Cervical fibroid presenting with heavy menstrual bleeding and symptomatic microcytic hypochromic anaemia

Abstract

Leiomyomas or fibroids occur in 20%–40% of women of reproductive age and are mostly located in the uterine corpus, with only 1%–2% in the cervix. Fibroids may present with abnormal uterine bleeding, pelvic pain, dysmenorrhoea and pressure-related or urinary symptoms, and diagnosis requires imaging studies. Hysterectomy or myomectomy remains the cornerstone of management but is challenging due to the increased risk of urinary tract injuries and intraoperative bleeding caused by distorted anatomy. We present the case of a perimenopausal woman in her early 50s who complained of heavy menstrual bleeding, was diagnosed with a cervical fibroid and, while on the waiting list for a hysterectomy, suffered a collapse and presented to the emergency department with anaemia requiring multiple blood transfusions. A cervical fibroid should be considered in the differential diagnosis of a woman presenting with heavy menstrual bleeding and symptomatic anaemia.