PMC6642253_01
Actively hemorrhaging superficial vein overlying a pedunculated Fibroid.
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On further exploration, a 20 cm pedunculated fibroid with an actively hemorrhaging superficial vein was visualized (Fig. 1).
A: Pedunculated Fibroid seen immediately upon opening the abdomen. B: Pedunculated Fibroid with overlying dilated veins. C: Shows the uterus from top down after fibroid resection.
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An intra-operative gynecology consultation was placed and the decision was to resect the leiomyoma with preservation of the uterus and tubes, given its prime location and visibility (Fig. 2A-C).
A: Abdominal aortic angiogram: performed via the right femoral artery. B: Angiogram visualizing the bilateral iliac arteries and an area with active extravasation of contrast from the left uterine artery which was subsequently embolized. C: Angiogram displaying successful selective gelfoam embolization of the left uterine artery. Markers from the packs which were left in the abdomen can also be seen in the image.
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As a result, she underwent embolization of the left uterine artery (Fig. 3A-C).
20 x 20 x 15 cm resected fibroid, gross specimen.
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FFP and 1 pooled cryoprecipitate). Final surgical pathology confirmed the diagnosis of leiomyoma and revealed focal areas with myxoid degenerative changes, the tumor measured to be 20 x 20 x 15 cm and weighed 1.25 kg (Fig. 4).