Uterine leiomyoma with fumarate hydratase deficiency A case report

Rationale: Hereditary leiomyomatosis and renal cell carcinoma is an uncommon autosomal dominant disease caused by mutations in the fumarate hydratase (FH) gene. They usually demonstrated multiple uterine myomas and preformed surgical procedures for myomectomy and/or hysterectomy 10 years earlier than sporadic myomas due to early development. This case report describes a woman with multiple uterine leiomyomas diagnosed with FH deficiency. Patient concerns: A 37-year-old woman visited a gynecological clinic for the discovery of uterine leiomyoma for more than 1 year. The size of the largest grew from 42 x 27 x 46 to 98 x 85 x 113 mm in 1 year. She had a history of surgery for breast cancer and thyroid cancer but denied a history of uterine leiomyoma in her family. Diagnosis and Interventions: The patient underwent successful transabdominal hysterectomy. The pathological results showed multiple uterine leiomyomas (partly cellular leiomyomas) with scattered large bizarre giant cells. Immunohistochemistry results demonstrated FH deficiency. Outcomes: On follow-up, the patient did not have any complications. She was finally referred to the oncologists and urologists for follow-up. Lessons: Gynecologists should be aware that early onset uterine leiomyoma presenting as large, multiple, and symptomatic lesion, may be associated with FH deficiency.

Automated summary

This case report describes a woman with multiple uterine leiomyomas diagnosed with FH deficiency. The patient underwent successful transabdominal hysterectomy and had no complications on follow-up. It is important for gynecologists to be aware that early onset uterine leiomyoma may be associated with FH deficiency, presenting as large, multiple, and symptomatic lesions.