Clinical Images  |   July 2018
Massively Enlarged Leiomyomatous Uterus
Author Notes
  • Financial Disclosures: None reported. 
  • Support: None reported. 
  •  *Address correspondence to Daniel Martingano, DO, New York University Langone Hospital - Brooklyn, Department of Obstetrics and Gynecology, 150 55th St, Brooklyn, NY 11220-2508. Email: daniel.martingano@nyumc.org
     
Article Information
Imaging / Obstetrics and Gynecology / Clinical Images
Clinical Images   |   July 2018
Massively Enlarged Leiomyomatous Uterus
The Journal of the American Osteopathic Association, July 2018, Vol. 118, 493. doi:10.7556/jaoa.2018.115
The Journal of the American Osteopathic Association, July 2018, Vol. 118, 493. doi:10.7556/jaoa.2018.115
A 37-year-old woman, gravida 3, para 3, presented with complaints of pelvic pressure, heavy bleeding, and pain with menses. Symptoms were unresponsive to a levonorgestrel intrauterine system and uterine artery embolization. A large, globular uterus was noted on pelvic examination. Computed tomographic (CT) images demonstrated a massively enlarged leiomyomatous uterus extending into the abdomen at the base of the stomach (image A). The uterus measured 18 × 16 cm with a subserosal leiomyoma (11 × 10 cm) at the uterine fundus. The patient underwent a total abdominal hysterectomy. Gross examination of the leiomyomatous uterus revealed a 30-week gestational-sized uterus with multiple leiomyomas and a 10-week sized subserosal leiomyoma at the fundus (image B). 

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