Atypical uterine leiomyoma: a rare variant of a common problem

Abstract

A myomectomy was performed in a 35-year-old woman, and microscopic examination of the resulting specimen revealed an atypical myoma. Due to the rarity of this diagnosis, it is difficult to give clinical guidance for these patients, especially when they are considering pregnancy in the future. We advised 6 monthly vaginal ultrasound and did not advise against pregnancy. At 18 months there are no signs of recurrence, although the patient is not yet pregnant.

Physiopathology and Management of Uterine Fibroids

“…Atypical leiomyoma is differentiated from leiomyosarcoma by a lack of necrotizing tumour cells and a mitotic count less than 7 per 10 HPFs. Nuclear atypia makes the difference with mitotically active leiomyoma [18]. Secondary changes may occur when the fibroids tend to outgrow their blood supply.…”

“…Different types of hysterectomies exist: laparoscopically-assisted vaginal hysterectomy, total vaginal hysterectomy, total abdominal hysterectomy and total laparoscopic hysterectomy. Total abdominal hysterectomy is considered to be beneficial in reducing fibroid-related symptoms, but total vaginal hysterectomy and total laparoscopic hysterectomy may have lower risks of complications, and shorter recovery times [18]. In 2010 Demir RH and Marchand GJ published a case report in which they resected a huge uterus weighing 3200 g via laparoscopic-assisted hysterectomy, laparotomy can be avoided in almost all instances of hysterectomy for benign disease for an experienced laparoscopic surgeon [27].…”