PMC3970342_01
Myoma at ultrasonographic exam.
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fig1
Abdominal ultrasound confirmed a viable fetus and a subserous large implant myoma (diameter of 20 cm; Figure 1), a mild bilateral dilatation of the renal pelvis (2 cm on the right-hand side and 3.5 cm on the left), and extrinsic compression of the low ureter with involvement of the initial portion of the ureters.
Bulky leiomyoma occupying the pouch of Douglas with signs of compression of ureters, bladder, sigma-rectus, and the gestational chamber; the presence of bulky leiomyoma (20 x 18 cm) with large base of implant (12 cm) occupying the pouch of Douglas. MRI also showed other multiple nodes, of which the bigger was of diameter 4 cm.
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fig2
Myomectomy and uterine wall reconstruction.
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fig3
After accurate operative field exposure, the huge myoma was removed (Figure 3).