DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20184994

Unusual giant central cervical leiomyoma: surgical challenge

Aayushi Kaushal, Manjeet Kaur, Vidur Bhalla, Dilpreet Kaur

Abstract


Leiomyomas are most common uterine and pelvic tumours. The most common anatomical location is uterus. Fibroids arising from cervix are rare tumours accounting for 2% of all fibroids. A cervical leiomyoma is commonly single and is either interstitial or subserous, rarely it becomes submucous and polypoidal. Here authors report a case of huge cervical fibroid in an unmarried lady who presented to us with complaint of heaviness in abdomen. On per abdomen examination a firm mass of 32 weeks size arising from pelvis with restricted mobility was noticed. Ultrasound showed 21*10.3*10 cm heterogenous mass in pelvis with evidence of internal vascularity. MRI was suggestive of fibroid arising from body of uterus. True cut biopsy of the lesion was taken which showed benign lesion. Decision for myomectomy or Hysterectomy (according to intraoperative findings) was taken. While doing the procedure, after accidental ligation of left ureter and injury to bladder, diagnosis of cervical fibroid was made. Hence pre-operative diagnosis of cervical fibroid is very important in order to avoid damage to bladder and ureters.


Keywords


Cervical fibroid, Hysterectomy

Full Text:

PDF

References


Bhatla N. Tumours of the corpus uteri. In: Jeffcoates Principles of Gynaecology. 5th ed. London: Arnold Publisher; 2001:470.

Anna K, Avi BS, Martin LP. Benign disorders of the uterine cervix. In: De Cherney AH, Nathan I, eds. Current Diagnosis and Treatment in Obstetrics and Gynecology. 10th ed. USA: McGraw Hill Companies; 2007:623-638.

Tiltman AJ. Leiomyoma of uterine cervix: A study of frequency. Int J Gynaecol. 1998;17:231-4.

Suneja A, Taneja A, Guleria K, Yadav P, Agarwal N. Incarcerated procidentia due to cervical fibroid: An unusual presentation. Aust N Z J Obstet Gynaecol. 2003;43:252-3.

Dutta DC. Benign lesions of the uterus. In: Textbook of Gynaecology including Contraception. 3rd ed. India: New Central Book Agency (p) Ltd; 2004:264.

Schorge JO, Halvorson LM, Bradshaw KD, Schaffer JI, Hoffman BL, Cunningham FG. Pelvic mass. In: Schorge JO, Halvorson LM, Bradshaw KD, Schaffer JI, Hoffman BL, Cunningham FG, eds. Williams Gynecology. 23rd ed. USA: McGraw Hill; 2008:97-224.

Kwawukume EY. Leiomyoma of the uterus. In: Kwawukumw EY, Emuveyan EE, eds. Comprehensive Gynaecology in the Tropics. Accra: Asante and Hittscher Printing Press Limited; 2002:124-137.

Lethaby A, Vollenhoven B, Sowter M. Pre-operative GnRH analogue therapy before hysterectomy or myomectomy for uterine fibroids. Cochrane Database Syst Rev. 2001;2:CD000547.

Buttram VC Jr., Reiter RC. Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril. 1981;36:433.

Singh S, Chaudhary P. Central cervical fibroid mimicking as chronic uterine inversion, Int J Reprod contracept Obstet Gynaecol 2013;2(4):687- 88.

Kumar P, Malhotra N. Tumours of the corpus uteri. In: Jeffcoat‟s Principles of Gynaecology. 7th ed. Jaypee Brothers Medical Publisher (Pvt.) Ltd. New Delhi; 2008:487-516.

Monaghan JM, Lopes AB, Naik R. Total hysterectomy for cervical and broad ligament fibroids. In: Huxley R, Taylor S, Chandler K, eds. Bonney’s gynaecological surgery. 10th ed. Blackwell Publishing; 2004:74-86.