Cutaneous malignant melanoma metastatic to a uterine leiomyoma: a case report.

BACKGROUND: Malignant melanoma is the sixth-most-common cancer in the United States and can spread throughout the body. This report represents the second case of a cutaneous melanoma involving a uterine leiomyoma. CASE: A 49-year-old woman presented with an inguinal mass; biopsy revealed an undifferentiated neoplasm. Further examination and computed tomography revealed an enlarged, fibroid uterus. The patient underwent a total abdominal hysterectomy, bilateral salpingo-oophorectomy and right inguinal lymphadenectomy. Histologic examination of the inguinal lymph node and the leiomyoma revealed metastatic melanoma. CONCLUSION: As the incidence of melanoma increases, metastasis to unusual locations, such as uterine fibroids, probably will be encountered more frequently.

Medical and surgical treatment of placenta percreta to optimize bladder preservation.

BACKGROUND: Placenta percreta is associated with significant morbidity and mortality. Interventions are dictated by hemodynamic stability, desire to retain future fertility, and efforts to reduce surgical morbidity at time of delivery. CASES: Two cases of antenatally diagnosed placenta percreta with bladder invasion are presented. Conservative management was used, including endovascular interventions, leaving the placenta in situ, methotrexate, and delayed hysterectomy. Postoperative outcomes were acceptable, with no significant hemorrhagic complications or need for extensive bladder reconstruction. CONCLUSION: Antenatal diagnosis of placenta percreta with bladder invasion is essential in the multidisciplinary management of this potentially catastrophic condition. A comprehensive approach including delayed hysterectomy after medical management resulted in an excellent clinical outcome.