Massive retroperitoneal uterine fibroid causing life-threatening pulmonary embolism: A case report

Uterine fibroids are common in women of reproductive age and frequently remain asymptomatic. However, depending on their location, they may lead to severe symptoms or complications. This report describes a case in which a large uterine fibroid extending into the retroperitoneal cavity obstructed venous return. In addition, pelvic nerve compression resulted in pain-induced immobility, which precipitated sudden and severe thromboembolism. The patient required emergency thrombectomy via thoracotomy, followed by definitive hysterectomy. Anticoagulation therapy was continued postoperatively; following a regression of the thrombus, the treatment was switched to oral anticoagulants. The patient was eventually discharged with an uneventful clinical course and no complications. This case underscores the critical importance of appropriately timing surgical management for uterine fibroids, with careful consideration of tumor location and associated symptoms, to prevent potentially fatal outcomes.