AI Article Synopsis

  • The study aimed to demonstrate a fertility-sparing approach for managing an atypical uterine myoma in a 32-year-old woman with a history of menstrual pain.
  • A step-by-step video detailed a transcervical biopsy performed under ultrasound guidance, followed by a minimally invasive myomectomy, ultimately allowing the patient to retain fertility.
  • The results showed that the biopsy was safe and effective, diagnosing a benign condition and confirming the success of the surgical procedure.

Article Abstract

Objective: To describe the fertility-sparing management of an atypical uterine myoma.

Design: Step-by-step video explanation of transcervical biopsy using transabdominal ultrasound guidance, highlighting tips and tricks. Patient consent was obtained before the publication of the case.

Setting: University hospital.

Patient(s): A 32-year-old nulliparous woman with a history of dysmenorrhea was found to have an atypical myoma FIGO 6, with suspicion of leiomyosarcoma on magnetic resonance imaging.

Intervention(s): A transcervical biopsy of an atypical myoma was done under transabdominal ultrasound guidance. A myomectomy by a minimally invasive approach was performed without morcellation.

Main Outcome Measure(s): Feasibility of transcervical biopsy and correlation with definitive anatomopathological diagnosis.

Result(s): The patient was under general anesthesia. A hysteroscopy confirmed the normal appearance of the uterine cavity with no direct access to the myoma. Four core biopsies were performed with a 16-gauge needle transcervically under ultrasound guidance. The preliminary diagnosis of cellular leiomyoma allowed a fertility-sparing surgery. Myomectomy and surgical treatment of endometriosis were performed secondarily. This patient had a successful recovery, and the diagnosis of benign cellular leiomyoma was confirmed on the surgical specimen.

Conclusion(s): The current video highlights the safety and feasibility of transcervical ultrasound-guided core biopsy in patients with atypical uterine fibroids.

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Source
http://dx.doi.org/10.1016/j.fertnstert.2021.09.028DOI Listing

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