Giant uterine leiomyoma: a case report with literature review
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20184548Keywords:
Cystic degeneration, Giant tumor, Leiomyoma, UterusAbstract
Uterine leiomyomas are one of the most common entities encountered in routine gynaecological practice; however, the giant uterine myomas are very rare and can often create a diagnostic dilemma and therapeutic challenge owing to their size, non-specific clinical presentation and degenerations. Here, in this article we review the literature on giant uterine leiomyomas and report one such case in a 38-year-old woman who presented with the complaints of vague abdominal lump, enlargement of abdomen, dysmenorrhea, lower abdominal and pelvic pain since last 2 years and a 6-month history of increased frequency of micturation. Physical examination and radiological investigations suggested a giant abdominopelvic mass, probably a uterine or an ovarian malignancy. An exploratory laparotomy was performed followed by total hysterectomy. Grossly, the specimen was a 15.2 kg uterine leiomyoma measuring 18x18x13 cm in size. Histologically, the benign leiomyoma showed cystic degeneration. The patient’s post-operative and follow-up period was uneventful.
References
Wronski K. Giant uterine leiomyoma: case report and review of literature. New Med. 2014;3:89-91.
Alam IP, Newaz R. A Case of Giant Fibroid Uterus. Bangladesh J Obstet Gynaecol. 2012;27(1):27-30.
Cramer SF, Patel A. The frequency of uterine leiomyomas. Am J Clin Pathol. 1990;94(4):435-8.
Ezugwu EC, Iyoke CA, Ezugwu FO, Ugwu G. Successful Pregnancy Following Myomectomy for Giant Uterine Fibroid in an Infertile Woman. J Reprod Infertil. 2014;15(4):233-6.
Rahman H, Sharma BK, Khalda E, Pathak R, Dubey S. Giant leiomyoma uterus with myomatous erythrocytosis syndrome: A rare case report. J Cases Obstet Gynecol. 2016;3(3):88-91.
Savulescu F, Iordache I, Albiţa O, Hristea R, Dumitru C, Iordache A, et al. Giant uterine leiomyoma.Chirurgia (Bucur). 2011;106(5):665-8.
Moris D, Vernadakis S. Giant uterine leiomyoma mimicking pregnancy. Mayo clinic proceedings. 2014;89(6):53-4.
Powell JL. Giant fibroids. J Am Coll Surg. 2004;199(4):670.
Jonas HS, Masterson BJ. Giant uterine tumors: case report and review of the literature. Obstet Gynecol. 1977;50 (1 Suppl):2s-4.
Evans AT 3rd, Pratt JH. A giant fibroid uterus. Obstet Gynecol. 1979;54(3):385-6.
Mazzocconi G, Stasio A, Campli M, Sbaffi E, Voccia E. Giant pedunculated leiomyoma of the fundus uteri. G Chir. 1996;17(8-9):413-5.
Ozsaran AA, Itil IM, Terek C, Kazandi M, Dikmen Y. Giant myoma and erythrocytosis syndrome. Aust NZJ Obstet Gynaecol. 1999;39(3):384-6.
Djelmis J, Mayer D, Majerovic M, Radanovic B, Starcevic V. Giant uterine leiomyoma devascularized by embolization prior to surgical removal. Eur J Obstet Gynecol Reprod Biol. 2001;99(2):278-80.
Oelsner G, Elizur SE, Frenkel Y, Carp H. Giant uterine tumors: two cases with different clinical presentations. Obstet Gynecol. 2003;101(5 Pt 2):1088-91.
Nguyen-Duc H. Large uterine fibroma in a 15 year old adolescent. Giant leiomyoma in adolescence. J Gynecol Obstet Biol Reprod (Paris). 2003;32(8 Pt 1):748-50.
Costa Benavente L, Silva Barroso F, Avila Flores E. Giant uterine myoma. Ginecol Obstet Mex. 2005;73(10):563-5.
Perez M, Ramon JM. Large abdominal mass due to a giant uterine leiomyoma. Mayo Clin Proc. 2006;81(11):1415.
Panayotidis C, Salleh S, Martin J E, Hirsh P, Wynn J. Giant uterine leiomyomas: dilemmas in surgical management. Gynaecol Surg. 2006;3(1):37-40.
Nappi L, Matteo M, Giardina S, Rosenberg P, Indraccolo U, Greco P. Management of uterine giant myoma. Arch Gynecol Obstet. 2008;278(1):61-3.
Karim T, Patil K, Panchal A. A case of giant fibroid uterus in an adolescent girl of 16. NJOG. 2010;4(2):49-50.
Steward RG, Denhartog HW, Katz AR. Giant uterine leiomyomata. Fertility Steril. 2011;95(3):1121.e15-7.
Murtaza B, Ahmad M, Afzal M, Khan NA, Saeed S. Pedunculated uterine fibroid with hydronephrosis and colonic adhesions. PAFMJ. 2011;61(1):82-5.
Öndeş B, Yumru AE, Dinçgez B. Giant Uterine Leiomyoma. JAREM. 2011;1:32-32.
Al-Obaidi SM, Akool MA. A case of Giant Uterine Fibroid in a Young Woman. Iraqi Postgraduate Med J. 2012;11(4):588-92.
Aydin C, Eris S, Yalcin Y, Sen Selim H. A giant cystic leiomyoma mimicking an ovarian malignancy. Int J Surg Case Rep. 2013;4(11):1010-2.
Mate S, Szatmari E, Sipos M, Szell J, Szantho A, Rigo J Jr. Giant uterine leiomyoma causing acute symptoms. Orv Hetil. 2013;154(10):387-90.
Gajewska M, Kosińska-Kaczyńska K, Marczewska J, Kamiński P. Huge uterine leiomyoma with degenerative changes mimicking ovarian carcinoma-a case report. Ginekol Pol. 2013;84(2):147-50.
Funaki K, Fukunishi H, Tsuji Y, Maeda T, Takahashi T. Giant cystic leiomyoma of the uterus occupying the retroperitoneal space. J Radio Case Rep. 2013;7(12):35-40.
Kalayci TO, Akath AN, Sonmezgoz F, Samdanci ET. A giant subserosal uterine leiomyoma mimicking an abdominal mass: multimodal imaging data. Acta Medica Iranica. 2015;53(4):246-9.
Yavuz A, Astepe B, Terzi H, Kale A. Management of uterine giant myoma: case report. Sakaryamj. 2015;5(1):34-8.
Mulayim B. Unaware of a large leiomyoma: A case report with respect to unusual symptoms of large leiomyomas. Ann Med Surg (Lond). 2015;4(4):431-3.
Sharma RP, Sharma N, Sharma K, Sharma A, Jain A, Prasad A. Giant Uterine Leiomyoma and Review of Literature. IJMSCI. 2015;2(1):640-4.
Reshmy JR, Misra B, Rai R. Giant cystic leiomyoma masquerading as ovarian tumour- a case report. Sch J Med Case Rep. 2015;3(7):608-10.
Carbunaru A, Herlea, Ionescu M, Dumitrascu T. Extensive Left Iliac Veins and Inferior Vena Cava Thrombosis Revealing a Giant Uterine Myoma. Rom J Intern Med. 2016;54(1):70-3.
Gennaro Della Rossa MN, Santana BN, Verdejo-Arias MR, Cardenas EV, Arranz JP. Uterine Reconstruction Due to a Giant Myoma. A Case Report and Literature Review. OJOG. 2016;6:64-72.
Ramteke S, Joshi P, Zararia A, Dharmale D. Fast Growing Giant Intamural Leiomyoma: a Case Report. Int J Health Sci Res. 2016;6(4):542-5.
Muller R, Bresky P. Giant uterine fibroid- case report. Ceska Gynekol. 2016;81(1):71-5.
Hrgovic Z, Habek D, Cerkez Habek J, Hrgovic I, Jerkovic Gulin S, Gulin D. Spontaneous pregnancy during ulipristal acetate treatment of giant uterine leiomyoma. J Clin Pharm Ther. 2018;43(1):121-23.
Bartos V, Korec P, Ficek R. Giant Uterine Leiomyoma in a Young Woman as an Incidental Finding After a Car Accident: a Case Report. Acta Medica (Hradec Kralove). 2018;61(1):29-32.
