Management of giant myoma – case report and literature review

Abstract

Introduction Uterine myomas are one of the most frequently discussed issues in gynecology. Most of them are asymptomatic, however, severe pain in pelvis minor, heavy uterine bleeding or infertility may be reported by the patients and worsen quality of women’s daily life. Giant myomas are very rare and can be directly life-threatening. Aim The aim of this study was to present a clinical case of giant myoma, its management and highlight the potential impact on women’s health and well-being. Case study A 70-years-old patient with a pain in lower part of abdomen, constipation and tiredness manifested difficulties in breathing. Abdominal examination revealed a huge, elastic abdominal mass extending from xiphoid process to the pubic bone. A total abdominal hysterectomy with right salpingo-oophorectomy was done.The patient was discharged from the hospital on the day 9 after the surgery and recovered without any incident. Results and discussion Patients with giant uterine myomas may develop respiratory failure and require intensive respiratory care. One of the highest priorities should be adequate ventilation and reduction the vena cava compression. Cleansing the intestines before surgery decreases the risk of contamination the peritoneal cavity by digestive tract content, in case of possible extension of the scope of surgery. Conclusions In the case of treatment of large uterine myomas, interdisciplinary cooperation of specialists in various fields is necessary in order to protect the patient’s vital parameters and prevent the occurrence of rare complications.