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Ginecología y obstetricia de México

Print version ISSN 0300-9041

Abstract

PICOS, Kenneth Fitch et al. Giant uterine leiomyoma in a 14-year-old Mexican adolescent, a rare case of abnormal uterine bleeding. Case Report. Ginecol. obstet. Méx. [online]. 2023, vol.91, n.7, pp.521-526.  Epub Oct 31, 2023. ISSN 0300-9041.  https://doi.org/10.24245/gom.v91i7.8236.

BACKGROUND:

Leiomyomas are common benign neoplasms during reproductive age. Its appearance in adolescents is exceptional and a diagnostic challenge in children under 18 years of age. The case reported here is one of the 26 cases reported in the bibliography and it is the largest tumor reported in the youngest patient to date.

CLINICAL CASE:

A 14-year-old patient with onset of abnormal uterine bleeding, increased abdominal circumference and three weeks with hypermenorrhea. Initial blood chemistry report: severe anemia and pelvic ultrasound: a large solid adnexal tumor. After improving the patient’s hemodynamic conditions through transfusions of erythrocyte concentrates, an exploratory laparotomy was performed and a giant leiomyoma, dependent on the uterus, was removed. The histopathological report was: leiomyoma of 16 cm in diameter, with red degeneration. The patient had no postoperative complications and to date she has not experienced recurrence or abnormal uterine bleeding.

CONCLUSION:

The pathophysiology of uterine fibroids remains poorly understood. Surgical treatment at an early age should take into account the desire for pregnancy and carry out a close follow-up to assess: fertility, recurrence, cellular atypia and menstrual disorders.

Keywords : Leiomyomas; Adolescents; Abnormal uterine bleeding; Severe anemia; Exploratory laparotomy; Uterus; Uterine diseases.

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