Rare cases in gynecology | Dr Najeeb Layyous

In short: This page presents a rare case from Dr. Najeeb Layyous’s clinic in Amman: a 42-year-old woman with severe menstrual bleeding caused by a rare benign mass in the muscle of the uterus (focal adenomyosis with fibrous changes). It explains how she was treated successfully by surgery while keeping the uterus and her ability to have children.

Focal adenomyosis with leiomyomatous changes

Let’s talk about one of the rare cases that visited us in the clinic. The honorable lady, who is 42 years old, came to our clinic because she is suffering from Heavy menstrual cycle . This bleeding resulted in the frequent need for blood transfusions and intravenous iron administration . Several Treatments were used aiming at decreasing the amount of menstrual flow, such as: aminor (progesterone) pills, combined hormonal pills (OCPs), pills Non-steroidal anti-inflammatory drugs such as mefanimic acid, but without any improvement in her condition, there were many Other options that were not considered in her case (such as hysterectomy) as she was still single and wanted to keep the uterus and the reproductive capacity for the future. When the patient came to the clinic, she was clinically examined and the uterus was evaluated on ultrasound, she was found to have a large fibroid protruding from the posterior wall of the uterus, 7 cm in size, affecting the uterine cavity and encroaching on the endometrium, thus affecting the stability of the endometrium. The clinical findings were discussed with the patient, and a decision to perform myomectomy was taken. During the operation, it was found that the fibroid was firmly attached to the wall of the uterus (and this is something unusual in the case of uterine fibroids that are easily peeled off) and There was difficulty in peeling it away from the wall and the cavity of the uterus, but the operation was completed successfully with complete preservation of the uterus and uterine. The sample was sent for histopathology , and it was found to be (focal adenomyosis with leiomyomatous changes). Focal adenomyosis with leomyomatous changes is a benign lump, but facing such a rare condition does not happen on a daily basis. Thanks to God and the efforts of Dr. Najeeb layyous, the operation was performed successfully.