Unsuspected components of a fibroid uterus: Angiolipoleiomyoma.

Angiolipoleiomyoma (ALLM) is a rare variant of benign neoplasm of the uterus. It has a prevalence of only 0.06% with only a handful of cases. According to our review of the literature, this case study is one of the only two youngest patients of ALLM reported. We present the case of a 26-year-old female with ALLM of the uterus. She presented with a large abdominopelvic mass and underwent myomectomy and plication of the round ligament to preserve fertility. Although renal angiomyolipomas are more prevalent, extrarenal manifestation especially that which is found in the uterus is still a rare entity. Commonly occurring in women in their fifth to sixth decades of their lives, the case presented here is of a woman in her reproductive age. Therefore, by reporting it we are not only acquainting physicians to consider this as a differential, but also for World Health Organisation (WHO) to include this in their classification of tumours of the female genital tract.

Incidence of acute kidney injury in patients with acute ischaemic stroke undergoing CT angiography (CTA) and CT perfusion (CTP): a systematic review and meta-analysis.

Background and purpose: We conducted a systematic review and meta-analysis to assess the incidence of acute kidney injury (AKI) in patients undergoing CT angiography (CTA) and CT perfusion (CTP) for acute ischaemic stroke (AIS). Concerns over contrast-induced nephropathy (CIN) often lead medical centres to mandate pre-imaging serum creatinine level assessments, causing unnecessary delays. We aim to confirm further the practice of conducting CTA/CTP without first testing creatinine. Methods: We searched PubMed, Cochrane Central and Scopus from inception until March 2023 for studies reporting on AKI in patients with AIS receiving CTA/CTP. Outcomes of interest were (1) the odds of AKI in patients receiving CTA/CTP versus non-contrast CT and (2) the overall incidence of AKI and haemodialysis in patients with AIS undergoing CTA/CTP. Results: Results were pooled using a random effects model. 13 studies were included (5 cohort and 8 single-arm studies) with 5104 patients in total, out of which 4347 patients received CTA/CTP and 757 patients received no contrast. In case-control studies, 4.8% (OR=0.66, 95% CI 0.35 to 1.22, Z=1.32, p=0.19) of patients who received CTA/CTP developed AKI, compared with 7.7% of patients in the control group. Temporary haemodialysis was required for two patients in the analysed studies. Conclusions: Non-randomised evidence suggests that CTA/CTP is not associated with a statistically significant increase in the risk of AKI in patients with stroke. Further well-designed prospective studies are required to explore potential risk factors of CIN in specific patient populations such as diabetes mellitus and chronic kidney disease.