An unusually large uterine fibroid: A case report of nulliparous with giant uterine fibroid removed 8 years after it was noticed

Abstract

The case is that of a 40 year old nulliparous who presented with progressive abdominal swelling, bilateral leg swelling, easy fullness and weight loss. She was married but husband had abandoned her because of this problem. Abdomen was massively distended without clinical signs of ascites. Ultrasound scan revealed abdominopelvic mass with features of uterine fibroid with pressure effects on the urinary tract. She had myomectomy done at which an unusually massive uterine fibroid in adhesions with anterior abdominal wall and the liver was found. She had prolonged daily peritoneal fluid effluent in excess of 300 mls for about 2 weeks which was managed. Histology of specimen revealed uterine leiomyoma. Late presentation for uterine fibroid is common in this part of the world, however this incident case that weighted 15 kg and involved in adhesion with the liver is not common. It is adviseable for patients with uterine fibroid to present early for treatment to achieve better outcome. It is also suggested for the gynecologist to counsel and peruse such cases at initial stages so to prevent adverse outcomes.