Massive uterine fibroid: a diagnostic dilemma: a case report and review of the literature

Abstract

Background Fibroids of the uterus are the most common benign pelvic tumors in women worldwide. Their diagnosis is usually not missed because of the widespread and well-established use of ultrasound in gynecological clinics. Hence, the development of an unusually large myoma is a rare event, particularly in first-world countries such as Germany. It is even more uncommon that a myoma is misdiagnosed as a dietary failure. Case presentation Herein, we report the case of a Caucasian woman with a giant fibroid that reached a size of over 50 cm, growing slowly over the past 15 years, and was misdiagnosed as abdominal fat due to weight gain. We aim to discuss the factors that lead to the growth of such a huge tumoral mass, including misdiagnosis and treatment, and the psychological impact. Through this case, we intend to increase the awareness among general physicians and gynecologists. Although menstrual disorders incorporate several pathologies, adequate assessment remains the primary responsibility of health care providers. A literature review revealed approximately 60 cases of giant uterine fibroids. Conclusion The use of clinical and diagnostic devices, especially ultrasound, in this case, is indispensable. In conclusion, the growth of a giant fibroid can have disastrous effects on a woman’s health, including surgical trauma and psychological issues.

Combined Influence of Nutrient Supply Level and Tissue Mechanical Properties on Benign Tumor Growth as Revealed by Mathematical Modeling

“…Interestingly, the formation of giant benign tumors in case of low hydraulic conductivity seems to be a physiologically reasonable result. Such situations were observed clinically, e.g., in cases of fibroepithelial tumors, which consist of epithelial and stromal tissues, the latter primarily being made of fibrous extracellular matrix [49,50], and in cases of fibroids, benign smooth muscle tumors, whose growth is accompanied by ample production of extracellular matrix [51,52].…”

Myomatous erythrocytosis syndrome: A case report

“…To date, the prevailing view is that uncontrolled ectopically produced EPO is responsible for the overproduction of RBCs[ 7 , 13 - 15 ]. EPO is a hematopoietic cytokine that is usually produced in the kidneys of adults[ 4 ].…”

“…In the nonpregnant control patients, although the expression of EPO and EPO-R was also observed, the frequency and intensity were much lower (4/8 with weak EPO expression and 3/8 with weak EPO-R expression). The author then pointed out that EPO was exclusively localized within the cytoplasm of uterine smooth muscles, whereas EPO-R was almost entirely localized within the vascular endothelial cells, in both the case and the control groups[ 14 ], proving that this autocrine or paracrine mechanism may exist, stimulating myoma cell growth, stabilizing vascular integrity, increasing the number of epithelial cells, protecting them against ischemia and apoptosis, and thus contributing to the unusual size of the myoma[ 15 , 16 ]. According to our findings, we also believe that the EPO produced by the uterine myoma is the cause of the excessive RBCs in the blood system, and the level of erythrocytosis is related to the amount of EPO.…”

Effects of ethanol extracts of Diodia sarmentosa leaves on biochemical and histopathological indices of monosodium glutamate-induced uterine leiomyoma in rats

“…Uterine leiomyoma, commonly known as a fibroid, is a benign tumor of the muscle tissue that grows in the wall of the uterus 3 . Uterine fibroids predominantly occur in women over the age of 30 4 . Fibroids are a common gynecological problem as well as the most common benign genital tract tumor, which can lead to pregnancy loss and other fertility issues in women of reproductive age 5-7 .…”