Giant isthmic fibromatous nodule developing within the cervix – clinical case

D. Popovici, R. Socolov, E. Anton, L. Hurjui, C. Stan, RBălan, C. Bradea, I. Hurjui, A. Hurjui, S. Bereşteanu, F.I. Rusu, S.C. Anton

Rezumat: Isthmic-cervical leiomyomas can grow very large and cause extreme discomfort. The surgical removal of these leiomyomas is a technical challenge, with an increased risk of operative and postoperative complications. This paper presents the case of a patient with a gynecopathy who presented herself to our clinic, having been diagnosed with a giant isthmic-cervical fibromatous nodule which was developing within the cervix and required extended surgery – i.e., the radical dissection of the pelvis, to ensure the success of the total en bloc hysterectomy. The radical pelvic dissection at the time of the total en bloc hysterectomy is necessary in most cases of large isthmic-cervical fibroids, to minimize the risk of intraoperative and postoperative complications. These isthmic-cervical fibroids have a very difficult surgical approach. Ideally, the medical team should be pluridisciplinary, and the gynecologist should do the surgery together with a general surgeon and a urologist. To conclude, the surgical treatment of giant isthmic-cervical fibroids should be personalized and individualized.
Cuvinte cheie: isthmus, isthmic, cervical, leiomyoma, surgical approach.