DOI: 10.36347/sjams.2023.v11i12.017

Pages: 2095-2098

Introduction: Uterine fibroids are very common benign pathologies in women of childbearing age, but large ones are rare. Their clinical manifestations are multiple, they are most often asymptomatic. They represent the main indication for hysterectomy in the premenopausal phase. Imaging makes it possible to make the diagnosis and guide the therapeutic approach. Ultrasound is an essential and first-line examination, but in cases of large or degenerating fibroids, it is not specific. CT scanning is a second alternative. The definitive diagnosis is histological after surgery. We report a case in order to highlight the contribution of imaging. Observation: Mrs AS, aged 41, housewife, without medical-surgical history. Married at 14, non-native, living in a rural area. She consults a traditional therapist due to an increase in the volume of her stomach, the latter confirms a “masked pregnancy” (not visible to modern medicine). Faced with the significant increase in volume and on the advice of a family member, she decided to come to town for better care. Received by a gynecologist at the Kati University Hospital, the examination revealed an hourglass-shaped abdominopelvic mass, lobular, firm and painless, measuring 37cm. The imaging (ultrasound and CT) carried out confirmed a polymyomatous uterus, the two largest of which were corporal of the interstitial type, measuring 127 and 110mm in diameter. A total hysterectomy performed brought back a piece of 15,000 grams, histology confirmed a leiomyofibroma. The postoperative course was simple. Conclusion: Giant fibroids are rare. The symptomatology is varied. Imaging is essential in the diagnosis but confirmation is histological after surgery.