Neglected case of a huge leiomyoma in an elderly postmenopausal woman: a case report

Abstract

Background Fibroids are benign tumors of the female reproductive tract originating from the myometrial smooth muscle cells. They are a frequent occurrence in women of childbearing age but their incidence is rare after menopause. In addition, there is a remote possibility of malignant transformation to leiomyosarcoma in less than 1% of cases. Case presentation We hereby report a case of large fibroid in a postmenopausal Indian female with rapid growth, raising the suspicion of malignant transformation into leiomyosarcoma. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. Histopathology report confirmed it to be benign leiomyoma without any evidence of neoplasia. Conclusion Sudden enlargement of leiomyoma in postmenopausal women should not be ignored due to possible malignant transformation and is to be dealt immediately with hysterectomy followed by histopathology.

Massive Cystic Degeneration Of Neglected Leiomyoma Mimicking An Ovarian Tumour In A 48 Year Old Woman

“…The combined weight of the solid tumour 4563g with 16 litres of cystic fluid estimated weight of weight of 16kg gives a total weight estimate of 20.5kg tumour. This weight is more than the weight of cases reported in India and Nigerian 13,14 . The weight of 20.5kg is however, compares favorably with the combined weight of higher order multiple pregnancy fetuses such as septuplets-7 or octuplets-8 at delivery.…”

Vulvar leiomyoma in a postmenopausal woman

“…It has been speculated that vulvar leiomyomas express oestrogen and progesterone receptors. Vulvar leiomyomas have been observed to grow with pregnancy, strengthening the hypothesis that they are driven by oestrogen and progesterone receptors 1 4. In addition, the decreased incidence in postmenopausal women also strengthens the theory of oestrogen dependence.…”

“…Leiomyomas are well-circumscribed, benign soft-tissue tumours of mesenchymal origin. Located within the uterus, leiomyomas, commonly referred to as fibroids, are tumours that affect 40%–50% of women older than age 35 who are in the reproductive age group but only 1%–2% of women in the 60–80 years old age group 1. Vulvar leiomyomas are much rarer, accounting for only 0.03% of all gynaecological neoplasms and 0.07% of all vulvar tumours 2.…”