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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (1): 135-138    DOI: 10.31083/j.ceog.2020.01.5001
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Pregnancy outcomes of a giant primary ovarian leiomyoma in the first trimester
S.Y. Jung1, H.Y. Cho1, S.H. Lee1, S. Lim1, K.B. Lee1, *()
1Department of Obstetrics and Gynecology, Gachon University Gil Medical Center, Incheon, South Korea
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Primary ovarian leiomyoma is a rare type of benign neoplasm. Ovarian leiomyoma cases until a recent date usually showed favorable pregnancy outcomes. Contrary to others, the present authors report a case of a nine-week miscarriage with a giant primary ovarian leiomyoma. This neoplasm originated from the ovary with estrogen secreted by the endocrine organs. Hormone secretion is increased during pregnancy, particularly in the first trimester; it is supposed that it stimulated growth and progression of the mass. A close examination in adnexa is necessary at prenatal check.

Key words:  First trimester      Leiomyoma      Miscarriage      Ovarian neoplasms      Pregnancy     
Published:  15 February 2020     
*Corresponding Author(s):  K.B. Lee     E-mail:

Cite this article: 

S.Y. Jung, H.Y. Cho, S.H. Lee, S. Lim, K.B. Lee. Pregnancy outcomes of a giant primary ovarian leiomyoma in the first trimester. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(1): 135-138.

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Figure 1.  — CT image and gross feature of primary ovarian leiomyoma. A) Transverse imaging: the uterus is deviated to the right; a large well-margined mass has a uniformly solid consistency in the pelvic cavity surrounded by the left salpinx. B) Sagittal imaging: there are no suspicious malignancy findings, such as ascites, metastasis, or enlarged lymph nodes. C) The uterus is displaced toward the right and forward. There are no remarkable findings in the right ovary. It has a round shape and well-circumscribed margin within the left ovary capsule without grossly normal ovarian tissues and is distinct from the uterus without coexistent leiomyoma. D) Left oophorectomy specimen: 17×12.5-cm-sized white solid mass.

Table 1  — Case characteristics of ovarian leiomyoma during pregnancy.
Author Maternal
GA1 at
GA at
Size of mass (cm)
ratio of mass2
Olshausen (1907) [9] 38 - 12 Man’s head size Abrupt growing3 Term birth
Moore and Forks (1945) [8] 34 - 12 16×13 Abrupt growing Term birth
Daniel et al (1997) [4] 31 Term Term Right: 8×5,
Left: 10×7
Incidental diagnosis4 Term birth
Kohno et al. (1999) [7] 30 16 20 23×23×20 Abrupt growing Term birth
Hsiao et al. (2007) [5] 42 Before conception Term 4.5×4.4×32 28.6% Term birth
Zhao et al. (2014) [10] 28 Before conception 14 18×16×10 650% Term birth
Kim (2016) [6] 35 Before conception 10 9.3×7.8 28.6% Term birth
Abdessayed et al. (2017) [3] 32 - 18 6.0×5.5 Incidental diagnosis Miscarriage
after operation
Current case 34 - 9 17×12.5 Abrupt growing Miscarriage
at GA 9 weeks
Figure 2.  — Microscopic finding of primary ovarian leiomyoma A) The tumor is well circumscribed. The ovarian stroma is visible on the right lower portion (Hematoxylin & Eosin staining, ×100). B) The tumor consists of spindle cells arranged in inter- secting fascicles (Hematoxylin & Eosin staining, ×200). C) The tumor cells are diffusely positive for smooth muscle actin (immunohistochemical staining, ×200).

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