Uterine Angioleiomyoma with Hypofibrinogenemia: A Rare Presentation

Abstract

Background: A uterine angioleiomyoma along with coexisting hypofibrinogenemia is a extremely rare clinical presentation. Case: A 37-year-old women presented with recent-onset menorrhagia and an abdominopelvic mass. She had a history of easy bruising and an increased tendency toward excessive bleeding, both of which started 6 months prior to presentation. Ultrasonography scanning revealed the presence of an 18 · 18 cm mass in the posterior wall; this mass was a degenerating leiomyoma. The patient's coagulation profile revealed coexisting hypofibrinogenemia. After adequate hematologic support, this patient underwent a myomectomy. During the surgery and postoperatively, she received additional cryoprecipitate support. Results: Her recovery was uneventful. Her coagulation abnormalities were resolved postoperatively. Conclusions: Similar cases of benign uterine tumors associated with hematologic abnormalities, resolving postoperatively after removal of such tumors have been reported. A recent onset of unusual bleeding tendencies and a coexisting benign uterine tumor should alert the clinician regarding a possible link between the two pathologies and the need for a multidisciplinary approach for managing such cases. ( J GYNECOL SURG 30:50)

Uterine angioleiomyoma – a rare variant of uterine leiomyoma: review of literature and case reports

“…Mucoid areas and hyalinised degeneration in uterine AL were reported by Kamath et al, Agorastos et al [28, 46], and Manimekhala et al [36]. …”

“…Literature reports present numerous complications posing a serious threat to the health and life of patients with uterine ALs, such as spontaneous rupture of the uterus with bleeding to the peritoneal cavity, and disordered blood clotting due to consumptive coagulopathy [5, 28]. …”

“…Culhaci et al suggested that massive bleeding might be due to hypertension [25]. Those symptoms might be more pronounced in AL cases compared to leiomyoma [2, 25, 28]. In the examined group as many as 77.8% patients presented with such complaints.…”

“…Kamath et al presented a case of hyperfibrinogenaemia in a patient with uterine AL [28]. Culhaci et al observed rupture of the uterine body due to angioleiomyoma [25].…”

“…In some cases degeneration in AL mimics ovarian pathology, which makes diagnosis more difficult, especially if the AL is located on the posterior wall of the uterus [28, 36, 41, 46]. …”