1. Spontaneous rupture of uterine smooth muscle tumour presenting acute abdominal pain and haemoperitoneum
- Author
-
Hiroshi Hirakawa and Hanako Oda
- Subjects
Leiomyosarcoma ,Adult ,medicine.medical_specialty ,Abdominal pain ,Percutaneous ,Perforation (oil well) ,Salpingo-oophorectomy ,Peritonitis ,Aftercare ,Hysterectomy ,03 medical and health sciences ,0302 clinical medicine ,Rare Diseases ,Asian People ,Rare Disease ,Medicine ,Humans ,030212 general & internal medicine ,Smooth Muscle Tumor ,Ultrasonography ,Rupture, Spontaneous ,business.industry ,Uterus ,General Medicine ,medicine.disease ,Smooth muscle tumour ,Magnetic Resonance Imaging ,Surgery ,Abdominal Pain ,body regions ,Leiomyoma ,Treatment Outcome ,030220 oncology & carcinogenesis ,Hemoperitoneum ,Uterine Neoplasms ,Female ,medicine.symptom ,business ,Rare disease - Abstract
Uterine smooth muscle tumours are histologically categorised into benign leiomyoma, malignant leiomyosarcoma or smooth muscle tumours of uncertain malignant potentials (STUMPs).(1) Common symptoms of uterine tumours are hypermenorrhea, dysmenorrhea, lumbago or irregular genital bleeding. We experienced a case of uterine tumour with atypical clinical behaviour. A 40-year-old woman who had been diagnosed with leiomyoma presented with severe abdominal pain and intraperitoneal haemorrhage. By emergent surgery, we found that the uterine tumour had ruptured spontaneously. The pathological diagnosis was STUMPs. 14 months later, she underwent a second surgery for a tumour recurrence. Pathological diagnosis was leiomyosarcoma. 20 months later, she underwent a third surgery for a re-recurrent tumour. After the third surgery, massive fluid containing haemorrhage accumulated inside the tumour. Percutaneous drainage of intratumour fluid was successfully performed. Chemotherapy was also taken, but it ended without significant efficacy. 3 years after the first surgery, she died because of intestinal perforation and peritonitis.
- Published
- 2018