Diffuse uterine leiomyomatosis: a rare discovery

• Published in: Archives of gynecology and obstetrics Vol. 309; no. 4; pp. 1659 - 1661
• Main Author: Tam, Teresa
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.04.2024; Springer Nature B.V
• Subjects: Case reports; Endocrinology; Female; Gynecology; Human Genetics; Humans; Hysterectomy; Images in Obstetrics and Gynecology; Leiomyomatosis - diagnostic imaging; Leiomyomatosis - surgery; Medicine; Medicine & Public Health; Obstetrics/Perinatology/Midwifery; Uterine Diseases - surgery; Uterine Neoplasms - diagnostic imaging; Uterine Neoplasms - surgery; Uterus - pathology; Leiomyomatosis; Leiomyomas; Heavy menstrual bleeding; Abnormal uterine bleeding; Anemia
• ISSN: 1432-0711; 0932-0067; 1432-0711
• DOI: 10.1007/s00404-023-07181-8

Purpose This case report aims to present a rare and challenging clinical scenario involving diffuse uterine leiomyomatosis (DUL), an infrequently encountered benign uterine pathology. The primary objective is to describe this unique case’s clinical presentation, diagnostic challenges, and subsequent management. Methods A detailed analysis of the patient’s medical history, diagnostic evaluations, and treatment approach was conducted. A relevant literature review on DUL was also performed. This case report includes high-resolution images and figures, showcasing MRI scans, surgical procedures, and histopathology slides related to the case. Results The case report outlines the clinical journey of a patient with DUL, an exceptionally rare uterine condition characterized by the uncontrolled proliferation of smooth muscle cells forming nodules and fascicles. This case illustrates the diagnostic complexities associated with DUL, as it mimics other uterine pathologies such as leiomyomas or adenomyosis. The patient’s clinical presentation included abnormal uterine bleeding, heavy menstrual bleeding, fertility issues, and dysmenorrhea, leading to initial misdiagnoses. Surgical intervention eventually addressed the condition with corresponding images illustrating the procedures. Conclusion This case report highlights DUL’s rarity and diagnostic challenges. Clinicians must be vigilant when encountering similar clinical presentations, ensuring a comprehensive diagnostic workup to differentiate DUL from other uterine pathologies. Enhanced awareness among healthcare providers and further research into DUL's pathophysiology is essential for accurate diagnosis and timely management. The presented case underscores the need for tailored approaches to managing DUL and expanding the knowledge base surrounding this puzzling uterine disorder.