Leiomioma Uteri Besar pada Wanita dengan Grande Multipara dan Pasca-Menopause di Rumah Sakit Umum Daerah Ciamis : Sebuah Laporan Kasus

Abstract

Pendahuluan: Leiomyoma uteri, merupakan neoplasma jinak yang berasal dari otot rahim. Leiomyoma uteri biasanya tumbuh selama usia 30 - 50 tahun, dan kemudian stabil atau menurun setelah menopause. Namun, terdapat beberapa laporan mengenai sejumlah besar pasien yang telah menjalani operasi leiomyoma uteri selama periode pasca-menopause.
Presentasi Kasus: Kami melaporkan kasus wanita dengan grande multipara berusia 58 tahun dan pasca-menopause dengan keluhan utama perut terasa membesar sejak 1 tahun. Pasien termasuk kedalam kategori obesitas tipe 2 dengan pemeriksaan tanda vital dalam batas normal dan Pemeriksaan abdomen di dapatkan massa yang mobile dengan ukuran uterus sebesar usia kehamilan 8 bulan yang terbentang di garis tengah tubuh area abdomen. Pada pemeriksaan USG di temukan adanya massa hipoekoik pada uterus. Dilakukan tatalaksana operatif pada pasien dengan giant leiomyoma uteri dengan berat 5 kg tanpa keluhan kompresi yaitu potongan beku, dan total abdominal histerektomi dengan bilateral salpingo-oophorectomy. Hasil pemeriksaan patologi anatomi yaitu tumor jinak leiomyoma uteri intramural.
Kesimpulan: Leiomioma sangat umum dan diasumsikan akan hilang seiring dengan di mulainya menopause. Penyebab terjadinya leiomyoma uteri di sebabkan karena interaksi berbagai variasi faktor risiko di antaranya usia, paritas, obesitas, merokok, hipertensi, diet, stress, riwayat kontrasepsi oral yang dapat menstimulasi peningkatan hormon estrogen dan progesterone yang meningkatkan pertumbuhan leiomyoma uteri secara definitif masih belum dapat di simpulkan.

Giant Uterine Leiomyoma in Grand Multiparity and Post Menopause Woman at Ciamis Regional General Hospital : A Case Report

Abstract
Introduction: Leiomyoma Uterine, are benign neoplasms originating from the uterus. Uterine leiomyomas typically grow during the age 30 to 50 years of age, and then stabilize or regress after menopause. However, there have been several reports of a considerable number of patients who have undergone surgery for uterine leiomyomas during the postmenpause period.
Case Presentation: We report the case of 58 year old female grand multiparity and post menopause with chief complaining of a fast expanding lump in her belly over the past year. Patient categorized a type two obesity, her vital sign was normal and during the abdominal examination a moveable mass that could have been an 8 month pregnancy was felt in the midline of the abdominal area. On ultrasound examination, it was found that there was a hypoechoic mass in uterine. A frozen section, a bilateral salpingo-oophorectomy, and total abdominal hysterectomy were performed for giant uterine leiomyoma weighing 5 kg without compression symptoms. The results of the histology suggested a benign intramural uterine leiomyoma.
Conclusion: Leiomyomas are very common and the assumption that they will resolve with the onset of the menopause. The occurrence of uterine leiomyomas was the result of mutual interaction among various factors including age, parity, obesity, smoking, blood pressure, diet, stress, oral contraceptive but whether some of the risk factors can promote estrogen and progesterone to induce uterine leiomyomas has no definitive conclusion.

Key words: Giant Leiomyoma; Post Menopause