Degenerative Fibroid presents as Intrautrine Collection-Pyometra ?

Leiomyoma of uterus is a benign tumor commonly seen in females of Reproductive age group. It arises from pelvis which can be of variable sizes. We are reporting a case of 40 yrs old women with history of cough & generalised weakness for two weeks. Abdominal examination revealed a 22 weeks mass arising from pelvis, firm to cystic in consistency, mobile and non tender on palpation. Ultrasound showed a large mass filling the abdominal cavity, but MRI suggested degenerative fibroid. The patient underwent total abdominal hysterectomy with bilateral salpingoophorectomy. In general fibroids can be managed medically, surgically, or expectant management, or combination of all the three treatments.