{"title":"A 40-Year-Old Woman with Inoperable Uterine Fibroids Treated with Combined Uterine Artery Embolization and Relugolix.","authors":"Livio Leo, Raphael Thomasset, Alessio Massaro, Raffaele Tinelli, Bianca Masturzo, Valentino Remorgida, Alessandro Libretti, Massimiliano Natrella","doi":"10.12659/AJCR.946334","DOIUrl":null,"url":null,"abstract":"<p><p>BACKGROUND Surgery was once considered the only possible treatment for uterine fibroids. However, a more conservative treatment approach can preserve women's reproductive capacity. In recent years, uterine artery embolization (UAE) and medical treatments have been introduced as a minimally or non-invasive therapeutic option. Relugolix is a non-peptide gonadotrophin-releasing hormone (GnRH) receptor antagonist used to reduce the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). This report presents the case of a 40-year-old woman with inoperable uterine fibroids managed with combined uterine artery embolization and Relugolix, a non-peptide gonadotrophin-releasing hormone (GnRH) receptor antagonist. CASE REPORT A woman in her 40s presented with recurrent menometrorrhagia and an 80-mm uterine fibroid causing bleeding and anemia. Due to her medical history and previous surgeries, surgery was deemed risky. Instead, a conservative approach involving UAE followed by Relugolix combination therapy (Relugolix-CT) was pursued before performing minimally invasive surgery. Following bilateral UAE, the ultrasound scan showed there had already been a reduction in the fibroid size. Right after the UAE, the patient was discharged with Relugolix-CT, which reduced the symptoms and helped further reduce the fibroid's size and vascularity. Six months later, a mini-resectoscopic myomectomy was performed under local anaesthesia. CONCLUSIONS This case underscores the effectiveness of UAE and Relugolix-CT as a pre-surgical strategy for large uterine fibroids in patients who are not immediately suitable candidates for major surgery. This new combined approach can lead to improved patient outcomes and reduced surgical risks.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e946334"},"PeriodicalIF":1.0000,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868963/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Case Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.12659/AJCR.946334","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
BACKGROUND Surgery was once considered the only possible treatment for uterine fibroids. However, a more conservative treatment approach can preserve women's reproductive capacity. In recent years, uterine artery embolization (UAE) and medical treatments have been introduced as a minimally or non-invasive therapeutic option. Relugolix is a non-peptide gonadotrophin-releasing hormone (GnRH) receptor antagonist used to reduce the release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH). This report presents the case of a 40-year-old woman with inoperable uterine fibroids managed with combined uterine artery embolization and Relugolix, a non-peptide gonadotrophin-releasing hormone (GnRH) receptor antagonist. CASE REPORT A woman in her 40s presented with recurrent menometrorrhagia and an 80-mm uterine fibroid causing bleeding and anemia. Due to her medical history and previous surgeries, surgery was deemed risky. Instead, a conservative approach involving UAE followed by Relugolix combination therapy (Relugolix-CT) was pursued before performing minimally invasive surgery. Following bilateral UAE, the ultrasound scan showed there had already been a reduction in the fibroid size. Right after the UAE, the patient was discharged with Relugolix-CT, which reduced the symptoms and helped further reduce the fibroid's size and vascularity. Six months later, a mini-resectoscopic myomectomy was performed under local anaesthesia. CONCLUSIONS This case underscores the effectiveness of UAE and Relugolix-CT as a pre-surgical strategy for large uterine fibroids in patients who are not immediately suitable candidates for major surgery. This new combined approach can lead to improved patient outcomes and reduced surgical risks.
期刊介绍:
American Journal of Case Reports is an international, peer-reviewed scientific journal that publishes single and series case reports in all medical fields. American Journal of Case Reports is issued on a continuous basis as a primary electronic journal. Print copies of a single article or a set of articles can be ordered on demand.