Volume : VI, Issue : IV, April - 2016

UNUSUAL PRESENTATION OF CERVICAL FIBROID

Dr. Shradha, Dr Prof. P. B. Sahay

Abstract :

 Leiomyoma is the commonest of all pelvic tumours, being present in 20% of all women of reproductive age group. Only 1–2% of these are confined to cervix and usually to supravaginal portion. Cervical leiomyoma is commonly interstitial or subserous, rarely does it become submucous and polypoidal. These tumours usually present with retention of urine, constipation, sensation of something coming out or foul smelling discharge per vaginum. At times though rarely it can present solely as an abdominal mass without other symptoms and may mimic an ovarian tumour as in the present case. Here we present a case of a seventeen years nulliparous female with huge abdominal lump and pain during menses for last six months. On examination there was 34 weeks size firm well defined abdominal lump arising from pelvis. Ultrasonographic findings were suggestive of an ovarian mass.CA125 was within normal limits and there was no ascitis. Our differential diagnosis was leiomyoma and ovarian tumour. However the diagnostic confusion got cleared only on exploratory lapratomy where a huge cervical fioid with a normal sized uterus sitting at top of it was found. This was referred to as lantern at the dome of st paul’s cathedral. Myomectomy was then performed with great difficulty. Postoperative period was uneventful; patient was discharged with advice for follow up visits. Cervical fioid with excessive growth is very uncommon and this case presented only as a huge abdominal mass with dysmenorrhoea leading to a diagnostic dilemma. Final diagnosis was made only at laprotomy. Myomectomy in this case was technically challenging as the pelvic anatomy was distorted and there was increased risk of injury to bladder, ureter and also an increased risk of intra operative bleeding. Moreover anatomical and functional restoration of cervix to achieve objective of future reproduction was limited. In the modern era such cases can be managed by laparoscopic surgery. INTRODUCTION

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Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

DR. SHRADHA, DR (PROF.) P. B. SAHAY UNUSUAL PRESENTATION OF CERVICAL FIBROID Indian Journal of Applied Research, Vol.6, Issue : 4 April 2016

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