Ovarian leiomyoma as a potential cause of compromised fertility

Abstract

Objective: To analyze cases of ovarian leiomyomas and to discuss the proper surgical management.

Design: A case series and discussion.

Setting: General university hospital and healthcare center.

Patient(s): Nine patients who were diagnosed with ovarian leiomyomas after surgery between 1993 and 2009.

Intervention(s): None.

Main outcome measure(s): A preoperative diagnosis that was matched to the postoperative diagnosis and the type of surgery.

Result(s): In all cases, ovarian leiomyoma was misdiagnosed preoperatively as pedunculated uterine myoma, ovarian fibroma, or even ovarian endometrioma. Seven (77.8%) of the nine patients underwent a salpingo-oophorectomy or an oophorectomy with or without hysterectomy, and only two (22.2%) patients were submitted to an ovary-preserving surgery (i.e., a cystectomy or ovarian wedge resection).

Conclusion(s): Because of their extreme rarity, ovarian leiomyomas are seldom suspected intraoperatively or preoperatively. However, most of these tumors appear at reproductive age and have a benign nature, similar to uterine myomas. Therefore, surgeons should perform ovary-preserving management, especially in young patients.