Retroperitoneal angioleiomyomatosis

Roche, Luz Angela Torres-de la; Devassy, Rajesh; Makhlouf, Ghaith; Juan, Johannes San; Eidswick, Jennifer; Wilde, Rudy Leon De

doi:10.1007/s13224-020-01404-7

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…Our findings are similar to other studies showing that contained morcellation is a feasible and safe method to retrieve large benign surgical specimens and for suspected cases of cancer. There were no intraoperative complications or postsurgical hernias at the port sites [21,43,[47][48][49]. We found that giant tumors (>1000 g) required greater skills for manipulation, thus reducing the possibility of cell spreading without significantly increasing the surgical time when compared with tumors less than 500 g. Two cases of puncture occurred; one of them was noticed immediately when the morcellator blade scraped one edge of the bag and only required the bag to be repositioned.…”

Section: Discussionmentioning

confidence: 75%

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The Future of Minimal-Access Myoma Surgery with In-Bag Contained Morcellation

Devassy

Wilde

et al. 2023

JCM

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Contained electromechanical morcellation has emerged as a safety approach for laparoscopic myomatous tissue retrieval. This retrospective single-center analysis evaluated the bag deployment practicability and safety of electromechanical in-bag morcellation when used for big surgical benign specimens. The main age of patients was 39.3 years (range 21 to 71); 804 myomectomies, 242 supracervical hysterectomies, 73 total hysterectomies, and 1 retroperitoneal tumor extirpation were performed. A total of 78.7% of specimens weighed more than 250 g (n = 881) and 9% more than 1000 g. The largest specimens, weighing 2933 g, 3183 g, and 4780 g, required two bags for complete morcellation. Neither difficulties nor complications related to bag manipulation were recorded. Small bag puncture was detected in two cases, but peritoneal washing cytology was free of debris. One retroperitoneal angioleiomyomatosis and three malignancies were detected in histology (leiomyosarcoma = 2; sarcoma = 1); therefore, patients underwent radical surgery. All patients were disease-free at 3 years follow-up, but one patient presented multiple abdominal metastases of the leiomyosarcoma in the third year; she refused subsequent surgery and was lost from follow-up. This large series demonstrates that laparoscopic bag morcellation is a safe and comfortable method to remove large and giant uterine tumors. Bag manipulation takes only a few minutes, and perforations rarely occur and are easy to detect intraoperatively. This technique did not result in the spread of debris during myoma surgery, potentially avoiding the additional risk of parasitic fibroma or peritoneal sarcoma.

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Section: Discussionmentioning

confidence: 75%

“…The markers HHV-8, S100, synaptophysin, and calretinin were negative. The cytology of peritoneal fluid showed mild subacute inflammation with activated mesothelial cells suggestive of exudative peritoneal effusion [21]. The peritoneal washing cytology examination of all specimens did not show any case of malignancy or tissue spillage (Table 4).…”

Section: Resultsmentioning

confidence: 93%

The Future of Minimal-Access Myoma Surgery with In-Bag Contained Morcellation

Devassy

Wilde

et al. 2023

JCM

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Clinical features and prognostic factors analysis of intravenous leiomyomatosis

Chen

Zhang

et al. 2023

Front. Surg.

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BackgroundThe treatment and prognostic factors of intravenous leiomyomatosis (IVL) remain lacking systematic evidence.MethodsA retrospective study was conducted on IVL patients from the Qilu Hospital of Shandong University, and IVL cases were published in PubMed, MEDLINE, Embase and Cochrane Library databases. Descriptive statistics were used for the basic characteristics of patients. The Cox proportional hazards regression analysis was used to assess the high-risk factors related to the progression-free survival (PFS). The comparison of survival curves was performed by Kaplan–Meier analysis.ResultsA total of 361 IVL patients were included in this study, 38 patients from Qilu Hospital of Shandong University, and 323 patients from the published literature. Age ≤45 years was observed in 173 (47.9%) patients. According to the clinical staging criteria, stage I/II was observed in 125 (34.6%) patients, and stage III/IV was observed in 221 (61.2%) patients. Dyspnea, orthopnea, and cough were observed in 108 (29.9%) patients. Completed tumor resection was observed in 216 (59.8%) patients, and uncompleted tumor resection was observed in 58 (16.1%) patients. Median follow-up period was 12 months (range 0–194 months), and 68 (18.8%) recurrences or deaths were identified. The adjusted multivariable Cox proportional hazard analysis showed age ≤45 years (vs. >45) (hazard ratio [HR] = 2.09, 95% confidence interval [CI] 1.15–3.80, p = 0.016), and uncompleted tumor resection (vs. completed tumor resection) (HR = 22.03, 95% CI 8.31–58.36, p < 0.001) were high-risk factors related to the PFS.ConclusionPatients with IVL have a high probability of recurrence after surgery and a poor prognosis. Patients younger than 45 years and with uncompleted tumor resection are at higher risk of postoperative recurrence or death.

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Retroperitoneal Angioleiomyoma: An Extremely Rare Case Report

Chandanwale,

Raj,

Kundlia

et al. 2024

Journal of the Scientific Society

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Angioleiomyoma (ALM) is a benign mesenchymal tumor arising from the smooth muscle cells of the vessel wall. Common sites include subcutaneous tissues of the lower extremities but can also be seen in unusual sites including the head-and-neck region, submandibular gland, uterus, ovary, and broad ligament. It is exceptionally rare in retroperitoneum. Local recurrence is extremely rare but known to occur. Imaging features are nonspecific. Differential diagnosis on the basis of radiological features is difficult. Definitive diagnosis requires histopathology examination. Angiomyolipoma and myopericytoma are considered close differentials on microscopy at retroperitoneal locations. Histopathological examination along with immunohistochemistry markers such as desmin and HMB-45 are required for definitive diagnosis. It is difficult to diagnose angioleiomoma preoperatively, considering its location, thereby we are tempted to present an extremely rare case of retroperitoneal ALM highlighting its diagnostic dilemma.

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Retroperitoneal angioleiomyomatosis

Cited by 3 publications

References 4 publications

The Future of Minimal-Access Myoma Surgery with In-Bag Contained Morcellation

The Future of Minimal-Access Myoma Surgery with In-Bag Contained Morcellation

Clinical features and prognostic factors analysis of intravenous leiomyomatosis

Retroperitoneal Angioleiomyoma: An Extremely Rare Case Report

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