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

Abstract

<i>Background</i>: 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. <i>Case</i>: 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. <i>Result</i>: 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. <i>Conclusion</i>: A DUL patient underwent extensive myomectomy. This atudy further discussed uterine-sparing treatments, and reviewed existing research reports.