Şebnem ALANYA TOSUN, Hamdullah SÖZEN, Tzevat TEFİK, Ahmet İYİBOZKURT, Yavuz SALİHOĞLU

UTERİN SERVİKAL LEİOMYOMU TAKLİT EDEN DEV EKSTRAVEZİKAL MESANE LEİOMYOMU: 8 YILLIK POSTOPERATİF TAKİBİ VE LİTERATÜRÜN GÖZDEN GEÇİRİLMESİ

Mesane leiomyomunun insidansı sadece %0,43 olarak tahmin edilmektedir; çünkü mesane tümörlerinin çoğu üroepitelyumdan kaynaklanmaktadır. Bunun yanı sıra, mesane leiomyomlarının sadece %30’u ekstra-vezikal tiptedir. Üriner sistem obstrüksiyonu, mesane irritasyonu, dizüri, disparoni veya hematüri gibi semptomlar kitlenin boyut ve yerine göre değişebilir. Yalnızca semptom ve görüntüleme tekniklerine dayanarak mesane leiomyomu tanısı konulamayabilmektedir. Preoperatif uterin servikal leiomyom ön tanısı düşünülen, 15,5x14,5x14 cm çapında tek taraflı üreteral distansiyona yol açan, nadir görülen bir ekstravezikal tip mesane leiomyomu olgusunu sunuyoruz. Sekiz yıllık postoperatif takip boyunca, hastanın iki sağlıklı term gebeliği mevcuttu ve nüks izlenmedi. Son beş yılın literatürü gözden geçirilerek 22 mesane leiomyomunun özellikleri sunuldu. Literatürden farklı olarak, mevcut olgu mesane leiomyomunun büyüklüğü, üreteral komplikasyonları ve uzun takip süresi ile benzersizdir. Mesane leiomyomları, pelvik kitlenin ayırıcı tanısında göz önünde tutulması gereken, nadir görülen mesane tümörleridir. Tanı ve tedavi için en faydalı prosedür cerrahi eksizyondur.

Anahtar Kelimeler:

Mesane leiomyomu, mesane tümörü, servikal leiomyom, servikal tümör, ayırıcı tanı

GIANT SIZED EXTRAVESICAL BLADDER LEIOMYOMA MIMICKING UTERINE CERVICAL LEIOMYOMA: A CASE REPORT WITH 8 YEARS’ POSTOPERATIVE FOLLOW-UP AND A REVIEW OF THE LITERATURE

The incidence of bladder leiomyoma is estimated at only 0.43% because most bladder tumors arise from the urothelium. Moreover, 30% of them are the extra-vesical type. The symptoms include urinary tract obstruction, bladder irritation, and dysuria, with the possibility of dyspareunia or hematuria depending on the size and location of the tumor. Bladder leiomyomas cannot be diagnosed solely by combining symptoms and imaging techniques. We present a rare case of giant sized extravesical-type bladder leiomyoma with a diameter of 15.5x14.5x14 cm, which was misdiagnosed as a uterine cervical leiomyoma. It caused unilateral ureteral distension without related symptoms. During the 8-year postoperative follow-up, the patient had two healthy full-term pregnancies and no recurrence was observed. We reviewed the literature of the most recent five years and discussed the characteristics of 22 bladder leiomyoma cases. Unlike the literature, the present case is unique due to the giant size of the bladder leiomyoma, its ureteral complications, and long follow-up period. Bladder leiomyomas are rare bladder tumors which should be borne in mind during the differential diagnosis of a pelvic mass. Surgical excision is the most useful procedure for diagnosis and treatment.

Keywords:

Bladder leiomyoma, bladder tumor, cervical leiomyoma, cervical tumor, differential diagnosis,

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