| Peer-Reviewed

Diffuse Uterine Leiomyomatosis: A Case Report and Review of the Literature

Received: 29 March 2023    Accepted: 18 April 2023    Published: 27 April 2023
Views:       Downloads:
Abstract

Background: Diffuse uterine leiomyomatosis is a benign disease with a low incidence rate, mainly manifested as menorrhagia and infertility. Due to its clinical manifestations similar to multiple uterine myomas or adenomyosis, it is often misdiagnosed in clinical practice. Research has found that they can be distinguished through histopathological examination. According to existing reported cases, Diffuse uterine leiomyomatosis mainly occurs during the child-bearing period and has a significant impact on fertility. Hysterectomy is recognized as a radical cure, but uterine-sparing treatment methods need to be continuously explored. Case: A 41-year-old woman presented with recurrent menorrhagia 5 years after myomectomy. B-ultrasound examination indicated that the uterus was enlarged and the myometrium was full of hypoechoic, Considering the patient's desire to preserve the uterus, we performed laparotomy myomectomy again. Result: Hysteroscopic myomectomy has been shown to have a certain therapeutic effect on infertile patients in the early stage of DUL. Laparotomy myomectomy can remove a wider range of lesions and can be combined with gonadotropin releasing hormone agonists or antagonists for pretreatment. Uterine artery embolization is also a commonly administered therapy. High-intensity focused ultrasound ablation has been used with significant success in reducing uterine volume but requires further evaluation for its impact on fertility. Conclusion: A DUL patient underwent extensive myomectomy. This atudy further discussed uterine-sparing treatments, and reviewed existing research reports.

Published in Journal of Gynecology and Obstetrics (Volume 11, Issue 2)
DOI 10.11648/j.jgo.20231102.15
Page(s) 52-55
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Diffuse Uterine Leiomyomatosis, Laparotomy Myomectomy, Uterine-Sparing Treatments

References
[1] Clement, P., Young, R. J. I. j. o. g. p. o. j. o. t. I. S. o. G. P., Diffuse leiomyomatosis of the uterus: a report of four cases, (1987), 6, 322-330, https://doi.org/10.1097/00004347-198712000-00004.
[2] Murray, H., Glynn, E., A Case of Complete Fibromyomatosis of the Corpus Uteri, BJOG, (1924), 31: 398–401.
[3] Lapan, B., Solomon., Diffuse leiomyomatosis of the uterus precluding myomectomy, L. J. O., & gynecology, (1979), 53, 82S-84S.
[4] Prasad, I., Sinha, S., Sinha, U., et al., Diffuse Leiomyomatosis of the Uterus: A Diagnostic Enigma, Cureus, (2022), 14 (9), e29595. https://doi.org/10.7759/cureus.29595
[5] Grignon, D. J., Carey, M. R., Kirk, M. E., et al., Diffuse uterine leiomyomatosis: a case study with pregnancy complicated by intrapartum hemorrhage, Obstetrics and gynecology, (1987), 69 (3 Pt 2), 477–480.
[6] Suminaga, Y., Taki, M., Okamoto, H., et al., A Case of a Patient with Adhesive Small Bowel Obstruction in Pregnancy after Extensive Myomectomy for Diffuse Uterine Leiomyomatosis, Case Rep Obstet Gynecol, (2022), 2022, 3601945. https://doi.org/10.1155/2022/3601945
[7] Quade, B., McLachlin, C., Soto-Wright, V., et al., Disseminated peritoneal leiomyomatosis. Clonality analysis by X chromosome inactivation and cytogenetics of a clinically benign smooth muscle proliferation, (1997), 150, 2153-2166,
[8] Fedele, L., Bianchi, S., Zanconato, G., et al., Conservative treatment of diffuse uterine leiomyomatosis, Fertil Steril, (2004), 82, 450-453, https://doi.org/10.1016/j.fertnstert.2004.01.029.
[9] Shimizu, Y., Yomo, H., Kita, N., et al., Successful pregnancy after gonadotropin-releasing hormone analogue and hysteroscopic myomectomy in a woman with diffuse uterine leiomyomatosis, Arch Gynecol Obstet, (2009), 280, 145-147, https://doi.org/10.1007/s00404-008-0864-4.
[10] Zhao, H., Yang, B., Li, H., et al., Successful Pregnancies in Women with Diffuse Uterine Leiomyomatosis after Hysteroscopic Management Using the Hysteroscopy Endo Operative System, J Minim Invasive Gynecol, (2019), 26, 960-967, https://doi.org/10.1016/j.jmig.2018.10.003.
[11] Mazzon, I., Favilli, A., Grasso, M., et al., Is 'cold loop' hysteroscopic myomectomy a better option for reproduction in women with diffuse uterine leiomyomatosis? A case report of successful repeated pregnancies, J Obstet Gynaecol Res, (2015), 41, 474-477, https://doi.org/10.1111/jog.12548.
[12] Konishi, I., Diffuse Leiomyomatosis: Complete Myomectomy for Innumerable Small Nodules to Achieve Fertility Sparing and Childbearing, Surg J (N Y), (2020), 6, S50-S57, https://doi.org/10.1055/s-0039-1693709.
[13] Chen, L., Xiao, X., Wang, Q., et al., High-intensity focused ultrasound ablation for diffuse uterine leiomyomatosis: A case report, Ultrason Sonochem, (2015), 27, 717-721, https://doi.org/10.1016/j.ultsonch.2015.05.032.
[14] Zhang, X., Tian, T., Zhu, J., et al., High intensity focused ultrasound treatment for diffuse uterine leiomyomatosis: a feasibility study, Int J Hyperthermia, (2020), 37, 1060-1065, https://doi.org/10.1080/02656736.2020.1815871.
[15] Scheurig, C., Islam, T., Zimmermann, E., et al., Uterine artery embolization in patients with symptomatic diffuse leiomyomatosis of the uterus, J Vasc Interv Radiol, (2008), 19, 279-284, https://doi.org/10.1016/j.jvir.2007.10.017.
Cite This Article
  • APA Style

    Wenpeng Xue, Bin Tang, Yang Li, Hong Zheng, Ya He, et al. (2023). Diffuse Uterine Leiomyomatosis: A Case Report and Review of the Literature. Journal of Gynecology and Obstetrics, 11(2), 52-55. https://doi.org/10.11648/j.jgo.20231102.15

    Copy | Download

    ACS Style

    Wenpeng Xue; Bin Tang; Yang Li; Hong Zheng; Ya He, et al. Diffuse Uterine Leiomyomatosis: A Case Report and Review of the Literature. J. Gynecol. Obstet. 2023, 11(2), 52-55. doi: 10.11648/j.jgo.20231102.15

    Copy | Download

    AMA Style

    Wenpeng Xue, Bin Tang, Yang Li, Hong Zheng, Ya He, et al. Diffuse Uterine Leiomyomatosis: A Case Report and Review of the Literature. J Gynecol Obstet. 2023;11(2):52-55. doi: 10.11648/j.jgo.20231102.15

    Copy | Download

  • @article{10.11648/j.jgo.20231102.15,
      author = {Wenpeng Xue and Bin Tang and Yang Li and Hong Zheng and Ya He and Weiwei Wei and Ruxia Shi and Jiming Chen},
      title = {Diffuse Uterine Leiomyomatosis: A Case Report and Review of the Literature},
      journal = {Journal of Gynecology and Obstetrics},
      volume = {11},
      number = {2},
      pages = {52-55},
      doi = {10.11648/j.jgo.20231102.15},
      url = {https://doi.org/10.11648/j.jgo.20231102.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.jgo.20231102.15},
      abstract = {Background: Diffuse uterine leiomyomatosis is a benign disease with a low incidence rate, mainly manifested as menorrhagia and infertility. Due to its clinical manifestations similar to multiple uterine myomas or adenomyosis, it is often misdiagnosed in clinical practice. Research has found that they can be distinguished through histopathological examination. According to existing reported cases, Diffuse uterine leiomyomatosis mainly occurs during the child-bearing period and has a significant impact on fertility. Hysterectomy is recognized as a radical cure, but uterine-sparing treatment methods need to be continuously explored. Case: A 41-year-old woman presented with recurrent menorrhagia 5 years after myomectomy. B-ultrasound examination indicated that the uterus was enlarged and the myometrium was full of hypoechoic, Considering the patient's desire to preserve the uterus, we performed laparotomy myomectomy again. Result: Hysteroscopic myomectomy has been shown to have a certain therapeutic effect on infertile patients in the early stage of DUL. Laparotomy myomectomy can remove a wider range of lesions and can be combined with gonadotropin releasing hormone agonists or antagonists for pretreatment. Uterine artery embolization is also a commonly administered therapy. High-intensity focused ultrasound ablation has been used with significant success in reducing uterine volume but requires further evaluation for its impact on fertility. Conclusion: A DUL patient underwent extensive myomectomy. This atudy further discussed uterine-sparing treatments, and reviewed existing research reports.},
     year = {2023}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Diffuse Uterine Leiomyomatosis: A Case Report and Review of the Literature
    AU  - Wenpeng Xue
    AU  - Bin Tang
    AU  - Yang Li
    AU  - Hong Zheng
    AU  - Ya He
    AU  - Weiwei Wei
    AU  - Ruxia Shi
    AU  - Jiming Chen
    Y1  - 2023/04/27
    PY  - 2023
    N1  - https://doi.org/10.11648/j.jgo.20231102.15
    DO  - 10.11648/j.jgo.20231102.15
    T2  - Journal of Gynecology and Obstetrics
    JF  - Journal of Gynecology and Obstetrics
    JO  - Journal of Gynecology and Obstetrics
    SP  - 52
    EP  - 55
    PB  - Science Publishing Group
    SN  - 2376-7820
    UR  - https://doi.org/10.11648/j.jgo.20231102.15
    AB  - Background: Diffuse uterine leiomyomatosis is a benign disease with a low incidence rate, mainly manifested as menorrhagia and infertility. Due to its clinical manifestations similar to multiple uterine myomas or adenomyosis, it is often misdiagnosed in clinical practice. Research has found that they can be distinguished through histopathological examination. According to existing reported cases, Diffuse uterine leiomyomatosis mainly occurs during the child-bearing period and has a significant impact on fertility. Hysterectomy is recognized as a radical cure, but uterine-sparing treatment methods need to be continuously explored. Case: A 41-year-old woman presented with recurrent menorrhagia 5 years after myomectomy. B-ultrasound examination indicated that the uterus was enlarged and the myometrium was full of hypoechoic, Considering the patient's desire to preserve the uterus, we performed laparotomy myomectomy again. Result: Hysteroscopic myomectomy has been shown to have a certain therapeutic effect on infertile patients in the early stage of DUL. Laparotomy myomectomy can remove a wider range of lesions and can be combined with gonadotropin releasing hormone agonists or antagonists for pretreatment. Uterine artery embolization is also a commonly administered therapy. High-intensity focused ultrasound ablation has been used with significant success in reducing uterine volume but requires further evaluation for its impact on fertility. Conclusion: A DUL patient underwent extensive myomectomy. This atudy further discussed uterine-sparing treatments, and reviewed existing research reports.
    VL  - 11
    IS  - 2
    ER  - 

    Copy | Download

Author Information
  • Department of Gynecology, The Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou, China

  • Department of Gynecology, The Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou, China

  • Department of Gynecology, The Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou, China

  • Department of Gynecology, The Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou, China

  • Department of Gynecology, The Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou, China

  • Department of Gynecology, The Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou, China

  • Department of Gynecology, The Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou, China

  • Department of Gynecology, The Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou, China

  • Sections