Uterine leiomyoma in an adolescent female

Uterine myomas are the most frequently occurring neoplasms in the female pelvis, presenting in approximately one-third of women. Fewer than half develop menstrual abnormalities, pelvic pain, and discomfort. Large myomas may compromise fertility. These tumors very rarely occur in the pediatric and adolescent population. When suspected on examination, careful evaluation is necessary to distinguish the tumor from an adnexal lesion.

A 17-year-old girl presented with a large asymptomatic pelvic mass, which was clinically suspected to be a leiomyoma. An initial sonographic study was questionable for a myoma but was confirmed on subsequent magnetic resonance imaging (MRI). A large myoma was noted and removed at surgery. The patient subsequently became pregnant and delivered at term by caesarean section.

Leiomyomas of the uterus in women under 20 years of age are rare and occur much less often than adnexal lesions. Although ultrasound studies are usually sufficient to make the distinction between the 2, MRI generally is superior to sonography in this regard. In this young population, myomectomy is the surgical procedure of choice to preserve fertility.