49-year-old woman
Presented for a 2nd opinion after hysterectomy was recommended due to the risk of malignancy.
Symptoms
- She reported minimal symptoms, not affecting her quality of life.
Ultrasound
- Multiple large fibroids
Examination
- 20-week size uterus filling the pelvis up to her umbilicus
Recommendations
- The patient was educated of the rarity of leiomyosarcoma. Given minimal effect on her QOL and proximity to menopause, no treatment (expectant management) was recommended. Other options discussed were UFE, myomectomy, and hysterectomy.
Treatment
- She elected no treatment with no increase in her symptoms. Following menopause, her uterus decreased in size by 50%.
Goldberg morcellation technique to remove central potato sized fibroid distorting endometrial cavity through mini-laparotomy incision
Fibroids removed