Massive Leiomyomatous Uterine Proliferation Following Kidney Transplantation: A Case Report and Literature Review
Uterine fibroids are the most common benign uterine tumors affecting > 50% of premenopausal women. The incidence, burden and symptoms from uterine fibroids are higher in women of African descent compared to Caucasians. Despite increasing number of African American females being evaluated for and...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2018-01-01
|
| Series: | Case Reports in Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2018/3874937 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832548486380257280 |
|---|---|
| author | Emmanuel J. Minja Miguel Tan Melissa J. Gibbs Marwan M. Kazimi Jonathan C. Hundley Harrison S. Pollinger |
| author_facet | Emmanuel J. Minja Miguel Tan Melissa J. Gibbs Marwan M. Kazimi Jonathan C. Hundley Harrison S. Pollinger |
| author_sort | Emmanuel J. Minja |
| collection | DOAJ |
| description | Uterine fibroids are the most common benign uterine tumors affecting > 50% of premenopausal women. The incidence, burden and symptoms from uterine fibroids are higher in women of African descent compared to Caucasians. Despite increasing number of African American females being evaluated for and undergoing kidney transplantation (KT), perioperative management guidelines for uterine fibroids currently do not exist. We present a case of a 40 y/o African American female with known symptomatic uterine fibroids preoperatively and medically managed, who underwent a successful KT and 4 years later progressively developed massive leiomyomatous uterine proliferation, causing a complete lateral displacement of the transplanted kidney with severe hydronephrosis, transplant ureteral obstruction and secondary urinary tract infections with bacteremia. This obstruction required a percutaneous nephrostomy tube placement followed by an interval transabdominal hysterectomy, which was complicated by transplant ureteral transection requiring ureteral reimplantation, resulting in prolonged hospitalization, follow-up and outpatient antibiotic regimen. There is a need for management guidelines for uterine fibroids incidentally encountered during the KT evaluation process to avoid similar preventable post-KT complications in patient populations most commonly affected. Literature review and perioperative management/surveillance strategies are provided. |
| format | Article |
| id | doaj-art-b2eec9fc570342ffa41dbd86658d7b15 |
| institution | Kabale University |
| issn | 2090-6943 2090-6951 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Transplantation |
| spelling | doaj-art-b2eec9fc570342ffa41dbd86658d7b152025-02-03T06:14:03ZengWileyCase Reports in Transplantation2090-69432090-69512018-01-01201810.1155/2018/38749373874937Massive Leiomyomatous Uterine Proliferation Following Kidney Transplantation: A Case Report and Literature ReviewEmmanuel J. Minja0Miguel Tan1Melissa J. Gibbs2Marwan M. Kazimi3Jonathan C. Hundley4Harrison S. Pollinger5Piedmont Hospital Atlanta, Piedmont Transplant Institute, 1968 Peachtree Street NW, 77 Building, 6th Floor, Atlanta, GA 30309, USAPiedmont Hospital Atlanta, Piedmont Transplant Institute, 1968 Peachtree Street NW, 77 Building, 6th Floor, Atlanta, GA 30309, USAPiedmont Hospital Atlanta, Piedmont Transplant Institute, 1968 Peachtree Street NW, 77 Building, 6th Floor, Atlanta, GA 30309, USAPiedmont Hospital Atlanta, Piedmont Transplant Institute, 1968 Peachtree Street NW, 77 Building, 6th Floor, Atlanta, GA 30309, USAPiedmont Hospital Atlanta, Piedmont Transplant Institute, 1968 Peachtree Street NW, 77 Building, 6th Floor, Atlanta, GA 30309, USAPiedmont Hospital Atlanta, Piedmont Transplant Institute, 1968 Peachtree Street NW, 77 Building, 6th Floor, Atlanta, GA 30309, USAUterine fibroids are the most common benign uterine tumors affecting > 50% of premenopausal women. The incidence, burden and symptoms from uterine fibroids are higher in women of African descent compared to Caucasians. Despite increasing number of African American females being evaluated for and undergoing kidney transplantation (KT), perioperative management guidelines for uterine fibroids currently do not exist. We present a case of a 40 y/o African American female with known symptomatic uterine fibroids preoperatively and medically managed, who underwent a successful KT and 4 years later progressively developed massive leiomyomatous uterine proliferation, causing a complete lateral displacement of the transplanted kidney with severe hydronephrosis, transplant ureteral obstruction and secondary urinary tract infections with bacteremia. This obstruction required a percutaneous nephrostomy tube placement followed by an interval transabdominal hysterectomy, which was complicated by transplant ureteral transection requiring ureteral reimplantation, resulting in prolonged hospitalization, follow-up and outpatient antibiotic regimen. There is a need for management guidelines for uterine fibroids incidentally encountered during the KT evaluation process to avoid similar preventable post-KT complications in patient populations most commonly affected. Literature review and perioperative management/surveillance strategies are provided.http://dx.doi.org/10.1155/2018/3874937 |
| spellingShingle | Emmanuel J. Minja Miguel Tan Melissa J. Gibbs Marwan M. Kazimi Jonathan C. Hundley Harrison S. Pollinger Massive Leiomyomatous Uterine Proliferation Following Kidney Transplantation: A Case Report and Literature Review Case Reports in Transplantation |
| title | Massive Leiomyomatous Uterine Proliferation Following Kidney Transplantation: A Case Report and Literature Review |
| title_full | Massive Leiomyomatous Uterine Proliferation Following Kidney Transplantation: A Case Report and Literature Review |
| title_fullStr | Massive Leiomyomatous Uterine Proliferation Following Kidney Transplantation: A Case Report and Literature Review |
| title_full_unstemmed | Massive Leiomyomatous Uterine Proliferation Following Kidney Transplantation: A Case Report and Literature Review |
| title_short | Massive Leiomyomatous Uterine Proliferation Following Kidney Transplantation: A Case Report and Literature Review |
| title_sort | massive leiomyomatous uterine proliferation following kidney transplantation a case report and literature review |
| url | http://dx.doi.org/10.1155/2018/3874937 |
| work_keys_str_mv | AT emmanueljminja massiveleiomyomatousuterineproliferationfollowingkidneytransplantationacasereportandliteraturereview AT migueltan massiveleiomyomatousuterineproliferationfollowingkidneytransplantationacasereportandliteraturereview AT melissajgibbs massiveleiomyomatousuterineproliferationfollowingkidneytransplantationacasereportandliteraturereview AT marwanmkazimi massiveleiomyomatousuterineproliferationfollowingkidneytransplantationacasereportandliteraturereview AT jonathanchundley massiveleiomyomatousuterineproliferationfollowingkidneytransplantationacasereportandliteraturereview AT harrisonspollinger massiveleiomyomatousuterineproliferationfollowingkidneytransplantationacasereportandliteraturereview |