Ovarian leiomyoma as a potential cause of compromised fertility

Objective To analyze cases of ovarian leiomyomas and to discuss the proper surgical management. Design A case series and discussion. Setting General university hospital and healthcare center. Patient(s) Nine patients who were diagnosed with ovarian leiomyomas after surgery between 1993 and 2009. Int...

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Published in:Fertility and sterility 2011-03, Vol.95 (3), p.1120.e11-1120.e14
Main Authors: Koo, Yu-Jin, M.D, Cho, Yeon-Jean, M.D., Ph.D, Kim, Ji-Young, M.D, Lee, Ji-Eun, M.D, Kim, Mi-La, M.D., M.S, Kim, Joo-Myung, M.D., Ph.D, Han, Ho-Won, M.D., Ph.D, Joo, Kwan-Young, M.D., Ph.D
Format: Article
Language:English
Subjects:
Adolescent
Adult
animal ovaries
Biopsy
Female
fibroma
Humans
hysterectomy
Infertility, Female - etiology
Infertility, Female - pathology
Infertility, Female - surgery
Internal Medicine
Laparoscopy
Leiomyoma - complications
Leiomyoma - pathology
Leiomyoma - surgery
Middle Aged
misdiagnosis
Obstetrics and Gynecology
Ovarian leiomyoma
Ovarian Neoplasms - complications
Ovarian Neoplasms - pathology
Ovarian Neoplasms - surgery
patients
Preoperative Care
preservation surgery
resection
surgeons
Young Adult
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Summary:Objective To analyze cases of ovarian leiomyomas and to discuss the proper surgical management. Design A case series and discussion. Setting General university hospital and healthcare center. Patient(s) Nine patients who were diagnosed with ovarian leiomyomas after surgery between 1993 and 2009. Intervention(s) None. Main Outcome Measure(s) A preoperative diagnosis that was matched to the postoperative diagnosis and the type of surgery. Result(s) In all cases, ovarian leiomyoma was misdiagnosed preoperatively as pedunculated uterine myoma, ovarian fibroma, or even ovarian endometrioma. Seven (77.8%) of the nine patients underwent a salpingo-oophorectomy or an oophorectomy with or without hysterectomy, and only two (22.2%) patients were submitted to an ovary-preserving surgery (i.e., a cystectomy or ovarian wedge resection). Conclusion(s) Because of their extreme rarity, ovarian leiomyomas are seldom suspected intraoperatively or preoperatively. However, most of these tumors appear at reproductive age and have a benign nature, similar to uterine myomas. Therefore, surgeons should perform ovary-preserving management, especially in young patients.
ISSN:0015-0282
1556-5653
DOI:10.1016/j.fertnstert.2010.09.007