Comprehensive management of a massively enlarged uterus resulting from multiple large fibroids: A case report

Abstract

This case report describes a 38-year-old female patient who presented with dysmenorrhea and for a pre-pregnancy check-up, revealing a massively enlarged uterus due to multiple large fibroids. Despite a history of fibroid diagnosis following a caesarean section in 2015, the patient had not undergone follow-up care. Examination and imaging, including ultrasound and MRI, identified several large fibroids, the largest measuring 16.1 cm. Surgical management involved a laparotomy and myomectomy, successfully removing seven fibroids with a specimen weight of 2.242 kg. Postoperative recovery was uneventful, and histopathology confirmed fibroid uterus without atypia. This case underscores the necessity of regular gynecological follow-ups for early detection and management of fibroids to avoid severe complications and highlights the effective use of diluted vasopressin in reducing intraoperative blood loss.