A Case Report of Large Subserosal Myoma

Backgrounds: Introductionleiomyomas are benign tumours of smooth muscle, taking origin in the myometrium. It is possible for these tumors to be inside the uterus in subserosal, intramuscosal, or submucosal forms as well as in the cervix, broad ligament, or on a base. They are usually multiple, and can range in size from a few millimetres to massive growths of 20cm diameter and more. They may be detected by physical examination or hip imaging Asymptomatic masses may be present in 40-50 percent of women over 35.Material and Method : Patient was a 40-year-old woman with knee and hip damage, and the right leg femur fracture caused by falling to the ground a month before coming to the hospital. During the diagnostic investigation, in the patient's graph, a large mass was detected in the abdomen and hip areas.The patient also stated that during the last few months she had constipation and menstrual disorder in the form of oligomenorrhea, but generally there was no discomforting symptoms making her come to the doctor. Physical examination revealed a large palpable, relatively mobile, non-tender mass in stiff and almost constant mass was felt in the hipogatstric region and the area below the navel. Laboratory test values were within normal limits.Result: Ultrasonography showed a large, rounded, homogeneous, relatively hypoechoic mass, measuring around 25cm. Color Doppler US detected minimal vascular flow within the mass. Contrast-enhanced helical CT of the abdomen demonstrated a well-circumscribed, heterogeneously but vividly enhancing mass in the left lower abdominal quadrant. The mass was in close relationship – but with intact interface – with the left psoas muscle and contrast-filled bowel loops. The uterus was enlarged with a deformed uterine contour consistent with leiomyomatous uterus. The patient's vital signs and tests were normal and the patient was posted for exploratory laparotomy .Investigating the inside of the abdomen, a large mass with a base was observed which originated in the uterus, occupied all the hip space, and was extended to the bottom of the liver. Investigating the other organs including the liver, no lesion was found. There was no paraaortic, mesenteric, and hip lymphadenopathy. The mentioned mass was resected from the base.Conclusion: Asymptomatic leiomyomas an be present in 40-50 percent of women over 35 and can lead to a range of symptoms from unnatural hemorrhage to feeling of pressure in the hip .