Atypical (symplastic) uterine leiomyoma masquerading as endometrial malignancy in a 78-year-old post-menopausal Nigerian woman
Abstract Background: The atypical (symplastic) uterine leiomyoma is uncommon and is often characterized by similar macroscopic features as typical uterine fibroid but differs microscopically by having intense cytological features such as enlargement of the nucleus, hyperchromasia, and prominent n...
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Babcock Medical Society
2024-12-01
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| Series: | Babcock University Medical Journal |
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| Online Access: | http://bumj.babcock.edu.ng/index.php/bumj/article/view/648 |
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| author | John Nwadiokwu Elizabeth Grillo Victor Okebalama Olutomiwa Omokore Obinna Onwe Aaron Uka Jennifer Ibhiedu Samuel Okore Nneoma Nwanna Chiomaefuelim Dibie |
| author_facet | John Nwadiokwu Elizabeth Grillo Victor Okebalama Olutomiwa Omokore Obinna Onwe Aaron Uka Jennifer Ibhiedu Samuel Okore Nneoma Nwanna Chiomaefuelim Dibie |
| author_sort | John Nwadiokwu |
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Abstract
Background: The atypical (symplastic) uterine leiomyoma is uncommon and is often characterized by similar macroscopic features as typical uterine fibroid but differs microscopically by having intense cytological features such as enlargement of the nucleus, hyperchromasia, and prominent nucleoli. It lacks histopathological features usually seen in leiomyosarcoma but harbours a low potential of transformation into leiomyosarcoma. Atypical leiomyoma very rarely occurs in post-menopausal women.
Case presentation: A 78-year-old postmenopausal woman presented to our gynaecology clinic with an 8-month history of post-menopausal bleeding and abdominal swelling. Physical examination revealed abdominal swelling but blood chemistry was normal. An initial diagnosis of endometrial carcinoma was made and she subsequently had a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Following histopathological evaluations, a confirmatory diagnosis of atypical uterine leiomyoma was made. She has been symptom-free for two years following surgical intervention.
Conclusion: Despite their rarity in postmenopausal women, atypical fibroids should be considered in the differential diagnosis for postmenopausal bleeding. Considering the malignant transformation potential, recurrence risk of this pathology, and the completion of family size in this case, hysterectomy is the most preferred treatment option even though myomectomy can be offered to patients with plans of conception in the future.
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| format | Article |
| id | doaj-art-527c45b4ea48489ca3ff23a64f95e534 |
| institution | Kabale University |
| issn | 2465-6666 2756-4657 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Babcock Medical Society |
| record_format | Article |
| series | Babcock University Medical Journal |
| spelling | doaj-art-527c45b4ea48489ca3ff23a64f95e5342025-01-05T18:31:33ZengBabcock Medical SocietyBabcock University Medical Journal2465-66662756-46572024-12-017210.38029/babcockuniv.med.j..v7i2.648Atypical (symplastic) uterine leiomyoma masquerading as endometrial malignancy in a 78-year-old post-menopausal Nigerian womanJohn Nwadiokwu 0Elizabeth Grillo1Victor Okebalama2Olutomiwa Omokore3Obinna Onwe4Aaron Uka5Jennifer Ibhiedu 6Samuel Okore7Nneoma Nwanna8Chiomaefuelim Dibie9Department of Anatomic Pathology and Forensic Medicine, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, NigeriaDepartment of Obstetrics and Gynaecology, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, NigeriaDepartment of Anatomic Pathology and Forensic Medicine, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, NigeriaBabcock University Teaching Hospital, Ilishan-Remo, Ogun State, NigeriaPrince Salman Bin Mohammed Hospital, Riyadh, Saudi ArabiaDivision of Neurology, Department of Internal Medicine, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, NigeriaDepartment of Internal Medicine, Babcock University Teaching Hospital, Ilishan-Remo, Ogun State, Nigeria.Alshatyea Hospital (MOH), Jizan, SaudChukwuemeka Odumegwu Ojukwu University Teaching Hospital Awka, NigeriaAccident and Emergency Department, Doncaster and Bassetlaw Teaching Hospital NHS Foundation Trust, United Kingdom Abstract Background: The atypical (symplastic) uterine leiomyoma is uncommon and is often characterized by similar macroscopic features as typical uterine fibroid but differs microscopically by having intense cytological features such as enlargement of the nucleus, hyperchromasia, and prominent nucleoli. It lacks histopathological features usually seen in leiomyosarcoma but harbours a low potential of transformation into leiomyosarcoma. Atypical leiomyoma very rarely occurs in post-menopausal women. Case presentation: A 78-year-old postmenopausal woman presented to our gynaecology clinic with an 8-month history of post-menopausal bleeding and abdominal swelling. Physical examination revealed abdominal swelling but blood chemistry was normal. An initial diagnosis of endometrial carcinoma was made and she subsequently had a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Following histopathological evaluations, a confirmatory diagnosis of atypical uterine leiomyoma was made. She has been symptom-free for two years following surgical intervention. Conclusion: Despite their rarity in postmenopausal women, atypical fibroids should be considered in the differential diagnosis for postmenopausal bleeding. Considering the malignant transformation potential, recurrence risk of this pathology, and the completion of family size in this case, hysterectomy is the most preferred treatment option even though myomectomy can be offered to patients with plans of conception in the future. http://bumj.babcock.edu.ng/index.php/bumj/article/view/648Atypical uterine fibroidsLeiomyomaPost-menopausal bleedingNigerian women |
| spellingShingle | John Nwadiokwu Elizabeth Grillo Victor Okebalama Olutomiwa Omokore Obinna Onwe Aaron Uka Jennifer Ibhiedu Samuel Okore Nneoma Nwanna Chiomaefuelim Dibie Atypical (symplastic) uterine leiomyoma masquerading as endometrial malignancy in a 78-year-old post-menopausal Nigerian woman Babcock University Medical Journal Atypical uterine fibroids Leiomyoma Post-menopausal bleeding Nigerian women |
| title | Atypical (symplastic) uterine leiomyoma masquerading as endometrial malignancy in a 78-year-old post-menopausal Nigerian woman |
| title_full | Atypical (symplastic) uterine leiomyoma masquerading as endometrial malignancy in a 78-year-old post-menopausal Nigerian woman |
| title_fullStr | Atypical (symplastic) uterine leiomyoma masquerading as endometrial malignancy in a 78-year-old post-menopausal Nigerian woman |
| title_full_unstemmed | Atypical (symplastic) uterine leiomyoma masquerading as endometrial malignancy in a 78-year-old post-menopausal Nigerian woman |
| title_short | Atypical (symplastic) uterine leiomyoma masquerading as endometrial malignancy in a 78-year-old post-menopausal Nigerian woman |
| title_sort | atypical symplastic uterine leiomyoma masquerading as endometrial malignancy in a 78 year old post menopausal nigerian woman |
| topic | Atypical uterine fibroids Leiomyoma Post-menopausal bleeding Nigerian women |
| url | http://bumj.babcock.edu.ng/index.php/bumj/article/view/648 |
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