BACKGROUND Tumors originating from the posterior bladder wall can be challenging to diagnose because they may mimic a mass from the uterine cervix.Atypical leiomyoma of the bladder trigone is extremely rare,with few r...BACKGROUND Tumors originating from the posterior bladder wall can be challenging to diagnose because they may mimic a mass from the uterine cervix.Atypical leiomyoma of the bladder trigone is extremely rare,with few reported cases,and requires caution during surgery to avoid damage to the adjacent ureter.Diagnostic surgery and confirmational pathology are essential to assess whether the tumor is malignant and relieve clinical symptoms.Herein,we describe a case of recurrent leiomyoma with focal atypia in the bladder trigone.CASE SUMMARY A 29-year-old woman with a uterine fibroid incidentally found at a regular checkup was referred to our hospital.Based on magnetic resonance imaging,either urinary bladder leiomyoma or protrusion of pedunculated uterine cervical fibroid into the bladder was suspected.This leiomyoma in the trigone of the bladder was completely excised by laparotomy,and the patient was discharged without complication.Follow-up outpatient ultrasonography identified tumor recurrence after four years.As focal atypia was identified previously,laparotomy was performed to confirm the pathology.A round solid mass was resected from the posterior bladder wall without injuring either ureteric orifice.This tumor was pathologically diagnosed as a leiomyoma without atypia.Three-year follow-up ultrasonography has revealed no recurrence.CONCLUSION Atypical leiomyoma in bladder trigone is rare and could be easily mistaken for fibroid in the uterine cervix.To confirm histopathology,surgical excision is mandatory and regular follow-up is necessary to detect recurrence.展开更多
BACKGROUND Resection of deep intracranial tumors requires significant brain retraction,which frequently causes brain damage.In particular,tumor in the trigone of the lateral ventricular presents a surgical challenge d...BACKGROUND Resection of deep intracranial tumors requires significant brain retraction,which frequently causes brain damage.In particular,tumor in the trigone of the lateral ventricular presents a surgical challenge due to its inaccessible location and intricate adjacent relationships with essential structures such as the optic radiation(OR)fibers.New brain retraction systems have been developed to minimize retraction-associated injury.To date,there is little evidence supporting the superiority of any retraction system in preserving the white matter tract integrity.This report illustrates the initial surgical excision in two patients using a new retraction system termed the cerebral corridor creator(CCC)and demonstrates its advantage in protecting OR fibers.CASE SUMMARY We report two patients with nonspecific symptoms,who had trigone ventricular lesions that involved the neighboring OR identified on preoperative diffusion tensor imaging(DTI).Both patients underwent successful surgical excision using the CCC.Total tumor removal was achieved without additional neurological deficit.DTI showed that the OR fibers were preserved along the surgical field.Preoperative symptoms were alleviated immediately after surgery.Clinical outcomes were improved according to the Glasgow-Outcome-Scale and Activity-of-Daily-Living Scale assessments.CONCLUSION In the two cases,the CCC was a safe and useful tool for creating access to the deep trigonal area while preserving the white matter tract integrity.The CCC is thus a promising alternative brain retractor.展开更多
目的研究两种不同侧脑室穿刺位置行脑室-腹腔分流术治疗脑积水的疗效,以及对术后并发症的影响。方法采用侧脑室副三角区穿刺脑室-腹腔分流术治疗52例脑积水患者(副三角区穿刺组),另取侧脑室三角区穿刺行脑室-腹腔分流术47例患者为对照...目的研究两种不同侧脑室穿刺位置行脑室-腹腔分流术治疗脑积水的疗效,以及对术后并发症的影响。方法采用侧脑室副三角区穿刺脑室-腹腔分流术治疗52例脑积水患者(副三角区穿刺组),另取侧脑室三角区穿刺行脑室-腹腔分流术47例患者为对照组。比较两组患者的术后并发症,以及术后1年与术前的美国国立卫生研究院卒中量表(National Institutes of Health stroke scale,NIHSS)评分。结果副三角区穿刺组脑室端堵管、总并发症的发生率均明显低于对照组,差异有统计学意义(均P <0. 05);两组感染、出血和硬膜下积液发生率的差异无统计学意义。两组术后1年时的NIHSS评分均明显低于术前(均P <0. 05)。结论与侧脑室三角区穿刺比较,副三角区穿刺行脑室-腹腔分流术可降低脑室端相关并发症的发生率,有效改善临床症状,具有良好的治疗效果。展开更多
文摘BACKGROUND Tumors originating from the posterior bladder wall can be challenging to diagnose because they may mimic a mass from the uterine cervix.Atypical leiomyoma of the bladder trigone is extremely rare,with few reported cases,and requires caution during surgery to avoid damage to the adjacent ureter.Diagnostic surgery and confirmational pathology are essential to assess whether the tumor is malignant and relieve clinical symptoms.Herein,we describe a case of recurrent leiomyoma with focal atypia in the bladder trigone.CASE SUMMARY A 29-year-old woman with a uterine fibroid incidentally found at a regular checkup was referred to our hospital.Based on magnetic resonance imaging,either urinary bladder leiomyoma or protrusion of pedunculated uterine cervical fibroid into the bladder was suspected.This leiomyoma in the trigone of the bladder was completely excised by laparotomy,and the patient was discharged without complication.Follow-up outpatient ultrasonography identified tumor recurrence after four years.As focal atypia was identified previously,laparotomy was performed to confirm the pathology.A round solid mass was resected from the posterior bladder wall without injuring either ureteric orifice.This tumor was pathologically diagnosed as a leiomyoma without atypia.Three-year follow-up ultrasonography has revealed no recurrence.CONCLUSION Atypical leiomyoma in bladder trigone is rare and could be easily mistaken for fibroid in the uterine cervix.To confirm histopathology,surgical excision is mandatory and regular follow-up is necessary to detect recurrence.
文摘BACKGROUND Resection of deep intracranial tumors requires significant brain retraction,which frequently causes brain damage.In particular,tumor in the trigone of the lateral ventricular presents a surgical challenge due to its inaccessible location and intricate adjacent relationships with essential structures such as the optic radiation(OR)fibers.New brain retraction systems have been developed to minimize retraction-associated injury.To date,there is little evidence supporting the superiority of any retraction system in preserving the white matter tract integrity.This report illustrates the initial surgical excision in two patients using a new retraction system termed the cerebral corridor creator(CCC)and demonstrates its advantage in protecting OR fibers.CASE SUMMARY We report two patients with nonspecific symptoms,who had trigone ventricular lesions that involved the neighboring OR identified on preoperative diffusion tensor imaging(DTI).Both patients underwent successful surgical excision using the CCC.Total tumor removal was achieved without additional neurological deficit.DTI showed that the OR fibers were preserved along the surgical field.Preoperative symptoms were alleviated immediately after surgery.Clinical outcomes were improved according to the Glasgow-Outcome-Scale and Activity-of-Daily-Living Scale assessments.CONCLUSION In the two cases,the CCC was a safe and useful tool for creating access to the deep trigonal area while preserving the white matter tract integrity.The CCC is thus a promising alternative brain retractor.
文摘目的研究两种不同侧脑室穿刺位置行脑室-腹腔分流术治疗脑积水的疗效,以及对术后并发症的影响。方法采用侧脑室副三角区穿刺脑室-腹腔分流术治疗52例脑积水患者(副三角区穿刺组),另取侧脑室三角区穿刺行脑室-腹腔分流术47例患者为对照组。比较两组患者的术后并发症,以及术后1年与术前的美国国立卫生研究院卒中量表(National Institutes of Health stroke scale,NIHSS)评分。结果副三角区穿刺组脑室端堵管、总并发症的发生率均明显低于对照组,差异有统计学意义(均P <0. 05);两组感染、出血和硬膜下积液发生率的差异无统计学意义。两组术后1年时的NIHSS评分均明显低于术前(均P <0. 05)。结论与侧脑室三角区穿刺比较,副三角区穿刺行脑室-腹腔分流术可降低脑室端相关并发症的发生率,有效改善临床症状,具有良好的治疗效果。
