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• W2019012181 abstract "The case that we describe refers to the casual appearance of pelvic mass in the progress of ultrasound performed for macrohematuria on 36 year-old patient in anticoagulant therapy for recurring thrombophlebitis. The patient had heterozygous antithrombin III deficiency (type 1). The last value of INR was 2.5. Ultrasound pointed out a bladder wall lesion responsible for blooding (Fig. 1) and a heterogeneous mass, with clean borders, in touch with the bladder (Fig. 2), with arterial and venous vessels (Fig. 3). The main hypothesis was that the patient was affected by a neoplasm, but it was not sure he did not have a hematoma. Contrast-enhanced CT confirmed the presence of a formation in the pelvis, median, of about 10 9 10 9 13 cm, homogeneously and slightly hyperdense already in the scannings of the base (40 H.U.) and with light densitometric increase in the different contrastographic phases (around 70 H.U. in the later phases), in relation to an arterial peripheral mesenteric branch. Therefore CT defined in a more precise way, the relationships of the mass that displaced and had close contact without an evident plane of cleavage in the back with the sigmoid and rectum, at the front with the bladder, the ureters, and some ileal loops, below with the seminal vesicles, nevertheless without coming to a diagnosis. A following contrast-enhanced MR brought the same conclusions, while a PET TC set the founded suspicion of neoplastic disease. The patient was operated on, and the following histological examination sets the diagnosis of ileal leiomyoma. The ileal leiomyoma, if there are not certain data on incidence and prevalence, is also a rare and benign tumor of the small bowel [1]. In one of the few statistic studies on Italian data, Giuliani et al. [2] refer that only about 10 % of small intestine tumors that went to the operating table are leiomyomas, while about 90 % are theriomas; these last tumors, according to the AIRTUM 2010 Report [3], in Italy have a prevalence of nine cases per 100,000 persons. According to some authors [4], usually, this tumor is asymptomatic; others [5] report intestinal blooding in 85 % of cases and mechanical ileus in 13 % of cases. The asymptomatology of the described case must, therefore, be considered exceptional in consideration of the big dimension of the tumor. In addition, unexpected results are usually feared because force physicians to perform further investigations Fig. 1 Pelvic ultrasound. Ultrasound investigation performed to clarify the causes of macrohematuria in the anticoagulated patient underlining a solid hyperechogenic lesion in the lumen (arrow)" @default.
• W2019012181 created "2016-06-24" @default.
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• W2019012181 date "2014-10-24" @default.
• W2019012181 modified "2023-09-25" @default.
• W2019012181 title "Accidental ultrasound finding of a big asymptomatic intestinal leiomyoma in an anticoagulated patient with macrohematuria" @default.
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• W2019012181 doi "https://doi.org/10.1007/s40477-014-0138-x" @default.
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