RESUMO
Background: Schwannomas (neurilemomas) are encapsulated tumours made entirely of benign neoplastic Schwann cells. They are the most common tumour of peripheral nerves, but very uncommon in gynaecologic practice. Objectives: The objective is to demonstrate unusual histology mimicking schwannoma in a case of leiomyoma in a woman who had a history of vaginal hysterectomy. Materials and Methods: We report a case of a 50-year-old hysterectomised patient who was referred with complaints of dull pain in the left inguinal region of the abdominal cavity during the last 3 months. The narrated surgical video article demonstrates the dissection of the left parametrium, tumour removal, colpotomy, specimen extraction, and vaginal laparoscopic suturing. Pre-operative CT-scan images of the pelvis with retroperitoneal tumour and macroscopic and histological views of the schwannoma are also provided. Main outcome measures: Full recovery of the patient after laparoscopic removal of the tumour. Results: As a result of the surgical treatment, the patient recovered fully. Conclusions: Schwannoma-like leiomyomas are rare tumours. They can be extra peritoneally located, without any connection to the uterus and adnexa. They are difficult to diagnose before surgery. The laparoscopic approach is the best option for the treatment of such rare extra organic tumours.
RESUMO
The aim of the study was to improve the diagnosis of structural changes in all parts of the cervix depending on the preferential localization of the inflammatory process - in the ectocervix, endocervix, and also in the stroma in women with ectopia (pseudoerosis) of the vaginal part of the cervix. The study included women of predominantly early and middle reproductive age, as these women have inflammatory processes more often than in menopause. To perform the work, a transvaginal imaging method was used, which allowed us to see the smallest structures (up to 0.5-1.0 mm) of the cervix. We have previously developed a technique for visualizing the external part of the cervix and obtained a patent of Ukraine. The results of the ultrasound were compared with laboratory data, colposcopy and cervicoscopy. Traditionally, the diagnosis of cervicitis was made on the basis of clinical symptoms, smear results to determine the presence and type of pathogen. Endoscopic methods allowed visualization of only the mucous membrane of the cervical canal and external part of the cervix. The deep layers of the ectocervix, endocervix and cervical stroma can only be visualized using high-frequency ultrasound in a transvaginal way. According to the results of the study, it was possible to determine the preferential localization of the inflammatory process, to determine the nature of changes in different layers of the cervix. These changes were expressed in the presence of calcifications and cystic cavities of various sizes (1-6 mm), an increase or decrease in echogenicity, the degree of heterogeneity of the structure of the ecto-, endocervix and stroma.