CASE REPORT   

Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2020 April;179(4):290-5

DOI: 10.23736/S0393-3660.19.04132-9

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Unconventional myomectomy for large nascent myoma

Angel D. YORDANOV ¹ ✉, Ilko I. ILIEV ¹, Latchezar S. TANCHEV ², Polina P. VASILEVA ³, Strahil A. STRASHILOV ⁴, Denis H. FARHAT ⁵

¹ Department of Gynecologic Oncology, Medical University, Pleven, Bulgaria; ² Acibadem City Clinic, Tokuda Hospital, Sofia, Bulgaria; ³ Department of Obstetrics and Gynecology, Medical University, Pleven, Bulgaria; ⁴ Department of Plastic Restorative, Reconstructive and Aesthetic Surgery, Medical University, Pleven, Bulgaria; ⁵ Medical University, Pleven, Bulgaria

Leiomyomas are the most common benign gynaecological tumors and are one of the most frequent reasons for hysterectomy worldwide. We present a 36-year-old nulliparous Caucasian woman, with complaints of severe and painful menstrual bleeding, dyspareunia for 6 months. A pelvic formation, measuring 5/28 cm was diagnosed. Because of the potential malignancy risk, the tumor size and the location non-standard combined double abdomino-vaginal surgical approach was used. There are many operative techniques described in the literature depending on size, location and number of the myomas as well as on patient’s preferences; there are still clinical situations that remain challenging to choose the best surgical approach. In cases, when the standard methods for myomectomy are not considered appropriate, the option for an individual non-standard approach has to be discussed.

KEY WORDS: Myoma; Surgical procedures, operative; Uterine myomectomy