Cervical Fibroids: A Surgical Challenge

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BSTRACT

Leiomyomas are the most common benign tumors affecting the female reproductive tract and constitute around 18–20% of all the uterine pathologies that are seen in women of reproductive age group. Based on their location in the uterus, fibroids can be uterine, cervical, and ligamentary, of which the cervical fibroids are the rarest and make up only around 2–2.5% of the total incidence of fibroids. Large cervical fibroids generally give a typical appearance of “Lantern on St. Paul’s dome,” where the small size uterus sits on top of the cervical fibroid mimicking the lantern on the dome of the famous St. Paul’s Cathedral of Russia. We report here a case series of cervical fibroids who reported to the gynecology OPD of our institute. The first patient was a 41-year-old lady who presented with complaints of heavy menstrual bleeding for the last 2 years. Clinical findings as well as imaging confirmed a 24-week size large cervical fibroid along with surprise element in form of double ureters on right side on intravenous urogram(IVU). Our second patient was a peri-menopausal lady with heavy menstrual bleeding(HMB)for 2 months and cervical fibroid of 16-week size gravid uterus on examination. The third patient was a 37-year-old lady with heavy menstrual bleeding with pressure symptoms in the form of retention of urine. Clinically, a 16-week size cervical fibroid was present which after surgery revealed STUMP on histopathology. All patients were managed surgically with uneventful postoperative recovery.