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.