A rare case of cystic degeneration of fibroid uterus with clinical dilemma

Richa Pal, Niteen Ghorpade, Shanmugapriya Mahendran
In: International Journal of Reproduction, Contraception, Obstetrics and Gynecology · 2022 · vol. 11(9) , pp. 2534 · doi:10.18203/2320-1770.ijrcog20222325 · W4293528175
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This case report describes a 31-year-old woman with a uterine fibroid that underwent cystic degeneration, mimicking other myometrial pathologies on ultrasound before successful laparoscopic myomectomy.

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This case report describes a 31-year-old woman with menorrhagia and dysmenorrhoea whose uterine fibroid underwent cystic degeneration, producing an atypical imaging appearance. Ultrasound findings mimicked a myometrial cyst, adenomyosis, or hematometra, creating a diagnostic dilemma; laparoscopic myomectomy was performed, and histopathology confirmed cystic degeneration of a leiomyoma. As a single case report, its principal limitation is that the findings illustrate a rare presentation rather than establish general diagnostic performance or management outcomes. Relevance to adenomyosis: adenomyosis was included as a possible imaging mimic in this case, though the paper's main focus is cystic degeneration of a uterine fibroid.

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Abstract

Uterine fibroids are most common benign uterine neoplasm occurring in 20-30% of reproductive age. Generally, the sonographic appearance of leiomyomas is characteristic; however, they can undergo various kind of degenerations that can dramatically change their sonographic appearance and make the diagnosis quite challenging. We hereby describe a case report of 31-year-old women who presented with menorrhagia and dysmenorrhoea and her imaging with an ultrasound revealed an uterine myoma that undergone cystic changes, mimicking myometrial cyst, adenomyosis, hematometra. Laparoscopic myomectomy was done and histopathological examination revealed cystic degeneration of fibroid.
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A rare case of cystic degeneration of fibroid uterus with clinical dilemma DOI: https://doi.org/10.18203/2320-1770.ijrcog20222325Keywords: Uterine fibroids, Cystic degeneration, Laparoscopic myomectomyAbstract Uterine fibroids are most common benign uterine neoplasm occurring in 20-30% of reproductive age. Generally, the sonographic appearance of leiomyomas is characteristic; however, they can undergo various kind of degenerations that can dramatically change their sonographic appearance and make the diagnosis quite challenging. We hereby describe a case report of 31-year-old women who presented with menorrhagia and dysmenorrhoea and her imaging with an ultrasound revealed an uterine myoma that undergone cystic changes, mimicking myometrial cyst, adenomyosis, hematometra. Laparoscopic myomectomy was done and histopathological examination revealed cystic degeneration of fibroid. Metrics References Low SCA, CL Chong. A case of cystic leiomyoma mimicking an ovarian malignancy. Ann Acad Med Singapore. 2004;33:371-4. Maria LCF, Kiran AJ. Case report: Degenerating cystic uterine fibroid mimics an ovarian cyst in a pregnant patient. J Ultrasound Med. 2008;25:671-4. Okizuka H, Sugimura K, Takemori M, Obayashi C, Kitao M, Ishida T. MR detection of degenerating uterine leiomyomas. J Comput Assist Tomogr. 1993; 17:760-6. Chhavi K, Akhila P, Yashvant S. Case series: cystic degeneration in uterine leiomyomas. Indian J Radiol Imaging. 2008;18(1):69-72. Anyanwu M, Gassama K, Kandeh M. Diagnostic dilemma of hyaline cystic degeneration of uterine fibroids. Obstet Gynecol Int J. 2019;10(3):202-5. Cohen JR, Laxman B, Sagi J. Utrasonic “Honeycomb” appearance of uterinesubmucous fibroids undergoing cystic degeneration. J Clin Ultrasound. 1995;23:293-6. Wilde S, Scott -Barrett S. Radiological appearances of uterine fibroids. Indian J Radiol Imaging. 2009;19(3): 222-31. Bhardwaj P, Singh N, Batra S, Das TK. Massive cystic degeneration in uterine fibroid: Laparoscopic management. Curr Med Res Prac. 2016;6:245-8.

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