MyMedR

Choriocarcinoma--a reappraisal

Sen DK

Med J Malaysia, 1979 Jun;33(4):286-8.

PMID: 522737

Matched MeSH terms: Uterine Neoplasms/epidemiology*

Primary uterine angiosarcoma with "rhabdoid morphology": A case report

Gandhi JS, Kamboj M, Gupta G, Seth N

Malays J Pathol, 2018 Aug;40(2):203-207.

PMID: 30173240

INTRODUCTION: Primary uterine angiosarcoma is a very rare tumour, with only 23 cases described till now. It is a malignant tumour with cells variably recapitulating the morphologic features of an endothelium and expressing immunohistochemical markers of endothelial cells. In general, it is a bulky neoplasm and frequently is at advance stage of disease at presentation. In general, patients with uterine angiosarcoma tend to have a poorer prognosis, mostly related to the aggressive nature and the metastatic potential of these tumours.

CASE REPORT: We report a rare case of primary uterine angiosarcoma with unusual rhabdoid morphology in a 41-year-old female, who underwent radical hysterectomy and died of disease after 4 months of treatment.

DISCUSSION: We described the differential diagnosis of primary angiosarcoma of the uterus that can pose a diagnostic challenge.

Matched MeSH terms: Uterine Neoplasms/pathology*

Fulltext Inadvertent posterior lower segment caesarean section in a sacculated uterus

Choong KH, Sivanesaratnam V, Sinnathuray TA

Med J Malaysia, 1981 Dec;36(4):250-3.

PMID: 7334964

Matched MeSH terms: Uterine Neoplasms/diagnosis*; Uterine Neoplasms/surgery

Fulltext Two variants of uterine leiomyoma in Malaysia's last Sumatran rhinoceros (Dicerorhinus sumatrensis)

Salleh A, Zainuddin ZZ, Mohamed Tarmizi MR, Yap KC, Zamri-Saad M

Vet Q, 2020 Dec;40(1):250-257.

PMID: 33045934 DOI: 10.1080/01652176.2020.1836431

Following its capture in March 2014, an adult female Sumatran rhinoceros frequently showed profuse vaginal bleeding. An ultrasonography suggested the presence of multiple reproductive lesions, including two uterine masses which were suspected to be leiomyomas. Soon after, an open pyometra was confirmed. Later in November 2019, the patient died and necropsy confirmed the presence of two uterine masses; one was located at the cervico-uterine junction and another in the uterine body, with pyometra, and cystic endometrial hyerplasia. Based on histological, special stains, and immunohistochemical examination, it was shown that one of the masses was composed of large, ovoid and polyhedral neoplastic mesenchymal cells with eosinophilic cytoplasm and a few binucleated cells surrounded by collagen fibres. It was tested positive for SMA and vimentin, while negative for desmin, cytokeratin AE1/AE3, EMA, CD34, and S100. The other mass was composed of mesenchymal cells undergoing myxoid degeneration as evidenced by the presence of glycosaminoglycan-rich matrix. It was tested positive for SMA, vimentin, partially positive for desmin, and negative for the other markers. With the aid of human medical nomenclature, these masses were diagnosed as epithelioid leiomyoma and myxoid leiomyoma, respectively. This report provides a clinical presentation, and histologic descriptions of the two variants of leiomyomas that have not been reported in veterinary medicine.

Matched MeSH terms: Uterine Neoplasms/diagnosis; Uterine Neoplasms/veterinary*

Fulltext Complete hydatidiform mole and surviving coexistent twin--a case report

Japaraj RP, Sivalingam N

Singapore Med J, 2000 Mar;41(3):126-8.

PMID: 11063197

Hydatidiform mole with a coexistent fetus is a rare occurrence with an incidence of I per 22,000-100,000 pregnancies. It is associated with persistent gestational trophoblastic tumour. Hence an early and correct diagnosis is imperative to plan subsequent management of such patients. We report a case of a primigravida who presented with vaginal bleeding at early second trimester. Expectant management was carried out for her pregnancy which finally ended in an abortion. The pathology, clinical findings and current management of this rare entity is discussed.

Matched MeSH terms: Uterine Neoplasms/diagnosis; Uterine Neoplasms/pathology*

Navigating an unexpected diagnosis - experience of a tertiary referral centre with two cases of intraplacental choriocarcinoma

Lim CCW, Punjabi LS, Bhatia A, Ng QJ, Jevon GP, Aggarwal IM

Malays J Pathol, 2024 Apr;46(1):91-94.

PMID: 38682848

Intraplacental choriocarcinoma is a rare tumour, with approximately 62 reported cases. It may manifest as a spectrum of disease ranging from an incidental lesion diagnosed on routine placental examination to disseminated maternal and/or neonatal disease. In this case series, we presented two rare cases of intraplacental choriocarcinoma with extremely varied clinical presentations. The extremely varied clinical presentations of both patients described in the case series complicated the process of arriving at the diagnosis. In both cases, subsequent investigations showed no maternal or neonatal metastasis, and maternal serum beta-hCG levels downtrended with conservative management. We aim to highlight the importance of performing a detailed physical examination and evaluation of the patient and multidisciplinary management with oncology opinion. A detailed examination of the placenta should also be considered when faced with obstetric complications so that early diagnosis and the required management can be executed in a prompt fashion.

Matched MeSH terms: Uterine Neoplasms/diagnosis; Uterine Neoplasms/pathology

Rare postpartum ruptured degenerated fibroid: a case report

Tan YL, Naidu A

J Obstet Gynaecol Res, 2014 May;40(5):1423-5.

PMID: 24689652 DOI: 10.1111/jog.12334

Spontaneous rupture of uterine fibroid is rarely encountered. We present a case of a 31-year-old who presented with acute abdominal pain at 9 weeks postpartum. On examination, the abdomen had diffuse tenderness, with rebound tenderness in the suprapubic area and in both iliac fossae. On ultrasonography, a 12.7 × 8.6 × 8.9-cm sized hyperechoic mass was visible on the posterior wall of the uterus. A large amount of fluid was visible in the paracolic gutters and the Pouch of Douglas (POD). The patient underwent an exploratory laparotomy. A ruptured, cystic degenerated uterine fibroid with active bleeding was found, as well as approximately half a liter of free, bloodstained peritoneal fluid and pus. Myomectomy was performed, followed by evacuation of the fluid and clots. The patient's postoperative course was uneventful. In conclusion, preoperative diagnosis of a perforated, uterine fibroid with spontaneous intra-abdominal hemorrhage is difficult; exploratory laparotomy is both diagnostic and therapeutic in this rare, life-threatening condition.

Matched MeSH terms: Uterine Neoplasms/surgery*

Huge uterine fibroid in a postmenopausal woman associated with polycythaemia: a case report

Abdul Ghaffar NA, Ismail MP, Nik Mahmood NM, Daud K, Abu Dzarr GA

Maturitas, 2008 Jun 20;60(2):177-9.

PMID: 18482807 DOI: 10.1016/j.maturitas.2008.03.013

Uterine fibroid or leiomyoma is the commonest benign uterine tumour. Its occurrence in the postmenopausal age group is rare and if enlargement of the fibroid noted during this time, the diagnosis of leiomyosarcoma is provisional until proven otherwise. A case of a postmenopausal woman with a huge uterine fibroid associated with polycythaemia is presented whereby the mass was noted to increase in size within 2 years. The patient was otherwise well except for the growing uterine mass. She had venesection done to treat her polycythaemia and later underwent surgery for total abdominal hysterectomy and bilateral salpingoophoorectomy. The histopathology report confirmed leiomyoma of uterus with no evidence of sarcomatous changes. It was suggested that large uterine myoma may cause secondary polycythaemia by three postulated mechanisms, i.e. presence of hypoxia suggesting shunting within the tumour, second, the uterine fibroid was compressing the ureters resulting in inappropriate excessive production of erythropoietin by the kidneys, and third, the tumour itself may have been producing the erythropoietin.

Matched MeSH terms: Uterine Neoplasms/complications*

Fulltext Molar pregnancy and glomerulonephritis

Teh HS, Halim AG, Soehardy Z, Fauzi AR, Kong CT

Med J Malaysia, 2006 Aug;61(3):361-2.

PMID: 17240591 MyJurnal

A 17-year-old, sexually active, single, nulliparous young woman presented to us with one week history suggestive of nephrotic syndrome. She was found to have a benign hydatidiform mole confirmed by histopathological examination after suction and curettage. Renal biopsy revealed focal segmental glomerulosclerosis. The renal pathology was most probably due to molar pregnancy due to the close temporal relationship. To our knowledge, this is the first case of focal segmental glomerulosclerosis associated with a gestation trophoblastic disease described in the literature.

Matched MeSH terms: Uterine Neoplasms/complications*

Fulltext Case report: Leiomyoma of the anterior abdominal wall

Ernest Ong CW, Siow SL

Med J Malaysia, 2016 04;71(2):81-2.

PMID: 27326950 MyJurnal

Leiomyomas are benign soft tissue swellings of smooth muscle origin, most commonly found in the uterus. Extra uterine leiomyomas presenting as an abdominal mass is often a diagnostic challenge as such occurrence is rare. We present a rare case of primary abdominal wall leiomyoma, and highlight the importance of laparoscopic approach in the diagnosis and treatment of such tumour.

Matched MeSH terms: Uterine Neoplasms/diagnosis*

Fulltext Fertility drugs and rapid growth of leiomyomata

Rachagan SP

Med J Malaysia, 1994 Dec;49(4):428.

PMID: 7674984

Matched MeSH terms: Uterine Neoplasms/pathology*

Recurrent hydatidiform mole: a report of a patient with 7 consecutive moles

Thavarasah AS, Kanagalingam S

Aust N Z J Obstet Gynaecol, 1988 Aug;28(3):233-5.

PMID: 3233084

A rare case of hydatidiform mole occurring 7 consecutive times in a Chinese woman is presented. She was first seen in 1979 at the age of 23 years, with a molar pregnancy and subsequently had 6 consecutive moles, the last being in July, 1986; at this visit the patient and her husband were very depressed, and convinced that a normal pregnancy was unlikely and requested a hysterectomy. They were warned earlier several times, of the possible long-term consequences of a recurrent mole and that their chance of having a normal baby was very remote. A total hysterectomy was performed at her last presentation as the patient requested one, instead of dilatation and curettage for a persistently high HCG and bulky uterus following suction evacuation. Histology revealed an invasive mole. The beta HCG level was less than 4IU/l by the end of September, 1986 and she is still being followed-up.

Matched MeSH terms: Uterine Neoplasms/diagnosis*

Recurrent uterine myomata in three sisters--an uncommon occurrence

Kulenthran A, Sivanesaratnam V

Int J Gynaecol Obstet, 1988 Oct;27(2):289-91.

PMID: 2903099

Three sisters who developed recurrent uterine myomata from a very young age are presented. Despite repeated attempts at myomectomy, all three cases had hysterectomies ultimately. Complications encountered during surgery were severe hemorrhage, inadvertent injury to bladder and bowel in two patients and a rare complication of colonic-uteric-cutaneous fistula occurring post-operatively in one patient. Histology of the final hysterectomy specimens in two cases showed low grade leiomyosarcoma and cellular myoma, respectively.

Matched MeSH terms: Uterine Neoplasms/genetics*

Prophylaxis against choriocarcinoma

Sivanesaratnam V, Ng KH

Med J Malaysia, 1977 Mar;31(3):229-31.

PMID: 904517

Matched MeSH terms: Uterine Neoplasms/prevention & control*

Suction curette evacuation of hydatidiform mole

Kuah KB

Med J Malaya, 1972 Mar;26(3):205-6.

PMID: 5031017

Matched MeSH terms: Uterine Neoplasms/surgery*

A case of Stein-Leventhal syndrome complicated by large multiple fibromyomas

Fook CW

Med J Malaya, 1970 Jun;24(4):314-6.

PMID: 4248357

Matched MeSH terms: Uterine Neoplasms/complications*

Atypical (symplastic) leiomyoma of the uterus--a case report

Siti-Aishah MA, Noriah O, Malini MN, Zainul-Rashid MR, Das S

Clin Ter, 2011;162(5):447-50.

PMID: 22041803

A 30-year-old, nulliparous woman presented with a history of subfertility. On examination she was found to have uterine fibroid of 28 weeks size of gravid uterus and subsequently laporatomy myomectomy was performed. Multilobulated masses, with diameters ranging from 22 mm to 160 mm were found. Cut sections of the lobulated masses showed whitish whorled cut surface. One of the multilobulated masses had a cystic cavity, measuring 60x50x35 mm(3). Light microscopic findings of the mass with the cystic cavity showed a well-circumscribed cellular tumour composed of cells exhibiting moderate nuclear atypia which were enlarged, nuclei with prominent chromatin clumping and were distributed in areas. Some tumour cells showed large nuclear pseudoinclusions, multinucleated or multilobated tumour giant cells, smudging and few enlarged nucleoli. Mitotic activity was 4 MFs per 10 HPFs. Occasional cells with intracytoplasmic inclusions resembling rhabdoid - like features were seen. There were no atypical mitoses or tumour necroses were noted. Diagnosis of atypical leiomyoma or symplastic leiomyoma was made. Atypical or symplastic leiomyomas are rare in the region of Malaysia and the present case discusses its incidence in younger age, its morphological features along with diagnosis and clinical outcome.

Matched MeSH terms: Uterine Neoplasms/diagnosis; Uterine Neoplasms/pathology*; Uterine Neoplasms/surgery; Uterine Neoplasms/chemistry

The management of gestational trophoblastic disease in developing countries such as Malaysia

Sivanesaratnam V

Int J Gynaecol Obstet, 1998 Apr;60 Suppl 1:S105-9.

PMID: 9833622 DOI: 10.1016/S0020-7292(98)80012-X

Gestational trophoblastic disease is a common gynaecological problem in Malaysia. The incidence of molar pregnancy is 2.8 per 1000 deliveries, being more common amongst the Chinese. The preferred method of evacuation is suction curettage; complete evacuation of the uterus was not achieved at the first attempt in 25 per cent of cases. Partial moles in our centre comprised 30 per cent of all moles. This is potentially malignant and needs follow-up for a complete mole. In the management of an invasive mole, chemotherapy should not be withheld in the presence of metastases and failure of regression of hCG. The role of prophylactic hysterectomy and prophylactic chemotherapy in the management of molar pregnancy is discussed "Selective preventive chemotherapy" in patients at "risk" appears appropriate. Chemotherapy remains the main modality of treatment for gestational trophoblastic tumours (GTT). We categorised our patients into low, medium and high-risk groups; survivals were 100, 98, and 61.7 percent respectively. These patients when categorised according to FIGO staging had survivals of 100, 80, 78.6 and 68.2 per cent respectively for stages 1, 2, 3 and 4 respectively. The reasons for the poor survival in the 'high-risk' group are discussed. Colour doppler blood flow studies are now being carried out; its role needs further evaluation. Surgery and radiotherapy have only a limited role in the management of these cases.

Matched MeSH terms: Uterine Neoplasms/therapy*

Choriocarcinoma--an unusual case

Khoo KE

Med J Malaysia, 1978 Dec;33(2):156-7.

PMID: 755169

Matched MeSH terms: Uterine Neoplasms/complications*

Unusual presentation of chorion epithelioma malignum

Subramanyam C, Lal M

Med J Malaya, 1970 Jun;24(4):306-7.

PMID: 4248354

Matched MeSH terms: Uterine Neoplasms/pathology

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