Vaginal Removal of Very Large Nascent Uterine Myoma - Case Report and Literature Review.

Abstract:

:This report shows that even extremely large nascent uterine myomas can be removed vaginally. A 25-year-old nulligravid and nulliparous patient with malaise, hypermenorrhea, and intermittent cramping pain in the lower abdomen was referred to our clinic. Gynecological examination revealed a round cauliflower-like tumor, 7 cm in diameter, originating from the external cervical os with a rough surface and without a palpable stalk or base. Ultrasound scan showed a hyperechogenic mass within the uterine cavity with two distinct subunits: one (55 × 44 mm) well-demarcated from the surrounding structures and the other (43 × 38 mm) in close proximity to the lower part of the anterior uterine wall and in continuity with the myometrium. At surgery, the myoma was completely removed vaginally. Recovery was prompt, complete, and uneventful. Follow-up at one and three months confirmed normal gynecological and sonographic findings. In conclusion, vaginal myomectomy is the treatment of choice for prolapsed pedunculated submucous myoma; even extremely large nascent myomas can be efficiently removed vaginally. ZUSAMMENFASSUNG:Die vaginale Entfernung eines riesigen Uterusmyoms wird hier beschrieben. Eine 25-jährige Nullipara/Nulligravida wurde mit folgenden Beschwerden vorstellig: sie fühlte sich nicht wohl, litt unter Hypermenorrhö und leichten krampfartigen Schmerzen im Unterleib. Der gynäkologische Befund ergab einen runden, blumenkohlförmigen Tumor mit einem Durchmesser von 7 cm an der Endozervix. Der Tumor hatte eine grobe Oberfläche und war ohne erkennbaren Stiel oder Basis. Die Ultraschalluntersuchung zeigte eine hyperechogene Masse in der Gebärmutterhöhle, die sich in 2 Partien gliederte: einen klar abgegrenzten Teil (54 × 44 mm) und einen sehr nah am unteren Teil der vorderen Gebärmutterwand gelegenen Teil (43 × 38 mm) mit Verbindung zum Myometrium. Der Tumor wurde chirurgisch vaginal entfernt. Die Genesung war schnell und problemlos. Die gynäkologischen und sonografischen Befunde bei den Kontrolluntersuchungen nach 1 und 3 Monaten waren normal. Fazit: Die vaginale Myomektomie stellt eine mögliche Therapie dar zur Behandlung von submukösen Prolapsmyomen; sie kann aber auch erfolgreich bei riesigen Myomen angewandt werden.

authors

Terzic M,Maricic S,Dotlic J

doi

10.1055/s-0032-1328724

subject

Has Abstract

pub_date

2013-07-01 00:00:00

pages

724-726

issue

7

eissn

0016-5751

issn

1438-8804

journal_volume

73

pub_type

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