Thinking it was a common uterine fibroid, doctors were surprised when opening the abdominal cavity

Hà Lê |

Thinking it was a normal uterine fibroid removal case, the surgical team had to change their strategy right on the operating table when they discovered the tumor strayed to an unexpected location.

Doctors of the Department of On-Demand Treatment, Central Obstetrics and Gynecology Hospital have just successfully operated on a female patient suffering from an extremely rare ectopic uterine fibroid. The special thing is that the tumor carries all the characteristics of a uterine fibroid but is not located in the uterus but appears in the abdominal wall.

The female patient, 31 years old, came for examination in a state of anxiety after being diagnosed with a large tumor located close to the uterus. Ultrasound and paraclinical tests showed that the tumor had a structure similar to a common uterine fibroid.

After a thorough examination and evaluation process, Assoc. Prof. Dr. Nguyen Manh Thang, Head of the Department of On-demand Treatment, prescribed laparoscopic surgery to remove the tumor and directly performed the surgery.

The team planned to perform a routine hysterectomy. However, when performing endoscopy, doctors were surprised to discover that the tumor had no connection to the uterus or appendages at all.

Instead, the tumor was localized in the abdominal wall, surrounded by adhesive bands of the connective membrane and peritoneum. Faced with an unexpected situation, the team quickly consulted and changed the surgical strategy right in the operating room.

Assoc. Prof. Dr. Nguyen Manh Thang said: "Our initial plan was to approach the tumor from the uterine side. However, when determining that the tumor was located in the abdominal wall, the team had to change the approach direction from the lower trocar position. Only when it was certain that the tumor was completely isolated, not invasive or causing damage to other internal organs, did we feel secure to proceed with dissection.

Thanks to professional experience and the smooth coordination of the entire team, the surgery took place smoothly. The tumor was completely removed by endoscopy without causing damage to healthy tissues and adjacent organs, while ensuring aesthetics for the young patient.

Assoc. Prof. Dr. Nguyen Manh Thang added that the phenomenon of ectopic uterine fibroids has been recorded in medical literature but often occurs in women who have had abdominal surgery history such as cesarean section or uterine fibroid removal.

What is noteworthy in this case is that the patient had never undergone any abdominal surgery or uterine procedure before. This is a factor that makes the case particularly rare in clinical practice.

Explaining this phenomenon, Assoc. Prof. Dr. Nguyen Manh Thang said that in patients who have undergone uterine surgery, smooth muscle cells can spread and adhere to other locations in the abdominal cavity. However, in more rare spontaneous cases, smooth muscle cells can move along the lymphatic system or bloodstream, or appear due to mediastinal dysplasia, thereby forming tumors in the abdominal wall.

Hà Lê
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