Intraoperative Finding of a Patient with Uterine Fibroid

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Abstract

INTRODUCTION: Most neoplasms in the pelvic cavity of women arise from organs of the reproductive system. However, diseases of the gastrointestinal and urinary tracts and neoplasms of a neurogenic and primary extraperitoneal nature can be also encountered in the pelvis where they may be mistaken as gynecological pathology. Thus, in an intraoperative discovery of previously undiagnosed foci of tumor lesions the surgical approach has to be changed, which can negatively affect the results of surgical treatment. Gastrointestinal stromal tumors (GISTs) refer to the most common tumors of the gastrointestinal tract originating from the mesenchymal anlage. Up to 70% of GISTs are located in the stomach, 20%–40% in the duodenum and small intestine, 5%–15% in the colon, and 2%–5% in the esophagus, with single tumors occurring in the appendix.

CONCLUSION: The article presents a clinical case of a patient who underwent hysterectomy for multiple uterine fibroids and in whom a large GIST of the sigmoid colon was found intraoperatively that was previously mistaken as one of the subserous nodes of uterine fibroids.

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About the authors

Elena A. Baklygina

Ryazan State Medical University

Author for correspondence.
Email: gnessocha1@rambler.ru
ORCID iD: 0000-0003-1174-7719
SPIN-code: 6408-1279
ResearcherId: ABG-4310-2020

assistant of department of obstetrics and gynekology

Russian Federation, Ryazan

Vadim V. Pchelintsev

Ryazan State Medical University

Email: obstetr-gyn.ryazgmu@mail.ru
ORCID iD: 0000-0003-4718-628X
SPIN-code: 4923-0484

MD, Cand. Sci. (Med.), Associate Professor

Russian Federation, Ryazan

Eugeniya M. Pristupa

Ryazan State Medical University

Email: empristupa@mail.ru
ORCID iD: 0000-0002-1227-5939
SPIN-code: 4099-1639

MD, Cand. Sci. (Med.)

Russian Federation, Ryazan

Elena N. Verkina

Ryazan State Medical University

Email: l_resnichka@mail.ru
ORCID iD: 0000-0003-0064-0895
SPIN-code: 6965-2347
Russian Federation, Ryazan

References

  1. Kornilova AG, Kogoniya LM, Mazurin VS, et al. Gastrointestinal stromal tumors: contemporary classification, differential diagnosis and prognostic factors. Effective Pharmacotherapy. Oncology, hematology, radiology. 2014;(1):20–3. (In Russ).
  2. Zhang H, Liu Q. Prognostic Indicators for Gastrointestinal Stromal Tumors: A Review. Translational Oncology. 2020;13(10):100812. doi: 10.1016/j.tranon.2020.100812
  3. Kaprin AD, Rukhadze GO, Kostyuk IP, et al. A case of treatment for giant gastrointestinal stromal tumor of the stomach with metastases in the serous membrane of the small intestine. P.A. Herzen Journal of Oncology. 2017;6(2):45–50. (In Russ). doi: 10.17116/onkolog20176245-50
  4. Klinicheskiye rekomendatsii “Gastrointestinal’nyye stromal’nyye opukholi”. 2020. Available at: https://old.oncology-association.ru/files/clinical-guidelines-2020/giso.pdf. (In Russ).
  5. Arkhiri PP, Stilidi IS, Poddubnaya IV, et al. Efficacy of surgical treatment of patients with localized gastrointestinal stromal tumors. Russian Journal of Oncology. 2016;21(5):233–37. (In Russ). doi: 10.18821/1028-9984-2016-21-5-233-237
  6. Bogomolov NI, Pakholchuk PP, Tomskikh NN, et al. Gastrointestinal stromal tumors (GIST): diagnosis and treatment. Acta Biomedica Scientifica. 2017;2(6):52–8. (In Russ). doi: 10.12737/article_5a0a856cd0a467.14225823
  7. Kashchenko VA, Karachun AM, Orlova RV, et al. Pecularities of surgical approach in treatment of gastrointestinal stromal tumors. Grekov’s Bulletin of Surgery. 2017;176(2):22–7. (In Russ). doi: 10.24884/0042-4625-2017-176-2-22-27
  8. Charyshkin AL, Toneev EA, Martynov AA, et al. Surgical treatment of giant GIST of the cardiac stomach. Grekov's Bulletin of Surgery. 2019;178(4):61–3. (In Russ). doi: 10.24884/0042-4625-2019-178-4-61-63

Supplementary files

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2. Fig. 2. A gastrointestinal stromal tumor of the sigmoid colon (arrow 1) in the distal third of the sigmoid colon (arrow 2) arising from the muscle layer of the gut wall. The tumor has a dense consistency, smooth walls, and pronounced vascular pattern on the surface. The diameter of the tumor was 8 cm, and the base was 5 cm.

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3. Fig. 1. Echogram of the pelvic organs, subserous location of the fibroid node: the uterine body is enlarged to nine weeks of pregnancy (arrow 1), interstitial submucous tumor node of 22 mm in diameter (arrow 2) (a); transverse scanning: in the posterior fornix, a volumetric mass of medium echogenicity of heterogeneous structure with sharp regular contours measuring 52 × 55 mm (b).

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