1/15. Benign periurethral masses in women.Benign periurethral masses were encountered in 4 women. The masses included 2 vaginal leiomyomas, 1 of which was found simultaneously with a urethral diverticulum, a fibrocystic urethral mass and hyperplastic glandular tissue obstructing the bladder outlet and resembling male prostate. The physical and endoscopic features were helpful in establishing the benign nature and extent of the lesions. Although the bladder base was deformed on an excretory urographic cystogram in each case the radiographic features were non-specific except as they applied to a urethral diverticulum. Transvaginal needle biopsy is recommended in contemplation of open surgical excision. Leiomyomas are best approached transvaginally and anterior urethral masses can be reached suprapubically.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/15. A huge 6.2 kilogram uterine myoma coinciding with omental leiomyosarcoma: case report.Surgery for massive abdominal tumors is both interesting and challenging. We present a case involving a multiple uterine myoma weighing 6.2 Kg which coincided with omental leiomyosarcoma. To our knowledge, this is the first report of this type of condition in the English literature. A 44-year-old nulliparous woman had suffered from abdominal pain for a long time. A huge abdominal mass was palpated on physical examination. Computed tomography scanning revealed a huge pelvic-abdominal mass with the possibility of small bowel loops invaded by the mass. A 6-cm omental mass was incidentally found during the subsequent hysterectomy procedure. Perforation of the urinary bladder occurred during the dissection of adhesion. Resection of the omental mass, wide wedge resection of the invaded small bowel, primary repair of the bladder, and hysterectomy were performed. The final pathologic diagnosis was uterine leiomyomata with omental leiomyosarcoma. The patient returned home on postoperative day 14 and was well at the 18-month follow-up examination. The challenge of these tumors lies in their proper diagnosis and surgical management. More case reports and follow-up studies are needed to confirm the efficacy of their management.- - - - - - - - - - ranking = 15.706169514351keywords = physical examination, physical (Clic here for more details about this article) |
3/15. A case of gastrointestinal stromal tumor of the stomach.In a 55-year-old man, a tumor about 3 cm in diameter was detected in the upper abdomen by abdominal ultrasound screening during follow-up of chronic hepatitis c discovered in 1990. There were no symptoms and no abnormalities on physical examination. Tests for tumor markers were negative. By barium meal and gastroscopy, submucosal tumor was found on the lesser curvature of the stomach, with bridging fold in the absence of central ulceration. biopsy revealed no tumor tissue. Under the diagnosis of submucosal tumor of the stomach, either a leiomyoma or leiomyosarcoma, partial resection of stomach was performed. Direct invasion of the surrounding organs, lymph node metastasis or distant metastasis was not observed grossly in the operation. Histologic examination of the resected specimen revealed proliferation of spindle cells and oval cells in an interlacing pattern. immunohistochemistry for CD34, vimentin and c-kit protein was strongly positive, while smooth muscle actin, S-100 protein, desmin and p53 protein were negative. The proliferating cell nuclear antigen index was about 50%, while the MIB-1 index was < or = 1%. From these findings, this tumor was diagnosed as a gastrointestinal stromal tumor of the uncommitted type.- - - - - - - - - - ranking = 15.706169514351keywords = physical examination, physical (Clic here for more details about this article) |
4/15. Bladder leiomyoma: a rare cause of urinary stress incontinence.Lejomyoma of the bladder is an uncommon lesion and usually present as small intramural or submucosal lesions. Preoperative evaluation based on careful physical and radiologic examinations must rule out malignant and other lesions. It is readily and successfully treated in most cases with transurethral or open resection. The prognosis of this tumor is excellent and no malignant degeneration has been reported. The most common presentations are obstructive voiding symptoms, irritative symptoms, and hematuria. Occasionally, it may be a cause of urinary stress incontinence. Although this condition is rare, it should be considered in the causes of urinary stress incontinence.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/15. Successful pregnancy in a woman with symptomatic fibroids who underwent laparoscopic bipolar coagulation of uterine vessels.OBJECTIVE: To report a case of successful pregnancy after laparoscopic bipolar coagulation of uterine vessels (LBCUV). DESIGN: Case report. SETTING: University-affiliated tertiary referral center. PATIENT(S): One woman, treated with LBCUV for symptomatic fibroids, who subsequently had a successful pregnancy. INTERVENTION(S): Laparoscopic bipolar coagulation of uterine arteries and anastomotic sites of uterine arteries with ovarian arteries. MAIN OUTCOME MEASURE(S): Patient evaluation by physical and ultrasound examinations. RESULT(S): Complete resolution of menorrhagia and dysmenorrhea was found after LBCUV. Reduction in fibroid size was seen by ultrasound. Two months later, the patient conceived a singleton pregnancy without the use of assisted reproductive technologies. The woman delivered by cesarean section. Neither myoma recurrence nor abnormality in uterine function was observed. CONCLUSION(S): Although fecundity- and pregnancy-related complications after LBCUV for managing uterine fibroids are still unclear, this first case report of successful pregnancy after LBCUV is promising. LBCUV might be a safe and effective alternative to myomectomy and hysterectomy.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/15. July 2002: 66-year-old female with a one-year history of progressive left proptosis.The July 2002 Case of the Month (COM). This 66-year-old Caucasian female presented with gradually increasing protrusion of her left eye over a one-year period. She complained of increased tearing and foreign body sensation. The physical examination revealed a visual acuity of 20/20, normal color testing, full vision field with motility of her left eye limited in lateral gaze. Pupils were round, symmetric, with no afferent pupillary defect noted. On external examination, her left eye was grossly proptotic with resistance to retropulsion. She had 4 mm proptosis of the left eye. Computed tomography and MR imaging demonstrated a left retro-orbital mass with gadolinium enhancement and focal remodeling of orbital bones. She underwent surgical resection of tumor with a diagnosis of solitary fibrous tumor, and postoperatively she was symptom free. The histopathological differential diagnoses of spindle cell neoplasms of the orbit are discussed. Five months after surgery, no evidence of tumor recurrence was seen on neuroimaging and her vision was 20/20.- - - - - - - - - - ranking = 15.706169514351keywords = physical examination, physical (Clic here for more details about this article) |
7/15. female paraurethral leiomyoma: ultrasonographic and magnetic resonance imaging findings.Primary benign paraurethral tumors in females are observed only rarely. They may occasionally be detected at physical examination or present with symptoms of bladder outlet obstruction. A leiomyoma originating from the smooth muscle fibers of the urethra in a 43-year-old woman is reported. The benign nature of the lesion was suspected on the basis of transvaginal ultrasonography and magnetic resonance imaging. Surgical enucleation was performed and light microscopy showed a well-differentiated smooth muscle tumor.- - - - - - - - - - ranking = 15.706169514351keywords = physical examination, physical (Clic here for more details about this article) |
8/15. Paraurethral leiomyoma in a female causing urinary obstruction.We report a case of paraurethral leiomyoma in a female patient, in which the first symptoms were dysuria and sensation of incomplete voiding. The physical examination revealed a mass in the anterior vaginal wall. The diagnosis was made through ultrasonography and pelvic MRI and confirmed by transvaginal ultrasound-guided needle biopsy. The surgical excision was accomplished without opening the urinary tract. A review of the relevant published studies and a suggestion for the appropriate management of these cases are included.- - - - - - - - - - ranking = 15.706169514351keywords = physical examination, physical (Clic here for more details about this article) |
9/15. leiomyoma of the epididymis treated with partial epididymectomy.BACKGROUND: A 56-year-old man presented to a urology clinic with a painless left-testicular mass of unknown duration. On physical examination, a firm mass measuring 2 cm x 2 cm and involving the inferior portion of the left epididymis was found. The left testicle, right testicle, and right epididymis looked normal on examination. INVESTIGATIONS: Assessment of tumor-marker levels, ultrasound examination of the scrotum, Doppler ultrasound examination, surgical exploration, and histologic examination of frozen sections. diagnosis: Pure leiomyoma arising from the epididymis. MANAGEMENT: Complete excision of the mass with its contiguous epididymis, preserving the left testicle and rest of the epididymis.- - - - - - - - - - ranking = 15.706169514351keywords = physical examination, physical (Clic here for more details about this article) |
10/15. Inflammatory pseudotumor of the uterus.The clinical and pathological features of two cases of inflammatory pseudotumor of the uterus are reported, a lesion previously undescribed in this site. In Case 1, a 6-year-old girl presented with abdominal pain, distension, and a suprapubic mass on physical examination. The lesion in Case 2 was an incidental finding in a 30-year-old woman at the time of hysterectomy. In both cases, solitary leiomyoma-like masses, measuring 12.5 and 4.5 cm in maximum diameter respectively, involved the myometrium. On histological examination the lesions were characterized by an admixture of spindle-shaped cells and a mixed inflammatory infiltrate rich in plasma cells. The spindle cells were positive for actin with immunoperoxidase staining, and in Case 1, exhibited the ultrastructural features of myofibroblasts. Both patients are alive with no evidence of disease at postoperative intervals of 5 and 4 1/2 years, respectively. The literature pertaining to other inflammatory and reactive tumor-like lesions within the female genital tract is reviewed.- - - - - - - - - - ranking = 15.706169514351keywords = physical examination, physical (Clic here for more details about this article) |
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