Урология №6 / 2022
Редкий случай лейомиомы мочевого пузыря во время беременности: клиническое наблюдение
1) Отделение урологии, больница Пенгаджар Университет Пенгаджар, Университет Путра, Малайзия;
2) Больница Университета Сайнс Малайзии, Кубанг-Кериан, Малайзия;
3) Акушерское отделение, Больница Университета Сайнс Малайзии, Кубанг-Кериан, Малайзия
Мы представляем редкий случай лейомиомы мочевого пузыря, диагностированной у 29-летней женщины во время первой беременности. Пациентка предъявляла жалобы на постепенное увеличение объема живота в течение 6 месяцев. На КТ выявлено неоднородное образование крупных размеров, накапливающее контраст, с зоной отсутствия контрастирования (некроза), подозрительное на злокачественную опухоль яичника. При гистологическом исследовании препарата подтвержден диагноз лейомиомы мочевого пузыря. В статье описана клиническая картина, результаты диагностических исследования и тактика лечения относительно редкой доброкачественной опухоли.
Introduction. Bladder Leiomyoma is a rare benign nonepithelial lesion which represents 0.04–0.5% of bladder tumors found in females between the age 40 to 50 [1]. The incidence of leiomyoma in pregnancy is rare and only four cases of bladder leiomyoma during pregnancy have been reported previously. To our knowledge, this case is the fifth case to be reported.
It origins from the smooth muscle bundles and therefore it can be found at any organ with this kind of tissue [1]. In the urinary system, the most frequent localizations are kidney and bladder. In the bladder, these lesions could be located at any level intramurally [2].
An occurrence of this tumor, it is believed to be related to an endocrine alteration [3]. Surgery is the standard treatment and the surgical approach depends on tumor size and localization at the bladder wall. Prognosis is good due to the benign behavior of these lesions [1].We present the case of a subserosal bladder leiomyoma presenting as malignant ovarian tumor in a 29-year primigravid.
Case report. 29 years old healthy lady, primigravida at 13weeks of pregnancy, presented with painless right-sided abdominal mass since March 2016. Initially patient sought treatment at the private clinic who subsequently referred the patient to HUSM O&G team as transabdominal ultrasound revealed suspicious right pelvic mass. The transabdominal and transvaginal scan was done and revealed, a huge solid tumor which lies adjacent to the uterus. The mass measuring 16.2x17.7 cm lies more on right iliac fossa and suprapubic region, extending up till the epigastric. Uterus 15x10cm with intrauterine pregnancy. Otherwise no hydronephrosis, no ascites, and liver are homogenous. Blood investigations is non-significant and tumor marker was shown CA 125:18, CEA:0.9, LDH:319, and Beta HCG: <0.1
The patient was subsequently arranged for contrast-enhanced CT abdomen and pelvis and it showed a large heterogenous enhancing mass in the right hemipelvis extending to the intrabdominal cavity till the lev...
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