ABSTRACT
Myometrial smooth muscle neoplasms are the most common gynecologic tumors with a prevalence of 70-80% at age 50. Among women undergoing hysterectomy or myomectomy for a suspected diagnosis of leiomyoma, 0.01% receive a diagnosis of STUMP. Clinically, the average age of presentation is between 41-48 years. Tumors ranging from 3 to 30 cm have been described. Signs and symptoms are similar to leiomyomas, such as abnormal uterine bleeding, anemia, dysmenorrhea, pelvic pain, pelvic mass, infertility or other types of pain secondary to compression of adjacent organs. Due to the limited literature available, there is no definite management consensus, and treatment and follow-up options are limited to observational studies. The standard treatment is total hysterectomy with or without bilateral salpingo-oophorectomy; if fertility has already been completed, there is no role for adjuvant hormonal therapy or chemotherapy. The overall 5-year survival is 92-100%. A case of a 31-year-old woman with STUMP is presented.
Subject(s)
Female , Adult , Uterine Neoplasms , LeiomyosarcomaABSTRACT
Objetivo: presentar el caso de una paciente con angiolipoleiomioma uterino confirmado histopatológicamente y diagnosticado prequirúrgicamente como un teratoma anexial, y realizar una revisión de la literatura respecto al diagnóstico clínico, imagenológico e histopatológico de la entidad. Materiales y métodos: se presenta el caso de una mujer de 61 años, a quien se le practicó laparotomía por sospecha de un teratoma anexial. En la cirugía se hace diagnóstico de miomatosis uterina y se practica histerectomía abdominal total y salpingooforectomía bilateral. En el estudio histopatológico se encuentran hallazgos compatibles con angiolipoleiomioma uterino. Se realizó una búsqueda en las bases de datos Medline vía PubMed, OVID y en Lilacs, con los términos "angiolipoleiomyoma", "angiolipoleiomyoma uterus", "uterine angiolipoleiomyoma","uterine angiolipoleiomyomas" y "angiomyolipoma uterus", se buscaron artículos de revisión, reportes y series de casos en inglés y español publicados desde 1966 hasta mayo de 2016. Resultados: se encontraron siete artículos, que corresponden a reportes de casos y revisión de la literatura, los cuales describen las principales características en cuanto a presentación clínica, diagnóstico clínico y paraclínicos basándose en pruebas de imagenología y estudios de histopatología. Conclusión: el angiolipoleiomioma uterino es una entidad benigna muy rara, cuyo diagnóstico diferencial clínico es complejo, ya que simula otras patologías ginecológicas. Es de suma importancia la sospecha clínica prequirúrgica de esta entidad y la posterior confirmación histopatológica.
Objectives: To present the case of a patient with a uterine angiolipoleiomyoma confirmed by histopathology, diagnosed as adnexal teratoma before surger y, and to conduct a review of the literature regarding clinical, imaging and histopathological diagnosis of this condition. Materials and methods: A 61-year old patient taken to laparotomy due a suspected adnexal teratoma. During surgery, uterine myomatosis was diagnosed and total abdominal hysterectomy and bilateral oophorectomy are performed. Findings on histopatholog y were consistent with uterine angiolipoleiomyoma. A search was conducted in the Medline databases via PubMed, Ovid and in LILACS using the terms "angiolipoleiomyoma", "angiolipoleiomyoma uterus", "uterine angiolipoleiomyoma", "uterine angiolipoleiomyomas" and "angiomyolipoma uterus". The search included review articles and case series and reports published in English and Spanish from 1966 to May 2016. Results: Seven study articles were found, including case reports and literature reviews describing the main characteristics in terms of clinical presentation, clinical diagnosis and paraclinical tests, based on imaging studies and histopathology. Conclusion: Uterine angiolipoleiomyoma is an extremely rare benign condition that mimics other gynaecological pathologies, making it a difficult clinical differential diagnosis. Preoperative clinical suspicion and postoperative histopathological confirmation are of the utmost importance.