Postmenopausal Bleeding in A 60-Year-old Woman by Uterine Fibroids

Abstract

Uterine fibroid or leiomyoma is the most common benign uterine tumor which affects mostly women in reproductive age. However, its occurrence after menopause is very rare as the growth of a fibroid depends on the hormone of estrogen. There are several risk factors including nulliparity, obesity, black race, family history, and hypertension. Therefore, fibroid degeneration is rare after menopause.We are reporting a case of a post-menopausal woman of 60-year-old, menopaused for ten years, with a history of bleeding for two years for whom the gynecological exam revealed a cervical budding lesion hypervascularized for which a previous cervicovaginal smear revealed no suspicious cells.Then a biopsy was performed and also devoid of malignancy signs.The ultrasound has identified two fibroids classified 2-5 for the first corporeal-fundial myoma about 50/55 mm ( myoma or sarcoma ?) and a corporeal posterior myoma type 2 about 40/30 mm repressing the endometrium (8,5mm).The eventual diagnosis of sarcoma was not excluded till then.The RMI has not been realized. A total hysterectomy with bilateral adnexectomy was performed focusing on the two fibroids, and the histopathological, report confirmed the leiomyoma tumor diagnosis.