PMC7298323_01
(a) Transvaginal ultrasonography: 20 mm of endometrium thickness (broken line).. (b) Hysteroscopy: Tumor lesion with entire circumference of atypical vessel in corpus uteri.
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Hysteroscopy revealed a protruding lesion with atypical vessels in the entire uterine cavity (Fig. 1a, b).
(a) Pelvic MRI (sagittal section of dynamic MRI) disruption of subendometrial enhancement in from uterine anterior wall to the fundus (white arrow).. (b) Contrast-enhanced CT (horizontal section) tumor lesion in uteri (white broken line) and umbilical hernia (white triangle).
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An examination of the sub-endometrial enhancement with dynamic MRI aroused the suspicion of a myometrial invasion in the anterior wall of the uterus, less than 1/2 thickness (Fig. 2a). A computed tomography examination showed an umbilical hernia and no distant metastasis or lymph node involvement (Fig. 2b).
(a) Before diet: body weight: 132.2kg, BMI: 52.9 kg/m2.. (b) 8 months after surgery: body weight: 117.0kg, BMI: 46.8 kg/m2.
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Her weight at the time of surgery was 115.5 kg which had been reduced by 20 kg from the time she was first brought in, and the BMI decreased from 54.4 to 45.3 kg/m2 (Fig. 3a, b).
Procedure of panniculectomy.. (a) Incised line was designed such that cranial line was at the umbilicus and the caudal end was at the superior anterior iliac spine.. (b) Extra skin and fat on the fascia were excised.. (c) After excision of the extra skin, umbilication was done. Four JVAC drains were retained on the fascia at the time of closing.. (d) Removed skin and fat was 6,870 g in weight.
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The excess skin and fat like dog ear, which weighed 6.870 kg together, were removed above the abdominal fascia and navel-plasty was performed (Fig. 4).
(a) Surgical specimen (uteri and both of adnexa): tumor lesion in endometrial cavity (black triangle).. (b) Histopathologic examination: dense hyperplasia of atypical endometrial duct.
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The histopathological diagnosis was endometrial cancer stage IA, pT1aN0M0, grade 1 endometrioid carcinoma (Fig. 5a, b).