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Giant prolapsed submucous leiomyoma: a surgical challenge for gynecologists
L G O Brito1, P S Magnani, A Eugênio de Azevedo Trapp
1Department of Gynecology and Obstetrics, Urogynecology Division, Faculty of Medicine of Ribeirão Preto, São Paulo University Ribeirão Preto, SP, Brazil. lgobrito@gmail.com
Abstract:
We present a case of a 45-year-old woman who presented with irregular vaginal bleeding and menorrhagia for two months, with an episode of massive bleeding initiating 24 hours before with hemodynamic shock. Vaginal inspection showed a soft, rounded, friable mass in vaginal introitus. After hospitalization, blood transfusion and hydration, she was submitted to vaginal myomectomy with the withdrawal of a 12-cm white, solid, huge, pedunculated, leiomyoma; however, hysterectomy was performed due to persistent uterine bleeding. The postoperation period had no complications. Macroscopy showed a retraction of the myoma pedicle. Gynecologists should prioritize clamping of a pedicle before surgery, reducing its size if the tumor is large.