Gigantic size leiomyoma in a patient with pulmonary embolism

Zhannur Torebek

2026

Closed access Metadata (CSL-JSON)
DOI 10.54500/2790-1203-2026-3-126-amj027
Data confidence 70 medium
How this score is calculated

It is built from checkable properties of the record itself: whether the article has a DOI, how many independent sources confirmed its data, whether the required fields are filled in, and how recent the latest confirmation is. Disagreement between sources and a missing identifier lower it. A value of 80 or above means the record was published without further checking; 60 to 79 means it is published at reduced confidence, with a manual check advisable. A record verified by an editor by hand is never pushed below 90 by a recalculation. This scores our data about the article, not the article itself.

Abstract

Introduction. Uterine fibroids or leiomyoma is a frequent diagnosis in women of reproductive age. They originate from monoclonal proliferation of smooth muscle cells of myometrium. Around 75% of women are diagnosed with fibroids by the age of 50. Depending on the location it can be classified as: subserosal, intramural, submucosal or pedunculated. Many cases might be asymptomatic, but the most common presentation of uterine fibroids is heavy menstrual bleeding, pelvic pressure and lower abdominal pain. The diagnosis is made by transvaginal ultrasound. Magnetic Resonance Imaging (MRI) can be used for detailed mapping in some rare cases. The acute complications of uterine leiomyoma are not common and include thromboembolism, urinary retention, vaginal or intraperitoneal hemorrhage and torsion of pedunculated polyps. Even if acute complications such as deep vein thrombosis (DVT) and pulmonary embolism (PE) are very rare they are associated with significant morbidity and mortality. We represent a case of a 48-year-old gravida 2, para 2 woman who came to the Clinical and Academic Department of Women’s Health, Corporate Fund «University Medical Center» (UMC) in Astana with a past medical history of pulmonary embolism because of large leiomyoma. She was successfully treated with supracervical hysterectomy. The actuality of this case is that this patient did not have any other risk factors of thromboembolic disease such as prolonged immobilization, hospitalizations, surgery, history of oral contraceptive pills use, etc. Her thromboembolism was mainly caused by mechanical obstruction of pelvic veins by a large fibroid. We aim to emphasize the importance of thorough evaluation of patients with uterine fibroids that are assumed to be mostly benign disease. By presenting the case of a patient with a history of deep vein thrombosis followed by pulmonary embolism secondary to gigantic size leiomyoma, we aim to increase physician's awareness of rare complications of fibroids and present available multimodal treatment strategies, prophylactic measures and prevention methods. Keywords: leiomyoma, venous thromboembolism, pulmonary embolism, venous thrombosis.