Disseminierte hormonbildende Leiomyomatose nach laparoskopischer suprazervikaler Hysterektomie: ein Fallbericht

Zusammenfassung

Im vorliegenden Fallbericht wird das Auftreten von multiplen peritonealen Leiomyomen, verbunden mit Endometriose und Endosalpingiose nach laparoskopischer suprazervikaler Hysterektomie mit Elektromorcellation, beschrieben. Interessanterweise kann die Korrelation der Serumöstradiolspiegel der Patientin mit dem Auftreten bzw. Vorhandensein von Leiomyomen auch nach bilateraler kompletter Adnexektomie gezeigt werden. Die Zunahme derartiger Fälle mit der Verbreitung der Elektromorcellation bei laparoskopischen Hysterektomien und Myomenukleationen wird ebenso diskutiert wie verschiedene Therapieansätze zur Behandlung der Tumoren. Die komplette Entfernung sämtlicher Gewebsfragmente wird als wichtiges Fazit für die Praxis hervorgehoben. Der mögliche Zusammenhang zu einer autokrinen Hormonproduktion durch die Tumoren muss weiter untersucht werden.

Abstract

The following case report describes the occurrence of multiple peritoneal leiomyomas associated with endometriosis and endosalpingiosis after laparoscopic supracervical hysterectomy using electromorcellation. Interestingly, we found a positive correlation between leiomyomas and serum estrogen levels even after bilateral adnexectomy. The increasing incidence of such cases after electromorcellation, a popular treatment approach, and the different therapeutic options for this metastatic tumor are discussed. The important conclusion for daily clinical practice is the necessity of completely removing all tissue fragments after morcellation. A correlation with autocrine hormone production in such tumors should be further investigated.

Schlüsselwörter

suprazervikale Hysterektomie - Leiomyomatose - Morcellation

Key words

supracervical hysterectomy - leiomyomatosis - morcellation

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