Clinical case of mitotically active uterine leiomyoma

Abstract

One of the rare variants of uterine smooth muscle tumors is mitotically active leiomyoma, histological characteristics of which are defined by a high number of mitoses in the absence of necrosis and cellular atypia. Despite the presence of mitotic activity, this tumor process is benign. Mitotically active leiomyoma of the uterus is usually diagnosed in patients in the perimenopausal period and its size typically does not exceed 10 cm. This article presents a rare clinical case of a giant-sized mitotically active leiomyoma of the uterus in a woman of reproductive age. Attention is drawn to the challenges in clinical diagnosis and the difficulties in differentiation from malignant neoplasms. The primary treatment method for mitotically active leiomyoma of the uterus is surgical (myomectomy or hysterectomy as indicated). According to several publications, no recurrence of this pathology was observed during patient follow-up after surgical treatment ranging from 6 months to 15 years. Considering the clinical and macroscopic similarity of mitotically active leiomyoma with leiomyosarcoma, careful histological verification of the diagnosis is necessary to determine the correct management strategy.