Volume 11, Issue 2 (2026)
SJMR 2026, 11(2): 87-92 |
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Nami F, Sanaye Naderi M, Mohammadian H. A Giant Cervical Subserosal Leiomyoma Presenting as a Pelvic Mass and Menorrhagia: A Case Report. SJMR 2026; 11 (2) : 6
URL: http://saremjrm.com/article-1-400-en.html
URL: http://saremjrm.com/article-1-400-en.html
1- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran.
2- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran. & School of Medicine, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran.
2- Sarem Gynecology, Obstetrics and Infertility Research Center, Sarem Women’s Hospital, Iran University of Medical Science (IUMS), Tehran, Iran. & School of Medicine, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran.
Abstract: (7 Views)
Introduction: Cervical leiomyomas are rare benign tumors of the female reproductive tract and account for only a small proportion of all uterine leiomyomas. Giant cervical leiomyomas, because of their large size, deep pelvic location, and close proximity to vital pelvic structures, may present considerable diagnostic and surgical challenges. This report describes the diagnosis and surgical management of a giant cervical subserosal leiomyoma treated at Sarem Women’s Hospital in Tehran, Iran.
Case Presentation: A 47-year-old woman presented to Sarem Women’s Hospital in Tehran, Iran, with menorrhagia during a routine gynecologic evaluation. Ultrasonography revealed a giant cervical subserosal leiomyoma measuring 143 × 114 × 104 mm located in the posterior wall of the lower cervical canal. In addition, two small intramural leiomyomas were identified in the uterine fundus, along with a low-risk left ovarian cyst (O-RADS II). Given the large size of the tumor, its anatomical location, and the presence of multiple uterine leiomyomas, the patient underwent laparotomy, total abdominal hysterectomy (TAH), bilateral salpingo-oophorectomy (BSO), and adhesiolysis. The procedure was completed without significant intraoperative complications, and the tumor was completely excised.
Conclusion: Although giant cervical subserosal leiomyoma is a rare condition, it should be considered in the differential diagnosis of large pelvic masses and abnormal uterine bleeding. Careful preoperative imaging evaluation and selection of an appropriate surgical approach based on the patient’s clinical characteristics are essential for minimizing complications and achieving favorable outcomes. This case highlights the importance of early diagnosis and appropriate surgical management in patients with giant cervical leiomyomas.
Case Presentation: A 47-year-old woman presented to Sarem Women’s Hospital in Tehran, Iran, with menorrhagia during a routine gynecologic evaluation. Ultrasonography revealed a giant cervical subserosal leiomyoma measuring 143 × 114 × 104 mm located in the posterior wall of the lower cervical canal. In addition, two small intramural leiomyomas were identified in the uterine fundus, along with a low-risk left ovarian cyst (O-RADS II). Given the large size of the tumor, its anatomical location, and the presence of multiple uterine leiomyomas, the patient underwent laparotomy, total abdominal hysterectomy (TAH), bilateral salpingo-oophorectomy (BSO), and adhesiolysis. The procedure was completed without significant intraoperative complications, and the tumor was completely excised.
Conclusion: Although giant cervical subserosal leiomyoma is a rare condition, it should be considered in the differential diagnosis of large pelvic masses and abnormal uterine bleeding. Careful preoperative imaging evaluation and selection of an appropriate surgical approach based on the patient’s clinical characteristics are essential for minimizing complications and achieving favorable outcomes. This case highlights the importance of early diagnosis and appropriate surgical management in patients with giant cervical leiomyomas.
Article number: 6
Keywords: Cervical leiomyoma, Giant subserosal leiomyoma, Menorrhagia, Pelvic mass, Total abdominal hysterectomy, Case report
Article Type: Case Report |
Subject:
Women Diseases
Received: 2026/07/16 | Accepted: 2026/07/30 | Published: 2026/08/8
Received: 2026/07/16 | Accepted: 2026/07/30 | Published: 2026/08/8
References
1. 1. Munro MG, Tchaikovski SN, Murji A. The epidemiology and pathogenesis of uterine fibroids. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics. 2025;171(3):1029-45. [DOI:10.1002/ijgo.70527] [PMID] [PMCID]
2. Fartushok TV, Smiianov V, Semenyna H, Fartushok N. Uterine Leiomyoma in women of reproductive age: A systematic review. Wiadomości Lekarskie. 2025;2025(2):415-24. [DOI:10.36740/WLek/195321] [PMID]
3. Sparic R, Mirkovic L, Malvasi A, Tinelli A. Epidemiology of uterine myomas: a review. International Journal of Fertility and Sterility. 2016;9(4):424-35.
4. Li B, Wang F, Chen L, Tong H. Global epidemiological characteristics of uterine fibroids. Arch Med Sci. 2023;19(6):1802-10. [DOI:10.5114/aoms/171786] [PMID] [PMCID]
5. De Barry L, Bahall V. Atypical manifestations of uterine leiomyomas - expecting the unexpected. Case reports in women's health. 2023;40:e00571. [DOI:10.1016/j.crwh.2023.e00571] [PMID] [PMCID]
6. Petanovski Z, Kurjak A. Uterine Fibroids (Leiomyoma, Myoma). Donald School Journal of Ultrasound in Obstetrics and Gynecology. 2022;16:282-97. [DOI:10.5005/jp-journals-10009-1948]
7. Ashindoitiang JA, Canice Nwagbara VI, Edet EE, Ugbem TI, Ukam JS, Asuquo ME. Large subserous uterine leiomyoma presenting as intraabdominal tumor: A case report. Rare tumors. 2024;16:20363613241285089. [DOI:10.1177/20363613241285089] [PMID] [PMCID]
8. Thanasa E, Thanasa A, Kamaretsos E, Paraoulakis I, Ziogas A, Kontogeorgis G, et al. Large Cervical Leiomyoma of the Uterus: A Rare Cause of Chronic Pelvic Pain Associated With Obstructive Uropathy and Renal Dysfunction: A Case Report. Cureus. 2023;15(1):e33387. [DOI:10.7759/cureus.33387]
9. Ferrari F, Forte S, Valenti G, Ardighieri L, Barra F, Esposito V, et al. Current Treatment Options for Cervical Leiomyomas: A Systematic Review of Literature. Medicina (Kaunas, Lithuania). 2021;57(2). [DOI:10.3390/medicina57020092] [PMID] [PMCID]
10. Mujalda A, Kaur T, Jindal D, Sindhu V, Jindal P, Mujalda J. Giant Cervical Fibroid: A Surgical Challenge. Cureus. 2:(5)150;023e39602.
11. Chen F, Bai F, Wang Y, Li W. Case report of a giant cervical leiomyoma. Front Med (Lausanne). 2025;12:1521984. [DOI:10.3389/fmed.2025.1521984] [PMID] [PMCID]
12. Thanasa E, Thanasa A, Kamaretsos E, Paraoulakis I, Ziogas A, Kontogeorgis G, et al. Large cervical leiomyoma of the uterus: A rare cause of chronic pelvic pain associated with obstructive uropathy and renal dysfunction: A case report. Cureus. 2023;15 (2). [DOI:10.7759/cureus.33387]
13. Addina H, Mayangsari NH, Frymonalitza N, Lubis MA. Giant cervical leiomyoma presenting as severe abnormal uterine bleeding and symptomatic anaemia in a perimenopausal woman: a case report. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2026;15(6):2208-10. [DOI:10.18203/2320-1770.ijrcog20261477]
14. Ferrari F, Forte S, Valenti G, Ardighieri L, Barra F, Esposito V, et al. Current Treatment Options for Cervical Leiomyomas: A Systematic Review of Literature. Medicina. 2021;57(2):92. [DOI:10.3390/medicina57020092] [PMID] [PMCID]
15. Mongan S, Wibowo A. Giant uterine leiomyoma with surgical difficulty. Journal of Medical Cases. 2021;12(10):386. [DOI:10.14740/jmc3764] [PMID] [PMCID]
16. Thanasa A, Thanasa E, Xydias E, Ziogas A, Thanasas I. Giant cervical uterine leiomyoma associated with bilateral ureterohydronephrosis and retroperitoneal perinephric urinoma at the left kidney: A case report and. Med Int. 2025;5(5):57. [DOI:10.3892/mi.2025.256] [PMID] [PMCID]
17. Acosta O, Chinea L, Reagin EK, Vangimalla NR, York D. Surgical management of an unusually large uterine leiomyoma with cervical dilation in a reproductive-age woman. 2026.
18. Chen F, Bai F, Wang Y, Li W. Case report of a giant cervical leiomyoma. Frontiers in Medicine. 2025;Volume 12 - 2025. [DOI:10.3389/fmed.2025.1521984] [PMID] [PMCID]
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