Atypical Uterine Leiomyoma: A Case Report and Literature Review

Introduction: Atypical leiomyomas are diagnosed histologically, showing pleomorphic atypical tumor cells with low mitotic counts and no coagulative necrosis. Surgical treatment is indicated when abnormal uterine bleeding or symptoms related to the size of the leiomyomas, infertility, or recurrent gestational loss are presented. Clinical case: A 40-year-old woman with a history of menstrual changes, abdominal pain, and intermenstrual bleeding was scheduled for surgery. Pathology reported an atypical leiomyoma (23x18x13 cm) with myxoid degeneration. Discussion: Uterine leiomyomas affect 70-80% of women in their reproductive age. Symptoms vary by size and location, including abnormal bleeding, pain, and pressure-related issues. This patient had a single pedunculated leiomyoma, no endometrial hyperplasia, negative cervical cytology, and uterine adhesions. Myomectomy was chosen to avoid organ damage. Conclusion: Atypical leiomyomas are rare tumors diagnosed through biopsy and histopathological examination, displaying 10 mitoses per field and no necrosis. Immunohistochemical studies are necessary to distinguish them from leiomyosarcoma. Long-term follow-up after myomectomy is essential to monitor for recurrence.