Evaluation of different treatment modalities for diffuse uterine leiomyomatosis: A case series report and review of the literature

Author:

Jin Xia12,Cao Yang1,Mi Kaihua3,Jiang Ying4,Fan Qingbo1,Shi Honghui1ORCID

Affiliation:

1. Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Disease Peking Union Medical College (PUMC) Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College Beijing China

2. Department of Obstetrics and Gynecology Anhui Province Maternity & Child Health Hospital Hefei Anhui China

3. Department of Obstetrics and Gynecology Beijing Daxing Maternity & Child Health Care Hospital Beijing China

4. Department of Pathology Peking Union Medical College Hospital, Chinese Academy of Medical Sciences Beijing China

Abstract

AbstractObjectiveTo provide perspectives on preoperative diagnosis and conservative treatment for diffuse uterine leiomyomatosis (DUL).MethodsThe clinical characteristics, management, and outcome of the five cases diagnosed with DUL receiving surgical treatment at Peking Union Medical College Hospital between January 2010 and December 2021 were retrospectively analyzed.ResultsDUL is a diagnosis based on histopathology. It is a subtype of uterine leiomyoma, characterized by innumerable, poorly circumscribed hypercellular nodules of bland smooth muscle cells with no cytologic atypia diffusely involving the myometrium. Clinical manifestations, including menorrhagia, anemia, and infertility, are similar to those of typical uterine leiomyomas, making a definitive preoperative diagnosis difficult. Magnetic resonance imaging plays an important role in the pre‐treatment mapping. Conservative surgery can reduce the uterine volume and improve the contour of the uterine cavity, thereby relieving symptoms of menorrhagia and improving the chance of conception. Gonadotropin‐releasing hormone (GnRH) agonist therapy is of great significance for controlling vaginal bleeding, reducing uterine volume, and delaying postoperative recurrence, and can be used alone or as postoperative adjuvant therapy for conservative surgery.ConclusionThe treatment goal for DUL patients with fertility‐sparing request should not aim at complete fibroid removal. A successful pregnancy can be achieved following conservative surgery and/or GnRH agonist therapy.

Publisher

Wiley

Subject

Obstetrics and Gynecology,General Medicine

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Diffuse uterine leiomyomatosis: a rare discovery;Archives of Gynecology and Obstetrics;2023-08-14

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