A 50 year old female name ParvatiNandlalDhakad coming from Madhya Pradesh admitted in Gynec Department of Civil Hospital, Ahmedabad with complaint of Abdominal Lump 6-7 years. She was menopausal since one year. On per abdominal examination there was hard mass corresponding to 36-38 weeks of pregnancy. On per vaginal examination uterus was not felt separately from the mass and both the fornices were full and non tender. To confirm and rule out malignancy CEA, CA125, CA19-9 and pap smear were done which suggested no malignancy. Her USG & MRI showed 16x28x28 cm. sized mass which was well defined, hetrogenous in echotexture possibility of FUNDAL FIBROID.
Pre operatively patient underwent B/L ureteric stenting and was operated on 14th June 2018 under spinal + epidural anaesthesia with right paramedian vertical incision by Dr. Tushar M. Shah, Associate Professor, Civil Hospital. Per operatively omentum was adherent to fundus of the uterus which was clamped, cut and ligated and 6.2 kg fibroid was removed followed by total hysterectomy with B/L salpingo-oophorectomy. Post operatively injectable antibiotics were given for three days. Stitches were removed on 12thpost operative day. Histopathology report confirmed the diagnosis of large leiomyoma in myometrium with hyaline changes. Patient was discharged on oral antibiotic.