A case of diffuse hydropic uterine leiomyoma that proved difficult to diagnose

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  • 広範な水腫様変性を伴い診断に苦慮した子宮筋腫の1例
  • 症例報告 広範な水腫様変性を伴い診断に苦慮した子宮筋腫の1例
  • ショウレイ ホウコク コウハン ナ スイシュ ヨウ ヘンセイ オ トモナイ シンダン ニ クリョ シタ シキュウ キンシュ ノ 1レイ

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The presence of edema fluid within uterine leiomyomas, a phenomenon known as hydropic degeneration, is a common local finding on both gross and microscopic examination. However, diffuse hydropic degeneration is a very uncommon growth pattern. A 39-year-old woman was suspected of developing retroperitoneal hematoma after delivery. Magnetic resonance imaging (MRI) revealed a tumor extending along the uterus, which remained almost unchanged and was suspected of degenerated myoma uteri on MRI performed three years later. However, MRI performed another three years later revealed growth, suggesting an aggressive tumor such as uterine sarcoma or retroperitoneal tumor. Laparotomy was performed and the uterus including the tumor was surgically resected. Histopathological examination revealed a markedly hydropic leiomyoma with no signs of malignancy. This case suggests that periodic examination is recommended for degenerated myoma uteri because of the possibility of its growth. [Adv Obstet Gynecol 66 (3) : 277-282, 2014 (H26.8)]

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