Diffuse uterine leiomyomatosis: A case report and review of literature  

作　　者：Hui-Min Ren Qing-Zhu Wang Jia-Nan Wang Gang-Jie Hong Shuang Zhou Jun-Yan Zhu Shan-Ji Li 

机构地区：[1]Department of Gynecology,Zhoushan Branch Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Zhoushan 316000,Zhejiang Province,China [2]Department of Obstetrics and Gynecology,Ningbo Hangzhou Bay Hospital,Ningbo 315336,Zhejiang Province,China [3]Department of Pathology,Zhoushan Branch Ruijin Hospital,Shanghai Jiaotong University School of Medicine,Zhoushan 316000,Zhejiang Province,China [4]Department of Obstetrics and Gynecology,Obstetrics and Gynecology Hospital,Fudan University,Shanghai 200090,China [5]Department of Obstetrics and Gynecology,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China

出　　处：《World Journal of Clinical Cases》2022年第24期8797-8804,共8页世界临床病例杂志

摘　　要：BACKGROUND Diffuse uterine leiomyomatosis(DUL)is a benign uterine smooth muscle neoplasm with unknown etiology.Since DUL is rarely reported,knowledge regarding it is limited.The rate of early diagnosis is low,and DUL is often misdiagnosed as common multiple uterine leiomyomas before surgery.CASE SUMMARY A 27-year-old patient with no sexual activity presented to the Emergency Department of our hospital complaining of heavy vaginal bleeding.She had a history of uterine fibroids and menorrhagia.Pelvic examination showed a regularly enlarged uterus,similar in size to that associated with a 4-mo pregnancy.Pelvic magnetic resonance imaging(MRI)revealed numerous multiple uterine fibroids,and a transabdominal myomectomy(TM)was performed.Intraoperative exploration revealed that the myometrium was full of myoma nodules of variable sizes.Over 50 leiomyomas were removed.The pathology report confirmed leiomyoma.The patient was discharged and received a gonadotropin-releasing hormone analog(3.75 mg)for 6 mo.Ten months after surgery,the patient presented to the hospital again for abnormal uterine bleeding.MRI showed an irregular mass with a diameter of 5.2 cm without sharp demarcation in the uterine cavity.Submucosal leiomyoma was considered first,and the patient underwent a hysteroscopic myomectomy plus hymen repair.Intraoperative exploration showed that there were several leiomyomatosis masses in the cavity.Postoperative pathological exam-ination confirmed submucosal leiomyoma and necrotic and generative tissue.Although the menstrual cycle was still irregular,the patient did not have symptoms of menorrhagia for a period of 28 mo after the second surgery.CONCLUSION Individuals with DUL are easily misdiagnosed due to the lack of specific manifestations of this disease.MRI is helpful for early identification and preoperative evaluation.There is currently no unified method of diagnosis.For women who want to preserve fertility,conservative surgery should be made an option.When TM is chosen,a modified new myomectomy should be consi

关 键 词：Diffuse uterine leiomyomatosis LEIOMYOMA MYOMECTOMY Uterine-sparing surgery Case report 

分 类 号：R737.33[医药卫生—肿瘤]