CERVICAL FIBROID- A DIAGNOSTIC DILEMMA FOR GYNEACOLOGISTS

Abstract

Leiomyomas are the predominant pelvic tumours, with cervical uterine myomas being the least prevalent among uterine fibroids, occurring in 0.6% of all cases. Cervical myomas can be categorised based on their location as extra cervical (subserosal myoma) and intracervical. Cervical fibroids can be classified as anterior, posterior, lateral, or central based on their location. The surgical management of cervical leiomyomas presents greater challenges due to the possibility of intraoperative haemorrhage and potential complications resulting from the proximity and displacement of nearby organs. We report the case of a 40-year-old female with pelvic heaviness, urine retention, and polymenorrhea. Contrast-enhanced magnetic resonance imaging revealed a large cervical myoma. Myomectomy was performed, followed by total abdominal hysterectomy with bilateral salpingectomy. Injury to the ureter can be prevented with preoperative cystoscopy-guided bilateral ureteral stenting, intraoperative ureter tracing prior to clamp application, and dissection within the fibroid capsule.