Fertility-sparing management of a suspicion of leiomyosarcoma: avoiding hysterectomy by performing transcervical myoma biopsy.
Fertil Steril
; 117(1): 230-231, 2022 01.
Article
en En
| MEDLINE
| ID: mdl-34753598
ABSTRACT
OBJECTIVE:
To describe the fertility-sparing management of an atypical uterine myoma.DESIGN:
Step-by-step video explanation of transcervical biopsy using transabdominal ultrasound guidance, highlighting tips and tricks. Patient consent was obtained before the publication of the case.SETTING:
University hospital. PATIENT(S) A 32-year-old nulliparous woman with a history of dysmenorrhea was found to have an atypical myoma FIGO 6, with suspicion of leiomyosarcoma on magnetic resonance imaging. INTERVENTION(S) A transcervical biopsy of an atypical myoma was done under transabdominal ultrasound guidance. A myomectomy by a minimally invasive approach was performed without morcellation. MAIN OUTCOME MEASURE(S) Feasibility of transcervical biopsy and correlation with definitive anatomopathological diagnosis. RESULT(S) The patient was under general anesthesia. A hysteroscopy confirmed the normal appearance of the uterine cavity with no direct access to the myoma. Four core biopsies were performed with a 16-gauge needle transcervically under ultrasound guidance. The preliminary diagnosis of cellular leiomyoma allowed a fertility-sparing surgery. Myomectomy and surgical treatment of endometriosis were performed secondarily. This patient had a successful recovery, and the diagnosis of benign cellular leiomyoma was confirmed on the surgical specimen. CONCLUSION(S) The current video highlights the safety and feasibility of transcervical ultrasound-guided core biopsy in patients with atypical uterine fibroids.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Histeroscopía
/
Preservación de la Fertilidad
/
Leiomioma
/
Leiomiosarcoma
Tipo de estudio:
Diagnostic_studies
/
Guideline
Límite:
Adult
/
Female
/
Humans
País/Región como asunto:
Europa
Idioma:
En
Revista:
Fertil Steril
Año:
2022
Tipo del documento:
Article
País de afiliación:
Francia