From Prevention to Care - Unveiling a Parasitic Leiomyoma Within a Gigantic Abdominal Mass

Sep 24, 2026

Uploaded by Franzy

Leiomyomas are common benign tumors arising from uterine smooth muscle and fibroblast components, typically asymptomatic, while parasitic leiomyomas represent a rare pedunculated variant. When symptomatic, they may produce abnormal uterine bleeding, pelvic pain/pressure, and fertility or pregnancy-related complications. This open-access case describes a 58-year-old woman whose routine cervical cancer screening revealed a massive 45 cm/35 kg abdominal mass consistent with a parasitic leiomyoma, redirecting urgent care through primary healthcare assessment.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages5

Reading Time13 min

AccessFree to download

Abstract

Introduction

Case Presentation

Clinical background and risk factors

Screening visit and presentation

Diagnostic work-up and key findings

Open Access Case Report DOI: 10.7759/cureus.47361 Review began 10/02/2023 Review ended 10/16/2023 Published 10/20/2023 © Copyright 2023 Pipa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited. From Prevention to Care: Unveiling a Parasitic Leiomyoma Within a Gigantic Abdominal Mass Teresa Pipa 1 , Carla Moreira 1 , Carolina Rodrigues 1 , Daniela Azevedo 1 , Fernando Albuquerque 1 , Filipe Fernandes 1 , Teresa Melanda 1 , Ana Marques 1 , Inês Figueiredo 1 , Rita Nunes 1 1. Family and Community Medicine, Unidade de Saúde Familiar (USF) Lusitana, Viseu, PRT Corresponding author: Teresa Pipa, [mteresapipa@gmail.com](mteresapipa@gmail.com) Abstract Leiomyomas are non-cancerous tumors emerging from the smooth muscle cells and fibroblasts ofthemyometrium. They are the most common pelvic tumors in females and are usually asymptomatic. Parasitic leiomyomas have been defined as unusual variants of pedunculated leiomyomas. When symptomatic, leiomyomas can cause abnormal uterine bleeding, pelvic pain/pressure, and reproductive effects, such as infertility or adverse pregnancy outcomes. Treatment varies depending on age, symptoms, and the preference to preserve fertility. In this article, we describe the case of a 58-year-old woman who presented for a scheduled cervical cancer screening in primary healthcare. Upon objective examination, the patient exhibited a distended and tense abdomen, along with edema in the lower limbs. These symptoms were associated with fatigue and weight gain over the last few months. Subsequent investigation led to an exploratory laparotomy which revealed a massive abdominal mass, measuring approximately 45 cm in diameter and weighing 35 kg. The findings were suggestive of a parasitic leiomyoma. Categories: Family/General Practice, Preventive Medicine, Obstetrics/Gynecology Keywords: parasitic leiomyomas, leiomyomas, gynecologic cancers, primary healthcare services, intra-abdominal mass, cervical cancer screening Introduction Leiomyomas are the most common solid pelvic tumors in women [1] . They are mostly asymptomatic and exhibit slow growth. Symptoms are related to the number, size, and location of the tumors and include menorrhagia, infertility, recurrent pregnancy loss, pelvic pain/pressure, polycythemia, impingement, and related complications [2] . Treatment depends on a woman’s age and her desire to maintain fertility. Symptomatic women who do not intend to or can no longer become pregnant should undergo total abdominal hysterectomy and bilateral salpingo-oophorectomy [2] . Cervical cancer screening is an important aspect of women’s healthcare that offers early detection and intervention, ultimately leading to improved outcomes. In primary healthcare in Portugal, every woman aged 25 to 60 is invited for screening, and if both their cytology results and human papillomavirus test are normal, they are subsequently recalled every five years [3] . The following clinical case discusses a patient’s routine screening visit for cervical cancer and how any visit to primary healthcare can and should be used to assess the presence of complaints that warrant timely counseling. The call to primary healthcare for screening facilitated the redirection of an acute, life-threatening, and rare condition, unrecognized by the patient. Case Presentation A 58-year-old Caucasian woman, with six years of education, was employed as an administrator in a construction company. She was married and resided in an extended family household, living with her parents, husband, daughter, and grandson. Socioeconomically, she belonged to class III (middle) according to the Graffar scale. Her medical history included an acute myocardial infarction, dyslipidemia (evidenced by xanthelasmas), anxiety, obesity,

FAQs

What distinguishes parasitic leiomyomas from other leiomyomas?

Parasitic leiomyomas are defined as unusual variants of pedunculated leiomyomas and are rare compared with typical uterine leiomyomas.

What symptoms can leiomyomas cause when symptomatic?

They can lead to abnormal uterine bleeding, pelvic pain/pressure, and reproductive effects such as infertility or adverse pregnancy outcomes.

How did the cervical cancer screening visit contribute to diagnosis and care?

The routine screening encounter prompted assessment of complaints, leading to recognition of an acute life-threatening condition and guiding urgent investigation that identified a massive abdominal parasitic leiomyoma.

Sep 24, 2026

Uploaded by Franzy