Malignant leiomyomatosis peritonealis disseminata

Article Abstract:

Leiomyomatosis peritonealis disseminata is a rare condition characterized by the widespread formation of smooth muscle tumors within the abdominal cavity. Of 42 cases reported in the literature, only one case progressed to the development of malignant (cancerous) tumors. All patients were female, and the average age was 37 years. The cause of this disease is not known, but may be related to a hormonal factor, because in more than half the cases the women were either pregnant or using oral contraceptives. A case is described of a 25-year-old woman who developed pain in the right lower abdomen. Gynecologic examination and ultrasonography, the use of sound waves to visualize internal structures, revealed the presence of tumors in the uterus and other abdominal organs. The patient underwent laparoscopy, the examination of the abdomen using a tube-like optical device called a laparoscope. Several tumors consisting of smooth muscle cells were detected throughout the abdominal area, and two large nonmalignant tumors were removed. One year after the laparoscopy, a tumor was detected by physical examination in the right lower abdomen near the vagina and rectum. A second laparoscopy was performed and several tumors ranging in size from 0.5 to 10 centimeters were detected throughout the abdomen, including the uterus, ovaries, and liver. A diagnosis of leiomyosarcoma was made. The patient refused chemotherapy, or treatment with anticancer agents, and the tumors increased in size. The patient's condition deteriorated and she died 22 months after the initial diagnosis of leiomyomatosis peritonealis disseminata. This is only the second reported case of leiomyomatosis peritonealis disseminata progressing to malignancy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prognosis, Pelvic cancer, Leiomyosarcoma

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The effects of atrial natriuretic factor and angiotensin II on fetal-placental perfusion pressure in the ex vivo cotyledon model

Article Abstract:

Higher than normal levels of a fetal hormone that dilates blood vessels may inhibit constriction of blood vessels induced by the constricting hormone angiotensin II. Researchers used two lobes from the same placenta to compare the effects of the vasodilating hormone atrial natriuretic factor (ANF) and the vasoconstricting hormone angiotensin II on blood flow. Angiotensin II increased blood pressure after injection into the placenta. Low levels of ANF were then injected into the placenta, but did not effect a change in blood pressure. High levels of ANF did cause placental vessels to dilate, and blood pressure dropped. ANF receptors may be present in placental blood vessels, and ANF may be a useful treatment for pregnant women with preeclampsia or impaired fetal growth.

Physiological aspects, Physiological regulation, Angiotensin, Angiotensins, Natriuretic peptides, Regional blood flow

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Recurrent leiomyomatosis peritonealis disseminata exacerbated by in vitro fertilization

Article Abstract:

In vitro fertilization should not be attempted in women with leiomyomatosis peritonealis disseminata, a usually benign disease that causes multiple tumors inside the abdominal cavity. In one case, hormonal stimulation during the IVF procedure caused the tumors to grow much bigger, threatening the baby and the mother. The baby was aborted and the woman had a hysterectomy.

Complications and side effects, Fertilization in vitro, Human, Human fertilization in vitro

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