A pedunculated uterine tumor

¹Cliniques Universitaires des Montagnes (CUM), Bangangté, West-Cameroon, ²Service d´Anatomie Pathologie de l´Hôpital Général de Douala, Littoral-Cameroon

^&Corresponding author
Stéphane Kohpé Kapseu, Cliniques Universitaires des Montagnes (CUM), Bangangté, West-Cameroon

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Endometrial pedunculated tumors have already been described in the literature. They can sometimes necrotize during a torsion. We present the case of a 38-year-old woman of black origin, married, housewife, nulliparous, immunocompetent with a BMI of 28 kg/m² and no pathological history. Last menstrual period was a week before admission. For 4 weeks she had menometrorrhagia. The abdomen was soft and painless, with no palpable mass. Genital examination with the speculum revealed a necrotic, foul-smelling mass delivered through the cervix, with the anterior lip of the cervix visible and the posterior lip obscured by the mass. Vaginal examination revealed an intra-cervical mass with a smooth surface and a soft consistency that did not bleed on contact, a smooth cervix and a fetid discharge. Biologically, the blood cells count showed mild anaemia. The cervical smear was normal. Ultrasound identified a hypervascularised tissue formation with central necrosis, posterior cervico-isthmic with irregular contours and sharp borders measuring 81 x 52 mm (ultrasound appearance in favour of a suspicious tumour). The mass was biopsied and histologically examined before vaginal removal; it was a proliferation of monomorphic fusiform cells, with no cytonuclear atypia. They are made up of extended nuclei and weakly delimited eosinophilic cytoplasm organized in bands. Patient was taken for surgery after obtaining appropriate consent. The tumor was resected under spinal anesthesia with an electric scalpel and the postoperative period showed no complications. The patient was followed up clinically for five days with an uneventful recovery.

Figure 1: (A) tumor at vulva seized with a hysterolab; (B) tumor removed with an electric scalpel; (C) tumor after removal; (D) histology: the proliferation of monomorphic fusiform cells, with no cytonuclear atypia; they are made up of extended nuclei and weakly delimited eosinophilic cytoplasm organised in bands