Presentation
Abnormal vaginal bleeding, with abdominal pain. There is a palpable abdominal mass.
Patient Data
A large, multilobulated, fibroid uterus is present. It measures at least 23.8 cm x 19.9 cm x 18.2 cm (L x AP x W) and extends up to the T12/L1 level in the left upper quadrant. There is no associated central or peripheral calcification. There is heterogeneous enhancement post-contrast administration with evidence of cystic degeneration. The right ovary is identified and appears normal. The left ovary is not identified. The bladder is displaced anteroinferior, with displaced however unobstructed ureters bilaterally. Displaced small and large bowel loops as expected, however, there is no bowel obstruction. CT imaging is otherwise unremarkable.
Macroscopy:
Gross specimens of the large uterus and fibroid, cervix, and bilateral fallopian tubes are provided. A large, solitary, uterine fibroid is present, measures 29.0 x 24.5 x 12.0 cm, and weighs 4.663 kg.
Microscopy:
There is no associated adenomyosis, no endometriosis, and no malignancy or dysplasia. The fallopian tubes and cervix are normal.
Case Discussion
A histopathologically confirmed solitary, large, benign uterine fibroid. The left and right ovaries were identified at the time of hysterectomy and appeared normal. The patient had an unremarkable post-surgical stay and left the hospital approximately 5 kilograms lighter in weight.
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