Uterine atypical leiomyoma: a rare feature of a common disease. Case reports and review of literature

D. Navolan, F. Olaru, M. Moldovan, L. Cseke, D. Grigoras

Abstract: We present two cases of uterine atypical leiomyoma (AL) and a review of the literature which refers to the question raised by the use of conservative and microinvasive techniques in the context of the recurrence and dissemination potential of these tumors. The AL cases were identified in two patients who underwent trachelectomy and subtotal hysterectomy. Interestingly, one AL developed on a residual cervix and showed a cystic aspect in ultrasound. This AL was associated with an intense necrosis which may have been caused by insufficient vascularisation in the cervix. For the second case, which was diagnosed with a huge tumor, a laparascopic subtotal hysterectomy with morcellation was planned. Because of technical problems the surgery was converted into laparotomy. In both cases the histology shows cells with pleomorphic nuclei, low mitotic activity and only for the first case the presence of intense aseptic necrosis. The reported cases showed no recurrence after a one-year follow-up. Because of the rare occurrence of these tumors it is very difficult to develop guidelines; that is why information can only be obtained from the few studies which exist in the medical databases. It is recommended that these rare cases should be reported in medical journals in order to cumulate the experience in the diagnosis and treatment of AL patients.
DOI:10.18643/gieu.2014.35

Keywords: uterine atypical leiomyoma, microinvasive surgery, recurrence risk