Spontaneous Regression Of A Giant Uterine Leiomyoma After Delivery: A Case Report And Literature Review
Zhu-Ge, L., Bei, Q., Pan, W., & Ni, X. (2024). Spontaneous regression of a giant uterine leiomyoma after delivery: a case report and literature review. BMC pregnancy and childbirth, 24(1), 123. https://doi.org/10.1186/s12884-024-06324-2
View Original Source →Abstract
BACKGROUND: Uterine leiomyomas are hormone-dependent benign tumors and often begin to shrink after menopause due to the reduction in ovarian steroids. The influence of pregnancy on uterine leiomyomas size remains unclear. Here, we present a case of spontaneous regression of a giant uterine leiomyoma after delivery. CASE PRESENTATION: A 40-year-old woman presented with multiple uterine leiomyomas, one of which is a giant uterine leiomyomas (approximately 8 cm in diameter) that gradually shrinked after delivery. At over two months postpartum, the large myometrial leiomyoma had transformed into a submucosal leiomyoma, and over 3 years postpartum, both the submucosal leiomyoma and multiple intramural leiomyomas completely regressed. CONCLUSION: Spontaneous regression of a giant uterine leiomyom is rare after delivery. Considering uterine leiomyoma regression until over 3 year postpartum,we need to observe the regression of uterine fibroid for a longer time postpartum in the absence of fibroid related complications. In addition, it will provide new insights for treatment options of uterine leiomyomas in the future.
Case Details
Disease Location
Uterus
Personal Characteristics
40-year-old female, gravida 6, para 1, with a history of cesarean section.
Clinical Characteristics
Ultrasound examination revealed multiple masses suggestive of leiomyomas. The largest leiomyoma in the posterior wall measured approximately 3.5×4.0×2.7 cm. One year later, an early intrauterine pregnancy was confirmed. Multiple medium-to- low echogenicity lesions were observed in the myo-atrium, including a larger one in the posterior wall measuring approximately 5.5×3.5 cm. Cesarean delivery was performed at 36+4 weeks of gestation due to premature rupture of membranes and a history of previous cesarean section. Intraoperatively, multiple leiomyoma-like masses were found in the posterior wall and bottom of the uterus, protruding into the serosal layer and not clearly into the mucosal layer.
Remission Characteristics
Annual follow-up ultrasound examinations after delivery suggested a gradual reduction in the size of uterine leiomyomas. In the third postpartum year, the ultrasound examination revealed no noticeable leiomyoma-like echoes in the posterior wall of the uterus
Treatment & Mechanisms
Proposed Remission Mechanisms
The strong post-delivery uterine contractions promote remodeling of the uterus and uterine leiomyomas and cause blood vessel occlusion, resulting in ischemia and hypoxia in the myometrium and uterine leiomyomas.
Clinical Treatment
C-section
Non-Clinical Treatment
None reported