A 44-year-old woman, resident of Singrauli (MP) presented to the AIIMS OPD with a huge abdominal distention for three years. She visited two other hospitals outside Bhopal but was denied treatment because of the high-risk condition of the patient. She came to the Department of Obstetrics & Gynecology 2 weeks back and was admitted for evaluation.
She had difficulty in breathing and was unable to walk due to a large tumor. Radiologically the size of the mass was 42x25x35 cm arising from the uterus. She was planned for surgery after a multidisciplinary discussion.
Under the guidance of Dr K Pushpalatha(HOD) OBGY and the collective efforts of team members Dr Ajay Halder, Dr Jyoti Nath Modi and Dr Bharti Singh, the case was successfully managed. The patient was operated recently by the operative team lead by Dr Bharti Singh and other team members were Dr Naina Gautam and Dr Harshita Naidu (senior residents). The successful surgery of the critical case was possible with the help of the anesthesia team comprised of Dr Ashutosh Kaushal and Dr Sonali. During the surgery, a very large uterine mass was found.
The total weight of the mass was around 29 kg (including tumor fluid), which was sent for histopathology. The patient is doing well in the postoperative period. Prof.(Dr.) Ajai Singh, Executive Director AIIMS Bhopal has congratulated the team for successful operation.
The occurrence of a giant pelvic mass arising from the uterus with an enormous amount of collection is extremely rare. The possibility of giant uterine myoma with degenerative changes is suspected in the above particular case.
These types of cases have many diagnostic and management dilemmas. The patient may develop cardiopulmonary complications during surgery due to sudden decompression of the abdomen.
Quick surgery and strict intraoperative monitoring are the keys to the successful outcome of the cases.