CASE REPORT
Management of giant myoma – case report and literature review
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1
II Chair and Department of Gynecology, Medical University of Lublin, Lublin, Poland
2
Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, Lublin, Poland
Submission date: 2023-08-29
Final revision date: 2023-10-06
Acceptance date: 2023-10-06
Online publication date: 2023-10-20
Corresponding author
Monika Ruszała
Chair and Department of Obstetrics and Perinatology,
Medical University of Lublin, Jaczewskiego 8, 20-090 Lublin, Poland.
Pol. Ann. Med. 2023;30(2):161-165
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Uterine myomas are one of the most frequently discussed issues in gynecology. Most of them are asymptomatic, however, severe pain in pelvis minor, heavy uterine bleeding or infertility may be reported by the patients and worsen quality of women’s daily life. Giant myomas are very rare and can be directly life-threatening.
Aim:
The aim of this study was to present a clinical case of giant myoma, its management and highlight the potential impact on women’s health and well-being.
Case study:
A 70-years-old patient with a pain in lower part of abdomen, constipation and tiredness manifested difficulties in breathing. Abdominal examination revealed a huge, elastic abdominal mass extending from xiphoid process to the pubic bone. A total abdominal hysterectomy with right salpingo-oophorectomy was done.The patient was discharged from the hospital on the day 9 after the surgery and recovered without any incident.
Results and discussion:
Patients with giant uterine myomas may develop respiratory failure and require intensive respiratory care. One of the highest priorities should be adequate ventilation and reduction the vena cava compression. Cleansing the intestines before surgery decreases the risk of contamination the peritoneal cavity by digestive tract content, in case of possible extension of the scope of surgery.
Conclusions:
In the case of treatment of large uterine myomas, interdisciplinary cooperation of specialists in various fields is necessary in order to protect the patient’s vital parameters and prevent the occurrence of rare complications.
FUNDING
None declared.
CONFLICT OF INTEREST
None declared.
REFERENCES (25)
1.
Ovayolu A, Filiz T, Savli T. A case of giant extra-uterine myxoid leiomyoma: An unusual benign pathology mimicking malignancy. Pol Ann Med. 2022;29(2):229–232.
https://doi.org/10.29089/paom/....
2.
Nappi L, Matteo M, Giardina S, Rosenberg P, Indraccolo U, Greco P. Management of uterine giant myoma. Arch Gynecol Obstet. 2008;278(1):61–63.
https://doi.org/10.1007/s00404....
3.
Okamoto T, Koshiyama M, Yamamoto K. Treatment of huge uterine tumors thought to be benign in post-menopausal women. Med Sci Monit. 2004;10(2):43–45.
4.
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):1010–1012.
https://doi.org/10.1016/j.ijsc....
6.
Yamamoto A, Suzuki S. Successful surgical treatment of a giant uterine leiomyoma: A case report. Int J Surg Case Rep. 2021;87:106416.
https://doi.org/10.1016/j.ijsc....
7.
Fellmann M, Battegay R, Rauchfleisch U, Mall-Haefeli M. Comparative socioeconomic, anamnestic and psychological studies of patients with uterine myoma and uterine prolapse [in German]. Schweiz Arch Neurol Neurochir Psychiatr. 1983;132(1):105–15.
10.
Nishikawa H, Ideishi M, Nishimura T, et al. Deep venous thrombosis and pulmonary thromboembolism associated with a huge uterine myoma. J Vasc Dis. 2000;51(2):161–166.
https://doi.org/10.1177/000331....
11.
Martín-Merino E, Wallander MA, Andersson S, Montse Soriano-Gabarró M, Rodríguez LAG. The reporting and diagnosis of uterine fibroids in the UK: an observational study. BMC Women's Health. 2016;16:45.
https://doi.org/10.1186/s12905....
13.
Milazzo GN, Catalano A, Badia V, Mallozzi M, Caserta D. Myoma and myomectomy: Poor evidence concern in pregnancy. J Obstet Gynaecol Res. 2017;43(12):1789–1804.
https://doi.org/10.1111/jog.13....
15.
Juhasz-Böss I, Jungmann P, Radosa J, et al. Two novel classification systems for uterine fibroids and subsequent uterine reconstruction after myomectomy. Arch Gynecol Obstet. 2017;295(3):675–680.
https://doi.org/10.1007/s00404....
16.
Ji L, Jin L, Hu M. Laparoscopic myomectomy with temporary bilateral uterine artery occlusion compared with traditional surgery for uterine myomas: Blood loss and recurrence. J Minim Invasive Gynecol 2018;25(3):434–439.
https://doi.org/10.1016/j.jmig....
17.
Keltz J, Levie M, Chudnoff S. Pregnancy outcomes after direct uterine myoma thermal ablation: Review of the Literature. J Minim Invasive Gynecol. 2017;24(4):538–545.
https://doi.org/10.1016/j.jmig....
18.
Pisat S, van Herendael BJ. Temporary ligation of the uterine artery at its origin using a removable ‘shoelace’ knot. J Minim Invasive Gynecol. 2020;27(1):26.
https://doi.org/10.1016/j.jmig....
19.
Stewart EA, Laughlin-Tommaso SK, Catherino WH, Lalitkumar S, Gupta D, Vollenhoven B. Uterine fibroids. Nat Rev Dis Primers. 2016;2:16043.
https://doi.org/10.1038/nrdp.2....
21.
Warda H. A trial placement of a prophylactic ureteral catheter during the excision of a huge pelvic mass with incidental cystotomy. Cent Eur J Urol. 2013;66:372–375.
https://doi.org/10.5173/ceju.2....
22.
Toyama K, Mitus WJ. Experimental renal erythrocytosis. Relationship between the degree of hydronephrotic pressure and the production of erythrocytosis. J Lab Clin Med. 1966;68(5):740–752.
25.
Stanko CM, Severson MA 2nd, Molpus KL. Deep venous thrombosis associated with large leiomyomata uteri. A case report. J Reprod Med. 2001;46(4):405–407.