Pyomyoma after uterine artery embolization: A case report

Ezzedine, Dima; Ndubizu, Chima; Kayani, Sohaib; David, Allison

doi:10.1016/j.crwh.2020.e00186

Cited by 5 publications

(7 citation statements)

References 9 publications

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“…Hysterectomy, besides broad-spectrum antibiotic treatment, is the therapy of choice for pyomyoma [ 8 , 12 , 13 ]. Consequently, only a few cases of uterus-preserving management have been reported.…”

Section: Discussionmentioning

confidence: 99%

Uterus-preserving management of pyomyoma: Case report of a rare complication after uterine artery embolization

Bußhoff

Thangarajah

Morgenstern

2022

Case Reports in Women's Health

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Section: Discussionmentioning

confidence: 99%

Uterus-preserving management of pyomyoma: Case report of a rare complication after uterine artery embolization

Bußhoff

Thangarajah

Morgenstern

2022

Case Reports in Women's Health

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“…At least 13 cases of pyomyoma secondary to UAE have been reported since 1945, ranging in patients aged 28 to 65 years and all were greater than 7 cm [5,[11][12][13][14]. It is thought that the UAE predisposes the development of a pyomyoma by deliberately infarcting the fibroid, increasing the likelihood of infection.…”

Section: Discussionmentioning

confidence: 99%

Large pyomyoma after an urgent uterine artery embolization (UAE)

Bechay¹,

Thomas²,

Le³

et al. 2022

J Clin Images Med Case Rep

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Leiomyomas, or fibroids, are a common, benign tumor of the smooth muscle of the uterus, with a cumulative incidence of 70% in white women and 80% in black women by age 50 [1]. Suppurative leiomyoma, also referred to as pyomyoma, is a rare disorder of infarction with subsequent infection of a leiomyoma, which must be distinguished from other degenerative changes [2,3]. Incidence of the disease is unknown but previously estimated under 1% of operated fibroids [3], and there have been approximately 100 cases reported since 1945. The modes of infection are thought to be via direct extension from the uterine cavity, a lymphatic or a vascular route of bacterial seeding [3,4]. Pregnancy, the post-partum period, and uterine instrumentation, including dilatation and curettage (D&C) and C-section, are important risk factors for direct inoculation and account for the majority of pyomyoma cases that were reported [5,6]. Idiopathic pyomyomas also occur, such as in post-menopausal women; risk factors for ischemia, such as hypertension, diabetes, and atherosclerosis, increase the risk of pyomyoma [4,5]. Uterine Artery Embolization (UAE) is increasingly used as a non-invasive treatment for symptomatic fibroids and involves infarction of leiomyomas, which can rarely lead to pyomyoma [7,8]. We present a case of pyomyoma that developed after an urgent uterine artery embolization with a follow-up discussion of the relevant literature.

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“…[ 6 ] However, diagnosis based on clinical findings is challenging, as its presentation mimics post-embolization syndrome (PES), which may also present with pelvic pain, elevated white cell count, and fever within 1 week of UAE. [ 4 , 7 ] PES can be seen in 21% of patients undergoing UAE, and is a self-limiting condition managed with hydration, pain control, and anti-inflammatory medications. [ 4 ] The persistence of symptoms beyond 1 week should raise suspicion of pyomyoma.…”

Section: Discussionmentioning

confidence: 99%

“…[ 4 ] The persistence of symptoms beyond 1 week should raise suspicion of pyomyoma. [ 7 ] Table 2 describes the differentiating features of pyomyoma and PES. Alternate differential diagnoses of pyomyoma include tubo-ovarian abscess, infected ectopic pregnancy, degenerated leiomyoma, or malignancy [ Table 3 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Ruptured pyomyoma – Rare complication of post-uterine artery embolization: A case report

Vulasala

Gopireddy

Mohamed

et al. 2021

JCIS

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Leiomyomas, also termed as fibroids, are benign smooth, muscle neoplasms seen in 70–80% of women by the age of 50 years. Uterine artery embolization (UAE) is a minimally invasive procedure that involves cessation of vascular supply to the fibroids, by infusion of gelatinous microspheres into the uterine arteries. Pyomyoma is a suppurative leiomyoma, secondary to infection of necrotic tissue. It is an infrequent complication of uterine artery embolization (UAE). Pyomyoma can lead to sepsis, peritonitis, and respiratory distress syndrome resulting in high morbidity and mortality. Due to its rarity, high suspicion is crucial in the diagnosis, and prompt treatment is recommended to reduce mortality. Ultrasound, computed tomography, and magnetic resonance imaging assist in diagnosis. We present a case of a 44-year-old woman with ruptured pyomyoma, following an UAE intervention. The patient was treated with total abdominal hysterectomy and salpingo-oophorectomy along with peritoneal irrigation and drainage.

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Pyomyoma after uterine artery embolization: A case report

Cited by 5 publications

References 9 publications

Uterus-preserving management of pyomyoma: Case report of a rare complication after uterine artery embolization

Uterus-preserving management of pyomyoma: Case report of a rare complication after uterine artery embolization

Large pyomyoma after an urgent uterine artery embolization (UAE)

Ruptured pyomyoma – Rare complication of post-uterine artery embolization: A case report

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