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  • Most Common Solid Pelvic Tumors in Women

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    kasranoorani
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    Smooth muscle tumors of the uterus, known as leiomyomas or fibroids, are the most common solid pelvic tumors in women aged 20-25 during their reproductive years. Leiomyomas are usually multiple, firm masses that are well-circumscribed but non-encapsulated with a pseudocapsule present. They can undergo degenerative changes like red degeneration, which causes pain, fever and rapid growth resembling raw meat. Diagnosis involves history, bimanual examination, ultrasonography and other imaging methods. Treatment options include observation for small asymptomatic fibroids, medical therapy using hormones, or surgical options like myomectomy or hysterectomy.

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    Smooth muscle tumors of the uterus, known as leiomyomas or fibroids, are the most common solid pelvic tumors in women aged 20-25 during their reproductive years. Leiomyomas are usually multiple, firm masses that are well-circumscribed but non-encapsulated with a pseudocapsule present. They can undergo degenerative changes like red degeneration, which causes pain, fever and rapid growth resembling raw meat. Diagnosis involves history, bimanual examination, ultrasonography and other imaging methods. Treatment options include observation for small asymptomatic fibroids, medical therapy using hormones, or surgical options like myomectomy or hysterectomy.

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    99 vizualizări22 pagini

    Most Common Solid Pelvic Tumors in Women

    Încărcat de

    kasranoorani
    Smooth muscle tumors of the uterus, known as leiomyomas or fibroids, are the most common solid pelvic tumors in women aged 20-25 during their reproductive years. Leiomyomas are usually multiple, firm masses that are well-circumscribed but non-encapsulated with a pseudocapsule present. They can undergo degenerative changes like red degeneration, which causes pain, fever and rapid growth resembling raw meat. Diagnosis involves history, bimanual examination, ultrasonography and other imaging methods. Treatment options include observation for small asymptomatic fibroids, medical therapy using hormones, or surgical options like myomectomy or hysterectomy.

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    din 22

    2

    Incidence

    Most common solid pelvic tumors

    Develop in 2025% of women during
    reproductive years

    3050 years old


    4
    Gross Appearance
    Rare only a singleusually many exist
    Well-circumscribednonencapsulated
    A pseudocapsule is present.
    The consistency is usually firm or even hard
    except when degeneration or hemorrhage
    has occurred.
    colorlight gray or pinkish white
    cut sectionan intertwining pattern or
    a whorl-like arrangement
    bulgy
    5






    Smooth muscle tumors of the uterus are often
    multiple. Seen here are submucosal, intramural,
    and subserosal leiomyomata of the uterus.
    6
    Classification1
    According to growth location
    Myomas on the body of uterus90%
    Myomas on the cervix of uterus10%
    7
    Classification2
    According to the relation to uterine muscle
    Submucous10 15%
    Intramural60 70%
    Subserosal20%

    Few leiomyomas are actually of a single pure
    type.
    hybrids
    9
    Symptoms
    menorrhagia and prolonged menstrual period
    common
    Pelvic pain
    occurs in pregnancy if undergoing degeneration
    or torsion of a pedunculated myoma
    Pelvic pressureurinary frequency
    bowel difficultyconstipation
    Spontaneous abortion
    Infertility




    10
    Signs
    A palpable abdominal tumour

    Pelvic examination
    uterus enlarged and irregular
    hard

    11
    Degeneration
    Hyaline degeneration
    Cystic degeneration
    Red degeneration
    Sarcomatous change
    The othersfat degeneration
    calcification
    the secondary infection
    Result from the diminished
    vascularity of the
    connective-tissue element
    12
    Red Degeneration
    Occasionally seen as a complication of
    pregnancyduring pregnancy or immediate
    postpartum period

    The pathogenesis is unknownmay be the
    result of the accumulation of blood in the
    tumour because of venous obstruction.
    The cut surface resembles raw meat.
    Clinical featuresa cause of painacute
    fever
    rapid growthtender
    13
    Here is a very large
    leiomyoma of the uterus
    that has undergone
    degenerative change
    and is red (so-called "red
    degeneration"). Such an
    appearance might make
    you think that it could be
    malignant. Remember
    that malignant tumors do
    not generally arise from
    benign tumors.
    14
    Sarcomatous Change
    Rare0.4% 0.8%
    More common at 40 50 years old
    Usually occur in intramural fiboids
    grow quickly
    vaginal bleeding

    15
    Diagnosis
    History
    Bimanual examination
    Ultrasonography
    Bultrasound examination

    Hysteroscopy
    Laparoscopy

    Hysterography



    16
    Differential Diagnosis
    Pregnancy
    Ovarian tumour
    Adenomyosis
    Malignant tumors of uterus
    sarcoma of uterus
    endometrial carcinoma
    cervical cancer

    18
    Observation and Follow Up
    Smallasymptomatic fibroids need not
    be treatedespecially near menopause.
    Interval36 months


    19
    Medical Treatment
    Androgenic agentstestosterone propionate

    GnRH-a
    induce a hypoestrogenic
    pseudomenopausal state
    not recommended for longer than 6
    months
    add-back regimens

    20
    Surgery Treatment1
    Indications
    greater than 10 weeks gestational size
    menorrhagialead to anemia
    have pressure symptoms
    grows rapidly
    failure of medical treatment




    21
    Surgery Treatment2
    Method
    Myomectomyconservative therapy
    preserve fertility
    significant risk of recurrence

    Hysterectomy radical therapy

    Subtotal hysterectomy





    Only true cure
    for leiomyomas
    22
    Surgery Treatment3
    Approach
    trans-abdominal

    trans-vaginal

    laparoscopic or hysteroscopic

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