An unusual clinical and histological consequence of uterine arterial embolization of a fibroid

Abstract

Objective Case report of an unusual clinical and histological consequence of uterine arterial embolization of a fibroid. Subject A 33-year-old patient with a large intramural fibroid causing menorrhagia who wished to avoid a myomectomy and/or hysterectomy. Interventions Uterine artery embolization was performed. The fibroid was partially resected from a submucosal location 6 weeks later, and a further 2 weeks later the remainder of the necrotic fibroid was removed from the uterine cavity. Results Histological examination showed that the fibroid was completely infarcted following uterine arterial embolization, and the gel foam particles were identified in the blood vessels of the fibroid. This intramural fibroid was subsequently extruded to a submucosal position where it could be resected and removed. Conclusion Uterine arterial embolization is used increasingly in the management of symptomatic uterine fibroids in women who wish to avoid a myomectomy and/or hysterectomy. We draw attention to this interesting case of sequestration and extrusion of a large intramural fibroid, with notable histological evidence of embolization.