medigraphic.com
Federación Mexicana de Ginecología y Obstetricia, A.C.

2023, Number 07

<< Back Next >>

Ginecol Obstet Mex 2023; 91 (07)

Giant uterine leiomyoma in a 14-year-old Mexican adolescent, a rare case of abnormal uterine bleeding. Case Report

Fitch PK, Rojas SJ, Zamora PJ, Vázquez BA, Sepúlveda BJ

Language: Spanish
References: 28
Page: 521-526
PDF size: 244.72 Kb.


ABSTRACT

Background: Leiomyomas are common benign neoplasms during reproductive age. Its appearance in adolescents is exceptional and a diagnostic challenge in children under 18 years of age. The case reported here is one of the 26 cases reported in the bibliography and it is the largest tumor reported in the youngest patient to date.
Clinical case: A 14-year-old patient with onset of abnormal uterine bleeding, increased abdominal circumference and three weeks with hypermenorrhea. Initial blood chemistry report: severe anemia and pelvic ultrasound: a large solid adnexal tumor. After improving the patient's hemodynamic conditions through transfusions of erythrocyte concentrates, an exploratory laparotomy was performed and a giant leiomyoma, dependent on the uterus, was removed. The histopathological report was: leiomyoma of 16 cm in diameter, with red degeneration. The patient had no postoperative complications and to date she has not experienced recurrence or abnormal uterine bleeding.
Conclusion: The pathophysiology of uterine fibroids remains poorly understood. Surgical treatment at an early age should take into account the desire for pregnancy and carry out a close follow-up to assess: fertility, recurrence, cellular atypia and menstrual disorders.


REFERENCES

  1. Murphy CA, Zarudskaya O, Kakish C, Zoorob D, Seo-Patel S.Uterine Fibroid in a 16-Year-Old Adolescent Managed witha Fertility-Sparing Approach: A Case Report and Review ofthe Literature. J Pediatr Adolesc Gynecol 2021; 34 (3): 427-31. https://doi.org/10.1016/j.jpag.2020.12.016

  2. Moroni RM, Vieira CS, Ferriani RA, Reis RM, Nogueira AA, OliveiraBrito LG. Presentation and treatment of uterine leiomyomain adolescence: a systematic review. BMC Women’s Health2015; 15: 4. https://doi.org/10.1186/s12905-015-0162-9

  3. Ernest A, Mwakalebela A, Mpondo BC. Uterine leiomyomain a 19-year-old girl: Case report and literature review.J Med Assoc Malawi 2016; 28 (1): 31-33. https://doi.org/10.4314/mmj.v28i1.8

  4. Kumura NDS, Siarezi S. A case of a prolapsed fibroid in a12-year-old girl. J Pediatr Adolesc Gynecol 2020; 33 (1):96-97. https://doi.org/10.1016/j.jpag.2019.08.013

  5. Wright KN, Laufer MR. Leiomyomas in adolescents. FertilSteril 2011; 95 (7): 2434.e15-7. https://doi.org/10.1016/j.fertnstert.2011.02.025.2434

  6. Diesen DL, Price TM, Skinner MA. Uterine leiomyoma ina 14-year-old girl. Eur J Pediatr Surg 2008; 18 (1): 53-5.https://doi.org/10.1055/s-2007-989299

  7. Maggiore ULR, Simone F, Bogiolo S, Fulcheri E, MusizzanoY, Menada MV. A case of a large uterine myoma in a14-year-old girl. J Gynecol Surg 2013; 29: 83 https://doi.org/10.1089/gyn.2012.0097

  8. Parker WH. Etiology, symptomatology, and diagnosis ofuterine myomas. Fertil Steril 2007; 87 (4): 725-36. https://doi.org/10.1016/j.fertnstert.2007.01.093

  9. De Rooy CG, Wiegerinck MA. A 15-year-old girl with anexpansively growing tumour. Eur J Obstet Gynecol ReprodBiol 1986; 22 (5-6): 373-7. https://doi.org/10.1016/0028-2243(86)90128-0

  10. Naiditch JA, Milad MP, Rowell EE. Uterine leiomyomacausing menometrorrhagia with a concomitant matureteratoma in a 15-year-old child: a case report and review ofthe literature. J Pediatr Surg 2011; 46 (10): E33-6. https://doi.org/10.1016/j.jpedsurg.2011.06.031

  11. Zigman JS, Brotherton J, Truong C, Yazdany T. Surgical planningand counseling in adolescence: A case report of a 16-year-oldwith an aborting pelvic mass. Gynecol Minim Invasive Ther2018; 7: 175-7. https://doi.org/10.4103/GMIT.GMIT_19_18

  12. Horejsi J, Zuntova A, Urbanova H. Giant leiomyoma uteriin a 15-year-old girl. J Pediatr Adolesc Gynecol 1988; 1 (4):267-70. https://doi.org/10.1016/S0932-8610(88)80010-0

  13. Grapsa D, Smymiotis V, Hasiakos D, Kontogianni-KatsarouK, Kondi-Pafiti A. A giant uterine leiomyoma simulating anovarian mass in a 16-year-old girl: a case report and reviewof the literature. Eur J Gynaecol Oncol 2006; 27 (3): 294-96

  14. Wisot AL, Neimand KM, Rosenthal AH. Symptomaticmyoma in a 13-year-old girl. Am J Obstet Gynecol 1969;105 (4): 639-41.

  15. Heimer G, Axelsson O, Johnson P. Uterine myoma causinguremia in a 15-year-old girl. Gynecol Obstet Invest 1991; 32(4): 247-48. https://doi.org/10.1159/000293043

  16. Morad NA, el-Said MM. Cellular uterine myoma causingvaginal bleeding in a 15-year-old girl. Aust N Z J ObstetGynaecol 1993; 33 (2): 211-13. https://doi.org/10.1111/j.1479-828x.1993.tb02398.x

  17. Fields KR, Neinstein LS. Uterine myomas in adolescents:case reports and a review of the literature. J Pediatr AdolescGynecol 1996; 9 (4): 195-98. https://doi.org/10.1016/s1083-3188(96)70030-x

  18. Nguyen-Duc H. Large uterine fibroma in a 15 year old adolescent.Giant leiomyoma in adolescence. J Gynecol ObstetBiol Reprod (Paris) 2003; 32 (8 Pt 1): 748-50.

  19. Bekker G, Gavrilescu T, Rickets-Holcomb L, Puka-KhandamP, Akhtar A, Ansari A. Symptomatic fibroid uterus in a15-year-old girl. Int Surg 2004; 89 (2): 80-2.

  20. Perkins JD, Hines RS, Prior DS. Uterine leiomyoma in anadolescent female. J Natl Med Assoc. 2009;101(6):611-3.https://doi.org/10.1016/s0027-9684(15)30954-8

  21. Karim T, Patil, Panchal, Basu C. Presentation andmanagement of giant fibroid uterus in an adolescentgirl. Open Access Surgery 2010; 3: 13-15.https://doi.org/10.2147/OAS.S9371

  22. Tsili AC, Lentoudi ED, Argyropoulou MI, Dalkalitsis N, BatistatouA, Paraskevaidis E, et al: Fibromatous uterus in a16-year-old girl: A case report. Case Rep Med 2010; 2010:5. https://doi.org/10.1155/2010/932762

  23. Khorrami H, Rackow BW. Hysteroscopic resection of asymptomatic uterine leiomyoma in an adolescent. J PediatrAdolesc Gynecol 2011; 24 (5): e111-4. https://doi.org/10.1016/j.jpag.2011.04.006

  24. Taşkın S, Sönmezer M, Kahraman K, Atabekoğlu C. Hysteroscopicresection of uterine submucous leiomyomaprotruding through hymen in a 16-year-old adolescent. JPediatr Adolesc Gynecol 2011; 24 (3): e77-8. https://doi.org/10.1016/j.jpag.2010.08.001

  25. Pérez Colon L, Colon V, Laboy Torres J, Arias W. Profusevaginal bleeding in an adolescent with a cervical myoma:a case report. Bol Asoc Med PR 2011; 103 (2): 65-6.

  26. Kayadibi Y, Ozmen E, Emir H, Emre S, Dervisoglu S, AdaletliI. Subserosal leiomyoma of uterus mimicking an ovariantumor in adolescent patient. Jpn J Radiol 2014; 32 (1): 48-52. https://doi.org/10.1007/s11604-013-0263-z

  27. Salehi PP, Tyson N. Laparoscopic myomectomy of a symptomaticuterine leiomyoma in a 15-year-old adolescent. JPediatr Adolesc Gynecol 2016; 29 (6): e87-e90. https://doi.org/10.1016/j.jpag.2016.05.007

  28. Morita N, Tanaka T, Hashida S, Tsunetoh S, Taniguchi K,Komura K, et al. Uterine leiomyoma in a 13-year-old adolescentsuccessfully treated with laparoscopic myomectomy.Medicine 2019; 98: e18301 http://doi.org/10.1097/MD.0000000000018301




2020     |     www.medigraphic.com