Pyomyoma mimicking tubo-ovarian abscess: Two case reports

Pyomyoma is an extremely rare complication, defined as an infection of a uterine leiomyoma. We describe two cases of pyomyoma that were initially considered to be tubo-ovarian abscesses but were later diagnosed as pyomyomas and managed with laparoscopic surgery. Case 1 was a 26-year-old nulliparous...

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Autores principales:	Kyoko Oshina, Rie Ozaki, Jun Kumakiri, Keisuke Murakami, Yu Kawasaki, Mari Kitade, Atsuo Itakura
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2022
Materias:	Case report Pyomyoma Laparoscopic surgery Surgery RD1-811 Gynecology and obstetrics RG1-991
Acceso en línea:	https://doaj.org/article/71690abb4fec479a9a02e85b0d1ec4a1
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spelling	oai:doaj.org-article:71690abb4fec479a9a02e85b0d1ec4a12021-11-26T04:30:01ZPyomyoma mimicking tubo-ovarian abscess: Two case reports2214-911210.1016/j.crwh.2021.e00372https://doaj.org/article/71690abb4fec479a9a02e85b0d1ec4a12022-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2214911221000904https://doaj.org/toc/2214-9112Pyomyoma is an extremely rare complication, defined as an infection of a uterine leiomyoma. We describe two cases of pyomyoma that were initially considered to be tubo-ovarian abscesses but were later diagnosed as pyomyomas and managed with laparoscopic surgery. Case 1 was a 26-year-old nulliparous woman who was previously diagnosed with bilateral endometriomas and presented to the hospital with lower abdominal pain. Magnetic resonance imaging revealed bilateral endometrial cysts and a 4-cm mass consistent with a tubo-ovarian abscess. The patient experienced continuous pain, and the cyst in the left adnexa enlarged; thus, laparoscopic surgery was performed. The cystic tumor in her uterus contained purulent fluid. Therefore, an abscess in the degenerative subserous myoma was diagnosed. Case 2 was a 47-year-old nulliparous woman who had undergone total mastectomy and postoperative radiotherapy for breast cancer. She was undergoing hormone therapy when she presented to the hospital with lower abdominal pain, fever, and increased inflammatory markers. Computed tomography revealed a 7-cm tumor with rim enhancement in her left adnexa; therefore, a tubo-ovarian abscess was suspected. After admission, drainage was performed under transvaginal ultrasound guidance, and antibiotics were administered. However, these treatments did not relieve her abdominal pain. Emergency laparoscopic surgery was performed, and intraoperative findings demonstrated an abscess in the degenerative subserous myoma of the uterus with normal adnexa. Laparoscopic hysterectomy and bilateral salpingectomy were performed. Laparoscopic surgery was effective for both patients. Delayed diagnosis of pyomyoma can result in serious complications. Timely surgery with concomitant antibiotic treatment may facilitate good outcomes.Kyoko OshinaRie OzakiJun KumakiriKeisuke MurakamiYu KawasakiMari KitadeAtsuo ItakuraElsevierarticleCase reportPyomyomaLaparoscopic surgerySurgeryRD1-811Gynecology and obstetricsRG1-991ENCase Reports in Women's Health, Vol 33, Iss , Pp e00372- (2022)
institution	DOAJ
collection	DOAJ
language	EN
topic	Case report Pyomyoma Laparoscopic surgery Surgery RD1-811 Gynecology and obstetrics RG1-991
spellingShingle	Case report Pyomyoma Laparoscopic surgery Surgery RD1-811 Gynecology and obstetrics RG1-991 Kyoko Oshina Rie Ozaki Jun Kumakiri Keisuke Murakami Yu Kawasaki Mari Kitade Atsuo Itakura Pyomyoma mimicking tubo-ovarian abscess: Two case reports
description	Pyomyoma is an extremely rare complication, defined as an infection of a uterine leiomyoma. We describe two cases of pyomyoma that were initially considered to be tubo-ovarian abscesses but were later diagnosed as pyomyomas and managed with laparoscopic surgery. Case 1 was a 26-year-old nulliparous woman who was previously diagnosed with bilateral endometriomas and presented to the hospital with lower abdominal pain. Magnetic resonance imaging revealed bilateral endometrial cysts and a 4-cm mass consistent with a tubo-ovarian abscess. The patient experienced continuous pain, and the cyst in the left adnexa enlarged; thus, laparoscopic surgery was performed. The cystic tumor in her uterus contained purulent fluid. Therefore, an abscess in the degenerative subserous myoma was diagnosed. Case 2 was a 47-year-old nulliparous woman who had undergone total mastectomy and postoperative radiotherapy for breast cancer. She was undergoing hormone therapy when she presented to the hospital with lower abdominal pain, fever, and increased inflammatory markers. Computed tomography revealed a 7-cm tumor with rim enhancement in her left adnexa; therefore, a tubo-ovarian abscess was suspected. After admission, drainage was performed under transvaginal ultrasound guidance, and antibiotics were administered. However, these treatments did not relieve her abdominal pain. Emergency laparoscopic surgery was performed, and intraoperative findings demonstrated an abscess in the degenerative subserous myoma of the uterus with normal adnexa. Laparoscopic hysterectomy and bilateral salpingectomy were performed. Laparoscopic surgery was effective for both patients. Delayed diagnosis of pyomyoma can result in serious complications. Timely surgery with concomitant antibiotic treatment may facilitate good outcomes.
format	article
author	Kyoko Oshina Rie Ozaki Jun Kumakiri Keisuke Murakami Yu Kawasaki Mari Kitade Atsuo Itakura
author_facet	Kyoko Oshina Rie Ozaki Jun Kumakiri Keisuke Murakami Yu Kawasaki Mari Kitade Atsuo Itakura
author_sort	Kyoko Oshina
title	Pyomyoma mimicking tubo-ovarian abscess: Two case reports
title_short	Pyomyoma mimicking tubo-ovarian abscess: Two case reports
title_full	Pyomyoma mimicking tubo-ovarian abscess: Two case reports
title_fullStr	Pyomyoma mimicking tubo-ovarian abscess: Two case reports
title_full_unstemmed	Pyomyoma mimicking tubo-ovarian abscess: Two case reports
title_sort	pyomyoma mimicking tubo-ovarian abscess: two case reports
publisher	Elsevier
publishDate	2022
url	https://doaj.org/article/71690abb4fec479a9a02e85b0d1ec4a1
work_keys_str_mv	AT kyokooshina pyomyomamimickingtuboovarianabscesstwocasereports AT rieozaki pyomyomamimickingtuboovarianabscesstwocasereports AT junkumakiri pyomyomamimickingtuboovarianabscesstwocasereports AT keisukemurakami pyomyomamimickingtuboovarianabscesstwocasereports AT yukawasaki pyomyomamimickingtuboovarianabscesstwocasereports AT marikitade pyomyomamimickingtuboovarianabscesstwocasereports AT atsuoitakura pyomyomamimickingtuboovarianabscesstwocasereports
_version_	1718409847793254400

Pyomyoma mimicking tubo-ovarian abscess: Two case reports

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