Cystic endometriosis in a degenerated sub-serous myoma in a sub-fertile woman: A case report

INTRODUCTION AND IMPORTANCE: Leiomyoma is the most common gynecologic tumor which may show atypical locations and degenerations. Cystic degeneration is said to be found in 4 % of all degenerations. Endometriosis, the presence of endometrial glands and stroma at extrauterine sites, is a common gynaecological condition seen in 10 % to 15 % of reproductive-age women usually being associated with various degrees of fertility problems. CASE PRESENTATION: 40 years old woman with P1L1A2, with secondary sub-fertility for 5 years, presented with chief complaints of dysmenorrhoea for 1 year initially around the menstrual cycle relieving with analgesics but later not limited to the menstrual cycle and pain not relieving with analgesics since 1 month. The patient underwent fertility-sparing laparoscopic removal avoiding a laparotomy and definitive hysterectomy. Manual morcellation was achieved. CLINICAL DISCUSSION: Cystic degeneration is rare in Leiomyoma although it is the more common gynaecological tumor in women and is associated with endometriosis probably due to retrograde menstruation. CONCLUSIONS: Laparoscopic removal of leiomyoma without laparotomy and definitive hysterectomy for a case of cystic endometriosis in a degenerated subserous myoma which to the best of our knowledge according to our search of articles on the relevant topic is the first reported case pertaining to the topic from Nepal.