Removal by laparoscopic partial ovariohysterectomy of a uterine leiomyoma assumed to have caused fetal death in a mare

Abstract

Summary A 13‐year‐old pluriparous Dutch Warmblood mare presented to Utrecht University's Department of Equine Sciences 4 weeks after suspected abortion at 3.5 months gestation, to investigate the nature of a uterine mass and persistent vulval discharge. Transrectal ultrasonographic examination revealed copious flocculent fluid and fetal remnants within the uterus and a 5–6 cm heterogenous mass in the uterine wall at the tip of the right horn. Expulsion of fetal parts and resolution of the coexisting endometritis were effected by a combination of repeated PGF2a analogue injections to induce oestrus, application of PGE2 gel to aid cervical relaxation, and daily uterine lavage and antibiotic instillation. The presence of the mass in the uterine wall was confirmed by hysteroscopy and the suspected tumour subsequently removed by partial laparoscopic ovariohysterectomy under standing sedation and local anaesthesia. The histological appearance of the tumour was consistent with a leiomyoma or moderately malignant leiomyosarcoma. Although a follow‐up examination 6 months post surgery revealed uncomplicated healing of the uterus, the owner decided to retire the mare from breeding. Uterine neoplasia is an extremely unusual cause of fetal death in the mare but, in the present case, laparoscopic partial ovariohysterectomy proved a promising, minimally invasive technique for salvaging sufficient uterus to make subsequent breeding a realistic proposition.

Uterine Fibrosarcoma in a Warmblood Mare

“…In some cases, even abdominal pain, secondary endometritis and protrusion of the tumour into the vulva may accompany the persistent haemorrhagic vaginal discharge (Hamir et al. 1989; Heijltjes et al. 2009).…”

The diagnostic challenge of scrotal enlargement in the stallion

“…; Heijltjes et al . ), it is still an uncommon problem, and there are even fewer reports of leiomyomas in the reproductive tract of the stallion. The authors are aware of only 4 reports of a leiomyoma of the tunica albuginea of the testis in a stallion (Klug and von Lepel ; Johnson and Steinberg ; Wilborn et al .…”

Rebreeding of the partially hysterectomised mare: Uterine surface area as a factor of success

“…Of the 13 mares discussed in this paper who had an entire uterine horn either removed (Rötting et al 2004) or ligated (McDowell et al 1988, only 4 (30.7%) were able to conceive and carry a foal. Based on the information available to date, the assumptions made by Heijltjes et al (2009) were likely quite correct and the mare in question may have successfully conceived and carried a foal to term.…”

“…In this issue, Heijltjes et al (2009) describe a laparoscopic partial ovariohysterectomy to remove a uterine leiomyoma in a 13-year-old Dutch Warmblood. Heijltjes et al (2009) reported removing approximately 30% of the right uterine horn in addition to the right ovary and mass. Although the owners elected not to breed the mare again, the authors believed that she could have successfully carried a foal to term.…”