22-year-old woman
Irregular vaginal bleeding and mass prolapsing through cervix initially believed to be a benign fibroid.
Symptoms
- Spotting throughout the month
Ultrasound
- Suspected fibroid in the endometrial cavity
Examination
- Necrotic fibroid at top of the vagina passing through a partially dilated cervix. The uterus was 14-week size.
Recommendations
- Patient initially recommended to undergo vaginal myomectomy.
Treatment
- D&C with removal of necrotic mass. Pathology reported a Leiomyosarcoma (cancerous fibroid). The patient then underwent TAH/BSO (total abdominal hysterectomy, bilateral salpingo-oophorectomy), lymph node dissection, and omentectomy.
Goldberg morcellation technique to remove central potato sized fibroid distorting endometrial cavity through mini-laparotomy incision
Fibroids removed