Torsion of a Pedunculated Subserous Leiomyoma in a Pregnant Woman: A Rare Case Report

Abstract

Torsion of a pedunculated subserous leiomyoma in a pregnant woman is a rare condition that requires prompt diagnosis and urgent surgical intervention. In this report, we present a case of torsion of a pedunculated subserous leiomyoma in a primigravid woman aged 33 years in her 30th week of gestation. A primigravid woman aged 33 years presented to our clinic in her 30th week of gestation with pain in the right lower quadrant that had developed in the last 24 hours. Our diagnosis was torsion of a pedunculated leiomyoma. The patient received a tocolytic of nifedipine and indomethacin preoperatively. Given the volume of the uterus and as a precaution to potential complications, a lower transverse (pfannenstiel) incision was preferred. The laparotomic myomectomy was successfully performed and the pregnancy continued uneventfully. Even though torsion of a pedunculated subserous leiomyoma in pregnancy is a very rare condition, prompt diagnosis and urgent surgical intervention is life saving and provides more favorable maternal and fetal outcomes. The surgical approach should be tailored to the patient and to the characteristics of the myoma and an expert team of surgeons and anesthesiologists is essential in order to reduce the risk of complications.