Uterine leiomyoma in a 40-year-old woman

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  • Post last modified:April 14, 2022
  • Post category:Medical News

A previously healthy 40-year old female presented to the gynaecological department of Care Hospital under Dr. Madhulika Rai, with gradual abdominal distension for six months, associated with progressive abdominal discomfort. There was no history of nausea, vomiting, weight loss, or anorexia. She reported no changes in bowel habits and denied genitourinary symptomatology. Her menstrual periods had always been regular. She denied recent sexual activity and was not currently taking oral contraceptives. The remainder of the patient’s history, including a focused family history, was non-contributory.

Physical examination revealed the presence of a somewhat firm, irregular, nontender, and mobile mass arising from the pelvis, corresponding in size to a pregnant uterus of 24 weeks’ gestation.

Laboratory analysis showed a blood haemoglobin concentration of 12.6 g/dL. The remainder of her laboratory results were within physiological parameters, and pregnancy was excluded.

Transabdominal ultrasonography revealed globular uterine enlargement and a hypoechoic mass measuring 18 cm × 14 cm. The ovaries and adnexa were not visualized because they were obscured by the enlarged, bulky uterus. Neither ascites nor hydronephrosis was noted. The patient was counselled about the diagnosis of uterine fibroid and underwent exploratory laparotomy after proper counselling.

Intraoperatively, the uterus was grossly enlarged by a large fibroid measuring 16 cm x 10 cm. Both ovaries and fallopian tubes were normal.

The patient’s postoperative course was uneventful, and she was discharged on postoperative day seven. A six-month follow-up with repeat ultrasonography was arranged. Counselling regarding recurrence and future fertility was offered before discharge. 

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