Cervical fibroid: A diagnostic dilemma and operative challenge – one year study

Abstract

: Cervical fibroids are very rare, with varying clinical presentations, and account for only 1–2% of cases. Cervical fibroids are enigmatic as they present with varying symptoms and simulate several clinical entities, for instance, a large cervical polyp, incarcerated procidentia, chronic uterine inversion, and the Ca cervix. : A two-year retrospective analysis of women diagnosed with cervical leiomyoma was conducted at Obstetrics and Gynaecology department, PGIMS Rohtak (a tertiary care institute in Northern India). A total of 24 cases diagnosed with cervical fibroid (CF) were studied. 75% of the females had vaginal bleeding, 44.6% had heavy menstrual bleeding, 33.3% had irregular bleeding, and one had postmenopausal bleeding. 41.6% had urinary symptoms; 1.5% complained of vaginal discharge; difficulty in stools (16.6%); and leiomyosarcoma (8.3%). We cannot find a clear demarcation of presenting symptoms between anterior and posterior fibroid. It was discovered that the development of malignancy and bladder and intestinal problems was linked to an increase in CF mass, while severe anaemia and vaginal bleeding were not. A cervical fibroid is mostly benign, can be present at extremes of age, and its atypical presenting symptoms pose difficulty in diagnosis. Vaginal bleeding and retention of urine are the most common symptoms. Central and supravaginal fibroids are difficult to operate. Proper pre-operative delineation of altered anatomical structure are essential for choosing the correct modality of treatment. In large cervical fibroids, suspected malignancy before surgery and hidden cervical malignancy can coexist.