A giant pedunculated sub-serosal uterine leiomyoma with hypertrophied vessels attached to the small and large intestines: A case report

Abstract

Background: Giant leiomyomas are rare; however, they can cause significant morbidity to the surrounding organs if left untreated. Early treatment is essential to reduce the associated morbidity.
Case presentation: A 38-year-old nulliparous woman presented to the emergency gynecologic unit at the Kenyatta National Hospital. She gave a history of abnormal uterine bleeding for eight years, progressive abdominal swelling for six years, and a one year history of poor feeding and weight loss. Her abdomen was grossly distended. Abdomino-pelvic ultrasound and Computed Tomography (CT) scan revealed a large heterogeneous solid mass with a pedicular attachment to the uterus. She was scheduled for an open myomectomy, and resection anastomosis of the small intestine was done.
Conclusion: There is a need to exclude malignancy in atypical giant leiomyomas, and a thorough preoperative workup and multidisciplinary management are essential to a successful outcome.