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1.
Medicine (Baltimore) ; 99(15): e19728, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32282731

RESUMO

BACKGROUND: The aim of this study was to present several cases of benign and malignant nipple lesions and contribute to diagnosis and differential diagnosis. METHODS: A retrospective study was conducted on 13 patients. All of the patients were evaluated by ultrasonography, and 11 of them had pathological results. We analyzed the clinical and sonographic features. RESULTS: There were 3 malignant lesions, 7 benign lesions, and 3 congenital nipple dysplasia, listed as follows:Malignant lesions (n = 3, 23%): Paget's disease (PD, n = 3, 23%). All of the patients with PD showed unilateral nipple erosion, discharge, and pain. The ultrasound showed abundant blood flow (n = 3, 23%); 2 patients (n = 2, 15%) had microcalcifications.Benign lesions (n = 7, 54%): Adenoma of the nipple (n = 2, 15%). One patient (n = 1, 8%) had nipple erosion and discharge. Two patients (n = 2, 15%) had a palpable nodule in the nipple. The ultrasound of both patients (n = 2, 15%) showed regular-shaped, clear border nodule with abundant blood flow (n = 2, 15%).Leiomyoma of the nipple (n = 1, 8%): This male patient was characterized by unilateral nipple enlargement and pain. The ultrasound showed a regular nodule with absent blood flow.Plasma cell mastitis (n = 2, 15%): Two patients showed unilateral nipple inversion and pain. One patient (n = 1, 8%) showed swollen and redness. The 2 patients showed a lesion in the gland around the nipple present as an irregular shape and unclear boundary hypoechoic mass.Nipple wart (n = 2, 15%): Two patients showed a unilateral soft exogenous neoplasm. Both of the patients showed a hypoechoic wart; the echo was similar to the nipple, the border was clear, and had no blood flow in the wart.Nipple Dysplasia (n = 3, 23%): Accessory nipple (n = 3, 23%). Two patients (n = 2, 15%) had accessory nipples in the subcoastal area, 1 patient (n = 1, 8%) in the areolar. All of the patients' sonographic features were the same as the nipple.The positive predict value (PPV) of the clinical symptoms: Erosion and discharge are both 75% (P < 0.05). The PPV of the US manifestations: irregular shape, indictinct margin, abundant blood flow, microcalcification, thicken skin in diagnosing malignant lesions are 60%,60%,60%,100%,100%, respectively (P < 0.05). CONCLUSIONS: The characteristic sonographic features together with clinical symptoms contribute to the diagnosis of nipple lesions.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Mamilos/irrigação sanguínea , Mamilos/diagnóstico por imagem , Ultrassonografia/métodos , Adenoma/patologia , Adulto , Neoplasias da Mama/patologia , Calcinose/patologia , Diagnóstico Diferencial , Feminino , Doença da Mama Fibrocística/patologia , Humanos , Leiomioma/patologia , Masculino , Mastite , Pessoa de Meia-Idade , Mamilos/patologia , Doença de Paget Mamária/patologia , Dor/diagnóstico , Plasmócitos/patologia , Valor Preditivo dos Testes , Estudos Retrospectivos , Ultrassonografia/tendências , Verrugas
2.
Medicine (Baltimore) ; 99(17): e19884, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32332661

RESUMO

To identify significant clinical and CT features for the differentiation of gastrointestinal stromal tumors (GISTs) from leiomyomas in the esophagogastric junction (EGJ).One hundred thirty six patients with pathologically proven GISTs (n = 87) and leiomyomas (n = 49) in the EGJ were enrolled. And preoperative CT images were available in 73 GISTs cases and 34 leiomyoma cases. Two radiologists reviewed the CT images by consensus with regard to tumor size, shape, growth pattern, surface, enhancement pattern, enhancement degree, attention at each phasic image and the presence of surface ulcer, calcification, and intralesional low attention.Eight significant clinical and CT features were identified for differentiating GISTs from leiomyomas: older age (>46.5 years), tumor long diameter >4.5 cm, heterogeneous enhancement, high degree enhancement, mean CT attenuation >69.2 HU, presences of intralesional low attenuation and surface ulcer, absences of calcification (P < .05). On the receiver operating characteristic curve analysis, an optimal cutoff score of 3.5 was achieved for differentiating GISTs from leiomyomas with an AUC of 0.844 (sensitivity: 76.7%, specificity: 76.5%).older age (>46.5 years), tumor long diameter >4.5 cm, heterogeneous enhancement, high degree enhancement, mean CT attenuation >69.2 HU, presences of intralesional low attenuation and surface ulcer, absence of calcification are significant features highly suggestive of GISTs in differentiation from leiomyomas in the EGJ.


Assuntos
Tumores do Estroma Gastrointestinal/etiologia , Leiomioma/complicações , Adulto , Idoso , Análise de Variância , China , Feminino , Tumores do Estroma Gastrointestinal/fisiopatologia , Humanos , Leiomioma/fisiopatologia , Masculino , Pessoa de Meia-Idade , Curva ROC , Tomografia Computadorizada por Raios X/métodos
3.
Rev Med Liege ; 75(3): 137-139, 2020 Mar.
Artigo em Francês | MEDLINE | ID: mdl-32157835

RESUMO

Uterine lipoleiomyoma is a rare and benign pathology whose etiopathogenesis is still poorly understood. Benign cystic teratoma of the ovary constitutes its main and primordial differential diagnosis because of the different treatments. Pelvic MRI is the best imaging technique to confirm the diagnosis.


Assuntos
Leiomioma , Lipoma , Neoplasias Ovarianas , Neoplasias Uterinas , Feminino , Humanos , Leiomioma/diagnóstico por imagem , Lipoma/diagnóstico por imagem , Imagem por Ressonância Magnética , Neoplasias Ovarianas/diagnóstico por imagem , Neoplasias Uterinas/diagnóstico por imagem
4.
Dis Aquat Organ ; 137(3): 211-216, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-32132274

RESUMO

This report describes a spontaneously arising non-infiltrative neoplasm of gastric tunica muscularis in a broodstock sea bass Dicentrarchus labrax from an Italian aquaculture farm. Microscopically, the mass was circumscribed and non-encapsulated and was composed of spindle cells arranged in parallel interlacing bundles or, occasionally, a whirling pattern. Cells had a small quantity of eosinophilic cytoplasm with distinct cell borders. Neoplastic cells were immuno-reactive with smooth muscle actin, vimentin and desmin; S100 was negative. The mucosal epithelium was intact with no neoplastic involvement. A gastric leiomyoma was diagnosed based on the findings. More efforts should be made to study the possible etiology of leiomyoma affecting fish from aquaculture.


Assuntos
Bass , Leiomioma , Animais , Aquicultura , Itália , Leiomioma/veterinária
6.
Can Assoc Radiol J ; 71(1): 75-80, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32062997

RESUMO

PURPOSE: Uterine artery embolization (UAE) is an effective treatment for the management of symptomatic uterine fibroids. We aim to evaluate the efficacy of superior hypogastric nerve block (SHNB) in reducing narcotic analgesia use for postprocedural pain after UAE. METHODS: A retrospective review of 88 consecutive patients with symptomatic fibroids who underwent UAE between August 2015 and August 2018 was performed. A total of 44 patients had intraprocedural SHNB and 44 patients had no SHNB. They were placed on a morphine patient-controlled anesthesia (PCA) pump after the procedure and were admitted for overnight observation. The total amount of PCA narcotic analgesia received was recorded for each patient. Additional factors including fibroid size, fibroid location, and patient age were evaluated to determine the predictors of narcotic use reduction after SHNB. RESULTS: The mean amount of postprocedural morphine use was 51.7 mg in patients who did not receive an SHNB versus 35.9 mg in patients who did receive an SHNB (P = .008), resulting in a 47.2% reduction in narcotic analgesia use in the SHNB cohort. A significant reduction in morphine use with SHNB was associated with fibroid size greater than 5 cm (P = .009), intramural fibroid location (P = .04), and patients 45 years or younger (P = .006). CONCLUSION: The use of SHNB could significantly reduce the amount of narcotic analgesia required for pain control after UAE with larger intramural fibroids and younger patients as predictors of increased efficacy.


Assuntos
Leiomioma/terapia , Morfina/uso terapêutico , Bloqueio Nervoso/métodos , Manejo da Dor/métodos , Dor Pós-Operatória/prevenção & controle , Embolização da Artéria Uterina , Neoplasias Uterinas/terapia , Adulto , Analgesia Controlada pelo Paciente , Feminino , Humanos , Pessoa de Meia-Idade , Medição da Dor , Estudos Retrospectivos
7.
Zhonghua Fu Chan Ke Za Zhi ; 55(1): 15-20, 2020 Jan 25.
Artigo em Chinês | MEDLINE | ID: mdl-32074768

RESUMO

Objective: To explore the importance of the diagnosis and treatment value of laparoscopy and hysteroscopy in patients with unexplained infertility. Methods: A total of 519 cases diagnosed as unexplained infertility, received laparoscopy and hysteroscopy in Peking Union Medical College Hospital from May 2012 to December 2015. The causes of infertility were evaluated, and the subjects were followed up to observe the nature pregnancy rate. Results: Among 519 unexplained infertility patients, pelvic abnormalities had been explored in 466 (89.8%, 466/519) cases. Pelvic endometriosis combined with adhesions, pelvic adhesion alone, uterine leiomyoma and uterine cavity polyp were 72.4% (376/519), 12.3% (64/519), 3.7% (19/519) and 1.3% (7/519) respectively. The total natural pregnancy rate within the 3 years of follow up was 53.9% (208/386), and the natural pregnancy rate was 29.8% (31/104) in patients aged 35 years and over. Conclusions: The patients with clinical diagnosis of unexplained infertility should be examined by hysteroscopy and laparoscopy. Under the examination, the causes of infertility could be found more intuitively, and targeted treatment could be carried out to improve the pregnancy rate. The natural pregnancy rate of the elderly patients decrease obviously after operation, and the time of natural trying pregnancy should not be too long.


Assuntos
Histeroscopia , Infertilidade Feminina/diagnóstico por imagem , Infertilidade Feminina/terapia , Laparoscopia , Adulto , Endometriose/complicações , Endometriose/diagnóstico por imagem , Feminino , Humanos , Leiomioma/complicações , Leiomioma/diagnóstico por imagem , Gravidez , Aderências Teciduais/complicações , Aderências Teciduais/diagnóstico por imagem
8.
Arkh Patol ; 82(1): 62-67, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32096493

RESUMO

OBJECTIVE: To reveal the morphological characteristics of simultaneously diagnosed leiomyoma of the corpus uteri and vulva. SUBJECT AND METHODS: The paper describes a case of multiple uterine leiomyomas concurrent with vulvar leiomyoma in a 39-year-old patient with progressive tumor nodule growth over 2 years. Vulvar tumor was biopsied simultaneously with extirpation of the uterus; vulvar leiomyoma was removed six months later. Histological and immunohistochemical studies: such as hematoxylin and eosin staining, the expression of smooth muscle actin, desmin, and progesterone and estrogen receptors, S100, CD10, and determination of Ki-67 proliferation index, were conducted. RESULTS: The largest (14-cm) multiple tumor nodule in the corpus uteri had the structure of leiomyoma of uncertain malignant potential; the large (8-cm) vulvar tumor was a leiomyoma with hyalinosis. The immunohistochemical profile of uterine and vulvar leiomyoma (smooth muscle actin+, desmin+, progesterone+, estrogen+ receptors, CD117-, and Ki-67) was the same (1-3%). The vulvar leiomyoma was assumed to be a tumor of metastatic origin. CONCLUSION: Vulvar leiomyoma is rare; it can arise from smooth muscle tissue of various anatomical structures of the skin and soft tissues. The pathogenesis of the so-called metastatic leiomyoma is unclear; there are concepts of a metaplastic transformation of subcelomic mesenchyme and multifocal smooth muscle proliferation. The presented case demonstrates the synchronous development of uterine and vulvar leiomyoma.


Assuntos
Leiomioma , Neoplasias Uterinas , Neoplasias Vulvares , Adulto , Feminino , Humanos , Receptores Estrogênicos , Útero
9.
Nat Commun ; 11(1): 1019, 2020 02 24.
Artigo em Inglês | MEDLINE | ID: mdl-32094355

RESUMO

Uterine leiomyomas (fibroids) are a major source of gynecologic morbidity in reproductive age women and are characterized by the excessive deposition of a disorganized extracellular matrix, resulting in rigid benign tumors. Although down regulation of the transcription factor AP-1 is highly prevalent in leiomyomas, the functional consequence of AP-1 loss on gene transcription in uterine fibroids remains poorly understood. Using high-resolution ChIP-sequencing, promoter capture Hi-C, and RNA-sequencing of matched normal and leiomyoma tissues, here we show that modified enhancer architecture is a major driver of transcriptional dysregulation in MED12 mutant uterine leiomyomas. Furthermore, modifications in enhancer architecture are driven by the depletion of AP-1 occupancy on chromatin. Silencing of AP-1 subunits in primary myometrium cells leads to transcriptional dysregulation of extracellular matrix associated genes and partly recapitulates transcriptional and epigenetic changes observed in leiomyomas. These findings establish AP-1 driven aberrant enhancer regulation as an important mechanism of leiomyoma disease pathogenesis.


Assuntos
Cromatina/genética , Regulação Neoplásica da Expressão Gênica , Leiomioma/genética , Complexo Mediador/genética , Neoplasias Uterinas/genética , Adulto , Substituição de Aminoácidos , Células Cultivadas , Sequenciamento de Cromatina por Imunoprecipitação , Quinase 8 Dependente de Ciclina/metabolismo , Elementos Facilitadores Genéticos/genética , Epigênese Genética , Éxons/genética , Feminino , Predisposição Genética para Doença , Humanos , Histerectomia , Leiomioma/patologia , Leiomioma/cirurgia , Complexo Mediador/metabolismo , Pessoa de Meia-Idade , Mutação , Miométrio/citologia , Miométrio/patologia , Miométrio/cirurgia , Cultura Primária de Células , RNA-Seq , Fator de Transcrição AP-1/genética , Fator de Transcrição AP-1/metabolismo , Transcrição Genética , Neoplasias Uterinas/patologia , Neoplasias Uterinas/cirurgia
10.
N Engl J Med ; 382(4): 328-340, 2020 01 23.
Artigo em Inglês | MEDLINE | ID: mdl-31971678

RESUMO

BACKGROUND: Uterine fibroids are hormone-responsive neoplasms that are associated with heavy menstrual bleeding. Elagolix, an oral gonadotropin-releasing hormone antagonist resulting in rapid, reversible suppression of ovarian sex hormones, may reduce fibroid-associated bleeding. METHODS: We conducted two identical, double-blind, randomized, placebo-controlled, 6-month phase 3 trials (Elaris Uterine Fibroids 1 and 2 [UF-1 and UF-2]) to evaluate the efficacy and safety of elagolix at a dose of 300 mg twice daily with hormonal "add-back" therapy (to replace reduced levels of endogenous hormones; in this case, estradiol, 1 mg, and norethindrone acetate, 0.5 mg, once daily) in women with fibroid-associated bleeding. An elagolix-alone group was included to assess the impact of add-back therapy on the hypoestrogenic effects of elagolix. The primary end point was menstrual blood loss of less than 80 ml during the final month of treatment and at least a 50% reduction in menstrual blood loss from baseline to the final month; missing data were imputed with the use of multiple imputation. RESULTS: A total of 412 women in UF-1 and 378 women in UF-2 underwent randomization, received elagolix or placebo, and were included in the analyses. Criteria for the primary end point were met in 68.5% of 206 women in UF-1 and in 76.5% of 189 women in UF-2 who received elagolix plus add-back therapy, as compared with 8.7% of 102 women and 10% of 94 women, respectively, who received placebo (P<0.001 for both trials). Among the women who received elagolix alone, the primary end point was met in 84.1% of 104 women in UF-1 and in 77% of 95 women in UF-2. Hot flushes (in both trials) and metrorrhagia (in UF-1) occurred significantly more commonly with elagolix plus add-back therapy than with placebo. Hypoestrogenic effects of elagolix, especially decreases in bone mineral density, were attenuated with add-back therapy. CONCLUSIONS: Elagolix with add-back therapy was effective in reducing heavy menstrual bleeding in women with uterine fibroids. (Funded by AbbVie; Elaris UF-1 and Elaris UF-2 ClinicalTrials.gov numbers, NCT02654054 and NCT02691494.).


Assuntos
Estradiol/uso terapêutico , Estrogênios/uso terapêutico , Hormônio Liberador de Gonadotropina/antagonistas & inibidores , Hidrocarbonetos Fluorados/uso terapêutico , Leiomioma/complicações , Menorragia/tratamento farmacológico , Pirimidinas/uso terapêutico , Adulto , Densidade Óssea/efeitos dos fármacos , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Fogachos/induzido quimicamente , Humanos , Hidrocarbonetos Fluorados/efeitos adversos , Menorragia/etiologia , Pessoa de Meia-Idade , Pirimidinas/efeitos adversos , Qualidade de Vida , Índice de Gravidade de Doença , Inquéritos e Questionários
11.
Br J Radiol ; 93(1105): 20190551, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31573326

RESUMO

Females with symptomatic leiomyomas (fibroids) wishing to maintain fertility are faced with difficult treatment choices. These include uterine fibroid embolization (UFE), myomectomy, hormonal therapy, MRI high intensity focused ultrasound, and myolysis. This review focuses on UFE, one of the most commonly accepted minimally invasive procedural choices among patients with symptomatic fibroids wishing to retain the option of becoming pregnant in the future, and makes comparisons to myomectomy which has historically been the surgical choice for fertility-preserving fibroid treatment. Pubmed and Google Scholar searches using keywords such as: uterine artery embolization, uterine fibroid embolization, pregnancy, complications, infertility were performed between Jan 1, 2019 and May 10, 2019. Publications were chosen based on their inclusion of information pertaining to fertility or pregnancy after UFE without being limited to single case reports.Randomized controlled trials comparing myomectomy and UFE are limited due to study size and confounding variables, but through registry data and familiarity with referring clinicians, UFE has gained wide acceptance. Healthy pregnancies following UFE have been sporadically reported but the actual fertility rate after UFE remains uncertain. Conversely, low birth weight, miscarriage and prematurity have been associated with UFE. Despite inherent risks of possible fertility issues after UFE, the procedure remains an option for females with clinically symptomatic fibroids who desire pregnancy. However, additional research regarding rates of conception and obstetrical risks of infertility following UFE is necessary.


Assuntos
Leiomioma/terapia , Complicações Neoplásicas na Gravidez/terapia , Embolização da Artéria Uterina , Neoplasias Uterinas/terapia , Feminino , Humanos , Infertilidade Feminina/etiologia , Seleção de Pacientes , Gravidez , Resultado da Gravidez , Embolização da Artéria Uterina/efeitos adversos
12.
Medicine (Baltimore) ; 98(49): e18276, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31804368

RESUMO

RATIONALE: Pulmonary benign metastasizing leiomyoma (PBML) is rare, usually occurs in women who underwent hysterectomy during the reproductive years, and has no obvious clinical symptoms. A full understanding of the characteristics of PBML is important for its sequential treatment and prognosis. PATIENT CONCERNS: In this report, a 36-year-old female patient with previous uterine leiomyoma who underwent 3 surgical resections of the uterus, bilateral fallopian tubes, and partial omentum was investigated. The physical examination revealed a tumor in the right lower lobe and mediastinum and a solid nodule in the right middle lobe. DIAGNOSES: Chest computed tomography (CT) confirmed a tumor in the right lower lobe and mediastinum and a solid nodule in the right middle lobe. Further positron-emission tomography computed tomography (PET-CT) with 18F-fluorodeoxyglucose (FDG) of the whole body showed mildly intense accumulation of 18F-FDG in the tumor (maximum standardized uptake value [SUV max], 2.6). A pathological examination then confirmed the presence of fibrous and vascular tissue after CT-guided percutaneous biopsy of the tumor in the right lower lobe. Additionally, surgical resection of the tumor and nodule was performed for histological analysis and immunohistochemical assays for estrogen receptor (ER) and progesterone receptor (PR). INTERVENTIONS: The patient underwent complete tumor surgical resection and nodule wedge resection. OUTCOMES: No postoperative complications occurred. No recurrence or other signs of metastasis were found during an 18-month follow-up observation period. CONCLUSION: In this case, lung and mediastinal metastasis of uterine fibroids was observed. However, depending on only a postoperative histological analysis is insufficient for the diagnosis of PBML. Histological analysis combined with an evaluation of the expression levels of ER and PR is crucial for the diagnosis and treatment of PBML.


Assuntos
Leiomioma/patologia , Neoplasias Pulmonares/secundário , Neoplasias do Mediastino/secundário , Neoplasias Uterinas/patologia , Adulto , Feminino , Humanos , Biópsia Guiada por Imagem , Leiomioma/cirurgia , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/cirurgia , Neoplasias Uterinas/cirurgia
13.
Medicine (Baltimore) ; 98(49): e18301, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31804377

RESUMO

RATIONALE: Uterine leiomyoma, which is very common gynecological tumor in the reproductive years, is extremely rare in adolescence. We herein report a case of a uterine leiomyoma treated with laparoscopic surgery in an adolescent. PATIENT CONCERNS: A 13-year-old girl with no gravida and her first menses at 11 years of age reported feeling bloated. She had a regular menstrual cycle but felt increased abdominal distension. DIAGNOSIS: Transabdominal ultrasound and magnetic resonance imaging revealed uterine leiomyoma with a diameter of 10 cm. INTERVENTION: Laparoscopic myomectomy was performed. OUTCOMES: The total weight of the leiomyoma removed was 660 g with pathological diagnosis of uterine leiomyoma. The postoperative course was uneventful. The patient was free of disease at the follow-up consultation 18 months after the treatment. LESSONS: Laparoscopic approach is a very useful and minimally invasive surgery for symptomatic leiomyoma in adolescents.


Assuntos
Laparoscopia/métodos , Leiomioma/cirurgia , Miomectomia Uterina/métodos , Neoplasias Uterinas/cirurgia , Adolescente , Feminino , Humanos , Leiomioma/diagnóstico por imagem , Neoplasias Uterinas/diagnóstico por imagem
14.
Khirurgiia (Mosk) ; (12): 47-53, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31825342

RESUMO

Diagnostics and surgical treatment of 2 patients with giant esophageal leiomyoma are reported. The diagnosis was confirmed by chest computed tomography, MRI of the mediastinum, endoscopic ultrasound. Resection of tumor with mucosa suturing and Nissen fundoplication was performed in 1 case. There were no intraoperative complications. Postoperative partial failure of the seams of the esophageal wall occurred in 1 case. Drainage of posterior mediastinum was performed. Treatment resulted closure of the esophageal wall defect. Control postoperative examination confirmed patent esophagus and preserved passage through the esophagus. Multidisciplinary approach to diagnosis and treatment of these patients results favorable outcomes.


Assuntos
Neoplasias Esofágicas/diagnóstico por imagem , Neoplasias Esofágicas/cirurgia , Leiomioma/diagnóstico por imagem , Leiomioma/cirurgia , Esofagectomia/efeitos adversos , Esofagectomia/métodos , Humanos
15.
Ceska Gynekol ; 84(5): 324-330, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31826627

RESUMO

OBJECTIVE: The aim of this study was to analyse the clinical outcome of patients with diagnosis of leiomyoma with bizarre nuclei (LBN) undergoing uterus saving surgery due to fertility preservation. DESIGN: Retrospective clinical study. SETTING: Department of Obstetrics and Gynaecology, First Faculty of Medicine, Charles University, General University Hospital, Prague. METHODS: This was a retrospective clinical study of patients with LBN diagnosis after myomectomy between January 2002 and June 2017 which were searched in our database. The data were obtained from medical documentation and from correspondence with patients. RESULTS: We identified 37 patients meeting the criteria in our database. The median age of the patients was 34.0 years. 30 patients (81.1%) underwent laparoscopic procedure, 7 (18.9.%) had open myomectomy. The perioperative appearance of fibroid was found normal in 27 cases (73.0%), in the rest the appearance was described somehow abnormal. The follow-up data were obtained from 35 women; the median follow-up time was 48 months. 9 patients (25.7%) needed re-intervention for fibroids with 2 specimens (22.2%) classified as LBN again. The overall pregnancy rate was 63.6% and life birth rate was 33.3%. We did not observe any distant recurrence of the disease or malignant recurrence or death related to the diagnosis. CONCLUSION: Uterus sparing surgery for treatment of LBN seems to be safe and reasonable therapy for women wishing to preserve fertility.


Assuntos
Laparoscopia , Leiomioma/cirurgia , Miomectomia Uterina , Neoplasias Uterinas/cirurgia , Adulto , Núcleo Celular/patologia , Feminino , Células Gigantes/patologia , Procedimentos Cirúrgicos em Ginecologia , Humanos , Laparoscopia/métodos , Leiomioma/patologia , Recidiva Local de Neoplasia , Preservação de Órgãos , Gravidez , Estudos Retrospectivos , Neoplasias Uterinas/patologia
17.
Arkh Patol ; 81(6): 41-48, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31851191

RESUMO

OBJECTIVE: To characterize endometrial structural and functional state and receptivity in women with hysteromyoma (HM) and chronic endometritis (CE) in infertile couples. MATERIAL AND METHODS: A total of 130 patients who had HM and/or CE in an infertile couple were examined. Group 1 included 64 women with HM and CE; Group 2 consisted of 24 patients with HM; group 3 comprised 42 patients with EC. A control group included endometrial biopsy specimens from 20 healthy women planning a pregnancy. RESULTS: Patients with HM and CE were found to develop endometrial dysfunction. Its structural signs were damage to the endometrial surface epithelium; intense stromal fibrosis with the high expression of type III and IV collagens; dysregulated processes of high angiogenesis; impaired maturation of pinopodia by the implantation window; high estrogen receptor (ER) expression in the nuclei of endometrial glandular and stromal cells; low progesterone receptor (PR) expression; and impaired secretory endometrial transformation. CONCLUSION: HM concurrent with CE is responsible for endometrial dysfunction. Its structural manifestations are mainly associated with CE.


Assuntos
Endometrite , Infertilidade Feminina , Leiomioma , Neoplasias Uterinas , Doença Crônica , Implantação do Embrião , Endométrio , Feminino , Humanos , Gravidez , Receptores Estrogênicos
18.
Medicine (Baltimore) ; 98(51): e18195, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860966

RESUMO

The finding of a decrease in subsequent fibroid-related operation following the use of Chinese herbal products (CHPs) has led to speculation that CHPs might play a role in uterine fibroids prevention.This study provides an overview of uterine fibroids incidence, comparing CHP users with those who do not use CHPs, referred to as non-CHP users. The results can provide information to clinicians for counseling women about the preventive use of CHPs.A total of 52,151 women (20-45 years of age) were recruited from a nationwide 1-million-person representative sample of those covered by National Health Insurance in Taiwan and were followed from 2000 to 2013. Exact matching was performed for comparative analysis. The age-specific hazard ratios (HRs) of uterine fibroids in relation to either CHP or the phytoestrogen use were calculated with multivariate Cox proportional hazard regression.More than 71% of patients had used a CHP at some point previously. The overall incidence density rate of uterine fibroids for non-CHP users was estimated at 27.5 per 1000 patient-years. The corresponding values for CHP and the phytoestrogen users were lower than those of the non-CHP group (CHP group = 15.5; the phytoestrogen group = 12.5 per 1000 patient-years). The covariate adjusted HRs for uterine fibroid were 0.73 (95% confidence interval [CI] 0.63-0.85) and 0.65 (95% CI 0.52-0.82) in women using CHPs and the phytoestrogen, respectively.CHPs seem to contribute to a decreased risk in developing uterine fibroids. Although the mechanism of action of these products is unclear, their use as a preventive agent for uterine fibroids might be taken into consideration.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Leiomioma/prevenção & controle , Adulto , Fatores Etários , Estudos de Coortes , Humanos , Leiomioma/epidemiologia , Pessoa de Meia-Idade , Fatores de Risco , Taiwan/epidemiologia , Adulto Jovem
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