Varied Clinical Presentations, the Role of Magnetic Resonance Imaging in the Diagnosis, and Successful Management of Cervical Leiomyomas: A Case-Series and Review of Literature

Gupta, Avantika; Gupta, Purnima; Manaktala, Usha

doi:10.7759/cureus.2653

Cited by 8 publications

(16 citation statements)

References 11 publications

(16 reference statements)

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“…We present the case of a giant cervical polyp was the first case in our centre in the past 20 years; thus, confirming its rarity. The symptoms of a painless mass protruding through the vagina with discharge and bleeding in our case was consistent with that reported in the literature [9], [10]. Only 22 cases of giant cervical polyps have been reported so far [11], and there is no case reported from North Macedonia.…”

Section: Discussionsupporting

confidence: 90%

An An Unusually Large Fibroepithelial Polyp of Uterine Cervix: Case Report and Review of Literature

Rexhepi¹,

Trajkovska²,

Koprivnjak³

2019

Open Access Maced J Med Sci

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BACKGROUND: Fibroepithelial cervical polyps (FEPs) are benign growths protruding from the inner surface of the cervix. They are typically asymptomatic, but a very small minority can undergo malignant change. Giant cervical polyps with a size greater than 4 cm are rare entities with only 23 reported cases in the literature. Cervical polyps develop as a result of focal hyperplasia of the columnar epithelium of the endocervix.CASE PRESENTATION: We present the case of a giant fibroepithelial polyp measuring approximately 11 x 6 x 4 cm which was protruding from the anterior lip of the uterine cervix in a 51-year-old woman who clinically presented vaginal bleeding. She was nulligravida and doesn’t have a child. The speculum examination revealed a soft, mobile, painless irregular cerebriform mass on the cervix, protruding through the vagina. The polyp was excised using a scalpel, and the pedicle was sutured using the Vicryl 1-0 under short-term intravenous anaesthesia. Histopathological examination revealed a polypoidal tumour mass composed of cellular fibrovascular stroma covered with stratified squamous epithelium. Three months after the initial surgery, there was no recurrence seen.CONCLUSION: Cervical giant polyps are rare entities and occur mostly in perimenopausal women. Transvaginal polypectomy, as performed for this patient followed by histopathological examination is an adequate procedure for these lesions.

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Section: Discussionsupporting

confidence: 90%

An An Unusually Large Fibroepithelial Polyp of Uterine Cervix: Case Report and Review of Literature

Rexhepi¹,

Trajkovska²,

Koprivnjak³

2019

Open Access Maced J Med Sci

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“…Cervical fibroids are rare and can be anterior, posterior, lateral and central. It commonly occurs as a single fibroid but can also be multiple and is either interstitial or subserous [2,3,5,6] . Rarely can it be sub mucosal or polypoidal [3,6] .…”

Section: Discussionmentioning

confidence: 99%

“…In this study we noted 2 central interstitial fibroids and two polypoidal variety. Very few cases of large isolated cervical fibroids have been reported in literature as excessive growths in cervical fibroids are rare due to the paucity of smooth muscles in the cervical stroma [1,2,3,5,6] . Fibroids are oestrogen dependent and usually occur in the reproductive age group.…”

Section: Discussionmentioning

confidence: 99%

“…They may present as an abdominal mass mimicking ovarian mass or like a large polyp. Cervical fibroids may be confused with an incarcerated procidentia or chronic uterine inversion [2,3,5] . There may be surgical difficulties due to their close proximity to pelvic organs and hence risk of bladder and bowel injuries is very common along with increased intraoperative bleeding.…”

Section: Introductionmentioning

confidence: 99%

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Varied presentation and management of cervical fibroids: A case series

Harikanth¹,

Shrigiriwar²,

Ramteke³

2021

Int. J. Clin. Obstet. Gynaecol.

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Cervical fibroids are rare pelvic tumours with varying clinical presentations. Clinical and radiological evaluation of these fibroids help in deciding the treatment approach. There will be surgical difficulties due to their close proximity to pelvic organs like bladder, ureters and rectum. Hence proper intraoperative delineation is important. We present a series of four cases of cervical fibroid with different presentations and management. All these cases were evaluated and surgically managed without complications. The first and third case presented with huge mass per abdomen and pressure symptoms. Both underwent exploratory laparotomy where fibroid was enucleated followed by hysterectomy. The second and fourth case mimicked like a large polyp. In both the cases, cervical fibroid was excised vaginally and was followed by hysterectomy. Histopathological examination was suggestive of cervical leiomyoma. Therefore, cervical fibroid as a differential diagnosis should always be considered while evaluating any pelvic masses.

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“…Pathologic entities such as endometriosis, 1 fibroids, 2 and gynecologic malignancy 3 can affect the ureters, usually due to extrinsic compression, leading to hydroureter, hydronephrosis, and ultimately, loss of renal function 4‐6 . Occasionally, patients have urologic symptoms such as colicky flank pain and hematuria in the setting of gynecologic disease 7 .…”

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confidence: 99%

Ureter Visualization With Transvaginal Ultrasound

Ong

Leonardi

Espada

et al. 2020

J of Ultrasound Medicine

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Objectives-To evaluate the learning curve of gynecologic surgical fellows (ie, in training) to properly identify the ureters in real time while simultaneously performing and interpreting transvaginal ultrasound (TVUS) examinations. Methods-We performed a prospective study, which took place at 2 centers in Sydney, Australia, from December 2017 to December 2018. Three fellows (F1-F3), of varying prestudy ultrasound (US) experience, were recruited to participate. One hundred fifty predetermined examinations were planned. A TVUS examination was performed by the study reference standard (an expert in gynecologic US). Subsequently, the fellows performed a focused component to identify bilateral ureters, having been blinded to the patient's clinical history and reference standard findings. Immediate feedback and hands-on teaching were provided after each of the fellow's evaluations were complete. To evaluate the number of scans needed to gain competency, the cumulative summation test for the learning curve was used. Results-A total of 150 examinations were performed on 145 patients. One patient had a single ureter, and 1 patient had US evidence of hydroureter. The cumulative summation test for the learning curve for bilateral ureter identification showed that F1 did not reach competency by 50 TVUS examinations, whereas F2 and F3 required 41 and 31 TVUS examinations to reach competency, respectively. Conclusions-Contrary to other studies on the topic, this study suggests that although it is feasible for surgical fellows to learn TVUS identification of bilateral ureters, not all fellows can reach competency during a program based on a predefined number of scans. We advocate for an individualized, competencybased medical education model in learning US for identifying the ureters.

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Varied Clinical Presentations, the Role of Magnetic Resonance Imaging in the Diagnosis, and Successful Management of Cervical Leiomyomas: A Case-Series and Review of Literature

Cited by 8 publications

References 11 publications

An An Unusually Large Fibroepithelial Polyp of Uterine Cervix: Case Report and Review of Literature

An An Unusually Large Fibroepithelial Polyp of Uterine Cervix: Case Report and Review of Literature

Varied presentation and management of cervical fibroids: A case series

Ureter Visualization With Transvaginal Ultrasound

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