AN UNUSUAL CASE OF A LARGE CERVICAL ANGIOLEIOMYOMA MANAGED LAPAROSCOPICALLY

Angioleiomyoma of uterine body is an extremely rare variety of leiomyoma and only few cases have been reported in the literature so far. Finding of a cervical angioleiomyoma is a more rare variant and its effective management laparoscopically makes our case unique. A, 45-year-old patient, P1L1, presented with complaints of heavy menstrual bleeding and heaviness in lower abdomen since last two months. Physical examination was suggestive of a cervical fibroid. An ultrasound pelvis revealed a single hypoechoic, well circumscribed lesion having central anechoic spaces of 77x81 mm in the body of the cervix. She was planned for total laparoscopic hysterectomy with bilateral salpingectomy. Intraoperative findings were of a bulky uterus with a large central cervical fibroid of around 10x10 cm. Bilateral adnexae were normal . Hysterectomy was preceded with meticulous step by step devascularisation of all capsular vessels of the fibroid, and endosuturing of bilateral uterine vessels. Intraoperative and postoperative findings were normal. Histopathological examination revealed angioleiomyoma of the cervix with no features of cellular atypia, increase mitosis or necrosis. Laparoscopic management of cervical fibroids are technically challenging because of the difficult accessibility and close proximity of vital structures like bladder and ureter, and thus the importance of being within the capsule of the fibroid while enucleating the fibroid. Keywords: Cervical fibroid; Angioleiomyoma; Laparoscopy; Hysterectomy