Abstract
A leiomyoma rarely causes disseminated intravascular coagulopathy (DIC). In the present report, we describe a case of DIC caused by leiomyoma. A 36-year-old nulliparous woman presented with hypermenorrhea and a lower abdominal mass. On magnetic resonance imaging, we detected a 14 cm uterine tumor, which was suspected to be a sarcoma. Blood tests at the preoperative examination indicated platelet count of 9.6 × 104/μL, fibrin degradation product level of 107.1 μg/mL (normal value, 0–5.0 μg/mL), and fibrinogen level of 54 mg/dL (normal value, 129–271 mg/dL). Based on these findings, we diagnosed the patient with DIC. The patient was treated with nafamostat mesilate and fresh frozen plasma, but the DIC did not show any improvement. Subsequently, a hysterectomy was performed, after which the DIC improved. Clinicopathological findings indicated the presence of a leiomyoma with multiple vessels containing thromboemboli, and suggested that the DIC was caused by the leiomyoma. Therefore, it is essential to consider that that a benign leiomyoma may be a cause of DIC.
Highlights
Leiomyoma occurs in 30–40% of women and is one of the most common benign gynecological diseases
The fibrin degradation product (FDP) level was elevated to 107.1 μg/mL, D-dimer level was elevated to 37.4 μg/mL, plasmin α2-plasmin inhibitor complex (PIC) level was increased to 6.4 μg/mL, and fibrinogen level was decreased to 54 mg/dL, indicating that the fibrinolysis system was activated
We describe the case of a patient with disseminated intravascular coagulopathy (DIC) caused by leiomyoma
Summary
Leiomyoma occurs in 30–40% of women and is one of the most common benign gynecological diseases. Leiomyoma may present with a variety of symptoms, such as hypermenorrhea and dysmenorrhea. An advanced malignant disease may reportedly coexist with disseminated intravascular coagulopathy (DIC). Cases wherein a leiomyoma has caused DIC are very rare. Magnetic resonance imaging (MRI) is useful for distinguishing between leiomyoma and sarcoma.
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