Cervical stump leiomyomata after supracervical hysterectomy; a case report with review of literature

Abstract Background Despite being a highly debated issue, subtotal or supracervical hysterectomy (SCH) is still considered a safe and effective treatment for women with benign gynecological lesions. Benign and malignant cervical diseases have been reported after SCH, with fibroids being the most fre...

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Main Authors: Ahmed Shoukry (Author), Mahmoud Yousri (Author)
Format: Book
Published: BMC, 2024-09-01T00:00:00Z.
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001 doaj_6aee3a84ea5745d1b22a6cdbeeb7b0a2
042 |a dc 
100 1 0 |a Ahmed Shoukry  |e author 
700 1 0 |a Mahmoud Yousri  |e author 
245 0 0 |a Cervical stump leiomyomata after supracervical hysterectomy; a case report with review of literature 
260 |b BMC,   |c 2024-09-01T00:00:00Z. 
500 |a 10.1186/s12905-024-03326-2 
500 |a 1472-6874 
520 |a Abstract Background Despite being a highly debated issue, subtotal or supracervical hysterectomy (SCH) is still considered a safe and effective treatment for women with benign gynecological lesions. Benign and malignant cervical diseases have been reported after SCH, with fibroids being the most frequently diagnosed lesions in the excised cervical stump. Recurrence of cervical disease after SCH usually presents with vaginal bleeding, pelvic mass, or abdominal pain; moreover, it may necessitate reoperation and resection of the cervical stump or trachelectomy. Trachelectomy is known to be a difficult surgical procedure that may be associated with significant intra- and post-operative morbidity. Case presentation We presented here a case of a 41-year-old nulliparous woman with a pelvic mass related to the cervical stump presented 2 years after subtotal hysterectomy, performed due to interactable abnormal uterine bleeding, which was attributed to a multiple fibroid uterus. Six years ago, she complained of pelvic pain, excessive vaginal discharge, and spotting. A transvaginal sonography and magnetic resonance imaging with contrast were performed, which revealed a 10.2 × 7.6 × 6.5 cm heterogeneous pelvic mass with irregular borders and marked vascularity on color Doppler. Surgical exploration and resection of the mass with cervical stump excision were performed. Histopathology confirmed the diagnosis of cervical stump multiple benign leiomyomata with no atypical features. Conclusion Recurrence or De novo development of leiomyomata and other cervical lesions might occur after supracervical or subtotal hysterectomy; thus, thorough pre-operative counseling for women requesting a SCH regarding the pros and cons of the procedure compared with total hysterectomy should be optimized. Meticulous follow-up, including the continuation of routine cervical cytological smears, is mandatory for patients with a retained cervix. 
546 |a EN 
690 |a Subtotal 
690 |a Supracervical 
690 |a Hysterectomy 
690 |a Stump 
690 |a Fibroids 
690 |a Gynecology and obstetrics 
690 |a RG1-991 
690 |a Public aspects of medicine 
690 |a RA1-1270 
655 7 |a article  |2 local 
786 0 |n BMC Women's Health, Vol 24, Iss 1, Pp 1-9 (2024) 
787 0 |n https://doi.org/10.1186/s12905-024-03326-2 
787 0 |n https://doaj.org/toc/1472-6874 
856 4 1 |u https://doaj.org/article/6aee3a84ea5745d1b22a6cdbeeb7b0a2  |z Connect to this object online.