Successful Magnetic Resonance Imaging-Guided Focused Ultrasound Surgery for Recurrent Uterine Fibroid Previously Treated with Uterine Artery Embolization

Sang-Wook Yoon,Jong Tae Lee,Kyoung Ah Kim,Sang Heum Kim

doi:10.1155/2010/351273

Abstract

A 45-year-old premenopausal woman was referred to our clinic due to recurring symptoms of uterine fibroids, nine years after a uterine artery embolization (UAE). At the time of screening, the patient presented with bilateral impairment and narrowing of the uterine arteries, which increased the risk of arterial perforation during repeated UAE procedures. The patient was subsequently referred for magnetic resonance imaging-guided focused ultrasound surgery (MRgFUS) treatment. Following the treatment, the patient experienced a significant improvement in symptoms (symptom severity score was reduced from 47 to 12 by 1 year post-treatment). MR images at 3 months showed a 49% decrease in fibroid volume. There were no adverse events during the treatment or the follow-up period. This case suggests that MRgFUS can be an effective treatment option for patients with recurrent fibroids following previous UAE treatment.

Highlights

Uterine leiomyoma is the most common reproductive tract tumor in women of reproductive age
We are currently noticing an increase in the number of uterine fibroid patients who seek minimally invasive or non-invasive treatment options
Patients should be made aware of all the treatment options available for uterine fibroids, including invasive, minimally invasive or noninvasive procedures

Summary

Introduction

Uterine leiomyoma (fibroid) is the most common reproductive tract tumor in women of reproductive age. Invasive or noninvasive treatments include uterine artery embolization (UAE), magnetic resonance imaging-guided focused ultrasound surgery (MRgFUS), and hormonal therapy [6,7,8,9]. Each of these treatment options, which require minimal or no hospitalization, enables women to preserve their uteri [10] and usually minimize complications, recovery time, and treatment costs [11, 12]. In cases where the ultrasound beam is interrupted by anatomical structures, such as bowels, bones, or nerves, MRgFUS treatment may be impossible without successful mitigation techniques [17]

Case Report

Findings

Discussion