Fibromatous Uterus in a 16-Year-Old Girl: A Case Report

Abstract

Although uterine leiomyomas are the most common neoplasms of the female genital tract, this is not the case when referring to women under the age of 20. Only a few cases of uterus leiomyomas have been reported in this age. Preoperative imaging evaluation is mandatory in adolescent women for the accurate detection, localization, and characterization of uterus leiomyomas. We report a case of a 16-year-old girl admitted to our hospital for pain and abdominal distention. The patient underwent multidetector CT examination of the abdomen and MR examination of the pelvis. Both imaging modalities revealed uterine enlargement and the presence of innumerable variably sized leiomyomas. Histopathologic examination following exploratory laparotomy confirmed the presence of uterus leiomyomas. The patient underwent laparoscopic myomectomy two years after the first operation, following MR examination of the pelvis.

Large Prolapsing Uterine Fibroid and Severe Anemia in a Teenager: A Case Report

“…The use of preoperative gonadotropin-releasing hormones has been used in the adolescent population in an attempt to decrease the size of the fibroid and minimize intraoperative complications. However, in one study, the administration of leuprolide acetate to a 14-year-old patient was followed by an inflammatory reaction and increased symptoms that necessitated an earlier surgery [3]. Both open and laparoscopic approaches to surgery have been described in the adolescent population and based on patient factors and uterus size [9].In our patient, surgical management was necessary given the severity and duration of symptoms.…”

“…Few cases of uterine fibroids have been reported in patients under twenty years of age [10,13]. Most of these studies have dealt with patients that have had solitary symptomatic fibroids [1,2,8,9,10,11,12,14], but others have involved multiple fibroids including one case with up to 19 separate fibroids [3].To our knowledge, this is the 16th reported case of uterine fibroids in a female less than 18 years of age, and the first reported case of an upper cervical fibroid that prolapsed to fill the vagina.…”

“…While imaging can be a good initial diagnostic tool, true diagnosis cannot be made without pathologic evaluation. It can be particularly difficult to differentiate benign from malignant histology in adolescent patients as over 50% of recorded cases have shown malignant characteristics, but have final pathology consistent with benign myomas [3]. Unlike in adults, fibroids in adolescents can show increased cellularity, nuclear atypia, and increased mitotic figures [13,14].…”

An Adolescent with innumerable myomas

“…These myomas were usually solitary leiomyoma picked up in the age 14-18, making the resection easier indispensable even for robotic surgery.4 Multiple myoma is solely reported in one case. 3 I t appears that careful evaluation is necessary to distinguish the tumor from an adnexal lesion, when myoma is suspected in young girl presenting with anaemia, menorrhagia, progressive abdominal enlargement and dysmenorrheal. Despite of the last two ¿ ndings met in our case, consideration to the diagnosis ran out of our mind.…”

An Adolescent with innumerable myomas

“…This case is fewer among the few, because of having exceptionally large numbers of myomas in young adolescent besides being primarily confused with ovarian tumour, with successful myomectomy operation removing 40 myomas quickly through a tedious process without requiring blood transfusion. 3…”