Mujalda Anshu, Kaur Tajinder, Jindal Disha, Sindhu Vogireddy, Jindal Priya, Mujalda Jagdish
Obstetrics and Gynaecology, Maharshi Markandeshwar Institute of Medical Sciences & Research (MMIMSR), Ambala, IND.
Obstetrics and Gynaecology, Adesh Medical College and Hospital Shahbad, Ambala, IND.
Cureus. 2023 May 28;15(5):e39602. doi: 10.7759/cureus.39602. eCollection 2023 May.
Leiomyomas are the most common pelvic tumors, cervical uterine myoma being rare of all uterine fibroids with an incidence of 0.6% of all fibroids. Based on their location, cervical myomas can be classified as extra cervical (sub-serosal myoma) and intracervical. Cervical fibroids can further be anterior, posterior, lateral, and central depending on their position. The surgical treatment of cervical leiomyomas poses more difficulty; due to the risk of intraoperative Hemorrhage and the potential injuries because of contiguity and dislocation of adjacent organs. We present the case of a 46-year-old female, presenting with pain abdomen and abdominal distension. Contrast enhanced-magnetic resonance imaging showed a giant cervical myoma. Enucleation of myoma was done followed by total abdominal hysterectomy with bilateral salpingectomy. Injury to the ureter can be avoided with preoperative cystoscopy-guided bilateral ureteral stenting, intraoperative tracing of the ureter before applying a clamp, and dissection inside the fibroid capsule.
平滑肌瘤是最常见的盆腔肿瘤，宫颈子宫肌瘤在所有子宫肌瘤中较为罕见，占所有肌瘤的0.6%。根据其位置，宫颈肌瘤可分为宫颈外（浆膜下肌瘤）和宫颈内肌瘤。宫颈肌瘤根据其位置还可进一步分为前位、后位、侧位和中央型。宫颈平滑肌瘤的手术治疗难度更大，因为术中存在出血风险，且由于相邻器官的毗邻和移位可能导致潜在损伤。我们报告一例46岁女性病例，该患者表现为腹痛和腹胀。增强磁共振成像显示为巨大宫颈肌瘤。行肌瘤剥除术，随后行全腹子宫切除术及双侧输卵管切除术。术前膀胱镜引导下双侧输尿管支架置入、术中夹闭前追踪输尿管以及在肌瘤包膜内进行剥离可避免输尿管损伤。
