Leuprolide acetate and intravascular leiomyomatosis
| Autor: | Datla G. Varma, Damrong Tresukosol, Andrzej P. Kudelka, Creighton L. Edwards, Anais Malpica, John J. Kavanagh |
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| Rok vydání: | 1995 |
| Předmět: |
Adult
medicine.medical_specialty medicine.diagnostic_test business.industry medicine.medical_treatment Uterus Obstetrics and Gynecology Debulking Preoperative care Surgery Leiomyomatosis medicine.anatomical_structure Laparotomy Preoperative Care Uterine Neoplasms medicine Humans Female Hormone therapy Leuprolide business Uterine Neoplasm Pelvic examination |
| Zdroj: | Obstetrics and gynecology. 86(4 Pt 2) |
| ISSN: | 0029-7844 |
| Popis: | Background Intravascular leiomyomatosis is an uncommon uterine tumor characterized by grossly visible intravascular proliferation of benign smooth muscle. Based on its role in reducing the size of leiomyomas, leuprolide acetate was given as induction therapy for extensive inoperable intravascular leiomyomatosis. Case A 44-year-old woman, gravida 1, para 1-0-0-1, presented in July 1992 with abnormal uterine bleeding. Pelvic examination and ultrasonography revealed the presence of a large irregular pelvic mass. At laparotomy, uterine and bilateral adnexal masses were noted extending up to the pelvic inlet and into the broad and infundibulopelvic ligaments. This tumor was not resectable. Based on histologic and immunoperoxidase studies, the lesion was interpreted as a plexiform epithelioid smooth-muscle tumor of uncertain malignant potential. Leuprolide acetate depot therapy (7.5 mg every 4 weeks) was begun in September 1992 and continued for a total of 20 months. Maximal tumor regression was achieved after 9 months. Subsequent reexploration at 20 months revealed a resectable tumor. Resection was accomplished successfully, leaving no apparent residual disease. Conclusion Leuprolide acetate induced tumor regression and rendered debulking surgery feasible in a patient with previously unresectable, widespread, retroperitoneal intravascular leiomyomatosis. Primary hormone therapy may provide alternative therapeutic options for certain cases of intravascular leiomyomatosis. |
| Databáze: | OpenAIRE |
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