Uterine Leiomyoma in an Adolescent Female by ProQuest


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Uterine Leiomyoma in an Adolescent Female
James D. Perkins, MD; Randall S. Hines, MD; Donald S. Prior, MD

                                                                                  20% of women present with menstrual abnormalities,
    Background: Uterine myomas are the most frequently occur-
                                                                                  pelvic pain, or discomfort. Although the exact etiology
    ring neoplasms in the female pelvis, presenting in approxi-
                                                                                  is unclear, it has been suggested that these tumors are
    mately one-third of women. Fewer than half develop men-
                                                                                  influenced by hormonal stimulation, involving estro-
    strual abnormalities, pelvic pain, and discomfort. Large
                                                                                  gen and possibly progesterone.1,2 Myomas have been
    myomas may compromise fertility. These tumors very rarely
                                                                                  noted to occur with greater frequency in African Ameri-
    occur in the pediatric and adolescent population. When
                                                                                  can women, occurring about 4 times more frequently
    suspected on examination, careful evaluation is necessary
                                                                                  than in Caucasian females. 2 However, the incidence
    to distinguish the tumor from an adnexal lesion.
                                                                                  of these tumors in women under 20 years is extremely
    Case: A 17-year-old girl presented with a large asymptom-                     rare.3 When they are found in this group, arriving at the
    atic pelvic mass, which was clinically suspected to be a                      diagnosis can be challenging, and formulating a man-
    leiomyoma. An initial sonographic study was questionable                      agement plan revolves around preservation of fertility.
    for a myoma but was confirmed on subsequent magnetic                          Furthermore, when initially suspected, it is important
    resonance imaging (MRI). A large myoma was noted and                          that appropriate imaging be performed to differentiate a
    removed at surgery. The patient subsequently became                           uterine mass from a lesion of adnexal origin.
    pregnant and delivered at term by caesarean section.
    Summary and Conclusion: Leiomyomas of the uterus in                           CASE REPORT
    women under 20 years of age are rare and occur much                               A 17-year-old African American female, gravida 0,
    less often than adnexal lesions. Although ultrasound studies                  was referred for an abdominopelvic mass found on a
    are usually sufficient to make the distinction between the 2,                 routine physical examination. Menarche was at age 13
    MRI generally is superior to sonography in this regard. In this               years, and she had no subsequent menstrual abnormali-
    young population, myomectomy is the surgical procedure                        ties. Her last period was approximately 2 weeks prior to
    of choice to preserve fertility.                                              presentation. There were no complaints of abdomino-
                                                                                  pelvic pain, pressure, or discomfort, and she denied
    Keywords: children/adolescents n sonography n                                 changes in bowel habits or urination. She denied any
    magnetic resonance imaging n obstetrics/gynecology                            prior sexual activity, and there was no history of sexu-
    J Natl Med Assoc. 2009;101:611-613                                            ally transmitted diseases or use of hormones. 
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