Aim: To analyze the management approach of difficult and unusual leiomyoma conditions.
Materials and methods: A retrospective analysis of all unusual cases of leiomyoma with special consideration to the challenges encountered during their management has been done in a tertiary care center in northern India over a 1-year duration. All cases were analyzed in detail and learning points extracted.
Results: A total of 11 cases were retrieved. All of them were unique in their course of surgical management. Five cases presented with abdominopelvic mass (APM). Two cases presented with abnormal uterine bleeding (AUB). Pressure symptoms were presenting complaints in two cases. Three cases presented with complaints of something coming out of the vagina. One case was antenatal and presented with a huge lower uterine segment (LUS) leiomyoma and uterine torsion in term pregnancy.
Conclusion: The unusual site, size, and location of leiomyomas may pose surgical challenges to their management. Proper preoperative planning, thorough knowledge of female pelvic anatomy, and good clinical acumen make management of such testing cases possible in the hands of an expert gynecologist. Clinical significance: This paper will provide insights to the treating gynecologist in the management of challenging leiomyoma cases posing a clinical and surgical dilemma to their management.
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