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2.1
Leiomyoma of the Small Intestine
Intestine Small Leiomyoma

Presentation

CONCLUSION: Jejunal leiomyoma should be considered in a child with neurofibromatosis presenting with gastro-intestinal bleeding. [ncbi.nlm.nih.gov]

Topic Images Snapshot A 45-year-old African American G2P2 woman presents with abnormal uterine bleeding. She reports irregular spotting between periods and pain with intercourse. [step2.medbullets.com]

Hypercalcaemia, hypophosphatemia, hyperchloremia, elevated chloride/phosphorus ratio, increased urinary cyclic AMP, and blood levels of immunoreactive parathormone were present. Electron microscopy showed dense round granules in the tumour cells. [cris.tau.ac.il]

Conclusion Jejunal leiomyoma should be considered in a child with neurofibromatosis presenting with gastro-intestinal bleeding. [link.springer.com]

Gastrointestinal

  • Melena

    Abstract A 41-year-old woman visited a local doctor with the chief complaint of massive melena. Upper and lower gastrointestinal endoscopy as well as abdominal computed tomography failed to reveal the source of the bleeding. [jstage.jst.go.jp]

    In the case of leiomyoma of the jejunum with massive enterorrhagia and melena reported below, the preoperative diagnosis was bleeding duodenal ulcer.Leiomyoma of the small intestine is rare. [nejm.org]

    Their clinical manifestations can include abdominal pain, diarrhea, melena, a palpable abdominal mass and weight loss. [academic.oup.com]

    […] jejunum, 010813, 漿膜, ショウマク, serosa, 011358, 再建術, サイケンジュツ, reconstructive surgery, 059071, 症例報告, ショウレイホウコク, case report, 054676, 男性, ダンセイ(オトコ), man, 017125, ダンセイ, 成人, セイジン, adult(person), 017082, adult, ヒト, ヒト, human(primates), 012150, human, 下血, ゲケツ, melena [togodb.biosciencedbc.jp]

    Case 1 was a 74-year-old female, who had a history of receiving multiple blood transfusions because of recurrent melena for several years. [iss.ndl.go.jp]

  • Intestinal Disease

    […] grêle Intestin pathologie Léiomyome Observation Tumeur Tunisie Afrique Keyword (en) Digestive diseases Human Hemorrhage Small intestine Intestinal disease Leiomyoma Observation Tumor Tunisia Africa Keyword (es) Aparato digestivo patologia Hombre Hemorragia [pascal-francis.inist.fr]

    054590, *, 腸疾患, チョウシッカン, intestinal disease, 054586, 胃腸疾患, イチョウシッカン, gastrointestinal disease, 054588, 消化器疾患, ショウカキシッカン, digestive system disease, 012793, 病気, ビョウキ, disease, 017213, 腸腫瘍, チョウシュヨウ, intestinal tumor, 054236, 消化器腫瘍, ショウカキシュヨウ, digestive [togodb.biosciencedbc.jp]

    Some inflammatory disorders predispose to malignancy 1,2 : celiac disease : lymphoma Crohn's disease : adenocarcinoma, 5-20 x increased risk immunoproliferative small intestinal disease (IPSID, Mediterranean lymphoma or diffuse small intestinal lymphoma [radiopaedia.org]

    Following resectable nodal metastases, median survival is 15 years.With non-resectable intestinal disease or liver metastases, survivals are 5 and 3 years, respectively. [surgwiki.com]

Workup

With MRI spatial resolution less than that achieved with conventional enteroclysis or CT, therefore it is less useful for evaluation of lesions Endoscopic ultrasonography (EUS) is very sensitive and effective for the workup of neoplasms in the ampullary [radiopaedia.org]

[4][6] Ultrasound pelvis (transvaginal, transabdominal) Most appropriate initial test for all patients with a suspected uterine leiomyoma [7] Supportive findings [8] Neither plain radiography nor CT is recommended in the workup of leiomyomas because of [amboss.com]

Treatment

The patient’s age and reproductive goals direct the modality and goals of treatment. Treatment options include both medical and surgical intervention [1]. [ncbi.nlm.nih.gov]

Uterine Fibroids: Diagnosis and Treatment. Am Fam Physician. 2017; 95 (2): p.100-107. Al-Hendy A, Lukes AS, Poindexter AN, et al. Treatment of Uterine Fibroid Symptoms with Relugolix Combination Therapy. [amboss.com]

Pathophysiology is emphasized throughout, providing a sound basis for discussions of the diagnosis, treatment, and prognosis that follow. [books.google.com]

[…] hyperechoic, well-circumscribed round masses STUDIES Labs β-hCG to rule out pregnancy Histology whorled pattern of smooth muscle bundles Differential Diagnosis Leiomyosarcoma Adenomyosis Endometrial polyp Pregnancy Diagnosis Confirmed with sonogram Treatment [step2.medbullets.com]

Metastatis to small bowel is rare, treatment is chemotherapy and the prognosis is poor. [omicsonline.org]

Prognosis

Metastatis to small bowel is rare, treatment is chemotherapy and the prognosis is poor. [omicsonline.org]

Pathophysiology is emphasized throughout, providing a sound basis for discussions of the diagnosis, treatment, and prognosis that follow. [books.google.com]

Prognosis The prognosis of uterine fibroids varies extensively for individual patients. Many patients have an excellent prognosis and remain asymptomatic for many years or indefinitely. [ncbi.nlm.nih.gov]

[…] childbearing potential uterine artery embolization preserves childbearing potential if myomectomy is not an option hysterectomy definitive therapy Complications very rarely (if at all) transforms into leiomyosarcoma infertility iron deficiency anemia Prognosis [step2.medbullets.com]

Etiology

Etiology Leiomyomas are comprised of monoclonal cells arising from the myometrium [5]. Continued research to determine the etiology of leiomyomas is ongoing. Several studies have identified specific gene mutations associated with fibroids [2]. [ncbi.nlm.nih.gov]

Etiology Predisposing factors [1][2] Nulliparity Early menarche (< 10 years of age) Age: 25–45 years Fibroids are largely found in women of reproductive age. [amboss.com]

(Etiology) The exact cause of Leiomyoma of Colon is unknown. Researchers have documented certain genetic changes within the tumor. However, cases where these specific genetic mutations have been observed are rare. [dovemed.com]

While duodenal ulcers and diverticulosis are certainly more common than symptomatic neoplasms of the small intestine, it is important to have a higher index of suspicion for additional etiologies, especially when irregularities of imaging studies are [academic.oup.com]

Pathophysiology Leiomyomas have a clonal origin Several alterations identified (Table 1) (Clin Obstet Gynecol 2016;59:25) Risk decreased by oral contraceptives May occur in hereditary leiomyomatosis and renal cancer syndrome (HLRCC) and Alport syndrome Etiology [pathologyoutlines.com]

Epidemiology

Uterine sarcoma: Classification, epidemiology, clinical manifestations, and diagnosis. In: Post TW, ed. UpToDate. [amboss.com]

[…] undergo a hysterectomy because she does not want any more children. summary Otherwise known as fibroids Leiomyomas are smooth muscle growths of the uterine myometrium can be intramural submucosal subserosal Often present with multiple discrete tumors Epidemiology [step2.medbullets.com]

These results suggest that mutations affecting the regulators of circadian rhythm can be frequently found in cancer, and therefore could help to understand the well-known linkage from epidemiologic studies between disrupted circadian rhythm and cancer [helda.helsinki.fi]

Epidemiology Leiomyomas are diagnosed in close to 70% of white women and more than 80% of black women by age 50, but the incidence of clinical symptoms in blacks is double that found in whites [2]. [ncbi.nlm.nih.gov]

Brooks SE, Zhan M, Cote T, Baquet CR (2004) Surveillance, epidemiology, and end results analysis of 2677 cases of uterine sarcoma 1989-1999. Gynecol Oncol 93:204. [omicsonline.org]

Pathophysiology

Pathophysiology is emphasized throughout, providing a sound basis for discussions of the diagnosis, treatment, and prognosis that follow. [books.google.com]

Describe the hormone responsiveness of tumors in the pathophysiology of leiomyomas. Explain the FIGO classification in the evaluation of leiomyomas. [ncbi.nlm.nih.gov]

The literature is revised emphasizing issues of pathophysiology, specific characteristics and the treatment of this tumour. [jsurgacad.com]

[…] fumarate hydratase deficient leiomyoma More common (up to 80%) in African American women References: Best Pract Res Clin Obstet Gynaecol 2008;22:571, BJOG 2017;124:1501 Sites Uterine corpus Less common in vulva, vagina, cervix, broad ligament, ovary Pathophysiology [pathologyoutlines.com]

Prevention

Hence, a complete removal of the tumor is recommended How can Leiomyoma of Colon be Prevented? Currently, no known preventive methods exist for Leiomyoma of Colon. [dovemed.com]

To expand our knowledge of leiomyomas, we need further research to identify predisposing genetic factors for potential use to better target preventive care. [ncbi.nlm.nih.gov]

With advanced disease, debulking or palliative resection is performed to prevent complications of bleeding or perforation, provided excessive removal of normal small bowel is avoided. [surgwiki.com]

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