Clinical and pathological characteristics, pathological reevaluation and recurrence patterns of cellular leiomyomas: a retrospective study in 76 patients

Rothmund, Ralf; Kurth, Ralf-Rainer; Lukasinski, Nadia-Maria; Huebner, Markus; Hartkopf, Andreas; Wallwiener, Markus; Staebler, Annette; Brucker, Sara; Taran, Florin Andrei

doi:10.1016/j.ejogrb.2013.10.004

Cited by 17 publications

(11 citation statements)

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“…Therefore, CL may represent a subtype of leiomyomas, in which benign diseases evolve into malignant tumors. Therefore, some scholars believe that high cellular leiomyomas should undergo hysterectomy 14,15 . Uterine artery embolization (UAE) and high‐intensity focused ultrasound (HIFU) have become research hotspots in the treatment of uterine leiomyomas in recent years.…”

Section: Discussionmentioning

confidence: 99%

Clinical value of contrast‐enhanced ultrasound for the differential diagnosis of specific subtypes of uterine leiomyomas

Zhang

Shen

et al. 2020

J of Obstet and Gynaecol

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ObjectiveTo improve the accuracy of clinical diagnosis by analyzing different contrast‐enhanced ultrasound (CEUS) imagines of specific subtypes of uterine leiomyomas.MethodsA total of 147 female patients received preoperative CEUS examination. The scanning plane of the biggest tumors for CEUS was found by common B‐mode ultrasonographic scanning on pelvic cavity, then 1.5 mL SonoVue were injected into the median cubital vein. According to the CEUS images, the lesion enhanced time, enhanced level and enhanced morphology were recorded. The time‐intensity curve was acquired and analyzed, meanwhile, the relevant parameters were calculated, including rise time (RT), peak intensity (PI), time to peak (TTP) and mean transit time (MTT).ResultsIn cellular uterine leiomyoma group, the percentage of high enhancement, early enhancement was higher, equal enhancement and synchronic enhancement were lower than those in the common uterine leiomyomas group. In hysteromyoma with hyaline degeneration group, the percentage of high enhancement, early enhancement was lower, while low enhancement and delayed enhancement were higher than those in the common uterine leiomyomas group. The ratio of PI in cellular uterine leiomyoma group was the highest, but the ratios of RT, TTP and MTT were the lowest of the three benign groups. The ratio of PI in hysteromyoma with hyaline degeneration group was the lowest, while the ratios of RT and TTP was the highest among the three benign groups.ConclusionDifferent pathological types of uterine leiomyomas have their own signal performance on CEUS. CEUS can be used to infer their pathological types and help differential diagnosis.

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Section: Discussionmentioning

confidence: 99%

Clinical value of contrast‐enhanced ultrasound for the differential diagnosis of specific subtypes of uterine leiomyomas

Zhang

Shen

et al. 2020

J of Obstet and Gynaecol

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“…Известно, что риск рециди-вирования выше при наличии множественных ми-ом. При единичном узле он составляет 27%, а риск повторной операции, связанной с рецидивом, -11%, а при множественных узлах -59 и 26% соот-ветственно [14]. В нашем исследовании большин-ство пациенток во всех группах сравнения имели множественную миому матки, что уже являлось фак-тором риска возможного рецидива.…”

Section: Discussionunclassified

Surgical treatment of uterine myoma after ineffective UAE and MRgFUS ablation

Porotikova¹,

Adamyan²,

Gavrilova³

et al. 2016

Probl. reprod.

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Миома матки является доброкачественной, хо-рошо ограниченной капсулированной опухолью, ко-торая развивается из мышечной ткани и имеет моно-клональное происхождение [1][2][3][4][5][6]. Это второе по ча-e-mail: irinaevgdoc@gmail.com стоте заболевание у женщин репродуктивного воз-раста, которое составляет, по данным разных авто-ров [2,4,5], от 10 до 30% всех гинекологических за-болеваний. Миома матки может иметь симптомное и Цель исследования -оценка характера изменений органов репродуктивной системы у женщин после ранее перенесенной неэффективной ЭМА, ФУЗ-МРТ абляции и миомэктомии (МЭ) на основании интраоперационных наблюдений. Материал и методы. Обследованы 110 женщин с наличием в анамнезе неэффективного лечения миомы матки с помощью ЭМА и ФУЗ-МРТ абляции и МЭ. Указанным пациенткам нами была проведена МЭ. 1-ю группу составили 32 пациентки с наличием в анамнезе ЭМА, 2-ю группу -26 пациенток с наличием в анамнезе ФУЗ-МРТ абляции миомы и 3-ю группу -52 пациентки, ранее перенесшие МЭ. Результаты. В 1-й группе отмечались трудности при вылущивании миоматозных узлов в связи с наличием конгломератов у 13 (40,6%) пациенток, отсутствием четких границ миомы -у 23 (71,9%), явлением некроза -у 20 (62,5%), явлениями отека -у 15 (46,9%) и наличием дегенеративных изменений -у 29 (90,6%) (p<0,05). Во 2-й группе конгломераты узлов были выявлены у 7 (26,9%), отсутствие четких границ миомы -у 5 (19,2%), явления отека -у 8 (30,8%), явления некроза -у 9 (34,6%), дегенеративные изменения миоматозных узлов -у 13 (50%). Выводы. Необходимо продолжить исследование для поиска новых критериев применения альтернативных методов лечения миомы матки у женщин репродуктивного возраста, страдающих бесплодием. Objective -to estimate the character of the changes of the reproductive system in women after previously made ineffective EMA, MRgFUS ablation and myomectomy on the basis of intraoperative observations. Material and methods. 110 women with a history of ineffective treatment of uterine fibroids with UAE, MRgFUS ablation and myomectomy. All patients had myomectomy. Group I included 32 patients with a history of UAE, II group consisted of 26 patients with a history of MRgFUS ablation of fibroids and III group contained 52 patients with previously made myomectomy. Ключевые слова: миома матки, миомэктомия, эмболизация маточных артерий, фокусированный ультразвук, магнитно-резонансная томография. Surgical treatment of uterine myoma after ineffective UAE and MRgFUS ablationResults. It was difficult to remove the fibroids in Group I due to the presence of conglomerates in 13 (40.6%) patients, the absence of clear borders fibroids of fibroids in 23 (71.9%) patients, necrosis phenomenon in 20 (62.5%) patients, edema -in 15 (46.9%) and the presence of degenerative changes -in 29 (90.6%) (p<0.05). In Group II conglomerates were identified in 7 (26.9%) patients, the absence of clear borders of fibroids -in 5 (19.2%), edema -in 8 (30.8%), the necrosis -in 9 (34,6%), degenerative changes of myoma -in 13 (50%). Conclusion. It is necessary to continue the resea...

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“…The recurrence rate of UF varies from 11 to 40%. A second surgery is necessary in 1.3–27% of cases 18 . UF belongs to diseases with a genetic predisposition 19 .…”

Section: Introductionmentioning

confidence: 99%

Alterations in lipid profile upon uterine fibroids and its recurrence

Tonoyan

Chagovets

Стародубцева

et al. 2021

Sci Rep

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Uterine fibroids (UF) is the most common (about 70% cases) type of gynecological disease, with the recurrence rate varying from 11 to 40%. Because UF has no distinct symptomatology and is often asymptomatic, the specific and sensitive diagnosis of UF as well as the assessment for the probability of UF recurrence pose considerable challenge. The aim of this study was to characterize alterations in the lipid profile of tissues associated with the first-time diagnosed UF and recurrent uterine fibroids (RUF) and to explore the potential of mass spectrometry (MS) lipidomics analysis of blood plasma samples for the sensitive and specific determination of UF and RUF with low invasiveness of analysis. MS analysis of lipid levels in the myometrium tissues, fibroids tissues and blood plasma samples was carried out on 66 patients, including 35 patients with first-time diagnosed UF and 31 patients with RUF. The control group consisted of 15 patients who underwent surgical treatment for the intrauterine septum. Fibroids and myometrium tissue samples were analyzed using direct MS approach. Blood plasma samples were analyzed using high performance liquid chromatography hyphened with mass spectrometry (HPLC/MS). MS data were processed by discriminant analysis with projection into latent structures (OPLS-DA). Significant differences were found between the first-time UF, RUF and control group in the levels of lipids involved in the metabolism of glycerophospholipids, sphingolipids, lipids with an ether bond, triglycerides and fatty acids. Significant differences between the control group and the groups with UF and RUF were found in the blood plasma levels of cholesterol esters, triacylglycerols, (lyso) phosphatidylcholines and sphingomyelins. Significant differences between the UF and RUF groups were found in the blood plasma levels of cholesterol esters, phosphotidylcholines, sphingomyelins and triacylglycerols. Diagnostic models based on the selected differential lipids using logistic regression showed sensitivity and specificity of 88% and 86% for the diagnosis of first-time UF and 95% and 79% for RUF, accordingly. This study confirms the involvement of lipids in the pathogenesis of uterine fibroids. A diagnostically significant panel of differential lipid species has been identified for the diagnosis of UF and RUF by low-invasive blood plasma analysis. The developed diagnostic models demonstrated high potential for clinical use and further research in this direction.

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Clinical and pathological characteristics, pathological reevaluation and recurrence patterns of cellular leiomyomas: a retrospective study in 76 patients

Cited by 17 publications

References 20 publications

Clinical value of contrast‐enhanced ultrasound for the differential diagnosis of specific subtypes of uterine leiomyomas

Clinical value of contrast‐enhanced ultrasound for the differential diagnosis of specific subtypes of uterine leiomyomas

Surgical treatment of uterine myoma after ineffective UAE and MRgFUS ablation

Alterations in lipid profile upon uterine fibroids and its recurrence

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