<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0300-9041</journal-id>
<journal-title><![CDATA[Ginecología y obstetricia de México]]></journal-title>
<abbrev-journal-title><![CDATA[Ginecol. obstet. Méx.]]></abbrev-journal-title>
<issn>0300-9041</issn>
<publisher>
<publisher-name><![CDATA[Federación Mexicana de Colegios de Obstetricia y Ginecología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0300-90412022000900786</article-id>
<article-id pub-id-type="doi">10.24245/gom.v90i9.7075</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Tratamiento laparoscópico de una paciente con un leiomioma uterino gigante cavitado, con cambio degenerativo mucomixoide]]></article-title>
<article-title xml:lang="en"><![CDATA[Laparoscopic treatment of a patient with a cavitated giant uterine leiomyoma with mucomyxoid degenerative change.]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Díaz-Juárez]]></surname>
<given-names><![CDATA[Rubén]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez-López]]></surname>
<given-names><![CDATA[José del Carmen]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castellanos-Lafont]]></surname>
<given-names><![CDATA[Jaime Rafael]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Aguilar-Clara]]></surname>
<given-names><![CDATA[Edith]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez-Hernández]]></surname>
<given-names><![CDATA[Clara Magdalena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Regional de Alta Especialidad de la Mujer  ]]></institution>
<addr-line><![CDATA[Villahermosa Tabasco]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Regional de Alta Especialidad de la Mujer  ]]></institution>
<addr-line><![CDATA[Villahermosa Tabasco]]></addr-line>
<country>México</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Hospital Regional de Alta Especialidad de la Mujer  ]]></institution>
<addr-line><![CDATA[Villahermosa Tabasco]]></addr-line>
<country>México</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital Regional de Alta Especialidad de la Mujer  ]]></institution>
<addr-line><![CDATA[Villahermosa Tabasco]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2022</year>
</pub-date>
<volume>90</volume>
<numero>9</numero>
<fpage>786</fpage>
<lpage>793</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0300-90412022000900786&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0300-90412022000900786&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0300-90412022000900786&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  INTRODUCCIÓN: Un leiomioma con cambios degenerativos poco frecuentes es un desafío diagnóstico difícil de diferenciar de sus homólogos malignos, si se pretende fundamentarlo solo en lo advertido en las imágenes.  CASO CLÍNICO: Paciente de 40 años de edad, enviada al servicio de Cirugía de mínima invasión en marzo del 2021 debido al aumento del perímetro abdominal, disminución del apetito y disnea de medianos esfuerzos. El ultrasonido abdomino-pélvico reportó que el útero estaba aumentado de tamaño, con miomas intramurales de medianos elementos. El endometrio heterogéneo. El ovario derecho tenía un quiste complejo, gigante, de 276 mm x 250 mm x 276 mm, con volumen de 10 000 cc. Además, esplenomegalia, hidronefrosis derecha y litiasis renal izquierda. Los marcadores tumorales se reportaron normales. En la cirugía por laparoscopia se observó un tumor que ocupaba toda la cavidad abdominal de 40 x 30 cm, adherido a la pared posterior del útero, con ambos ovarios sin alteraciones, sin líquido libre; se procedió a la histerectomía total.  CONCLUSIONES: Los cambios degenerativos en los leiomiomas uterinos pueden distorsionar la estructura habitual del tumor y reflejarla en imágenes típicas de una tumoración quística de ovario; en el estudio inicial esto representa un desafío para el cirujano y debe considerarse parte del diagnóstico diferencial de las masas anexiales. En la paciente del caso, con cirugía de mínima invasión, se consiguió la resección completa de la pieza, a pesar del tamaño aumentado, con menores riesgos de complicaciones en la herida y menos dolor posoperatorio; las incisiones son pequeñas y con desenlaces estéticos favorables y menos días de estancia intrahospitalaria.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  INTRODUCTION: A leiomyoma with rare degenerative changes is a diagnostic challenge difficult to differentiate from its malignant counterparts, if it is intended to be based only on imaging findings.  CLINICAL CASE: 40-year-old female patient referred to the Minimally Invasive Surgery service in March 2021 due to increased abdominal perimeter, decreased appetite and dyspnea on medium exertion. Abdomino-pelvic ultrasound reported that the uterus was enlarged, with medium-element intramural fibroids. The endometrium was heterogeneous. The right ovary had a complex, giant cyst, 276 mm x 250 mm x 276 mm, with a volume of 10,000 cc. In addition, splenomegaly, right hydronephrosis and left renal lithiasis. Tumor markers were reported normal. Laparoscopic surgery showed a tumor occupying the entire abdominal cavity measuring 40 x 30 cm and attached to the posterior wall of the uterus, with both ovaries unaltered, with no free fluid; total hysterectomy was performed.  CONCLUSIONS: Degenerative changes in uterine leiomyomas can distort the usual tumor structure and reflect it in images typical of an ovarian cystic tumor; in the initial study this represents a challenge for the surgeon and should be considered part of the differential diagnosis of adnexal masses. In the case patient, with minimally invasive surgery, complete resection of the specimen was achieved, despite the increased size, with less risk of wound complications and less postoperative pain; the incisions are small and with favorable esthetic outcomes and fewer days of in-hospital stay.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Leiomioma]]></kwd>
<kwd lng="es"><![CDATA[cirugía de mínima invasión]]></kwd>
<kwd lng="es"><![CDATA[apetito]]></kwd>
<kwd lng="es"><![CDATA[disnea]]></kwd>
<kwd lng="es"><![CDATA[útero]]></kwd>
<kwd lng="es"><![CDATA[endometrio]]></kwd>
<kwd lng="en"><![CDATA[Leiomyoma]]></kwd>
<kwd lng="en"><![CDATA[Minimally invasive surgery]]></kwd>
<kwd lng="en"><![CDATA[Appetite]]></kwd>
<kwd lng="en"><![CDATA[Dyspnea]]></kwd>
<kwd lng="en"><![CDATA[Uterus]]></kwd>
<kwd lng="en"><![CDATA[Endometrium]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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