Giant uterine leiomyoma successfully managed by surgical excision: a case report
Journal
Journal of Surgical Case Reports
ISSN
20428812
Date Issued
2026-04-01
Author(s)
Llerena Freire, Luis F
Llerena Ojeda, Cintya A
Llerena Morales, Gloria A
Vela Arias, Gabriela D
Arteaga Terán, Joaury L
Valle Acurio, Cynthia Y
Lopez, Sandra C
Aguirre Vázconez, Lucia D C
Silva Vizuete, Nayely G
Ruiz Solis, Ivanova D
Type
Article
Abstract
Giant uterine leiomyomas (>10 cm) are uncommon in the modern imaging era and may mimic ovarian malignancy due to their size and heterogeneous appearance, posing a diagnostic and therapeutic challenge. A 34-year-old nulliparous woman presented with progressive abdominal distension and pelvic pressure. Imaging revealed a 19 × 14 cm multinodular uterine mass with heterogeneous features and preserved surrounding fat planes. Given the patient’s strong desire for uterine preservation, an open abdominal myomectomy was performed. A highly vascular, multicompartmental leiomyoma arising from the uterine body was successfully enucleated with vasopressin-assisted hemostasis and meticulous multilayer myometrial reconstruction. Estimated blood loss was 1000 ml without transfusion. Histopathology confirmed a benign leiomyoma. The postoperative course was uneventful. This case highlights that, despite their size and complexity, giant multicompartmental leiomyomas can be safely managed with uterine-preserving myomectomy in carefully selected patients. Adequate preoperative assessment, intraoperative vascular control, and advanced reconstructive techniques are critical to guide surgical decision-making and optimize outcomes. © The Author(s) 2026. Published by Oxford University Press and JSCR Publishing Ltd.