Roza Shahhosseini - Mazandaran university of medical sciences

Background and Aim : A case report of large subserosal myoma Introduction:Leiomyomas are benigntumors of smooth muscle.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. Women of all races are affected.These tumorshave receptors of estrogen, progesterone, and gonadotropin-releasing hormone.RiskFactors:Obesity,precocious menarche, Family history of uterine fibroid,African American race, Age,Food(red meat, ham). protective factors:Smoking, Exercise ,Pregnancy,Multiparity ,Green vegetables,OCP andHRT have no role in fibroid formation.Generally,No enlargement of fibroid in pregnancy.The mostcommon symptoms include : AUB, feeling of heaviness inside the pelvis, secondary dysmenorrhea andpressure effects such as frequent urination and constipation.They may be present as asymptomatic massesin 40-50% of women over 35.Leiomyomas are rarely the primary reason of infertility .The diagnosis isclinical (%95) and in the bimanual examination.Operation is the main treatment method for leiomyomasMethods : Case reportResults : Case: A 40-year-old woman with the right femur fracture caused by falling down one month ago.In her pelvic x ray, a large mass like density was evident in upper portion of pelvic cavity. In careful historytaking,revealed that she had AUB and several times medical treatment in several offices but withoutultrasonographic evaluation . A large palpable, relatively mobile, non-tender mass in the hypogastric regionin physical examination . According to findings, she was prepared for surgery. Investigating the inside ofthe abdomen, there was a large mass originated from the uterus which occupied all the pelvic area, andextended to the bottom of the liver, with wide adherence to bowel loops. Investigating the other organsincluding the liver, no lesion was found. The mentioned mass was resected from the base, completely .Conclusion : CONCLUSIONS: Many women with symptomatic fibroids live with this conditionchronically without seeking care. It appears that for some, limited knowledge regarding fibroids and normalmenstruation may lead to a distorted view of uterine bleeding, resulting in limited treatment seekingbehavior. Others know their symptoms are abnormal but simply avoid the problem. There is a need forpatient-centered and community-based education to improve women s knowledge of fibroids and symptomsand necessity of ultrasonographic evaluation in AUB to promote treatment options

Subserosal myoma,uterine bleeding,ultrasonography