Лейомиома матки в педиатрической популяции: обзор литературы

Кумыкова З.Х., Батырова З.К., Диланян Т.Г., Турчинец А.И., Уварова Е.В. Лейомиома матки в педиатрической популяции: обзор литературы. Гинекология. 2023;25(4):442–446.
DOI: 10.26442/20795696.2023.4.202552

© ООО «КОНСИЛИУМ МЕДИКУМ», 2023 г.

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Kymykova ZKh, Batyrova ZK Dilanyan TG, Turchinets AI, Uvarova EV. Uterine leiomyoma in the pediatric population: literature review. Gynecology. 2023;25(4):442–446. DOI: 10.26442/20795696.2023.4.202552

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Аннотация

Миома матки – наиболее распространенная доброкачественная неопластическая опухоль матки, встречающаяся у подростков с частотой менее 1%. По литературным данным, у 87,5% юных пациенток, как правило, имеют место разнообразные симптомы, наиболее частыми из которых являются аномальное маточное кровотечение, анемизирующее больную, боли в животе, увеличение живота в объеме. Постановка диагноза у девочек-подростков может быть затруднена по причине редкости у данного контингента больных, а также наличия некоторых ограничений при эхографическом исследовании, выполняемом, как правило, трансабдоминальным доступом, особенно при больших размерах образования. Методы лечения миом у женщин хорошо известны и достаточно широко описаны в клинических рекомендациях, варьируя от хирургических до медикаментозных, однако не стандартизированы для педиатрической популяции. В настоящее время в литературе описано не более 25 клинических наблюдений, что указывает на важность накопления и анализа клинических данных с целью выработки оптимального клинического подхода, направленного на сохранение репродуктивной функции у таких больных.

Ключевые слова: миома матки, лейомиома матки, девочки-подростки

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Uterine fibroids are the most common benign neoplastic tumor of the uterus, occurring in adolescents with a frequency of less than 1%. According to literature data, 87.5% of young patients, as a rule, have a variety of symptoms, the most frequent of which is abnormal uterine bleeding, anemizing the patient, abdominal pain, abdominal enlargement in volume. Diagnosis in adolescent girls may be difficult, due to the rarity, as well as the presence of some limitations in the echographic examination performed, as a rule, by transabdominal access. Methods of treating leiomyomas in women are well known and are widely described in clinical guidelines ranging from surgical to medicinal, however, they are not standardized for the pediatric population. Currently, no more than 25 clinical observations have been described in the literature, which indicates the importance of accumulating clinical data in order to develop an optimal clinical approach aimed at preserving reproductive function in such patients.

Keywords: uterine myoma, leyomyoma, adolescents

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Список литературы

1. Murphy CA, Zarudskaya O, Kakish C, et al. Uterine Fibroid in a 16-Year-Old Adolescent Managed with a Fertility-Sparing Approach: A Case Report and Review of the Literature. J Pediatr Adolesc Gynecol. 2021;34(3):427-31. DOI:10.1016/j.jpag.2020.12.016
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3. Barahmeh S, Shrateh ON, Jobran AWM, et al. Rare clinical entity of huge leiomyoma uteri in a 17-year-old adolescent managed with a fertility-sparing procedure: Case report and literature review. Int J Surg Case Rep. 2023;107:108367. DOI:10.1016/j.ijscr.2023.108367
4. Moroni RM, Vieira CS, Ferriani RA, et al. Presentation and treatment of uterine leiomyoma in adolescence: a systematic review. BMC Womens Health. 2015;15:4.
DOI:10.1186/s12905-015-0162-9
5. Лисицына О.И., Хащенко Е.П., Кюрдзиди С.О., и др. Лейомиома матки больших размеров: обзор литературы и клиническое наблюдение у девочки 16 лет. Акушерство и гинекология. 2021;9:180-8 [Lisitsyna OI, Khashchenko EP, Kyurdzidi SO, et al. Large uterine leiomyoma: a literature review and a clinical case report of a 16-year-old girl. Obstetrics and Gynecology. 2021;9:180-8 (in Russian)]. DOI:10.18565/aig.2021.9.180-188
6. Проект федеральных клинических рекомендаций: аномальные маточные кровотечения в пубертатном периоде. M., 2021 [Proiekt federal'nykh klinicheskikh rekomendatsii: anomal'nyie matochnyie krovotecheniia v pubertatnom periode. Moscow, 2021 (in Russian)].
7. Prokai D, Willson E. Large Prolapsing Uterine Fibroid and Severe Anemia in a Teenager: A Case Report. J Pediatr Adolesc Gynecol. 2019;32(2):226-7. DOI:10.1016/j.jpag.2019.02.080
8. Khorrami H, Rackow W. Hysteroscopic resection of a symptomatic uterine leiomyoma in an adolescent. J Pediatr Adolesc Gynecol. 2011;24(5):e111-4.
9. Morad NA, El-Said MM. Cellular uterine myoma causing vaginal bleeding in a 15-year-old girl. Aust N Z Obstet Gynaecol. 1993;33(2):211-3.
10. De Rooy CG, Wiegerinck MA. A 15-year-old girl with an expansively growing tumour. Eur J Obstet Gynecol Reprod Biol. 1986;222(5-6):373-7. DOI:10.1016/0028-2243(86)90128-0
11. Heimer G, Axelsson O, Johnson P. Uterine myoma causing uremia in a 15-year-old girl. Gynecol Obstet Invest. 1991;32(4):247-8.
12. Kayadibi Y, Ozmen E, Emir H, et al. Subserosal leiomyoma of uterus mimicking an ovarian tumor in adolescent patient. Jpn J Radiol. 2014;32:48-52.
13. Salehi P, Tyson N, Laparoscopic Myomectomy – Symptomatic Uterine Leiomyoma in a 15-year old adolescent. J Pediatr Adolesc Gynecol. 2016;5:7. DOI:10.1016/j.jpag.2016.05.007
14. Martucci C, Crocoli A, Persano G, et al. Uterine leiomyoma in pediatric population: A case report and review of the literature. Front Pediatr. 2022;10:1020072. DOI:10.3389/fped.2022.1020072
15. Fitch PK, Rojas SJ, Zamora PJ, et al. Giant uterine leiomyoma in a 14-year-old Mexican adolescent, a rare case of abnormal uterine bleeding. Case Report. Ginecol Obstet Mex. 2023;91(07):521-6.
16. Opperman P, Suh M, Abasolo P, Abdessalam S. Giant uterine leiomyoma: Not all pediatric pelvic masses are ovarian. J Pediatr Surg Case Rep. 2021;69:101820. DOI:10.1016/j.epsc.2021.101820.
17. Karim T, Patil, Panchal, Basu C. Presentation and management of giant fibroid uterus in an adolescent girl. Open Access Surgery. 2010;3:13-5. DOI:10.2147/OAS.S9371
18. Nguyen-Duc H. Large uterine fibroma in a 15 year old adolescent. Giant leiomyoma in adolescence. J Gynecol Obstet Biol Reprod (Paris). 2003;32(8 Pt. 1):748-50 (in French).
19. Федеральные клинические рекомендации: эндометриоз. M., 2022 [Federal'nyie klinicheskiie rekomendatsii: endometrioz. Moscow, 2022 (in Russian)].
20. Kumura NDS, Siarezi S. A Case of a Prolapsed Fibroid in a 12-Year-Old Girl. J Pediatr Adolesc Gynecol. 2020;33(1):96-7. DOI:10.1016/j.jpag.2019.08.013
21. Botting AJ, Soule EH, Brown AL Jr. Smooth muscle tumors in children. Cancer. 1965;18:711-20. DOI:10.1002/1097-0142
22. Parazzini F, Negri E, La Vecchia C, et al. Uterine myomas and smoking. Results from an Italian study. J Reprod Med. 1996;41(5):316-20.
23. Parker W. Etiology, symptomotology and diagnosis of uterine myomas. Fert Steril. 2007;87:725-36. DOI:10.1016/j.fertnstert.2007.01.093
24. Wisot AL, Neimand KM, Rosenthal AH. Symptomatic myoma in a 13-year-old girl. Am J Obstet Gynecol. 1969;105(4):639-41.
25. Taşkin S, Sönmezer M, Kahraman K, Atabekoğlu C. Hysteroscopic resection of uterine submucous leiomyoma protruding through hymen in a 16-year-old adolescent. J Pediatr Adolesc Gynecol. 2011;24(3):e77-8. DOI:10.1016/j.jpag.2010.08.001
26. Tsili AC, Lentoudi ED, Argyropoulou MI, et al. Fibromatous uterus in a 16-year-old girl: a case report. Case Rep Med. 2010;2010:932762. DOI:10.1155/2010/932762
27. Fields KR, Neinstein LS. Uterine myomas in adolescents: case reports and a review of the literature. J Pediatr Adolesc Gynecol. 1996;9(4):195-8.
DOI:10.1016/S1083-3188(96)70030-X
28. Wright KN, Laufer MR. Leiomyomas in adolescents. Fertil Steril. 2011;95(7):e2415-37.
29. Gong YY, George V, Appleton J, et al. Single Incision Laparoscopic Surgery for Leiomyoma in the Adolescent Patient: A Case Report. J Pediatr Adolesc Gynecol. 2021;34(4):573-5. DOI:10.1016/j.jpag.2021.02.103
30. Bowkley C, Dubel G, Haas R, et al. Uterine artery embolization for control of life-threatening hemorrhage at menarche: brief report. J Vasc Interv Radiol. 2007;18:127-31. DOI:10.1016/j.jvir.2006.10.015
31. Naiditch JA, Milad MP, Rowell EE. Uterine leiomyoma causing menometrorrhagia with a concomitant mature teratoma in a 15-year-old child: a case report and review of the literature. J Pediatr Surg. 2011;46(10):E33-6.
32. Rubisz P, Ciebiera M, Hirnle L, et al. The Usefulness of Immunohistochemistry in the Differential Diagnosis of Lesions Originating from the Myometrium. Int J Mol Sci. 2019;20(5):1136. DOI:10.3390/ijms20051136
33. Egorova A, Shtykalova S, Maretina M, et al. Polycondensed Peptide Carriers Modified with Cyclic RGD Ligand for Targeted Suicide Gene Delivery to Uterine Fibroid Cells. Int J Mol Sci. 2022;23(3):1164. DOI:10.3390/ijms23031164
34. Adams CL, Dimitrova I, Post MD, G et al. Identification of a novel diagnostic gene expression signature to discriminate uterine leiomyoma from leiomyosarcoma. Exp Mol Pathol. 2019;110:104284. DOI:10.1016/j.yexmp.2019.104284
35. Ponomarenko I, Reshetnikov E, Polonikov A, et al. Candidate Genes for Age at Menarche Are Associated With Uterine Leiomyoma. Front Genet. 2021;11:512940. DOI:10.3389/fgene.2020.512940
36. Yatsenko SA, Mittal P, Wood-Trageser MA, et al. Highly heterogeneous genomic landscape of uterine leiomyomas by whole exome sequencing and genome-wide arrays. Fertil Steril. 2017;107(2):457-66.e9. DOI:10.1016/j.fertnstert.2016.10.035
37. Machado-Lopez A, Simón C, Mas A. Molecular and Cellular Insights into the Development of Uterine Fibroids. Int J Mol Sci. 2021;22(16):8483. DOI:10.3390/ijms22168483
38. Yang Q, Ciebiera M, Bariani MV, et al. Comprehensive Review of Uterine Fibroids: Developmental Origin, Pathogenesis, and Treatment. Endocr Rev. 2022;43(4):678-719. DOI:10.1210/endrev/bnab039
39. Тоноян Н.М., Козаченко И.Ф., Асатурова А.В., и др. Иммуногистохимические маркеры рецидивирования миомы матки. Акушерство и гинекология. 2022;4:123-31 [Tonoyan NM, Kozachenko IF, Asaturova AV, et al. Immunohistochemical markers of uterine myoma recurrence. Obstetrics and Gynecology. 2022;4:123-31 (in Russian)]. DOI:10.18565/aig.2022.4.123-131

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1. Murphy CA, Zarudskaya O, Kakish C, et al. Uterine Fibroid in a 16-Year-Old Adolescent Managed with a Fertility-Sparing Approach: A Case Report and Review of the Literature. J Pediatr Adolesc Gynecol. 2021;34(3):427-31. DOI:10.1016/j.jpag.2020.12.016
2. Federal'nyie klinicheskiie rekomendatsii: mioma matki. Moscow, 2022 (in Russian).
3. Barahmeh S, Shrateh ON, Jobran AWM, et al. Rare clinical entity of huge leiomyoma uteri in a 17-year-old adolescent managed with a fertility-sparing procedure: Case report and literature review. Int J Surg Case Rep. 2023;107:108367. DOI:10.1016/j.ijscr.2023.108367
4. Moroni RM, Vieira CS, Ferriani RA, et al. Presentation and treatment of uterine leiomyoma in adolescence: a systematic review. BMC Womens Health. 2015;15:4.
DOI:10.1186/s12905-015-0162-9
5. Lisitsyna OI, Khashchenko EP, Kyurdzidi SO, et al. Large uterine leiomyoma: a literature review and a clinical case report of a 16-year-old girl. Obstetrics and Gynecology. 2021;9:180-8 (in Russian). DOI:10.18565/aig.2021.9.180-188
6. Proiekt federal'nykh klinicheskikh rekomendatsii: anomal'nyie matochnyie krovotecheniia v pubertatnom periode. Moscow, 2021 (in Russian).
7. Prokai D, Willson E. Large Prolapsing Uterine Fibroid and Severe Anemia in a Teenager: A Case Report. J Pediatr Adolesc Gynecol. 2019;32(2):226-7. DOI:10.1016/j.jpag.2019.02.080
8. Khorrami H, Rackow W. Hysteroscopic resection of a symptomatic uterine leiomyoma in an adolescent. J Pediatr Adolesc Gynecol. 2011;24(5):e111-4.
9. Morad NA, El-Said MM. Cellular uterine myoma causing vaginal bleeding in a 15-year-old girl. Aust N Z Obstet Gynaecol. 1993;33(2):211-3.
10. De Rooy CG, Wiegerinck MA. A 15-year-old girl with an expansively growing tumour. Eur J Obstet Gynecol Reprod Biol. 1986;222(5-6):373-7. DOI:10.1016/0028-2243(86)90128-0
11. Heimer G, Axelsson O, Johnson P. Uterine myoma causing uremia in a 15-year-old girl. Gynecol Obstet Invest. 1991;32(4):247-8.
12. Kayadibi Y, Ozmen E, Emir H, et al. Subserosal leiomyoma of uterus mimicking an ovarian tumor in adolescent patient. Jpn J Radiol. 2014;32:48-52.
13. Salehi P, Tyson N, Laparoscopic Myomectomy – Symptomatic Uterine Leiomyoma in a 15-year old adolescent. J Pediatr Adolesc Gynecol. 2016;5:7. DOI:10.1016/j.jpag.2016.05.007
14. Martucci C, Crocoli A, Persano G, et al. Uterine leiomyoma in pediatric population: A case report and review of the literature. Front Pediatr. 2022;10:1020072. DOI:10.3389/fped.2022.1020072
15. Fitch PK, Rojas SJ, Zamora PJ, et al. Giant uterine leiomyoma in a 14-year-old Mexican adolescent, a rare case of abnormal uterine bleeding. Case Report. Ginecol Obstet Mex. 2023;91(07):521-6.
16. Opperman P, Suh M, Abasolo P, Abdessalam S. Giant uterine leiomyoma: Not all pediatric pelvic masses are ovarian. J Pediatr Surg Case Rep. 2021;69:101820. DOI:10.1016/j.epsc.2021.101820.
17. Karim T, Patil, Panchal, Basu C. Presentation and management of giant fibroid uterus in an adolescent girl. Open Access Surgery. 2010;3:13-5. DOI:10.2147/OAS.S9371
18. Nguyen-Duc H. Large uterine fibroma in a 15 year old adolescent. Giant leiomyoma in adolescence. J Gynecol Obstet Biol Reprod (Paris). 2003;32(8 Pt. 1):748-50 (in French).
19. Federal'nyie klinicheskiie rekomendatsii: endometrioz. Moscow, 2022 (in Russian).
20. Kumura NDS, Siarezi S. A Case of a Prolapsed Fibroid in a 12-Year-Old Girl. J Pediatr Adolesc Gynecol. 2020;33(1):96-7. DOI:10.1016/j.jpag.2019.08.013
21. Botting AJ, Soule EH, Brown AL Jr. Smooth muscle tumors in children. Cancer. 1965;18:711-20. DOI:10.1002/1097-0142
22. Parazzini F, Negri E, La Vecchia C, et al. Uterine myomas and smoking. Results from an Italian study. J Reprod Med. 1996;41(5):316-20.
23. Parker W. Etiology, symptomotology and diagnosis of uterine myomas. Fert Steril. 2007;87:725-36. DOI:10.1016/j.fertnstert.2007.01.093
24. Wisot AL, Neimand KM, Rosenthal AH. Symptomatic myoma in a 13-year-old girl. Am J Obstet Gynecol. 1969;105(4):639-41.
25. Taşkin S, Sönmezer M, Kahraman K, Atabekoğlu C. Hysteroscopic resection of uterine submucous leiomyoma protruding through hymen in a 16-year-old adolescent. J Pediatr Adolesc Gynecol. 2011;24(3):e77-8. DOI:10.1016/j.jpag.2010.08.001
26. Tsili AC, Lentoudi ED, Argyropoulou MI, et al. Fibromatous uterus in a 16-year-old girl: a case report. Case Rep Med. 2010;2010:932762. DOI:10.1155/2010/932762
27. Fields KR, Neinstein LS. Uterine myomas in adolescents: case reports and a review of the literature. J Pediatr Adolesc Gynecol. 1996;9(4):195-8.
DOI:10.1016/S1083-3188(96)70030-X
28. Wright KN, Laufer MR. Leiomyomas in adolescents. Fertil Steril. 2011;95(7):e2415-37.
29. Gong YY, George V, Appleton J, et al. Single Incision Laparoscopic Surgery for Leiomyoma in the Adolescent Patient: A Case Report. J Pediatr Adolesc Gynecol. 2021;34(4):573-5. DOI:10.1016/j.jpag.2021.02.103
30. Bowkley C, Dubel G, Haas R, et al. Uterine artery embolization for control of life-threatening hemorrhage at menarche: brief report. J Vasc Interv Radiol. 2007;18:127-31. DOI:10.1016/j.jvir.2006.10.015
31. Naiditch JA, Milad MP, Rowell EE. Uterine leiomyoma causing menometrorrhagia with a concomitant mature teratoma in a 15-year-old child: a case report and review of the literature. J Pediatr Surg. 2011;46(10):E33-6.
32. Rubisz P, Ciebiera M, Hirnle L, et al. The Usefulness of Immunohistochemistry in the Differential Diagnosis of Lesions Originating from the Myometrium. Int J Mol Sci. 2019;20(5):1136. DOI:10.3390/ijms20051136
33. Egorova A, Shtykalova S, Maretina M, et al. Polycondensed Peptide Carriers Modified with Cyclic RGD Ligand for Targeted Suicide Gene Delivery to Uterine Fibroid Cells. Int J Mol Sci. 2022;23(3):1164. DOI:10.3390/ijms23031164
34. Adams CL, Dimitrova I, Post MD, G et al. Identification of a novel diagnostic gene expression signature to discriminate uterine leiomyoma from leiomyosarcoma. Exp Mol Pathol. 2019;110:104284. DOI:10.1016/j.yexmp.2019.104284
35. Ponomarenko I, Reshetnikov E, Polonikov A, et al. Candidate Genes for Age at Menarche Are Associated With Uterine Leiomyoma. Front Genet. 2021;11:512940. DOI:10.3389/fgene.2020.512940
36. Yatsenko SA, Mittal P, Wood-Trageser MA, et al. Highly heterogeneous genomic landscape of uterine leiomyomas by whole exome sequencing and genome-wide arrays. Fertil Steril. 2017;107(2):457-66.e9. DOI:10.1016/j.fertnstert.2016.10.035
37. Machado-Lopez A, Simón C, Mas A. Molecular and Cellular Insights into the Development of Uterine Fibroids. Int J Mol Sci. 2021;22(16):8483. DOI:10.3390/ijms22168483
38. Yang Q, Ciebiera M, Bariani MV, et al. Comprehensive Review of Uterine Fibroids: Developmental Origin, Pathogenesis, and Treatment. Endocr Rev. 2022;43(4):678-719. DOI:10.1210/endrev/bnab039
39. Tonoyan NM, Kozachenko IF, Asaturova AV, et al. Immunohistochemical markers of uterine myoma recurrence. Obstetrics and Gynecology. 2022;4:123-31 (in Russian). DOI:10.18565/aig.2022.4.123-131

Авторы

З.Х. Кумыкова*¹, З.К. Батырова¹, Т.Г. Диланян¹, А.И. Турчинец^1,2, Е.В. Уварова^1,2

¹ФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. Кулакова» Минздрава России, Москва, Россия;
²ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия
*zai-kumykova@yandex.ru

________________________________________________

Zaira Kh. Kymykova*¹, Zalina K. Batyrova¹, Tamara G. Dilanyan¹, Anna I. Turchinets^1,2, Elena V. Uvarova^1,2

¹Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia;
²Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
*zai-kumykova@yandex.ru

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