Miomatosis Uterina Gigante

Abstract

Uterine fibroids are the most common form of benign uterine tumors of the female reproductive tract, also known from the pathologically as leiomyomas or fibroids, according to the predominance of smooth muscle fibers or the amount of fibrous tissue (1) ( 2); growth and development of uterine fibroids are involved both estrogen and progesterone, however, currently through studies and scientific evidence it updated cytokines and growth factors (3) engages; thus having uterine fibroids from millimeters to large tumors occupying the entire abdominal cavity called giant uterine fibroids, the large size of such tumors who experienced a huge growth has been described in amazement over time, that is why this type of uterine fibroids they are very rare tumors and are a challenge for both diagnosis and for therapeutic; it is also an exceptional case as it was presented in a postmenopausal patient, knowing that fibroids regress during menopause, why a real and current case is presented; considering giant uterine fibroids a fibroid uterus that exceeds a size of 9 cm and a weight of 800 grams, according to magazine published in 2016 (1), formerly considered a diameter greater than 20 cm according to Journal of Gynecology and Obstetrics of Mexico in 2005 (4). Its prevalence is very difficult to define because it is a rare neoplasm, however it is estimated around 4-25% of cases, so the record in the literature stands as today, due to advances in the different diagnostic methods, gynecological cancers are diagnosed in early stages, so it is rare presentation of patients with large tumors. As for the clinical manifestations they are often asymptomatic, but 30% of affected patients have menstrual bleeding, acute abdominopelvic pain and other conditions depending on the size of the fibroid uterus pelvic pressure (1) (3) (5). The diagnosis is based on physical examination, performing the two-hand touch detecting an enlarged uterus, irregular contour or low mobility of the uterus, confirmed by transvaginal ultrasound or hysteroscopy MRI, Sonohysterography or allowing to determine the location, size and invasion cavity (1). The main goal of treatment is to relieve symptoms; the type and timing of intervention must be individualized based on age, type, severity of symptoms, size and location of the fibroid (1). During the development of this clinical case we specify in detail the clinical, diagnostic methods, treatment and evolution that had the patient during their hospital stay.