Fertility-sparing approach in a teenager with uterine tumor diagnosed as a sarcoma on imaging.

BACKGROUND: Uterine tumors are extremely rare in teenage patients. Although magnetic resonance imaging (MRI) can help distinguish between leiomyoma and sarcoma, it may also seriously mislead the diagnosis. CASE REPORT: An 18-year-old female patient presented with marked anemia, and a rapidly growing uterine tumor that strongly suggested uterine sarcoma on MRI. In order to avoid dispensable radical surgery, explorative laparotomy with tumor biopsy was performed after balancing risk/benefit ratio. Extemporaneous pathologic examination revealed a benign leiomyoma, and the patient subsequently underwent complete conservative myomectomy. CONCLUSION: Preserving fertility is an important issue in young patients with uterine tumors, and tumor biopsy may overcome MRI false positive results, as illustrated in this case. Conservative approach deserves further evaluation in this specific setting.