Selective Embolisation of a Heavily Bleeding Cervical Fibroid in a Pregnant Woman

Lohle, Paul N.M.; Boekkooi, Peter F.; Fiedeldeij, Cora A.; Berden, H.J.J.M.; Jong, Wim de; Reekers, Jim A.; Franx, Arie; Rooij, W. J. J. van

doi:10.1007/s00270-015-1099-y

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…These women may benefit from super-selective embolization of the leiomyoma or cervicovaginal artery; however, subsequent pregnancies after uterine embolization have a statistically significantly higher rate of spontaneous abortion (56% vs. 10.5%), malpresentation (20%), and cesarean section (80%) compared to those following surgical uterine artery occlusion [84]. In the study of Ferrari et al, IRT procedures were successful in 10/18 (55.5%) cases and in the two cases undergoing super-selective cervico-vaginal artery embolization and UFE (pregnant patient), respectively [7,80]. The largest treated tumor was of 9 cm in maximum size [7].…”

Section: Discussionmentioning

confidence: 99%

“…Only three (13%) patients with CL were treated with surgery (2 vaginal myomectomy at 15 and 36 weeks of gestation, respectively) or IRT (1 super-selective uterine fibroid embolization) during pregnancy [7,64,80,81]. No relevant complications were reported in these cases, but prolapse and/or premature rupture of membranes with chorioamnionitis and fetal loss could sometimes happen [64,75,78,82,83].…”

Section: Discussionmentioning

confidence: 99%

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Lipoleiomyomas of the Uterine Cervix: A New Series including the First Recurrent Case and the First Systematic Literature Review

Palicelli

Ardighieri

Broggi

et al. 2022

JPM

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Uterine leiomyomas usually arise from the uterine body (95%), and rarely from the cervix (0.6%) or other urogenital sites. Lipoleiomyomas are benign, uncommon variants of leiomyomas (0.03–0.2%), histologically composed of smooth muscle cells and mature adipocytes; they usually occur in the uterine body and exceptionally in the cervix. We performed the first systematic literature review of cervical lipoleiomyomas (PRISMA guidelines), presenting five new cases. Including our series, thirty-one detailed cases were reported in the literature (mainly in Asia). The age range was 35–74 years, revealing a higher mean age than conventional cervical leiomyomas (46.5 vs. 39.4 years). Patients were usually multiparous (94%), typically complaining of vaginal bleeding (11/31, 36%), pelvic/abdominal pain (10/31, 32%), and/or urinary disturbances (6/31, 19%) 1 week to 10 months before presentation. Clinical examination revealed a pedunculated tumor (48%), or prolapse of ≥1 pelvic organs (16%). Twenty-four (77%) patients underwent total hysterectomy ± additional surgery; simple myomectomy/excision was performed in five (16%) cases. Only one (3%) of our cases recurred 2 years after partial excision; no evidence of disease was found 13 years after recurrence excision. Adipocytes occupied ≤50% of the tumor volume. Hyaline or myxoid changes and cartilaginous metaplasia were uncommon histological findings. Surgically challenging cases or pregnant patients may require expert gynecologists. Interventional radiology or conservative treatments were rarely proposed.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Lipoleiomyomas of the Uterine Cervix: A New Series including the First Recurrent Case and the First Systematic Literature Review

Palicelli

Ardighieri

Broggi

et al. 2022

JPM

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“…We are aware of two reports [ 24 , 27 ] on UAE in the treatment of cervical leiomyomata. The first report compared effectiveness of UAE of cervical leiomyomata versus uterine fundal/body leiomyomata with imaging and stated that “the results of UAE were disappointing, indicating a need for caution in selecting and counseling patients for this treatment” [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…The second publication concerns the world’s first reported UAE during pregnancy [ 27 ]. We hypothesized that the pregnancy itself would be an influencing factor on the cervical leiomyomata growth, which is why we excluded pregnant or postpartum patients in this study [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Uterine Artery Embolization in Women with Symptomatic Cervical Leiomyomata: Efficacy and Safety

Bruijn¹,

Adriaansens

Smink

et al. 2018

Cardiovasc Intervent Radiol

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Purpose To perform an evaluation on safety and efficacy of uterine artery embolization (UAE) in the patients with symptomatic cervical leiomyomata. Methods Patients with symptomatic cervical leiomyomata who underwent UAE in one specialized hospital were retrospectively analyzed, both clinically and with MR imaging. The 3-month outcomes were assessed with MR imaging and a validated questionnaire. Long-term follow-up was assessed by direct contact or file review. To determine the efficacy of UAE for cervical leiomyomata, the primary objective was to assess the clinical outcome with the UFS-QOL questionnaire, containing the health-related quality of life (HRQOL) and symptom severity score (SSS). To assess safety, the secondary objective included leiomyomata volume reduction, the infarction/complication rate and secondary interventions were needed. Results Between 2006 and 2017, eight of 1180 patients underwent UAE and were eligible for inclusion. All embolizations were technically successful ( n = 8). At 3 months, all patients showed cervical leiomyomata volume reduction with a median reduction of 41.5% (38.8 cm 3 ) compared to baseline ( p = 0.012). No complications occurred. At a median follow-up of 3 months (range 1–7, n = 7), the HRQOL and SSS improved with a median difference of 13 points (range − 5 to 60, p = 0.063) and − 13 points (range − 79 to 3, p = 0.046), respectively. Long-term follow-up showed two secondary interventions (median of 43.5 months). Six patients reported no symptom recurrence. Conclusion UAE in women with symptomatic cervical leiomyomata is effective and safe with significant improvement in symptoms and quality of life. UAE is a valuable option for women seeking a non-surgical solution. Electronic supplementary material The online version of this article (10.1007/s00270-018-2081-2) contains supplementary material, which is available to authorized users.

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Pregnancy after Superselective Embolization of the Cervicovaginal Arteries for a Bleeding Cervical Fibroid

DeMeritt

Wajswol

Wattamwar

2019

Journal of Vascular and Interventional Radiology

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Selective Embolisation of a Heavily Bleeding Cervical Fibroid in a Pregnant Woman

Cited by 5 publications

References 16 publications

Lipoleiomyomas of the Uterine Cervix: A New Series including the First Recurrent Case and the First Systematic Literature Review

Lipoleiomyomas of the Uterine Cervix: A New Series including the First Recurrent Case and the First Systematic Literature Review

Uterine Artery Embolization in Women with Symptomatic Cervical Leiomyomata: Efficacy and Safety

Pregnancy after Superselective Embolization of the Cervicovaginal Arteries for a Bleeding Cervical Fibroid

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