Summary

A 56-year-old postmenopausal patient presented with acute exacerbation of chronic pelvic pain to the gynaecological ward. Her pelvic pain was dull, grinding and constant with radiation to lower back. There were no bowel problems like per rectal bleeding, constipation or diarrhoea. She had two children. On examination, 12 to 14 week size mass was palpated in her abdomen which was slightly tender. Ultrasound scan and MRI of the pelvis showed a well-circumscribed mass about 10 cm size, heterogeneous in appearance posterior to a normal sized uterus. The provisional diagnosis was of either a subserosal fibroid or an ovarian fibroma. Her Ca-125 was within normal limits. She underwent laparotomy with subtotal abdominal hysterectomy and bilateral salpingo-oophorectomy. There was a 10 cm mass arising from the posterior aspect the uterus. The histopathology report showed mature lipoleiomyoma.