Meenakshi Hospital Thanjavur successfully performed a complex surgery to remove a 27 kg fibroid mass from the uterus of a 45-year-old woman, along with her ovary and uterus—organs that were under pressure from the benign tumor—bringing an end to her two-year-long ordeal.
A fibroid mass refers to a non-cancerous growth made of muscle and fibrous tissue that develops from the uterus. These are also called leiomyomas. This is an extremely rare case; only one in 2.5 lakh leiomyomas grow to this size. The surgery required extensive pre- and post-operative care, and it lasted for nearly five hours. However, the woman has made a complete recovery and is now free from the discomfort she endured for so long.
"The woman, a mother of two daughters, first noticed a small swelling in her abdomen about two years ago. The mass gradually grew, and the abdominal protrusion became visibly prominent. Despite the discomfort, she avoided seeking medical help, fearing that hospitalization would leave her children alone, as her husband was working abroad. However, in recent weeks, the mass grew so large that she began experiencing severe breathing difficulties and could neither sit nor lie down without enormous difficulty. This eventually forced her to seek treatment.
Since the mass growth had the possibility of affecting the location and functioning of several internal organs including the heart and the lungs, a multidisciplinary team was involved in the medical examination and evaluation of the treatment procedures. The surgical team was led by Dr. R. Nirmala, Senior Consultant - Gynaecology, with anesthetic support from Dr. G. Arimanickam, Senior Consultant – Anesthesiology and Dr Vinodha Devi, Senior Consultant - Anesthesiology. Post-operative care was provided by the ICU team headed by Dr Senthil Kumar.
In her comments, Dr. Nirmala, Senior Consultant – Gynaecology, Meenakshi Hospital Thanjavur said, “When the woman came to us, she had multiple complaints, including severe breathing difficulty, constipation, and trouble with basic movements like sitting, standing, or even lying down. We conducted CT and MRI scans, along with tests for ovarian tumor markers. Although the markers were negative, we couldn't rule out cancer, especially given the size and rapid growth of the mass. Such aggressive growth is unusual for a benign tumor. Based on these concerns, we proceeded with a staging laparotomy, and removed the mass along with the uterus, ovaries, pelvic lymph nodes, and omentum. Fortunately, the biopsy results confirmed that the growth was non-cancerous—a large fibroid mass.”
Talking about the pre- and post-operative care, Dr. Nirmala said, “We anticipated a complex surgery, as the mass had displaced and impaired the function of several vital internal organs, including the heart and lungs. To prepare the patient, we trained her with breathing exercises to help her better cope with the postoperative phase. One of our concerns was whether the lungs would respond well once the mass was removed, as they would suddenly be released from the upward pressure exerted by it. Fortunately, the surgery proceeded without complications. However, due to the extensive network of blood vessels connected to the mass, there was significant blood loss.”
She added that postoperatively, the team was unable to immediately wean the patient off the ventilator, as the lungs needed time to adjust to their new position. As a result, the woman had to remain intubated for a day after the procedure. “Many of these challenges could have been avoided if the patient had sought medical attention earlier, when the mass was still small.”
Dr. V. Praveen, Deputy Medical Superintendent, Dr. Nuzhat Zeba, Consultant – Gynaecology, and Dr. Steffi Kiran Pandian, Associate Consultant – Gynaecology were also present during the press conference.