Grapsa D, Smymiotis V, Hasiakos D, Kontogianni-Katsarou K, Kondi-Pafiti A
Pathology Laboratory, University of Athens, Aretaieion Hospital, Athens , Greece.
Eur J Gynaecol Oncol. 2006;27(3):294-6.
Uterine leiomyomas are extremely rare neoplasms in the pediatric and adolescent population. We report a case of a giant uterine leiomyoma measuring 30 cm in the largest diameter in a 16-year-old girl. To our knowledge this is the largest leiomyoma reported thus far in women under the age of 20 years. The patient was admitted to our hospital for the investigation of menstrual disorders, vaginal bleeding and progressive abdominal enlargement. Preoperative diagnosis was ovarian malignancy. Myomectomy was performed. Histopathologic study of the tumor showed an otherwise typical leiomyoma, both grossly and microscopically, with extensive hydropic and myxomatous degeneration and areas of prominent vessels, suggesting an angiomatous neoplasm. Leiomyomas in teenagers often exhibit histological features favoring the diagnosis of malignancy, and should be evaluated with extreme caution. The management of leiomyomas in these young patients should be conservative for the preservation of fertility.
子宫平滑肌瘤在儿童和青少年人群中是极其罕见的肿瘤。我们报告一例16岁女孩，其患有直径达30厘米的巨大子宫平滑肌瘤。据我们所知，这是迄今为止报道的20岁以下女性中最大的平滑肌瘤。该患者因月经紊乱、阴道出血及进行性腹部增大入院检查。术前诊断为卵巢恶性肿瘤。遂行肌瘤切除术。肿瘤的组织病理学研究显示，大体和显微镜下均为典型的平滑肌瘤，但伴有广泛的水肿和黏液样变性以及明显的血管区域，提示为血管瘤样肿瘤。青少年平滑肌瘤常表现出有利于恶性诊断的组织学特征，应极其谨慎地进行评估。对于这些年轻患者的平滑肌瘤治疗应采取保守措施以保留生育能力。
