Common Benign Tumor Research Articles

Progress in the Treatment of Ovarian Cysts by Combination of Traditional Chinese and Western Medicine

Ovarian cyst is a common benign tumor in gynecology, often occurring in women of childbearing age. Its essence is a solid or liquid cystic filling structural disease formed inside or on the surface of the ovary, which is not easy to be detected in the early stage, the onset is slow, and serious symptoms and signs such as abdominal fullness, menstrual disorders, and touching mass will occur, affecting women's work and life. At present, both Chinese medicine and Western medicine have certain cognition and advantages in the treatment of ovarian cysts. Chinese medicine can be divided into internal treatment and external treatment, while Western medicine can be divided into drug treatment and surgical treatment. Clinical treatment should be fully considered in the selection of patients' clinical conditions. This paper analyzes the advantages of TCM and Western medicine in clinical treatment, aiming to improve clinical efficacy, reduce cyst recurrence, promote ovarian function recovery, and better protect female ovarian health through the combination of traditional Chinese and Western medicine.

Plasma extracellular vesicles proteomics in meningioma patients

Tumor derived Extracellular vesicles (EVs) in circulating system may contain tumor-specific markers, and EV detection in body fluids could become an important tool for early tumor diagnosis, prognosis assessment. Meningiomas are the most common benign intracranial tumors, few studies have revealed specific protein markers for meningiomas from patients’ body fluids. In this study, using proximity labeling technology and non-tumor patient plasma as a control, we detected protein levels of EVs in plasma samples from meningioma patients before and after surgery. Through bioinformatics analysis, we discovered that the levels of EV count and protein count in meningioma patients were significantly higher than those in healthy controls, and were significantly decreased postoperatively. Among EV proteins in meningioma patients, the levels of MUC1, SIGLEC11, E-Cadherin, KIT, and TASCTD2 were found not only significantly elevated than those in healthy controls, but also significantly decreased after tumor resection. Moreover, using publicly available GEO databases, we verified that the mRNA level of MUC1, SIGLEC11, and CDH1 in meningiomas were significantly higher in comparison with normal dura mater tissues. Additionally, by analyzing human meningioma specimens collected in this study, we validated the protein levels of MUC1 and SIGLEC11 were significantly increased in WHO grade 2 meningiomas and were positively correlated with tumor proliferation levels. This study indicates that meningiomas secret EV proteins into circulating system, which may serve as specific markers for diagnosis, malignancy predicting and tumor recurrent assessment.

Comparison of uterine myometrial thickness at the site of myomectomy scar after surgery using laparoscopic and laparotomy methods.

Fibroids are the most common benign tumours of the uterus, often requiring surgery when symptomatic. This study aims to investigate the impact of surgery using two methods, laparoscopy and laparotomy, on the thickness and vascularity of the uterine myometrium at the site of myomectomy scar (comparing sonographic features at the surgical scar site, including thickness, vascularity, and the extent of fibrotic tissue, in both open and laparoscopic surgical approaches). In this clinical trial, 100 women with type 2-5 fibroids and clinical symptoms, seeking surgery et al. Zahra Hospital, were enrolled in two groups: laparoscopy and laparotomy. Inclusion criteria were a maximum fibroid size of 8cm and, in the case of multiple fibroids, a maximum of three, with the largest being 8cm. 6 months post-surgery, sonographic assessments of the myomectomy scar site were compared between both groups. Participants showed no significant differences in demographic and obstetric factors. The most common clinical symptom (87%) in both groups was abnormal uterine bleeding (AUB). The mean hospital stay duration was statistically significantly lower in the laparoscopy group at 1.64 (SD 0.56) compared to 1.89 (SD 0.58) in the laparotomy group (p = 0.028). Additionally, the decrease in haemoglobin levels was 0.89 (SD 0.92) and 1.87 (SD 2.24) units, respectively, which showed a statistically significant difference (p = 0.003). The duration of surgery was significantly shorter in the laparotomy group (p = 0.001). Abdominal pressure was not observed in the laparoscopy group, while 12% of the laparotomy group reported complaints (p = 0.013). Based on the results obtained in this study, it can be concluded that there was no difference between these two methods in terms of improving uterine thickness and associated complications. However, the decrease in haemoglobin levels and the length of hospital stay were lower in patients undergoing laparoscopy.

Osteochondroma at the Ventro-Medial Surface of the Scapula Causing Pseudo Winging Scapular Resection with Computer-Assisted Navigation: A Case Report and Literature Review

Purpose: Osteochondromas, the most common benign bone tumors, primarily occur in the long bones, with scapular osteochondromas constituting less than 1% of cases. A unique challenge in ventral scapular osteochondromas is limited visibility from the dorsal side. Computer-assisted surgery, which is widely employed in tumor surgery is a promising solution for minimally invasive resection with reduced muscle injury. Methods: We present the case of a thirteen-year-old female with a ventral scapular osteochondroma that cause winging and snaping of her left arm. The patient underwent computer-assisted surgery under general anesthesia in the prone position. The procedure involved a minimal incision over the crest of the scapular spine, enabling precise identification of the tumor from the dorsal side using navigation tools. Results: The tumor, identified as an osteochondroma on CT scans, was successfully resected with minimal soft tissue damage. Postoperatively, the patient's arm was immobilized for two weeks, followed by a pain-free return to normal activity. Radiographic evaluation confirmed complete tumor removal. Conclusions: Computer-assisted navigation can help locate the ventral osteochondroma of the scapula with minimal soft tissue damage and a quicker recovery time.

Solitary intraosseous neurofibroma of the oral cavity: rare localization in the maxilla

BackgroundNeurofibroma is a common benign tumor of neuronal origin that can occur as a solitary tumor or as a component of the generalized syndrome of neurofibromatosis. Neurofibromas are primarily located in the subcutaneous soft tissues and commonly involve extra-oral sites. Solitary intraosseous neurofibromas of the oral cavity are infrequent, with occurrences in the maxilla being exceedingly rare.Case presentationA 22-year-old male patient presented with an asymptomatic mass in the maxilla. Cone-beam computed tomography revealed a round, well-outlined, radiolucent lesion with expansive growth. The neoplasm with the complete capsule was completely removed and confirmed as a neurofibroma based on histopathological and immunohistochemical findings. The reported cases of solitary intraosseous neurofibromas located in the maxilla published in the English literature were compiled to assist in the diagnosis of solitary intraosseous neurofibromas of the maxilla. Nine months after the surgery, there were no signs of tumor recurrence or malignant transformation.ConclusionsThis report emphasizes that rare locations of neurofibromas, such as solitary intraosseous neurofibromas in the maxilla, typically demonstrate nonspecific clinical and radiological features. Clinicians should consider solitary intraosseous neurofibromas as possible differential diagnoses and recognize the histopathological and immunohistochemical features to confirm the correct diagnosis. A longer follow-up period is required because of the potential for local recurrence and malignant transformation of these tumors.

Compound composite odontome-A report of seven case series with brief review of literature.

Odontomes are the most common benign odontogenic tumors of the jaw which are usually slow-growing and non-aggressive. They are generally asymptomatic and diagnosed during routine radiographic investigations and are mostly associated with tooth eruption disturbances. The present case series report covers seven cases of odontomes discussing on clinical, radiographic, and histopathologic features (ground section and decalcification) along with a brief review of the literature.

Study of prevalence and evolution of uterine fibroids during pregnancy in patients of the Medical Center and Medical Specialties FOB of Guayaquil

Fibroids or leiomyomas are the most common benign tumors of the upper portion of the female genital tract; They can reach large sizes and generally do not require surgical treatment during pregnancy. Most of these masses present asymptomatically and are discovered as an incidental finding in ultrasounds during pregnancy or at termination in the case of a cesarean section. Knowing the prevalence of fibroids in the pregnant population is of utmost importance to understand its possible impact on the health of the mother and fetus. Determining the prevalence and evolution of fibroids during pregnancy allows us to identify the number of women with this condition that may be affected by this pathology. The objective of this study is to evaluate the prevalence and evolution of uterine fibroids during pregnancy and determine their complications in women between 20 and 45 years old at the Medical Center and Medical FOB Specialties of Guayaquil. From the results of this study it can be concluded that fibroids during pregnancy are related to maternal age and their size does not increase, but rather tends to decrease. Its association with pregnancy increases the risk of complications. Pregnant patients with fibroids have a higher risk of uterine atony and bleeding after cesarean section than patients who terminated their pregnancy by delivery. Understanding the prevalence of fibroids during pregnancy is crucial to improve knowledge, clinical management, and prevention and care strategies in this population

Case Report: Giant lung hamartoma : An usual cause of lobectomy in a five-year child

Pulmonary hamartomas are the most common benign tumors of the lung in adults. They are usually asymptomatic because of their small size and their slow-growing character. We report the case of a 5-year-old child presenting with a giant lung mass causing recurrent right pneumonia. Surgical resection with middle lobectomy was performed. Final histology revealed pulmonary hamartoma with predominant adenofibromatous and lipomatous differentiation.

Assessment of Uterine Fibroids in Pre and Post Menopausal Women by Transabdominal Ultrasound

Background: Uterine fibroids are common benign tumors of the uterus, affecting a significant proportion of women, particularly during their reproductive years. These growths can lead to symptoms such as heavy menstrual bleeding, pelvic pain, and reproductive issues, thus impacting women's quality of life. Objective: The objective of this study was to evaluate the prevalence of uterine fibroids in pre- and post-menopausal women and to assess the sensitivity of transabdominal ultrasound in diagnosing these fibroids. Methods: This cross-sectional study was conducted over six months in the Radiology Department of District Headquarter Hospital, Swabi, KP, Pakistan. The study included pre- and post-menopausal women presenting with abnormal vaginal bleeding or diagnosed with symptomatic uterine fibroids, excluding those with known endometrial hyperplasia, adenomyosis, pelvic inflammatory disease, gynecologic malignancies, adnexal pathology, or pregnancy. Transabdominal ultrasound was performed with patients in a supine position and a filled urinary bladder, using both longitudinal and transverse sections. Data were collected on demographic information, clinical presentation, and ultrasound findings, and were analyzed using SPSS version 25. Results: A total of 112 women participated in the study. Among these, 94 (83.9%) reported pelvic pain, while 18 (16.1%) did not. The locations of fibroids identified were anterior (44, 39.3%), fundal (25, 22.3%), and posterior (43, 38.4%). Intramural fibroids were present in 61 (54.5%) patients, submucosal fibroids in 32 (28.5%), and subserosal fibroids in 19 (17.0%). Premenopausal women had a higher prevalence of fibroids (80) compared to postmenopausal women (32). Conclusion: Transabdominal ultrasound is a sensitive and reliable diagnostic tool for detecting uterine fibroids. It should be considered the primary imaging modality for evaluating abnormal uterine bleeding across different age groups, providing accurate and non-invasive diagnosis.

Neonatal Cardiac Rhabdomyoma: A Single-Center Experience.

Cardiac rhabdomyoma, known as the most common benign cardiac tumor in childhood, is strongly associated with tuberous sclerosis complex. This study aims to present our single-center experience regarding clinical observations, diagnostic approaches, and treatment modalities for cardiac rhabdomyoma identified during the neonatal period. In this clinical observational study, we retrospectively assessed the outcomes of 12 newborn patients diagnosed with cardiac rhabdomyoma who were followed up in our neonatal intensive care unit over the past 12 years. The mean gestational age of the patients was 38.2±1.6 weeks, with an average birth weight of 3193±314 grams. The mean postnatal age at initial diagnosis was 12.42±15.75 days. Tuberous sclerosis complex was clinically identified in 50% of cases (six patients). Seven infants received everolimus treatment, while three infants underwent clinical monitoring without specific interventions. A significant reduction in cardiac mass size was observed in all surviving patients, leading to their subsequent discharge from the hospital. Cardiac rhabdomyomas often undergo spontaneous regression in early childhood. However, in cases with obstructive lesions or arrhythmias, they may present life-threatening consequences. Timely diagnosis, appropriate clinical management, and monitoring are crucial in optimizing outcomes for neonates with cardiac rhabdomyoma.

A 3D surface coil with deep learning‐based noise reduction for parotid gland imaging at 7T

AbstractBackgroundBackground: Parotid gland neoplasms occur near the facial nerve. Hence, it is crucial to determine whether the malignant neoplasms involve the facial nerve and whether sacrifice of the nerve in surgery is necessary. Furthermore, while 20% of all neoplasms are malignant, the most common benign neoplasm, pleomorphic adenoma, has a risk for malignant transformation, making early detection and treatment essential. 7T magnetic resonance imaging offers increased signal‐to‐noise ratio (SNR) and sensitivity.AimIn this work, we address imaging the parotid gland since it remains challenging at 7T because of its spatial location.Materials and MethodsHere, we present a novel three‐dimensional surface coil (3D Coil) architecture that offers increased depth penetration and SNR compared to the single channel surface coil. We further developed a deep learning (DL)‐based noise reduction method that receives inputs from three elements of the 3D Coil.ResultsThe 3D coil with DL‐based denoising method offers twice the SNR compared to the single channel surface coil for parotid gland imaging at 7T.Discussion and ConclusionThe proposed 3D Coil and DL‐based noise reduction method offers a promising way of achieving higher SNR for parotid salivary gland imaging at 7T, paving the road for clinical applications.

Uterine disorders in reproductive life

The development of new medical diagnostic technologies and procedures and the drop in the birth rate observed in the last decades represent the main causes of increased incidence of uterine disorders. Endometriosis, adenomyosis and uterine fibroids are benign uterine disorders whose understanding have greatly increased and clinical management have improved in recent times. Molecular pathogenetic aspects, new imaging technologies (transvaginal ultrasound and magnetic resonance), biochemical markers, hormonal drugs, minimally invasive surgical technologies were studied for diagnosis and treatment of endometriosis, adenomyosis and uterine fibroids. Sex steroid hormones, inflammation and fibrosis are key pathogenetic mechanisms of uterine disorders. Endometriosis is characterized by endometrial cells migrating outside the uterus and implanting in the pelvis, associated with inflammation, neuroangiogenesis and fibrosis causing dysmenorrhea, pelvic pain, dysuria and dyschezia. The painful symptoms may activate central sensitization and stress responses. Adenomyosis is caused by the presence of endometrial cells within the myometrium, characterized by pelvic pain, abundant menstrual bleeding and infertility. Heavy menstrual bleeding can cause the reduction of iron reserves and consequently iron deficiency anemia. Uterine fibroids are the most common benign tumors of the uterus in women of reproductive age. They can be asymptomatic, but they frequently manifest with abnormal uterine bleeding, pelvic discomfort, and challenges with fertility. Submucosal or intramural fibroids can hinder embryo implantation and potentially lead to pregnancy-related complications such as miscarriage, placenta previa, preterm labor, or postpartum hemorrhage. The increased incidence of uterine disorders has a major clinical impact on women’s health and a very poor quality of life is often reported. Therefore, prompt diagnosis and effective management are mandatory.

Multimodality Imaging of Cardiac Myxomas.

Cardiac myxomas are the most common benign cardiac neoplasms. Echocardiography is the first-line imaging modality used to analyze cardiac masses, allowing the detection of tumor location, size, and mobility. However, additional imaging techniques are required to confirm the diagnosis, evaluate tissue characteristics of the mass, and assess potential invasion of surrounding structures. Second-line imaging includes cardiac magnetic resonance imaging (MRI) and/or computed tomography (CT) depending on availability and the patient's characteristics and preferences. The advantages of CT include its wide availability and fast scanning, which allows good image quality even in patients who have difficulty cooperating. MRI has excellent soft-tissue resolution and is the gold standard technique for noninvasive tissue characterization. In some cases, evaluation of the tumor metabolism using 18F-fluorodeoxyglucose positron emission tomography with CT may be useful, mainly if the differential diagnosis includes primary or metastatic cardiac malignancies. A cardiac myxoma can be identified by its characteristic location within the atria, typically in the left atrium attached to the interatrial septum. The main differential diagnoses include physiological structures in the atria like crista terminalis in the right atrium and the coumadin ridge in the left atrium, intracardiac thrombi, as well as other benign and malignant cardiac tumors. In this review paper, we describe the characteristics of cardiac myxomas identified using multimodality imaging and provide tips on how to differentiate myxomas from other cardiac masses.

Global trends and hotspots on recurrent respiratory papillomatosis: A 20-year bibliometric analysis.

Recurrent respiratory papillomatosis (RRP) is the most common benign laryngeal tumor in children. It can cause serious psychological and mental burden on patients since RRP requires repeated surgical treatment. This study aims to delineate the global trends and identify hotspots related to RRP over the past two decades. We systematically gathered research findings on RRP from 2004 to 2023, utilizing the Web of Science as our data source. Subsequently, we performed a comprehensive bibliometric analysis of the literature using Vosviewer, CiteSpace, and Bibliometrics online analysis platform. A total of 839 publications were finally identified on RRP from 2004 to 2023. The United States has the largest number of publications (392), accounting for 46.7%. The Capital Medical University is the most productive organization (24), followed by the Centers for Disease Control and Prevention (18). The most productive journal was the Laryngoscope, with 86 publicatios. Comparatively, Vaccine is the most cited journal (2297). Craig S. Derkay ranked highest among all authors in publication (16). Burst detection shows onset, adjuvant therapy, management, juvenile-onset RRP, systemic bevacizumab, avastin, human papillomavirus vaccine are recent keywords of great interest to researchers. Research on RRP has progressed significantly over the past two decades, especially in terms of therapeutic strategies. We strongly believe that this article will provide new research directions for other researchers and may contribute to future breakthroughs in the field.

Overview of Characteristics of Parathyroid Tumor Patients at Dr. Hasan Sadikin General Hospital Bandung, Indonesia: A 5-Year Study

Background: Parathyroid tumors are the most common endocrine neoplasms, with hyperparathyroidism as the main clinical manifestation. Parathyroid adenoma is the most common benign neoplasm, while parathyroid carcinoma is relatively rare but difficult to differentiate from benign disorders. This study aims to describe the characteristics of parathyroid tumor patients at Dr. Hasan Sadikin General Hospital (RSHS) Bandung over the last 5 years. Methods: This descriptive observational research was carried out by collecting medical record data from parathyroid tumor patients at RSHS Bandung for the 2019-2023 period. Parameters identified included age, gender, and histopathological type. Data analysis was carried out using SPSS univariately. Results: There were 12 patients with parathyroid tumors with an increasing trend in cases over the last 5 years. The average age of patients was 37.33 years, with the majority (9 cases) being women. Parathyroid adenoma was the most common histopathological type (8 cases), followed by parathyroid carcinoma (2 cases), osteitis fibrocystica (1 case), and bone deformity (1 case). One patient with parathyroid adenoma was also diagnosed with fibrous dysplasia. Conclusion: The majority of cases of parathyroid tumors at RSHS Bandung occur in women, with the incidence of parathyroid carcinoma being the same in men and women. Parathyroid adenoma is the most common histopathological type, and bone abnormalities complications can occur in patients with parathyroid disorders (3 patients).

Pilomatrixomas: 31 years of experience in population under and over 18 years of age.

Pilomatrixoma, also known as calcifying epithelioma of Malherbe, is a benign cutaneous neoplasm that demonstrates differentiation towards the matrix portion of hair follicles. It is the most common benign cutaneous neoplasm in childhood and youth, although it can occur at any age. With a general incidence ranging from 0.001% to 0.0031% of all cutaneous tumors. There is a slight predilection for females, with a female-to-male ratio of 1.15:1. Observational, descriptive, retrospective, and cross-sectional study conducted using the electronic database of the dermatopathology department of Dr. Manuel Gea González General Hospital, from January 1992 to July 2023. Only cases with a histopathological diagnosis of pilomatrixoma, pilomatricoma, and Malherbe's calcifying epithelioma were included. A total of 200 pilomatrixomas were recorded in 177 patients. The tumor predominantly affected females in the pediatric age group, with an average age of 22.98 years in the studied population. The most common location was the head (periorbital region), followed by the upper extremities and trunk. Upon separating the population into pediatric and adult groups, 111 and 89 cases were identified, respectively. We present a detailed study on pilomatrixomas with a comprehensive overview of the demographic, clinical, and epidemiological characteristics of this benign cutaneous neoplasm. The results revealed robust statistical data highlighting the distribution by age, gender, topography, morphology, accompanying symptoms, and frequency of clinical differential diagnoses. This study significantly contributes to the existing knowledge of pilomatrixomas and serves as a valuable reference for future research and clinical practice.

“Sex Cord Stromal Tumor Masquerading as Broad Ligament Fibroid in a Postmenopausal Woman: Lessons Learned from a Case Report”

Background:: Ovarian fibromas are sex cord-stromal tumors accounting for 4% of all ovarian tumors. They are benign, solid ovarian tumors commonly encountered in perimenopausal and postmenopausal women. They are usually asymptomatic or present with vague symptoms like abdominal pain. This makes their pre-operative diagnosis difficult. Case Report:: The present case report briefs the finding of ovarian fibroma in a 59-year-old postmenopausal woman presenting with dull aching lower abdominal pain, misdiagnosed as broad ligament fibroid on ultrasonography and malignant ovarian mass on MRI. She underwent exploratory laparotomy with total abdominal hysterectomy and bilateral salpingo-oophorectomy. Intraoperative findings included a right-sided smooth, solid, freely mobile ovarian mass of size 4x5 cm, uterus and left ovary were atrophic, with healthy bilateral fallopian tubes. Her histopathology report revealed ovarian fibroma with minimal nuclear atypia. Conclusion:: Ovarian fibromas are common benign solid ovarian tumors, that are difficult to diagnose pre-operatively, and often confused with uterine or broad ligament fibroids due to their similar clinical and radiological presentations. Hence, the clinician should keep ovarian fibromas as one of the differentials in the diagnosis of solid adnexal masses mimicking broad ligament fibroids.

Non-coding RNA in infantile hemangioma.

Infantile hemangioma (IH) is the most common benign vascular tumor of infancy, but its pathogenesis has not been fully discovered. From the cellular perspective, CD133+ stem cells orchestrate the proliferation and development of IH. Regarding molecular mechanisms, hypoxia inducible factor-1α, renin-angiotensin system, and vascular endothelial growth factor are current study hotspots, while non-coding RNAs (ncRNAs) might be essential factors participating in this network. Therefore, this article reviewed published studies concerning the roles of ncRNAs in IH and listed noted miRNAs, lncRNAs, and circRNAs. Other ncRNAs, such as snRNAs, snoRNAs, and tsRNAs, though have not been examined in IH, are mentioned as well to discuss their potential functions. Due to the continuous development of sequencing technologies and computational pipelines for ncRNAs annotation, relevant studies will provide evidence to gradually enhance acknowledgments of ncRNAs' role in IH. The pathogenesis of IH might be revealed and the treatment protocol would be optimized in the future. IMPACT: Non-coding RNAs (ncRNAs) play critical roles in infantile hemangioma. This article thoroughly reviewed all ncRNAs (miRNAs, lncRNAs, and circRNAs) mentioned in previous studies regarding the pathogenesis of infantile hemangioma. Other ncRNAs are promising subjects for further investigation. This review introduced the emerging ncRNAs that need to be explored in IH.

Clinical and radiologic features in patients with the WHO grade I and II meningiomas

Introduction: Meningiomas are the most common benign tumor of the central nervous system, accounting for 53.3% and 37.6% of all central nervous system tumors (1). The World Health Organization (WHO) Grade I meningiomas account for 80.5% of all meningiomas and are considered benign meningiomas; the WHO Grade II meningiomas account for 17.7% of all meningiomas and exhibit more aggressive behavior. Methods: In the period 2015-2022, a retrospective single-center study at the clinic of neurosurgery at the Clinical Center University of Sarajevo was conducted, which included patients with a pathohistological finding of WHO Grade I or II meningioma. Depending on the pathohistological grade of the tumor, patients were divided into two groups: Grade I and Grade II patients. Patients were examined clinically and radiologically. Clinical data collected included in the study: Gender, age, number of symptoms before surgery, whether patients were symptomatic or asymptomatic, pre-operative Eastern Cooperative Oncology Group,and Karnopsky performance scale. Pre-operative contrast magnetic resonance imaging of the head measured tumor volume, temporal muscle thickness (TMT), sagittal midline shift, and surrounding cerebral edema. Results: A total of 80 patients were enrolled in the study, 68 with WHO Grade I and 12 with WHO Grade II meningiomas. We found that patients with Grade I meningioma were younger and that the mean thickness of the temporal muscle was statistically thicker than in patients with Grade II. Increasing TMT was significantly and positively associated with Grade I tumors and negatively associated with Grade II tumors (p = 0.032). Conclusion: This study demonstrates that TMT can serve as a radiologic pre-operative indicator of meningioma grade and provide valuable guidance to neurosurgeons in surgical planning. Further studies are needed to validate these results.

Fundal Anterior to Posterior Hysterotomy and Cesarean Myomectomy in Fibroid Uterus

Fibroids are a common benign tumor located in the female reproductive tract and affect up to 10 percent of women, leading to challenges during cesarean section. Few cases of myomectomy at the time of cesarean section have been described and most describe uteri with only a few fibroids present. Our case describes a 39 year old G1P0101female with extensive fibroids including large fibroids located at the lower uterine segment. This patient underwent cesarean section and myomectomy at 27 weeks and five days gestation with a fundal, vertical hysterotomy, extending from the anterior to posterior wall of uterus. This is the first case described in the literature of a cesarean section performed on a uterus with innumerable intramural fibroids and first case documented of a fundal, anterior to posterior hysterotomy.