Sarcomatoid transformation of uterine myoma identified through physical examination: a case report

Abstract Background Uterine myomas are the most common benign tumors in the female reproductive system. The incidence of malignant transformation within a uterine myoma is low, but once it occurs, the prognosis is usually poor. The clinical symptoms of this disease are not specific, which can easily...

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Main Authors: Xiaohui Zhou, Chenyu Wu, Mingli Shi
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Journal of Medical Case Reports
Subjects:
Online Access:https://doi.org/10.1186/s13256-025-05447-0
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author Xiaohui Zhou
Chenyu Wu
Mingli Shi
author_facet Xiaohui Zhou
Chenyu Wu
Mingli Shi
author_sort Xiaohui Zhou
collection DOAJ
description Abstract Background Uterine myomas are the most common benign tumors in the female reproductive system. The incidence of malignant transformation within a uterine myoma is low, but once it occurs, the prognosis is usually poor. The clinical symptoms of this disease are not specific, which can easily lead to misdiagnosis or missed diagnosis. Therefore, early diagnosis and timely treatment are crucial for improving the prognosis of patients. Case presentation A 58-year-old married Chinese female patient had undergone annual check-ups at our hospital from 2007 to 2024, totaling 18 visits. During her initial examination in 2007, uterine fibroids were detected. She experienced natural menopause in 2010. By 2019, no significant changes were observed in the size or characteristics of the uterine fibroids. In 2020, follow-up examinations revealed an increase in the size of the fibroids, although the patient reported no significant subjective symptoms. A preliminary diagnosis of sarcomatous transformation of uterine myomas was made. Subsequently, the patient underwent surgical intervention at an alternative medical facility. Postoperative pathology confirmed the diagnosis of sarcomatous transformation of uterine fibroids. As of the time of writing, she has been attending regular follow-up appointments annually since then, with the most recent visit occurring in November 2024. Currently, the patient’s overall health status remains stable, with no reported discomfort. Gynecological examinations and tumor markers (carbohydrate antigen 125 [CA125], carbohydrate antigen 199 [CA199], alpha-fetoprotein [AFP], and carcinoembryonic antigen [CEA]) are all within normal limits. Conclusion The malignant transformation of a uterine myoma is a rare but extremely serious complication. Timely and accurate diagnosis, followed by appropriate therapeutic interventions, is crucial for improving patient prognosis. Clinicians should maintain heightened vigilance for postmenopausal uterine fibroids that do not undergo expected regression but instead demonstrate growth.
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spelling doaj-art-e1b9990db1634782839ed2b4e84a05152025-08-24T11:31:41ZengBMCJournal of Medical Case Reports1752-19472025-08-011911410.1186/s13256-025-05447-0Sarcomatoid transformation of uterine myoma identified through physical examination: a case reportXiaohui Zhou0Chenyu Wu1Mingli Shi2Department of Gynecology, Shanghai Health and Medical CenterDepartment of Gynecology, Shanghai Health and Medical CenterDepartment of Physical Diagnosis, Shanghai Health and Medical CenterAbstract Background Uterine myomas are the most common benign tumors in the female reproductive system. The incidence of malignant transformation within a uterine myoma is low, but once it occurs, the prognosis is usually poor. The clinical symptoms of this disease are not specific, which can easily lead to misdiagnosis or missed diagnosis. Therefore, early diagnosis and timely treatment are crucial for improving the prognosis of patients. Case presentation A 58-year-old married Chinese female patient had undergone annual check-ups at our hospital from 2007 to 2024, totaling 18 visits. During her initial examination in 2007, uterine fibroids were detected. She experienced natural menopause in 2010. By 2019, no significant changes were observed in the size or characteristics of the uterine fibroids. In 2020, follow-up examinations revealed an increase in the size of the fibroids, although the patient reported no significant subjective symptoms. A preliminary diagnosis of sarcomatous transformation of uterine myomas was made. Subsequently, the patient underwent surgical intervention at an alternative medical facility. Postoperative pathology confirmed the diagnosis of sarcomatous transformation of uterine fibroids. As of the time of writing, she has been attending regular follow-up appointments annually since then, with the most recent visit occurring in November 2024. Currently, the patient’s overall health status remains stable, with no reported discomfort. Gynecological examinations and tumor markers (carbohydrate antigen 125 [CA125], carbohydrate antigen 199 [CA199], alpha-fetoprotein [AFP], and carcinoembryonic antigen [CEA]) are all within normal limits. Conclusion The malignant transformation of a uterine myoma is a rare but extremely serious complication. Timely and accurate diagnosis, followed by appropriate therapeutic interventions, is crucial for improving patient prognosis. Clinicians should maintain heightened vigilance for postmenopausal uterine fibroids that do not undergo expected regression but instead demonstrate growth.https://doi.org/10.1186/s13256-025-05447-0Uterine myomaUterine fibroidsSarcomatous changeMalignant transformationColor doppler ultrasound
spellingShingle Xiaohui Zhou
Chenyu Wu
Mingli Shi
Sarcomatoid transformation of uterine myoma identified through physical examination: a case report
Journal of Medical Case Reports
Uterine myoma
Uterine fibroids
Sarcomatous change
Malignant transformation
Color doppler ultrasound
title Sarcomatoid transformation of uterine myoma identified through physical examination: a case report
title_full Sarcomatoid transformation of uterine myoma identified through physical examination: a case report
title_fullStr Sarcomatoid transformation of uterine myoma identified through physical examination: a case report
title_full_unstemmed Sarcomatoid transformation of uterine myoma identified through physical examination: a case report
title_short Sarcomatoid transformation of uterine myoma identified through physical examination: a case report
title_sort sarcomatoid transformation of uterine myoma identified through physical examination a case report
topic Uterine myoma
Uterine fibroids
Sarcomatous change
Malignant transformation
Color doppler ultrasound
url https://doi.org/10.1186/s13256-025-05447-0
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AT chenyuwu sarcomatoidtransformationofuterinemyomaidentifiedthroughphysicalexaminationacasereport
AT minglishi sarcomatoidtransformationofuterinemyomaidentifiedthroughphysicalexaminationacasereport