An unusual presentation of central cervical fibroid: a case report

Samal, Sunita; Rathod, Setu; Rajsekaran, Anandraj; Rani, Reddi

doi:10.5455/2320-6012.ijrms20140878

Cited by 7 publications

(21 citation statements)

References 2 publications

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“…For enucleation in case of central cervical fibroid, the Rotherford Morrison's technique of hemisection of the uterus can also be used. 5 The problems anticipated during hysterectomy for large cervical fibroid are due to distortion of normal anatomy of ureter and uterine vessels and sometimes due to pulled up bladder anteriorly. Therefore, there are more chances of injury to ureter, bladder and uterine vessels.…”

Section: Discussionmentioning

confidence: 99%

“…3 If gonadotropin-releasing hormone (GnRH) analogues are given 3 months prior to surgery, they facilitate by reducing the size and vascularity of fibroids. 3,5,7 The disadvantage of GnRH analogue is that they can destroy the fine plane of cleavage between the capsule of the tumour and the surrounding structures.…”

Section: Discussionmentioning

confidence: 99%

“…On laparotomy the typical "Lantern on the top of St Paul's cathedral" appearance can be made out as the uterus will be sitting on top of the fibroid. 5,6 For symptomatic women, the treatment is either hysterectomy or myomectomy and the surgery depends on an accurate assessment of the size, number, and position of fibroids. MRI allows evaluation of the number, size, and position of fibroid and can evaluate their proximity to the bladder, rectum and endometrial cavity.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5] Pelvic pain and foul smelling vaginal discharge can be associated with the above mentioned symptoms. 3,5 Abdominal mass, incarcerated procidentia, sensation of something coming down and in case of pregnancy with cervical fibroid it can cause obstructed labour. 2 Central cervical fibroid expands the cervix equally in all directions so the pelvic cavity will be completely filled by the tumour.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7] Symptoms are mainly due to pressure effects on the bladder leading to acute urinary retention and increased frequency of micturition, the pressure effect on the rectum can cause constipation. [3][4][5] Pelvic pain and foul smelling vaginal discharge can be associated with the above mentioned symptoms. 3,5 Abdominal mass, incarcerated procidentia, sensation of something coming down and in case of pregnancy with cervical fibroid it can cause obstructed labour.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Central cervical fibroid with a typical Lantern on top of St. Paul's cathedral appearance

Bhandiwad

Gowda

Anupama

2016

Int J Reprod Contracept Obstet Gynecol

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Central cervical fibroid with a typical Lantern on top of St. Paul's cathedral appearance

Bhandiwad

Gowda

Anupama

2016

Int J Reprod Contracept Obstet Gynecol

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Large cervical fibroid: a rare case report

Sunanda

2019

Int J Reprod Contracept Obstet Gynecol

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Although leiomyomas are the most common pelvic tumors presenting in the reproductive age group, cervical fibroids are rare accounting for 2% of all uterine fibroids. We report a case of 40 year old lady presenting with a firm, nontender mass of 22-24 weeks size pregnant uterus with restricted mobility. Laparotomy showed a large mass arising from the anterior lip of cervix, with a small uterus pushed posteriorly. Enucleation followed by total abdominal hysterectomy was done. Large cervical fibroids are rare, presenting with surgical difficulties. Careful dissection by expert hands is needed in the management of such cases.

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Challenging myomectomy of large cervical fibroid - successful fertility outcome: a case report

Banu,

Altarique,

Sultana

et al. 2024

Int J Reprod Contracept Obstet Gynecol

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The cervical fibroids are rare and large cervical fibroids are rarer. Removing large cervical fibroids when a patient desires future fertility is a surgical challenge because of the risks of significant blood loss, bladder and ureteric injury, and unplanned hysterectomy. For women who desire future fertility, myomectomy can improve the chances of pregnancy by restoring normal anatomy. In this article, we describe a successful pregnancy following the restoration of the normal anatomy of the cervix by a challenging myomectomy in a sub-fertile patient with a large cervical fibroid. A 38-year-old nulliparous lady presented to the reproductive endocrinology and infertility (REI) department of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh with primary sub-fertility for five and half years, and dysmenorrhea for 2 years. She was a regularly menstruating woman with average flow and duration. Being a resident of Canada, she was diagnosed there as a case of large cervical fibroid (10×9 cm) by TVS extending up to the posterior wall of the uterus, cervix, and upper vagina impacted in the pouch of Douglas during infertility workup. For this reason, she was advised for in vitro fertilization (IVF) keeping the fibroid in situ. However, due to the failure of embryo transfer with this large cervical fibroid, she was advised for embryo transfer following myomectomy. Hysteroscopic myomectomy was tried first (in February 2019 in Canada) but was unable to be removed. Then Laparotomy was tried (in September 2019 in Canada) but failed again. Being a complicated case, she was counselled there for myomectomy by a multidisciplinary approach with the high risk of injury to the urinary bladder, ureter, bowel, and other pelvic structures. But she refused to do a myomectomy there after knowing the dreadful complications with the fear of injury to the pelvic organs. With this problem, she went to different institutions both in the country and abroad but couldn’t get the proper treatment. Finally, she visited the outpatient department (OPD) of the REI department, BSMMU, Dhaka, Bangladesh with the hope of getting the most appropriate treatment for her and she was reassured, counselled, and managed by a challenging myomectomy (in March 2022) through a combined approach of the vagina and abdominal route without any significant intra and post-operative complications. Her whole post-operative period was uneventful, the anatomy of the cervix was restored and detected by TVS, and trial transfer was done before embryo transfer with easy negotiation to the cervix. Finally, she conceived 1 year after myomectomy with easy frozen embryo transfer. Myomectomy in expert hand even for the large cervical fibroid can restore normal anatomy and can achieve successful pregnancy outcomes.

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An unusual presentation of central cervical fibroid: a case report

Cited by 7 publications

References 2 publications

Central cervical fibroid with a typical Lantern on top of St. Paul's cathedral appearance

Central cervical fibroid with a typical Lantern on top of St. Paul's cathedral appearance

Large cervical fibroid: a rare case report

Challenging myomectomy of large cervical fibroid - successful fertility outcome: a case report

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