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Imaging showed a large type 2 myoma with central necrosis and cervical-vaginal prolapse; fertility-preserving vaginal myomectomy removed a 120 mm necrotic fibroid with uneventful recovery and stable follow-up.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/vaginal-resection-of-a-large-nascent-uterine-pyomyoma-following-late-miscarriage/437349/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/vaginal-resection-of-a-large-nascent-uterine-pyomyoma-following-late-miscarriage/437349.png","ImageObject",300,407,{"name":42,"@type":43},"eBook King","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-02","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",10,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What complication followed the late miscarriage in this case?","Question",{"text":63,"@type":64},"A large necrotizing uterine fibroid progressed to a “pyomyoma nascent,” with central necrosis and infection risk after the 15-week miscarriage.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was the fibroid classified on imaging?",{"text":68,"@type":64},"Imaging initially categorized it as FIGO type 3, with later discussion indicating possible conversion to FIGO type 2 under pregnancy-related hormonal stimulation and necrosis.",{"name":70,"@type":61,"acceptedAnswer":71},"Why was vaginal myomectomy chosen instead of hysterectomy?",{"text":72,"@type":64},"A conservative, fertility-preserving vaginal myomectomy enabled complete removal of the necrotic fibroid while avoiding hysterectomy in a selected patient.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},437349,1791110770,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":55,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":55,"slug":125},"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":97,"slug":129},19,"General","general",{"code":4,"msg":82,"data":131},{"doc_id":79,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":116,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":143,"read_time":144,"preview_page_count":4},962088006270,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","Review began 10/20/2025  \nReview ended 12/02/2025  \nPublished 12/05/2025  \n© Copyright 2025  \nDe Walque et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98531  \nOpen Access Case Report  \nVaginal Resection of a Large Nascent Uterine Pyomyoma Following Late Miscarriage  \nPerrine De Walque 1, Philippe Van Trappen 2  \n1. Gynecology, Vrije Universiteit Brussel, Bruges, BEL 2. Gynecology/Oncology, AZ Sint-Jan Hospital, Bruges, BEL Corresponding author: Perrine De Walque, [perrinedewalque@hotmail.com](perrinedewalque@hotmail.com)  \nAbstract  \nUterine myomas are common benign tumors in women of reproductive age and may undergo degenerative changes during or after pregnancy. In rare cases, rapid growth and necrosis can complicate the clinical course and pose significant risks for infection and fertility. We report the case of a 29-year-old nulliparous woman who presented two months after a late miscarriage at 15 weeks of gestation with severe abdominal pain and a necrotizing uterine fibroid. Imaging revealed a large type 2 myoma, initially classified as type 3, according to the International Federation of Gynecology and Obstetrics (FIGO) classification, with central necrosis, prolapsing through the cervix into the vagina. Despite broad-spectrum antibiotics, symptoms persisted, and inflammatory markers increased. A fertility-preserving vaginal myomectomy was performed, allowing complete removal of a 120 mm necrotic fibroid. Postoperative recovery was uneventful, and followup imaging at three months showed only a small stable intramural remnant. The uterine cavity appeared normal on hysteroscopy, and the patient remained asymptomatic. Necrotizing fibroids following miscarriage pose diagnostic and therapeutic challenges. Magnetic resonance imaging (MRI) provides essential information for surgical planning, and vaginal myomectomy can be a fertility-preserving alternative when the fibroid becomes nascent. This case illustrates that even FIGO type 3 fibroids can be effectively managed by vaginal myomectomy. The myoma may convert to a FIGO type 2 myoma under pregnancy-related hormonal stimulation and subsequent necrosis, and may become infected, forming a “pyomyoma nascent.”In selected patients, this approach enables rapid infection control, avoids hysterectomy, and preserves fertility.  \nCategories: Obstetrics/Gynecology  \nKeywords: benign uterine tumor, fertility preservation, myoma nascent, uterine fibroid degeneration, vaginal myomectomy  \nIntroduction  \nUterine myomas are the most common benign pelvic neoplasms in women of reproductive age [1,2] . They originate from the smooth muscle cells of the myometrium and can vary in size, number, and location. The International Federation of Gynecology and Obstetrics (FIGO) classification system categorizes fibroids from types 0 to 8, distinguishing submucosal, intramural, subserosal, and pedunculated variants based on their position relative to the uterine cavity [3] . Risk factors include early menarche, hereditary predisposition, Black ethnicity, arterial hypertension, and chronic stress [2,4-8] . Clinically, myomas may remain asymptomatic or present with abnormal uterine bleeding (which can lead to chronic anemia), pelvic pain, bulk-related symptoms (such as abdominal distension, bladder or bowel dysfunction, and early satiety), and reproductive issues (including infertility and recurrent pregnancy loss) [9] .  \nDuring pregnancy, myomas may undergo morphological and vascular changes. Smaller fibroids (\u003C1 cm) tend to grow more rapidly, while larger ones (>3 cm) often remain stable or even regress [10]. In some cases, rapid growth exceeds their vascular supply, leading to red degeneration-a hemorrhagic infarction characterized by ischemia, necrosis, and prostaglandin r","cbCaijFl4r0oiL5h","https://ap.wps.com/l/cbCaijFl4r0oiL5h","pdf",4894578,"English","# Introduction\n## Case Presentation\n## Patient information\n## How to cite this article","[{\"question\":\"What complication followed the late miscarriage in this case?\",\"answer\":\"A large necrotizing uterine fibroid progressed to a “pyomyoma nascent,” with central necrosis and infection risk after the 15-week miscarriage.\"},{\"question\":\"How was the fibroid classified on imaging?\",\"answer\":\"Imaging initially categorized it as FIGO type 3, with later discussion indicating possible conversion to FIGO type 2 under pregnancy-related hormonal stimulation and necrosis.\"},{\"question\":\"Why was vaginal myomectomy chosen instead of hysterectomy?\",\"answer\":\"A conservative, fertility-preserving vaginal myomectomy enabled complete removal of the necrotic fibroid while avoiding hysterectomy in a selected patient.\"}]","Vaginal Resection of a Large Nascent Uterine Pyomyoma Following Late Miscarriage | PDF",1790681230,23]