Bladder leiomyoma
Introduction
Introduction to bladder leiomyoma Leiomyoma occurs in the uterus, gastrointestinal tract, skin and subcutaneous soft tissue. The leiomyomas that occur in the urinary tract are rare. In 1974, Farman summarized 7784 cases of leiomyomas, 95% of which occurred in the female reproductive system, and only 5 cases occurred in Bladder, renal pelvis, ureter, urethra leiomyoma have also been reported in clinical cases, of which bladder leiomyomas are the most reported, followed by the urethra, and only a few cases of renal pelvis or ureter are reported, smooth muscles in the urinary tract Tumors are more common in female patients. basic knowledge The proportion of illness: 0.001% Susceptible population: more common in female patients Mode of infection: non-infectious Complications: uterine fibroids
Cause
Cause of bladder leiomyomas
(1) Causes of the disease
The cause of bladder leiomyomas is still unclear. It is thought to be related to inflammatory stimuli or embryogenic factors. Bladder leiomyomas occur in women. The age of onset is similar to that of uterine fibroids, and bladder leiomyoma with uterine fibroids. The incidence rate of 10%, revealing the occurrence of bladder leiomyoma seems to be related to endocrine factors.
(two) pathogenesis
According to the relationship between tumor site and bladder wall, it is divided into bladder submucosa, bladder wall and bladder subserosal type 3, of which bladder submucosal type is the most common, accounting for 63%, followed by bladder subserosal type, accounting for about 30. %, the bladder wall type accounts for 7%, the tumor is expansive growth, the bladder submucosal leiomyomas sometimes form a bladder tumor like pedicle, the tumor is often in the posterior wall of the bladder, there is a complete capsule, the tumor size is counted Between millimeters and several centimeters, the average diameter is about 6cm; mostly single hair, domestic and foreign reports, the histological observation of tumors consists of well-differentiated smooth muscle cells, tumor cells are fusiform, cytoplasm rich The border is clear, there are longitudinal myofibrils, the dyeing is dark pink, the nucleus is rod-shaped, the ends are blunt, no change, no nuclear division, the tumor cells are gathered into bundles, arranged in a braided or swirling shape, sometimes between smooth muscle fibers. There are unequal amounts of fibrous tissue.
Prevention
Bladder leiomyoma prevention
There are generally no special precautions.
Complication
Bladder leiomyomas complications Complications uterine fibroids
The incidence of leiomyomas and uterine fibroids is 10%.
Symptom
Symptoms of leiomyosarcoma of the bladder common symptoms pelvic mass urinary frequency acute urinary retention hematuria
The clinical manifestations of leiomyosarcoma are related to the type and location of the tumor. Submucosal tumors are mainly characterized by hematuria. When the tumor is large or located near the mouth of the urethra, it may be urinary frequency, dysuria or even obstruction of the urethra due to tumor. Acute urinary retention occurs from the urethra, and the interstitial tumor is asymptomatic in the early stage. When the tumor is larger, it may cause hematuria when it protrudes into the bladder cavity. Frequent urination or dysuria is difficult. Subserosal tumors are mainly pelvic masses.
Examine
Examination of bladder leiomyoma
Urine routine examination: red blood cells may be present when accompanied by hematuria.
B-ultrasound can determine the size, location and extent of the tumor. It is the most economical and practical method for diagnosing bladder leiomyoma. It can be performed through the abdomen or rectum. It usually shows a hypoechoic mass, and the bladder mucosa on the surface of the tumor is a strong echo. Figure 1), CT is a solid tumor of the bladder wall, CT value is about 30 Hu, when the tumor is larger, there is a necrotic area in the center of the tumor, and MRI can determine the size of the tumor through cross-sectional, coronal and sagittal scans. The location and extent of the adjacent organs can also be seen (Figure 2). Cystoscopy found that the bladder wall of the normal bladder mucosa should be considered for bladder leiomyomas, but when the tumor surface mucosa forms ulcers or erosion, it is easy Misdiagnosed as a malignant tumor.
Diagnosis
Diagnosis and diagnosis of bladder leiomyoma
Diagnosis can be determined by B-ultrasound, IVU, CT, MRI, cystoscopy, combined with clinical signs.
When the surface of the bladder leiomyoma is necrotic or infected in the bladder, it needs to be differentiated from bladder cancer. It is difficult to diagnose by cystoscopy alone. When the diagnosis is difficult, biopsy or urine cytology may be used for identification.
