RESUMEN
AIM: To present a case of a woman diagnosed with intravenous leiomyomatosis of the uterus. TYPE OF STUDY: Case report. SETTING: Department of Obstetrics & Gynaecology, Stredomoravská nemocnicní a.s., Prerov Hospital. CASE REPORT: A 39-year old woman was referred to our unit with uterine fibroids, dysfunctional uterine bleeding and anaemia. Abdominal hysterectomy was performed. The histopathological analysis diagnosed the presence of intravenous leiomyomatosis. After a thorough literature review, we decided to perform an adnexectomy. It was not possible to perform this laparoscopically due to adhesions from previous operation. A conversion to open surgery was necessary. CONCLUSION: Intravenous leiomyomatosis is a rare clinical condition characterised by the ability of the leiomyoma to spread outside the uterus via the venous system. The diagnosis is difficult to obtain and can only be made after histopathological examination. There are no universal treatment guidelines in place at present.
Asunto(s)
Leiomiomatosis , Miometrio , Neoplasias Uterinas , Adulto , Femenino , Humanos , Leiomioma/diagnóstico , Leiomioma/cirugía , Leiomiomatosis/diagnóstico , Leiomiomatosis/cirugía , Embarazo , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/cirugía , Neoplasias VascularesRESUMEN
PURPOSE: Thermophysical properties of three tableting excipients; microcrystalline cellulose, lactose and dicalcium phosphate dihydrate were observed to evaluate their ability to resist temperature induced changes in tablet form. METHODS: Two thermophysical parameters, thermal diffusivity and specific heat, were measured by a pulse heating method. The materials were also evaluated by differential scanning calorimetry (DSC). RESULTS: Microcrystalline cellulose in tablet form was found to be rather insensitive to heating and cooling treatments, even though the tablets seemed to remain in a stressed state four weeks after tableting. This stress, indicated by low temperature anomalies, was observed by the pulse method, but not by DSC. When magnesium stearate was incorporated as a lubricant within the microcrystalline cellulose powder, the thermophysical parameters indicated that the internal structure of the tablets changed with heating and cooling. Magnesium stearate eliminated the low temperature anomalies as well. The heat treatment changed the thermophysical properties of tablets made of the crystalline excipients lactose and dicalcium phosphate dihydrate, permanently causing irreversible structural changes. CONCLUSIONS: The melting of the lubricant together with enhanced stress relaxation in the structure of microcrystalline cellulose most probably caused the improved thermal diffusivity. The observed thermophysical changes with the crystalline excipients were due to changes in tablet's structure and material. The combination of methods used was found to be an accurate and reliable way to obtain useful information on the structural changes and material relaxations of intact tablets during temperature treatment and age-related changes in material properties.