Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.
Clinical considerations and sonographic findings of a large nonpedunculated primary cervical leiomyoma complicated by heavy vaginal haemorrhage: A case report and review of the literature
Leiomyomas of the uterine cervix are uncommon. Cervical leiomyomas in non-pregnant women rarely are of clinical significance and their complications include pressure effects on the bladder or urethra, degenerative phenomema and menorrhagia. We present a case of 46-year-old female, gravida 2, para I who was presented in the gynaecological emergency room with the chief complaint of profound vaginal bleeding over the previous three weeks with recent passage of clots. Pregnancy test was negative. She suffered from profound orthostatic hypotension and tachycardia. On examination, her abdomen was soft, non-tender, and without rebound, guarding or palpable masses. Bimanual examination was notable for the presence of a large firm mass fixed to the uterine cervix. The cervix was 8 cm dilated and the body of the uterus was felt separate from the mass. The sonographic findings were consistent with a large cervical leiomyoma. Subtotal hysterectomy with salpingo-oophorectomy was performed and the patient's postoperative course was uneventful. In conclusion, in the present case the cause of the heavy vaginal bleeding was a primary cervical fibroid as the uterus attempted to abort it.