Bhusal Amrit, Rai Prashant, Pradhan Anju, Agrawal Ajay
BP Koirala Institute of Health Sciences, Nepal.
BP Koirala Institute of Health Sciences, Nepal.
Int J Surg Case Rep. 2023 Apr;105:107975. doi: 10.1016/j.ijscr.2023.107975. Epub 2023 Mar 17.
Leiomyoma is the most common gynecologic tumor which may show atypical locations and degenerations. Cystic degeneration is said to be found in 4 % of all degenerations. Endometriosis, the presence of endometrial glands and stroma at extrauterine sites, is a common gynaecological condition seen in 10 % to 15 % of reproductive-age women usually being associated with various degrees of fertility problems.
40 years old woman with P1L1A2, with secondary sub-fertility for 5 years, presented with chief complaints of dysmenorrhoea for 1 year initially around the menstrual cycle relieving with analgesics but later not limited to the menstrual cycle and pain not relieving with analgesics since 1 month. The patient underwent fertility-sparing laparoscopic removal avoiding a laparotomy and definitive hysterectomy. Manual morcellation was achieved.
Cystic degeneration is rare in Leiomyoma although it is the more common gynaecological tumor in women and is associated with endometriosis probably due to retrograde menstruation.
Laparoscopic removal of leiomyoma without laparotomy and definitive hysterectomy for a case of cystic endometriosis in a degenerated subserous myoma which to the best of our knowledge according to our search of articles on the relevant topic is the first reported case pertaining to the topic from Nepal.
平滑肌瘤是最常见的妇科肿瘤，可能表现出非典型位置和变性。据报道，囊性变在所有变性中占4%。子宫内膜异位症是指子宫外部位存在子宫内膜腺体和间质，是一种常见的妇科疾病，在10%至15%的育龄妇女中可见，通常与不同程度的生育问题有关。
一名40岁女性，孕1产1人流2次，继发性不孕5年，主要症状为痛经1年，最初在月经周期出现，服用止痛药后缓解，但后来不限于月经周期，且自1个月以来服用止痛药后疼痛未缓解。患者接受了保留生育功能的腹腔镜切除术，避免了剖腹手术和根治性子宫切除术。采用了手动分碎术。
囊性变在平滑肌瘤中较为罕见，尽管平滑肌瘤是女性中较常见的妇科肿瘤，且可能由于经血逆流而与子宫内膜异位症有关。
对于一例变性浆膜下肌瘤合并囊性子宫内膜异位症患者，在未进行剖腹手术和根治性子宫切除术的情况下，通过腹腔镜切除平滑肌瘤。据我们所知，根据我们对相关主题文章的检索，这是尼泊尔首次报道的与该主题相关的病例。
