis. Renal leiomyomas have no aggressive behaviour and they usually do not metastasize. The prognosis, after surgery, is excellent without recurrence. We report a case of leiomyoma in a 31-year-old man who presented hematuria and flank pain. We also review the literature and provide a summary of clinical, radiological and histological features of renal leiomyomas.
Collapse
Affiliation(s)
- Eugenio Brunocilla
- Department of Urology, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy
| | | | | | | | | | | |
Collapse
|
14
|
|
15
|
Hwang JH, Lee JK, Oh MJ, Lee NW, Hur JY, Lee KW. A leiomyoma presenting as an exophytic periurethral mass: a case report and review of the literature. J Minim Invasive Gynecol 2009; 16:507-9. [PMID: 19573833 DOI: 10.1016/j.jmig.2009.04.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2009] [Revised: 04/22/2009] [Accepted: 04/26/2009] [Indexed: 11/26/2022]
Abstract
Periurethral masses in females are rarely observed, although they can occur anywhere along the genitourinary tract. They may be detected on physical examination or present with symptoms such as vaginal swelling, bladder outlet obstruction, vaginal bleeding, hematuria, or urinary tract infection. We report a sexually inactive, 27-year-old woman with an exophytic, fimbria-like periurethral mass. The benign nature of the lesion was suspected on the basis of the findings of magnetic resonance imaging. Surgical enucleation was performed. The microscopic examination revealed a urethral leiomyoma. Immunohistochemical study confirmed a leiomyoma with positive staining for smooth muscle actin and negative staining for S-100.
Collapse
Affiliation(s)
- Jong Ha Hwang
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Guro-gu, Seoul, Korea
| | | | | | | | | | | |
Collapse
|
16
|
Hernandez DJ, Chan DY. Bladder leiomyomata and pelvic pain. Urology 2007; 70:807-8. [PMID: 17991566 DOI: 10.1016/j.urology.2007.07.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2007] [Revised: 05/03/2007] [Accepted: 07/16/2007] [Indexed: 10/22/2022]
Affiliation(s)
- David J Hernandez
- James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland 21287, USA.
| | | |
Collapse
|
17
|
Sherer DM, Cheung W, Gorelick C, Lee YC, Serur E, Zinn HL, Sokolovski M, Abulafia O. Sonographic and magnetic resonance imaging findings of an isolated vaginal leiomyoma. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2007; 26:1453-6. [PMID: 17901151 DOI: 10.7863/jum.2007.26.10.1453] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Affiliation(s)
- David M Sherer
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, 445 Lenox Rd, Box 24, Brooklyn, NY 11203-2098, USA.
| | | | | | | | | | | | | | | |
Collapse
|
18
|
Sherer DM, Gorelick C, Gabbur N, Cheung W, Lee YC, Serur E, Zinn HL, Zigalo A, Abulafia O. Color Doppler imaging and 3-dimensional sonographic findings of urinary bladder leiomyoma. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2007; 26:667-70. [PMID: 17460009 DOI: 10.7863/jum.2007.26.5.667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Affiliation(s)
- David M Sherer
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, State University of New York, Downstate Medical Center, Brooklyn, NY 11203-2098, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Bai SW, Jung HJ, Jeon MJ, Jung DJ, Kim SK, Kim JW. Leiomyomas of the female urethra and bladder: a report of five cases and review of the literature. Int Urogynecol J 2007; 18:913-7. [PMID: 17333443 DOI: 10.1007/s00192-006-0257-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2006] [Accepted: 10/25/2006] [Indexed: 11/25/2022]
Abstract
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.
Collapse
Affiliation(s)
- Sang Wook Bai
- Department of Obstetrics and Gynecology, Yonsei University College of Medicine, Shinchon-dong 134 Seodaemun-gu, 120-752, Seoul, South Korea.
| | | | | | | | | | | |
Collapse
|
20
|
Gómez Pérez L, Budía Alba A, Delgado Oliva FJ, Boronat Tormo F, Pontones Moreno JL, Jiménez Cruz JF. [Leiomyoma of renal pelvis]. Actas Urol Esp 2006; 30:641-3. [PMID: 16921845 DOI: 10.1016/s0210-4806(06)73508-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Renal leiomyoma are uncommon mesenchymal tumours, which can arise from any organ of the genitourinary tract with smooth muscle cells. The diagnostic imaging techniques available can not differentiated easily leiomyoma from other malignant renal masses. Since preoperative diagnosis cannot be made, management usually involves radical nephrectomy as in the case described. After treatment, prognosis is excellent.
Collapse
Affiliation(s)
- L Gómez Pérez
- Servicio de Urología, Hospital Universitario La Fe, Valencia.
| | | | | | | | | | | |
Collapse
|
21
|
Rha SE, Byun JY, Jung SE, Oh SN, Choi YJ, Lee A, Lee JM. The renal sinus: pathologic spectrum and multimodality imaging approach. Radiographics 2005; 24 Suppl 1:S117-31. [PMID: 15486236 DOI: 10.1148/rg.24si045503] [Citation(s) in RCA: 91] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Various pathologic conditions can occur in the renal sinus, primarily originating in the constituents of the renal sinus, and the renal sinus can be secondarily involved by surrounding renal parenchymal and adjacent retroperitoneal lesions. Lipomatosis and cysts are common renal sinus lesions with little clinical significance, but differentiation from other pathologic conditions is important. Renal vascular lesions such as renal artery aneurysm or arteriovenous fistula can mimic other parapelvic or peripelvic lesions at excretory urography, but their vascular nature is evident at color Doppler ultrasonography, contrast material-enhanced computed tomography (CT), and magnetic resonance (MR) imaging. Although most tumors originating in the renal pelvis are transitional cell carcinoma or squamous cell carcinoma, renal parenchymal tumors such as renal cell carcinoma or benign multilocular cystic nephroma have a tendency to grow into the renal sinus. Rare tumors of mesenchymal origin can develop in the renal sinus, but their imaging findings are nonspecific. The observation of renal sinus fat is important for detecting a small tumor located in that area and determining the exact tumor stage. Multiplanar CT or MR images can allow exact evaluation of the extent of complex renal sinus disease.
Collapse
Affiliation(s)
- Sung Eun Rha
- Department of Radiology, College of Medicine, Catholic University of Korea, 505 Banpo-Dong, Seocho-Ku, Seoul 137-040, South Korea
| | | | | | | | | | | | | |
Collapse
|
22
|
Abstract
Spindle cell proliferations of the urinary bladder are uncommon but may cause significant diagnostic difficulty resulting from the degree of morphologic overlap between clinically benign and malignant lesions. These difficulties may be amplified in small biopsies because some of the more specific diagnostic features may not be present for evaluation. In addition, the number of different diagnostic terms applied to the same entity has added confusion to this diagnostic area. This review discusses the nomenclature, morphologic criteria, and immunohistochemical features used to classify spindle cell proliferations occurring in the urinary bladder, including those with myofibroblastic, smooth muscle, skeletal muscle, epithelial (sarcomatoid urothelial carcinoma), fibroblastic, and neural differentiation. A separate discussion of 5 challenging differential diagnostic scenarios is also presented.
Collapse
Affiliation(s)
- Jesse K McKenney
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, 72205, USA.
| |
Collapse
|
23
|
Devine C, Szklaruk J, Tamm EP. Magnetic resonance imaging in the characterization of pelvic masses. Semin Ultrasound CT MR 2005; 26:172-204. [PMID: 15987066 DOI: 10.1053/j.sult.2005.02.013] [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] [Indexed: 11/11/2022]
Abstract
Female pelvic masses most commonly arise from the reproductive tract, although masses may arise from other structures in the pelvis, such as the gastrointestinal or urinary tracts. The evaluation of a pelvic mass often begins with the physical exam and proceeds to ultrasound, computed tomography, or magnetic resonance imaging. Each of these modalities has a role in the work-up of pelvic masses and each modality has inherent advantages and disadvantages. The focus of this article is to demonstrate the imaging features and role of MRI, in contrast to CT, for detecting, characterizing, and staging pelvic masses. The differential diagnosis for pelvic masses is extremely broad. Clinical history, precise anatomical localization, and MR imaging characterization can significantly narrow the differential diagnosis. With recent advances in therapeutic strategies, a non-invasive, preoperative diagnosis is highly desirable to suggest prognosis and to tailor the treatment approach.
Collapse
Affiliation(s)
- Catherine Devine
- Diagnostic Radiology, Department of Diagnostic Imaging, University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA
| | | | | |
Collapse
|
24
|
Ozel B, Ballard C. Urethral and paraurethral leiomyomas in the female patient. Int Urogynecol J 2005; 17:93-5. [PMID: 15905997 DOI: 10.1007/s00192-005-1316-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2004] [Accepted: 03/07/2005] [Indexed: 10/25/2022]
Abstract
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.
Collapse
Affiliation(s)
- Begüm Ozel
- Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA.
| | | |
Collapse
|
25
|
Blaivas JG, Flisser AJ, Bleustein CB, Panagopoulos G. Periurethral Masses: Etiology and Diagnosis in a Large Series of Women. Obstet Gynecol 2004; 103:842-7. [PMID: 15121554 DOI: 10.1097/01.aog.0000124848.63750.e6] [Citation(s) in RCA: 102] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To describe the differential diagnosis of periurethral masses in a consecutive series extracted from a single tertiary urogynecologic practice database. METHODS A patient database of a private urology and urogynecology practice with 1,950 women was searched for patients who were found to have a periurethral mass during the accrual dates of 1994 to 2002, and these records were reviewed for diagnostic testing and results. All women provided a history, completed a questionnaire, and underwent physical examination, voiding diary, cystoscopy, and videourodynamic testing; selected patients then underwent additional imaging. RESULTS Seventy-nine (4%) patients aged 41.2 +/- 14 years were identified. Of these, 72 (91%) had been referred for evaluation of persistent irritative lower urinary tract symptoms or incontinence. Seven patients (9%) had been referred specifically because of a periurethral mass. Sixty-six patients (84%; 95% confidence interval [CI] 73%, 91%) had urethral diverticula, of which 4 (6%; 95% CI 2%, 14.8%) contained malignancies. Six patients (7%; 95% CI 3%, 15%) had vaginal cysts histologically identified as fibromuscular tissue, 4 (5%; 95% CI 1%, 12%) had leiomyomata, and 2 (2.5%; 95% CI 0.03%, 8.8%) had ectopic ureteroceles. Two patients had vaginal squamous cell carcinomas (2.5%; 95% CI 0.03%, 8.8%), and 1 had an infected granuloma. Masses were palpable in 42 patients (53.8%; 95% CI 42%, 64%) and in 37 patients either were encountered at surgery (n = 5) or were urethral diverticula diagnosed by voiding cystourethrogram (n = 32). CONCLUSION Periurethral masses were encountered in less than 4% of our patient sample. Most masses were urethral diverticula; however, the differential diagnosis included leiomyoma, vaginal cysts, and malignancy. Masses were generally either palpable or seen at imaging studies performed during evaluation of lower urinary tract symptoms.
Collapse
Affiliation(s)
- Jerry G Blaivas
- Joan and Sanford Weill College of Medicine, Cornell University, New York, New York 10021, USA.
| | | | | | | |
Collapse
|
26
|
Silva-Ramos M, Massó P, Versos R, Soares J, Pimenta A. Leiomioma de vejiga. análisis de agregación de 90 casos. Actas Urol Esp 2003; 27:581-6. [PMID: 14587232 DOI: 10.1016/s0210-4806(03)72979-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Bladder leiomyomas (BL) are rare. Most publications regarding these tumours are reports of isolated cases; therefore they don't allow an evaluation of diagnostic and treatment procedures. MATERIAL & METHODS We preformed a pooled analysis of 90 cases of BL reported in the literature. RESULTS Mean age was 45.3 (19 to 85 years), 68 (75.6%) were women. Filling symptoms were the most frequently reported (50%), followed by voiding symptoms (24.4%). Twenty four patients (26.7%) were asymptomatic. Tumours were endoluminal in 46 patients (51.1%), intramural in 27 (30%) and extravesical in 15 (16.7%). A laparotomy was performed in 56 patients (62.2%), with enucleation in 29 (32.2%), partial cystectomy in 25 (27.8%) and total cystectomy in 2 (2.2%). A transurethral resection was preformed in 27 (30%) and a transvaginal resection in 5 (5.6%). Two patients underwent conservative treatment. In 3 cases there were reports of recurrence and one patient got a vesicovaginal fistula. CONCLUSIONS Although BL are rare, when evaluating bladder tumours, imaging techniques can make suspect of this neoplasm. Surgical treatment of these tumours has a very high success rate. Usually an enucleation or a transurethral resection is sufficient to render the patient tumour free, avoiding a more iatrogenic surgery.
Collapse
Affiliation(s)
- M Silva-Ramos
- Serviço de Urologia, Hospital Geral de Santo António, Porto, Portugal
| | | | | | | | | |
Collapse
|