Spontaneous expulsion of a huge cervical leiomyoma from vagi
The present case report has been published in the journal Medicine. A 22-year-old primipara came to the emergency room with a complaint of fever (up to 39.2 °C), and a mass extrusion in the vaginal orifice with smelly discharge for 2 days. She had delivered a female baby by cesarean in the local hospital in her hometown 2 weeks before. Although she did not have a regular antenatal care there was nothing special about the gestational procedure.

When she felt regular uterine contractions at about 9 months’ gestation, she went to the local hospital. And the ultrasonic test showed a transverse lie of the fetus, so the doctor proposed her a cesarean. Her baby weighted 2850 g and was healthy. The postoperative course was uneventful and she was discharged 3 days after the cesarean.

On postpartum day 12, she had a fever of 38 °C to 39.2 °C , and, she felt uncomfortable about the vagina. When she squatted, a big mass extruded from the vagina with a lot of foul-smelling discharge. Her doctor was not sure about the mass and referred her to the hospital.

At the time of admission, general physical examination was unremarkable except a temperature of 38.3 °C. She appeared calm without severe pain. Cardiopulmonary examination was nothing special. There was no abdominal tenderness, and the incision healed well.

An irregular, long, thin, and broad sarcoid mass hung down through the vaginal orifice with foul-smelling serosanguinous discharge on the surface. Speculum examination showed that the mass seemed to come from the internal uterine cavity. The cervix was dilated. The uterus was firm and tenderness on bimanual examination. The tips of the doctor's fingers in the vagina could not reach the root of the mass.

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