Large cervical myoma originating from the uterine corpus

Abstract

This case report aimed to present a case of large cervical myoma that obliterated the ureterovesical area and filled the entire cervix. A 33-year-old patient had a tumoral lesion of approximately 80x60 mm, compatible with myoma, that filled the cervical cavity. On vaginal examination, a barrel-shaped, immobile and large cervix was palpated. A preoperative bilateral double J catheter was applied to the patient. While the uterine cervix was barrel-shaped due to myoma and was palpable from Douglas, it was firmly fixed anteriorly to the bladder and corpus. During bladder dissection, approximately 4 cm defect was formed in the isthmus, and the uterine cavity was entered. A myoma with a diameter of approximately 9 cm, which filled the entire cervix from the uterine isthmus and had a stem attached to the fundus, was observed in the cavity, and the myoma was pulled out from the defect with a tenaculum and removed. Since the anterior cervix could not be reached and bladder dissection could not be achieved, a subtotal hysterectomy was performed. Although they are mainly treated surgically, there is no standard treatment for cervical myomas. Due to its proximity to vital organs, care should be taken against the risk of organ injury.