Spontaneous Expulsion of a Prolapsed Pedunculated Uterine Leiomyoma: A Rare Gynecologic Enigma.

ABSTRACT

Uterine leiomyomas, also known as uterine fibroids, are smooth muscle tumors in the uterus, mostly benign in nature. They occur in the reproductive age group i.e. between 15 and 49 years. Asymptomatic in nature; rarely, they may be associated with symptoms like abnormal uterine bleeding, pelvic pain, and compression symptoms or secondary changes. Patients of the reproductive age group may be associated with infertility and recurrent pregnancy loss. Fibroids run in families and are associated with both estrogen and progesterone levels. Myomas produce symptoms depending on their site, size, position, number, or any secondary changes. The submucosal type of fibroid is associated with symptoms more commonly. Based on presenting symptoms, uterine leiomyoma can be managed medically or surgically. Here we present a case of a 32-year-old multigravida who had a spontaneous vaginal expulsion of a pedunculated intramural fibroid. Very rarely as in this case, complete expulsion of leiomyoma is seen. When it occurs in the reproductive age group, it may mimic many clinical conditions like incomplete or inevitable abortion. Such a case may also be associated with excess hemorrhage and can cause significant morbidity to the patient; hence it is essential to make an early diagnosis and necessary timely intervention.