Description
Clinical History
A 30-year old female presents with inability to conceive. She also reports a history of intermittent pelvic discomfort, menorrhagia and painful periods. On examination a pelvic mass was palpable. All of her blood tests were within normal ranges. A pelvic ultrasound showed a hypoechoic mass within the myometrium of her uterus. She went for hysteroscopic myomectomy but unfortunately complications meant her surgery was converted to an emergency hysterectomy. She made a full recovery post-op.
Pathology
The specimen includes the cervix, body and fundus of the uterus. The uterus, which is of normal size, has been cut in the sagittal plane. A large ovoid mass approximately 4cm x 2cm protrudes into the uterine cavity and extends as far inferiorly as the opening of the cervix. It originates from the posterior aspect of the uterus. The cervical canal is clearly visible.
Further Information
Uterine leiomyomas , also called fibroids, are the most common pelvic tumors in females. They are present in almost 25% of reproductive females. They are benign tumors arising from smooth muscle and fibroblasts of the myometrium. They usually involve the myometrium of the uterine body. Rarely they can affect the lower uterus or cervix. Leiomyomas can occur as single lesions or multiple and can grow very large. There are rare variants, which can extend and spread distally but are still considered benign: e.g. the benign metastasizing leiomyoma, which commonly spread to the lining; or disseminated peritoneal leiomyomatosis, which appears on the peritoneum covering the uterus
Risk factors for developing fibroid include being of reproductive age, being a black woman and early menarche. Higher parity has been found to be protective. Most leiomyomas have normal karyotypes but there are some which show mutation in the HMG genes. Transformation into malignant leiomyosarcoma is very rare.
Common symptoms of uterine fibroids include abnormal vaginal bleeding, pelvic pain, dyspareunia, dysmenorrhea and symptoms of pelvic structure compression such as urinary symptoms or venous compression symptoms. Leiomyomas can decrease fertility and in pregnant females increase the rate of early pregnancy loss, fetal malpresentation and postpartum hemorrhage. Pelvic ultrasound is usually used to diagnose leiomyomas. CT and MRI scans are rarely used to diagnose.
Leiomyomas can grow but can also regress. Treatment is reserved for persistently or severely symptomatic fibroids. Hormonal treatment may be used to regulate irregular menstrual bleeding symptoms. Surgical treatments include myomectomy (removal of fibroids from myomectomy), hysterectomy, myolysis (thermal ablation of leiomyoma) and uterine artery ablation/embolization.
Advantages
- Anatomically accurate and identical to real specimen
- No ethical issues - not real human body parts
- Reasonably priced
- Available within a short lead time
- Reproducible, several identical prints can be used as a classroom set
- Can be produced in different sizes to cater for the needs of the teacher
Human Cadavers
- Access to cadavers can be problematic. Many countries cannot access cadavers for cultural and religious reasons
- Cadavers cost a lot money
- High cost for establishing your own plastination suite
- Wet specimens cannot be used in uncertified labs
- Dissection of cadavers is a lot of staff time and that is a cost
- Storage of cadaver material needs special refrigeration etc. which has coast
- If you want another specimen you have to start all over again
Plastinates
- Costs
- Ethical issues
- Timeframe for plastination process
- Many countries do not allow their importation
- One of a kind
Superior 3D print results compared with conventional methods
- Vibrant color offering with 10 million colors
- UV-curable inkjet printing
- High quality 3D printing that can create products that are delicate, extremely precise and incredibly realistic
Clear Support Material
- To avoid breakage of fragile, thin, and delicate arteries, veins or vessels, a clear support material is printed on such spots. This makes the models robust and can be handled by students easily.
