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DOI: 10.1055/s-0040-1721351
Does Big Mean Evil? Giant, but Benign Uterine Leiomyoma: Case Report and Review of the Literature
Será que grande significa maligno? Leiomioma gigante, porém benigno: Relato de caso e revisão de literaturaAbstract
Uterine leiomyoma is the most prevalent benign type of gynecological tumor. It affects more than 80% of women worldwide and, within this group, more than 50% may be asymptomatic. However, large fibroid volumes may be associated with symptoms of extrinsic compression, and most of the cases do not present atypical cells. We present the case of a 49-year-old woman who underwent a total abdominal hysterectomy of a 13.5-kg uterine leiomyoma with no malignancies at histopathology and review the literature about giant uterine leiomyomas and their clinical repercussion. We concluded that large volumes do not always pose a threat regarding malignancy; however, future molecular studies are needed to investigate giant uterine fibroids.
Resumo
Leiomioma uterino é o tumor benigno ginecológico de maior prevalência. Ele afeta mais de 80% das mulheres no mundo e, deste grupo, mais de 50% podem ser assintomáticas. Contudo, miomas de grande volume podem ser associados com sintomas de compressão extrínseca, e a maioria dos casos não apresentam células atípicas. Nós apresentamos o caso de uma mulher de 49 anos que foi submetida a histerectomia total abdominal de um espécime de 13,5 quilos sem malignidades ao exame histopatológico. Também revisamos a literatura sobre leiomiomas uterinos de grande volume e sua repercussão clínica. Concluímos que grandes volumes nem sempre representam um risco relacionado à malignidade; contudo, estudos moleculares futuros são necessários para investigar leiomiomas uterinos gigantes.
Publikationsverlauf
Eingereicht: 25. Mai 2020
Angenommen: 22. September 2020
Artikel online veröffentlicht:
29. Januar 2021
© 2021. Federação Brasileira de Ginecologia e Obstetrícia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
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References
- 1 Moroni R, Vieira C, Ferriani R, Candido-Dos-Reis F, Brito L. Pharmacological treatment of uterine fibroids. Ann Med Health Sci Res 2014; 4 (Suppl. 03) S185-S192
- 2 Jonas HS, Masterson BJ. Giant uterine tumors: case report and review of the literature. Obstet Gynecol 1977; 50 (1, Suppl) 2s-4s
- 3 Hunt SH. Fibroid weighing one hundred and forty pounds. Am J Obstet Dis Women Child 1888; 21 (01) 62-63
- 4 Behrend M. Report of a case of fibromyoma of the uterus weighing 133 pounds removed at operation. Am J Obstet Gynecol 1930; 20 (05) 699-702
- 5 Singhabhandhu B, Akin Jr JT, Ridley JH, Gray SW, Skandalakis J. Giant leiomyoma of the uterus: report of a case and review of the literature. Am Surg 1973; 39 (07) 391-397
- 6 Evans III AT, Pratt JH. A giant fibroid uterus. Obstet Gynecol 1979; 54 (03) 385-386
- 7 Oelsner G, Elizur SE, Frenkel Y, Carp H. Giant uterine tumors: two cases with different clinical presentations. Obstet Gynecol 2003; 101 (5 Pt 2): 1088-1091
- 8 Reddy BV, Lee J, Cunningham PL. Giant uterine leiomyoma with air-fluid levels. J Am Coll Surg 2004; 198 (05) 844-845
- 9 Pérez M, Ramón JM. Large abdominal mass due to a giant uterine leiomyoma. Mayo Clin Proc 2006; 81 (11) 1415
- 10 Nappi L, Matteo M, Giardina S, Rosenberg P, Indraccolo U, Greco P. Management of uterine giant myoma. Arch Gynecol Obstet 2008; 278 (01) 61-63
- 11 Amber I, Kennedy G, Martinez H, Pearson JM, Jimenez E. A leiomyoma in a cachectic woman presenting as a giant abdominal mass. J Radiol Case Rep 2009; 3 (10) 23-29
- 12 Semczuk A, Skorupski P, Olcha P, Skomra D, Rechberger T, Gogacz M. Giant uterine leiomyomas causing bilateral hydronephrosis coexisting with endometrial cancer in polyp: a case study. Eur J Gynaecol Oncol 2009; 30 (03) 344-346
- 13 Săvulescu F, Iordache I, Albiţa O, Hristea R, Dumitru C, Iordache A. et al. Giant uterine leiomyoma. Chirurgia (Bucur) 2011; 106 (05) 665-668
- 14 Aydin C, Eriş S, Yalçin Y, Sen Selim H. A giant cystic leiomyoma mimicking an ovarian malignancy. Int J Surg Case Rep 2013; 4 (11) 1010-1012
- 15 Máté S, Szatmári E, Sipos N, Széll J, Szánthó A, Rigó Jr J. [Giant uterine leiomyoma causing acute symptoms]. Orv Hetil 2013; 154 (10) 387-390
- 16 Orazulike NC, Green KI, Uzoigwe SA. Giant uterine fibroids: consequences of delay in presentation. Eur J Obstet Gynecol Reprod Biol 2015; 194: 251-252
- 17 Ezugwu EC, Iyoke CA, Ezugwu FO, Ugwu G. Successful pregnancy following myomectomy for giant uterine fibroid in an infertile woman. J Reprod Infertil 2014; 15 (04) 233-236
- 18 Moris D, Vernadakis S. Giant uterine leiomyoma mimicking pregnancy. Mayo Clin Proc 2014; 89 (06) e53-e54
- 19 Sonoo T, Tokunaga K, Fukuda T, Nakamura K. Cardiac arrest induced by a giant uterine leiomyoma. BMJ Case Rep 2015; 2015: bcr2015213370
- 20 Lim PT, Tan CH, Chia HL, Phoon J. Management of a giant uterine leiomyoma. BMJ Case Rep 2018; 2018: bcr2017224052
- 21 Kogan EA, Zharkov NV, Askolskaya SI, . Popov, Krot MA, Demura TA. [Growth mechanisms and morphological structural features of large uterine leiomyoma]. Arkh Patol 2018; 80 (05) 16-22
- 22 Moroni RM, Vieira CS, Ferriani RA, Reis RM, Nogueira AA, Brito LG. Presentation and treatment of uterine leiomyoma in adolescence: a systematic review. BMC Womens Health 2015; 15: 4