Uterine leiomyoma in a 14 – year – old girl: Case report and literature review

Abstract

Background: Uterine leiomyomas are benign tumors arising from the smooth muscle cells of the uterus or extracellular matrix, that are very common among women of reproductive age between 30 and 50 years of age. However, their incidence is extremely rare in women under 15-year-old (<1%) with unknown etiology. Ultrasound and magnetic resonance imaging (MRI) comfirms the location, number, size of mass, which plays an important role in prognosis and treatment. Leiomyomas have been managed in a variety of methods and are considered to decide the most optimal way to preserve fertility in adolescents. Case: A 14 year of age female patient was admitted with increased abdominal volume and pelvic mass over 6 months. Physical examination revealed the mass from the pelvic, corresponding in size to a pregnant uterus of 18 weeks (fundal height is 14cm). Ultrasound and MRI showed a uterine leiomyoma type 2 -5 (FIGO) and a differential diagnosis of leiomyosarcoma. The patient was managed successfully with complete tumor resection through abdominal myomectomy to preserve fertility. Histological results confirmed the final diagnosis was “benign degeneration of uterine leiomyoma”. Summary and conclusion: Although the occurrence of uterine leiomyomas in adolescents is very rare, this diagnosis is considered since a pelvic mass in this age group is discovered. Through rare but the differential diagnosis of uterine leiomyoma in the young population is leiomyosarcoma. Myomectomy is a suitable management to preserve fertility.