Objective

To describe the fertility-sparing management of an atypical uterine myoma.

Design

Step-by-step video explanation of transcervical biopsy using transabdominal ultrasound guidance, highlighting tips and tricks. Patient consent was obtained before the publication of the case.

Setting

University hospital.

Patient(s)

A 32-year-old nulliparous woman with a history of dysmenorrhea was found to have an atypical myoma FIGO 6, with suspicion of leiomyosarcoma on magnetic resonance imaging.

Intervention(s)

A transcervical biopsy of an atypical myoma was done under transabdominal ultrasound guidance. A myomectomy by a minimally invasive approach was performed without morcellation.

Main Outcome Measure(s)

Feasibility of transcervical biopsy and correlation with definitive anatomopathological diagnosis.

Result(s)

The patient was under general anesthesia. A hysteroscopy confirmed the normal appearance of the uterine cavity with no direct access to the myoma. Four core biopsies were performed with a 16-gauge needle transcervically under ultrasound guidance. The preliminary diagnosis of cellular leiomyoma allowed a fertility-sparing surgery. Myomectomy and surgical treatment of endometriosis were performed secondarily. This patient had a successful recovery, and the diagnosis of benign cellular leiomyoma was confirmed on the surgical specimen.

Conclusion(s)

The current video highlights the safety and feasibility of transcervical ultrasound-guided core biopsy in patients with atypical uterine fibroids.

中文翻译：

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怀疑平滑肌肉瘤的保留生育能力管理：通过进行经宫颈肌瘤活检避免子宫切除术

客观的

描述非典型子宫肌瘤的保留生育能力的管理。

设计

使用经腹超声引导进行经宫颈活检的分步视频解释，突出提示和技巧。病例发表前已获得患者同意。

环境

大学医院。

耐心）

一名有痛经病史的 32 岁未生育女性被发现患有非典型肌瘤 FIGO 6，磁共振成像怀疑为平滑肌肉瘤。

干预措施

在经腹超声引导下对非典型肌瘤进行经宫颈活检。通过微创方法进行肌瘤切除术，无需分碎。

主要观察指标）

经宫颈活检的可行性及其与明确的解剖病理学诊断的相关性。

结果）

患者处于全身麻醉状态。宫腔镜检查证实了子宫腔的正常外观，没有直接进入肌瘤。在超声引导下，使用 16 号针经宫颈进行四次核心活检。细胞平滑肌瘤的初步诊断允许进行保留生育能力的手术。其次进行子宫肌瘤切除术和子宫内膜异位症的手术治疗。该患者恢复成功，手术标本确诊为良性细胞平滑肌瘤。

结论

当前视频重点介绍了经宫颈超声引导核心活检在非典型子宫肌瘤患者中的安全性和可行性。