摘要
Objective:To analyze the clinical characteristics,diagnostic challenges,treatment strategies,and long-term outcomes of ovarian leiomyomas through a 20-year retrospective study,aiming to improve awareness and management of this rare tumor.Methods:This single-center retrospective study included 39 cases of ovarian leiomyomas confirmed by histopathology and immunohistochemistry between January 2003 and December 2023 at the Obstetrics and Gynecology Hospital affiliated with Fudan University.Clinical,imaging,surgical,and follow-up data were systematically reviewed.Pathological criteria,including mitotic index and immunohistochemical markers,were used for tumor classification.Results:Among the 39 patients,10 were diagnosed with primary ovarian leiomyomas and 29 with secondary forms.The average age was 52.3 years,and most tumors were unilateral and incidentally discovered.Clinical symptoms included abdominal pain,distension,and abnormal uterine bleeding,while 66.7%of patients were asymptomatic.Imaging via ultrasound revealed solid or hypoechoic masses,but lacked specificity.MRI was used in only three cases.Histologically,tumors showed well-differentiated smooth muscle cells with low mitotic activity.Immunohistochemical staining confirmed smooth muscle origin.All patients underwent surgical excision.No recurrences were observed during a median follow-up of 12 years.Conclusion:Ovarian leiomyomas are rare and often asymptomatic,leading to frequent misdiagnosis.Accurate diagnosis relies on histopathology and immunohistochemistry.Surgical resection offers excellent outcomes,and ovary-sparing approaches should be considered in younger patients.Greater clinical awareness and additional research are essential to improve diagnostic accuracy and therapeutic strategies.
