2University of Health Sciences Turkey, Gaziosmanpaşa Training and Research Hospital, Clinic of Radiology, İstanbul Turkey
3İstanbul Yeni Yüzyil University, Gaziosmanpaşa Hospital, Department of Radiology, İstanbul, Turkey
4Babaeski State Hospital, Clinic of Obstetrics and Gynecology, Kırklareli, Turkey
Abstract
Uterine leiomyomas constitute an important group of abnormal uterine bleeding (AUB) according to International Federation of Gynecology and Obstetrics classification system (PALM-coein). Bicornuate uterus anomaly is the 3rd most common uterine anomaly and the combination of these two entities is also rare. We present 46 years old gravida 1, para 1 women suffering from AUB for 6 years. There was bicornuate retroverted uterus image with 2 different endometrial cavities and 5 cm class 2 leiomyoma according to PALM-coein classification. Oral progesterone treatment was insufficient formerly and she refused hysterectomy or myomectomy procedures. Because she is not suitable for intrauterine levonorgestrel treatment, she was discussed with the interventional radiologists and planned for uterine artery embolization (UAE). Maximum diameter of 54 mm intramural myoma on magnetic resonance imaging before embolization was shrunk to 39 mm at the 6th month of intervention with no further anemia, AUB, and fatigue. This is the first case report representing the treatment of uterine leiomyoma in a bicornuate uterus with a successful UAE despite its uterine anomaly. UAE is a reliable technique in patients refusing surgery and predicted to have a risky and difficult operation, if performed by experienced interventional radiologists.