Acute abdomen by red degeneration of a parasitic leiomyoma: A case report and literature review
A 43-year-old woman, with a history of uterine fibroids and multiple myomectomy, presented with acute lower abdominal pain. Computed tomography revealed multiple tumors, including a high-density mass in the left lower abdomen indicative of a parasitic leiomyoma undergoing red degeneration. This unco...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-04-01
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| Series: | Radiology Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1930043324000311 |
| _version_ | 1797293002482253824 |
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| author | Rika Yoshida Yuko Makihara, MD Akina Miyamoto, MD Hisatoshi Araki, MD Shinji Ando, MD Takeshi Yoshizako, MD Aki Oride, MD Yasushi Kaji, MD |
| author_facet | Rika Yoshida Yuko Makihara, MD Akina Miyamoto, MD Hisatoshi Araki, MD Shinji Ando, MD Takeshi Yoshizako, MD Aki Oride, MD Yasushi Kaji, MD |
| author_sort | Rika Yoshida |
| collection | DOAJ |
| description | A 43-year-old woman, with a history of uterine fibroids and multiple myomectomy, presented with acute lower abdominal pain. Computed tomography revealed multiple tumors, including a high-density mass in the left lower abdomen indicative of a parasitic leiomyoma undergoing red degeneration. This uncommon condition is due to acute occlusion, often caused by peripheral venous thrombosis at the fibroid edge. The diagnosis was corroborated by distinctive findings on magnetic resonance imaging and computed tomography. Notably, high signal intensity on T1-weighted images (T1WI) suggested methemoglobin presence due to hemorrhagic infarction, whereas low signal intensity on T2-weighted images (T2WI) indicated deoxyhemoglobin. Symptom improvement followed treatment with analgesics. This case underscores the significance of considering parasitic myomas in the differential diagnosis of intraperitoneal tumors after myomectomy and proposes that vascular torsion from mechanical stress on the mobile mesentery may contribute to red degeneration in such tumors. In this report, we detail the imaging characteristics and clinical progression of red degeneration in a parasitic leiomyoma, emphasizing the importance of this diagnosis in patients with a history of uterine surgery. |
| first_indexed | 2024-03-07T20:05:37Z |
| format | Article |
| id | doaj.art-fe927f2471a9481c82baaccea9937541 |
| institution | Directory Open Access Journal |
| issn | 1930-0433 |
| language | English |
| last_indexed | 2024-03-07T20:05:37Z |
| publishDate | 2024-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Radiology Case Reports |
| spelling | doaj.art-fe927f2471a9481c82baaccea99375412024-02-28T05:13:09ZengElsevierRadiology Case Reports1930-04332024-04-0119415331536Acute abdomen by red degeneration of a parasitic leiomyoma: A case report and literature reviewRika Yoshida0Yuko Makihara, MD1Akina Miyamoto, MD2Hisatoshi Araki, MD3Shinji Ando, MD4Takeshi Yoshizako, MD5Aki Oride, MD6Yasushi Kaji, MD7Department of Radiology, Faculty of Medicine, Shimane University, Izumo, Shimane, Japan; Corresponding author.Department of Radiology, Faculty of Medicine, Shimane University, Izumo, Shimane, JapanDepartment of Radiology, Faculty of Medicine, Shimane University, Izumo, Shimane, JapanDepartment of Radiology, Faculty of Medicine, Shimane University, Izumo, Shimane, JapanDepartment of Radiology, Faculty of Medicine, Shimane University, Izumo, Shimane, JapanDepartment of Radiology, Faculty of Medicine, Shimane University, Izumo, Shimane, JapanDepartment of Obstetrics and Gynecology, Faculty of Medicine, Shimane University, Enya-cho, 89-1, Izumo 693-8501, Shimane, JapanDepartment of Radiology, Faculty of Medicine, Shimane University, Izumo, Shimane, JapanA 43-year-old woman, with a history of uterine fibroids and multiple myomectomy, presented with acute lower abdominal pain. Computed tomography revealed multiple tumors, including a high-density mass in the left lower abdomen indicative of a parasitic leiomyoma undergoing red degeneration. This uncommon condition is due to acute occlusion, often caused by peripheral venous thrombosis at the fibroid edge. The diagnosis was corroborated by distinctive findings on magnetic resonance imaging and computed tomography. Notably, high signal intensity on T1-weighted images (T1WI) suggested methemoglobin presence due to hemorrhagic infarction, whereas low signal intensity on T2-weighted images (T2WI) indicated deoxyhemoglobin. Symptom improvement followed treatment with analgesics. This case underscores the significance of considering parasitic myomas in the differential diagnosis of intraperitoneal tumors after myomectomy and proposes that vascular torsion from mechanical stress on the mobile mesentery may contribute to red degeneration in such tumors. In this report, we detail the imaging characteristics and clinical progression of red degeneration in a parasitic leiomyoma, emphasizing the importance of this diagnosis in patients with a history of uterine surgery.http://www.sciencedirect.com/science/article/pii/S1930043324000311Acute abdomenComputed tomographyMagnetic resonance imagingParasitic leiomyomaRed degeneration |
| spellingShingle | Rika Yoshida Yuko Makihara, MD Akina Miyamoto, MD Hisatoshi Araki, MD Shinji Ando, MD Takeshi Yoshizako, MD Aki Oride, MD Yasushi Kaji, MD Acute abdomen by red degeneration of a parasitic leiomyoma: A case report and literature review Radiology Case Reports Acute abdomen Computed tomography Magnetic resonance imaging Parasitic leiomyoma Red degeneration |
| title | Acute abdomen by red degeneration of a parasitic leiomyoma: A case report and literature review |
| title_full | Acute abdomen by red degeneration of a parasitic leiomyoma: A case report and literature review |
| title_fullStr | Acute abdomen by red degeneration of a parasitic leiomyoma: A case report and literature review |
| title_full_unstemmed | Acute abdomen by red degeneration of a parasitic leiomyoma: A case report and literature review |
| title_short | Acute abdomen by red degeneration of a parasitic leiomyoma: A case report and literature review |
| title_sort | acute abdomen by red degeneration of a parasitic leiomyoma a case report and literature review |
| topic | Acute abdomen Computed tomography Magnetic resonance imaging Parasitic leiomyoma Red degeneration |
| url | http://www.sciencedirect.com/science/article/pii/S1930043324000311 |
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