A rare case of a giant cystic leiomyoma presenting as a retroperitoneal mass

BACKGROUND

Giant retroperitoneal uterine leiomyomas are uncommon. Degenerative changes of a leiomyoma may lead to unusual presentation resulting in misdiagnosis preoperatively. The final diagnosis can be made either intraoperatively or histologically.

CASE

We report a 45-year-old multiparous women presented with abdominal distension and fatigue for six months. Abdominopelvic Sonography and computed tomography showed a large cystic mass that filled the pelvis and abdomen. With the preoperative diagnosis of a malignant tumor, a laparotomy was planned. Intraoperatively, a cystic mass originated from the uterus near the left side of the broad ligament extending to the retroperitoneal space was observed. Total hysterectomy and bilateral salphingo-oopherectomy was administered. The histology revealed a leiomyoma with cystic degeneration.

CONCLUSION

Retroperitoneal leiomyomas should be kept in mind in the diferrential diagnosis of a giant cystic mass in abdomen.

Primary uterine hydatid cyst: a case report

Echinococcosis, which is caused by echinococcus granulosus, is also known as cystic hydatid disease, unilocular echinococcosis or cystic echinococcosis. Cystic echinococcosis is an alarming public health problem in some countries. Although the liver and lung are the organs involved most commonly by the disease, it may appear rarely in other tissues as a primary disease. Here, we present a 66-year-old patient who is invoved in farm work work. A Uterine multiseptate hydatid cyst was found on radiological investigations and the patient underwent surgery. A total hysterectomy was carried out. There were no postoperative complications.

Maternal magnesium level effect on preterm labor treatment

OBJECTIVE

To compare the initial serum magnesium levels between preterm labor (PL) and control groups and to evaluate MgSO4 treatment response in preterm labor group according to their initial serum magnesium levels.

METHODS

Hundred women diagnosed as preterm labor between 28 and 33 weeks of gestation and 100 non-complicated pregnant women were enrolled in this prospective study. Total basal serum magnesium levels were measured in both the groups. After a 6 g intravenous bolus of MgSO4, a dose of 2 g/h was given as an infusion in the preterm labor group.

RESULTS

Serum magnesium levels were significantly lower in preterm labor group (p < 0.001). The active contractions stopped in 69 (73,4%) preterm patients. The basal Mg level was significantly lower in this preterm group (1.6 versus 1.9, respectively, p < 0.001). Predictive value of basal magnesium level measurement for magnesium tocolysis response was calculated by receiver operating characteristic analyses with 95% confidence interval. Positive predictive and negative predictive values were found as 64.5% and 92.5%, respectively, with 83% accuracy, when cut-off magnesium value was taken as a <1.75 mg/dl (sensitivity = 80%, specificity = 84,1%).

CONCLUSIONS

Basal magnesium levels in preterm labor had a predictive value in evaluating MgSO4 tocolysis response. It may help to select patients who are appropriate for MgSO4 tocolysis.