Case Report: Spontaneous Restitution of Giant Myoma - Is it possible?

Journal für Reproduktionsmedizin und Endokrinologie - Journal of Reproductive Medicine and Endocrinology 2017; 14 (3): 124-125

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Keywords: gynecology,  infertility,  myoma

We present a case of an unexpected complete regression of a giant uterine intramural myoma which was associated with infertility in a patient with consecutive 2 pregnancies with favourable outcomes. A 55-year-old Caucasian woman was in a programme of assisted reproductive technology since she failed to achieve pregnancy in a period of 12 years. One intrauterine fetal demise after assisted conception cycle happened in the first trimester at the age of 41. Serial ultrasound examinations in a period of 3 years have revealed the growth of a large heterogeneous intramural myoma measuring 18 cm in diameter with abundant vascularisation. In vitro fertilization with intracytoplasmic sperm injection followed by blastocyst transfers was undertaken at the age of 42. The course of pregnancy was normal with intermittent pains and she had delivered vaginally on term. Since the described myoma showed increase growth (around 25 cm in diameter) the patient was planned for hysterectomy which she did not consent and moreover spontaneously achieved pregnancy at the age of 44. The pregnancy outcome was again favourable with term eutrophic neonates. Postpartal anaemia treated with iron supplements. At the age of 50, an ultrasound examination revealed intramural myoma measuring 18 cm in diameter with rich vascularisation. After menopause the patient was referred for a gynaecological exam after 3 years, when the ultrasound showed resorbed intramural myoma measuring 1.8 cm without vascularisation.