Ceska Gynekol. 2020 Winter;85(3):197-200.
Case description of dissecting uterine leiomyoma with extrauterine extension and infiltration of right parametrium, ureter and bladder wall.
Case report.
Department of Pathology, Znojmo Hospital.
A 64-year-old woman with chronic pelvalgia and loss of renal function of the right kidney due to urinary tract obstruction is presented. Ultrasound examination, magnetic resonance imaging and computer tomography scan revealed a pelvic tumour affecting the right edge of the uterine wall, the right parametrium, distal part of the right ureter, the right and partially the cranial bladder wall. Due to this finding, hysterectomy, unilateral parametrectomy, partial resection of the bladder wall and resection of the distal part of the ureter was performed. Histology revealed morphologically bland spindle-cell smooth-muscle tumour corresponding to conventional uterine leiomyoma. Tumour necrosis, cellular atypia, vascular invasion or hydropic degeneration were not observed. A final diagnosis of dissecting leiomyoma of the uterus was made.
The diagnosis of dissecting leiomyoma should be considered in all malignant tumours affecting the uterine corpus.
描述一例具有子宫外延伸和右侧宫旁、输尿管和膀胱壁浸润的解剖性子宫肌瘤病例。
病例报告。
兹诺伊莫医院病理科。
报告一名 64 岁女性，因尿路梗阻导致慢性骨盆痛和右肾功能丧失。超声检查、磁共振成像和计算机断层扫描显示盆腔肿瘤影响右侧子宫壁、右侧宫旁、右输尿管远端、右侧和部分颅侧膀胱壁。由于这一发现，进行了子宫切除术、单侧宫旁切除术、部分膀胱壁切除术和输尿管远端切除术。组织学显示形态上为良性梭形平滑肌肿瘤，符合常规子宫平滑肌瘤。未观察到肿瘤坏死、细胞异型性、血管浸润或水样变性。最终诊断为子宫解剖性平滑肌瘤。
在所有影响子宫体的恶性肿瘤中，都应考虑诊断为解剖性平滑肌瘤。
