Ultrasound-guided needle biopsy for preoperative assessment of uterine fibroids: Our experience and a review of the literature

Abstract

Leiomyomas are the most common uterine benign tumor, and their malignant counterpart leiomyosarcomas are extremely rare. Despite this, a preoperative diagnosis could be useful for safe surgical minimally invasive management. At present, some clinical and ultrasound findings help recognizing lesions at risk of malignancy. We tried to implement a technique for the preoperative diagnosis for lesions at risk performing ultrasound-guided biopsies of suspected lesions in ten patients. Among them, one case was diagnosed as malignant by the needle biopsy. All patients underwent surgery for myomectomy or hysterectomy, and the histology was confirmed in all cases. No complications occurred. The review of the literature shows other similar experiences of preoperative biopsy of uterine lesions, showing good results for the differential diagnosis between uterine sarcoma and leiomyoma. In our experience, despite the small number of patients enrolled, this technique is safe and effective to plan minimally invasive surgery of uterine fibroids.

Keywords

• biopsies
• differential diagnosis
• leiomyoma
• leiomyosarcoma
• ultrasound