Degenerated fibroid: a diagnostic dilemma


  • Nayanika Gaur Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
  • Manish Jha Department of Anesthesia and Critical Care, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India



Degenerated myoma, Laparotomy, Leiomyoma, Malignancy, Ovarian mass, Ovarian malignancy


Leiomyoma is one of the most commonly encountered benign gynaecological neoplasms. With a wide range of symptoms, sometimes even asymptomatic, these tumors are easy to diagnose and treat, unless there are degenerative changes, which makes them difficult to diagnose and differentiating them from other serious conditions including malignancy, thereby, complicating their management also. Here, the case present to you a case of 48-year-old women with symptoms and clinical examination suggesting fibroid uterus but imaging studies inconclusive to differentiate fibroid uterus with ovarian malignancy, thus, creating a diagnostic dilemma. Ultimately, patient underwent exploratory laparotomy, keeping possibility of ovarian malignancy. Histopathological examination of the specimen of total abdominal hysterectomy with bilateral salpingo-oopherectomy concluded extensive cystic degeneration of leiomyoma and no evidence of malignancy.


Walker CL, Stewart EA, Uterine fibroids: the elephant in the room. Sci. 2005;308(5782):1589-92.

Stewart EA. Uterine fibroids. Lancet. 2001;357:293-8.

Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, et al. GLOBOCAN 2012 v1. 0, Cancer incidence and mortality worldwide: IARC CancerBase No. 11. International Agency for Research on Cancer, Lyon, France. 2013. globocan. iarc. fr. 2015.

Odofin O, Nasir N, Satyadas T, Lower AM, Akle C. An unusual case of ectopic or “parasitic” leiomyoma excised by laparoscopic surgery. Int Surg. 2004;89(3):161-3.

Bansal P, Garg D, A case of massive broad ligament leiomyoma imitating an ovarian tumor. J Clin Diagn Res. 2014;8:136-7.

Ueda H, Togashi K, Konishi I, Kataoka ML, Koyama T, Fujiwara T, et al. Unusual appearances of uterine leiomyomas: MR imaging findings and their histopathologic backgrounds. Radiograph. 1999;19:131-5.

Rock JR, Jones HW. Leiomyomata Uteri and Myomectomy. In: Te Linde’s Operative Gynecology. 10th edition Philadelphia: Wolters Kluwer Health/ Lippincott Williams and Wilkins; 2008:687-712.






Case Reports