Author/Editor		Pišek, Aleš; Ismaili, Hatije
Title		Miom okrogle maternične vezi, ki ponareja klinično sliko dimeljske kile - klinični primer
Translated title		Myoma of the round ligament mimicking the clinical appearance of the inguinal hernia - a case report
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 73, št. 12
Publication year		2004
Volume		str. 911-4
Language		slo
Abstract		Background. Myomas are the most frequent gynecological tumors. They first occur during puberty; however, they are most frequent among aged between 35 and 50. In this age group their incidence is 15-20%. They are rare after menopause. The majority of myomas arise in the uterus, but they may arise from other extrauterine sites such as the fallopian tubes, ovaries, round ligament, ligamentum latum, sacrouterine ligament, vagina and even the urethra. Most authors agree that there are numerous causes for the occurrence of myomas; however, they have not yet been clearly proven. They however agree that the myomas appear most frequently in the reproductive age, when the ovarian hormone levels are high and they diminish after menopause. They equally agree that the risk factors for the clinically significant myomas are nulliparity, obesity, a positive family history of myomas and African racial origin. Patients and methods. A 43 year-old patient was referred to our institution for operative treatment by her personal gynaecologist who clinically and sonografically verified a solid tumor situated to the rightside of the uterus. The size of the tumor was that of a newborn's head. The patient, however, had been observing a reponible inguinal hernia the size of a female fist for a period of four years. A solid tumor (22X6X7 cm) arising from the right round ligament, was remowed during surgery. Half of its size was situated in the inguinal canal thus mimicking the clinical appearance of the inguinal hernia. After the tumor was removed the inner door of the inguinal canal closed by itself, no surgical repair was necessary. On histological examination the tumor was classified as a leiomyoma.
Summary		Izhodišča. Miomi so najpogostejši ginekološki tumorji. Pojavljati se začnejo v puberteti, najpogostelši pa so pri ženskah med 35. in 50. letom, ko jih najdemo v IS-20%. V menopavzi so redki. Največkrat jih najdemo v maternici, lahko pa se pojavijo tudi v jajcevodih, jajčnikih, okrogli maternični vezi, širokih materničnih vezeh, križničnih vezeh maternice, nožnici in celo sečnici. Večina avtorjev meni, da so vzroki za nastanek miomov številni in raznoliki, a ne popolnoma jasno dokazani. Strinjajo pa se, da se najpogosteje pojavijo v rodnem obdobju, ko je raven hormonov jajčnika visoka, in se zmanjšajo v pomenopavznem obdobju. Prav tako se strinjajo, da se miomi pogosteje pojavijo pri nerodkah, debelih ženskah, ženskah, katerih sorodnice imajo miome, in črnkah. Bolniki in metode. Opisujemo primer 43-letne bolnice, ki jo je izbrani ginekolog poslal na operativni poseg zaradi klinično in UZ ugotovljenega solidnega tumorja velikosti novorojenčkove glavice, ki je ležal desno ob uterusu. Bolnica je sicer že štiri leta opazovala desnostransko dimeljsko kilo, ki je bila reponibilna in velika za žensko pest. Bolnico smo operirali in od stranili 22X6X7 cm velik tumor, ki je pripadal desni okrogli maternični vezi in je s polovico velikosti segal v dimeljski kanal Ko smo tumor odstranili, se je notranja odprtina dimeljskega kanala spontano zaprla, zato kirurška oskrba ni bila potrebna. Histološka preiskava tumorja je pokazala, da gre za leiomiom.
Descriptors		LEIOMYOMA UTERINE NEOPLASMS HERNIA, INGUINAL ADULT