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Published in: BMC Pregnancy and Childbirth 1/2021

Open Access 01-12-2021 | Fertility | Case report

Enlarged uterine fibroid forming uterine diverticulum during pregnancy: a case report

Authors: Erina Akashi, Tatsuya Ishiguro, Taro Nonaka, Akiko Kobayashi, Koichi Takakuwa, Takayuki Enomoto

Published in: BMC Pregnancy and Childbirth | Issue 1/2021

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Abstract

Background

Although uterine fibroids are a common gynecologic neoplasm, uterine diverticulum accompanied by a uterine fibroid is unique. In addition, pregnancy complicated with uterine diverticulum is extremely rare. We experienced a case of a uterine fibroid that was associated with a uterine diverticulum that enlarged during pregnancy and puerperium.

Case presentation

A 25-year-old nulligravida woman had an abnormal uterine cavity surrounded by myomatous mass. After natural conception, the mass and pouch had enlarged during pregnancy. Six months after elective cesarean delivery, she underwent laparotomy because of abdominal pain caused by the myomatous mass and the fluid inside. The tumor was connected to the midline of the posterior wall of the normal uterus. The resected tumor was pathologically diagnosed as leiomyoma and diverticulum.

Conclusions

Pregnancy can stimulate uterine fibroids to form uterine diverticula. Resection of the diverticulum and fibroid is a useful option for symptomatic patients with desired future fertility.
Literature
1.
go back to reference Stewart EA. Clinical practice. Uterine fibroids. N Engl J Med. 2015;372:1646–55.CrossRef Stewart EA. Clinical practice. Uterine fibroids. N Engl J Med. 2015;372:1646–55.CrossRef
2.
go back to reference Vitagliano A, Noventa M, Di Spiezio Sardo A, Saccone G, Gizzo S, Borgato S, et al. Uterine fibroid size modifications during pregnancy and puerperium: evidence from the first systematic review of literature. Arch Gynecol Obstet. 2018;297:823–35.CrossRef Vitagliano A, Noventa M, Di Spiezio Sardo A, Saccone G, Gizzo S, Borgato S, et al. Uterine fibroid size modifications during pregnancy and puerperium: evidence from the first systematic review of literature. Arch Gynecol Obstet. 2018;297:823–35.CrossRef
3.
go back to reference Umezaki I, Takagi K, Aiba M, Ohta H. Uterine cervical diverticulum resembling a degenerated leiomyoma. Obstet Gynecol. 2004;103:1130–3.CrossRef Umezaki I, Takagi K, Aiba M, Ohta H. Uterine cervical diverticulum resembling a degenerated leiomyoma. Obstet Gynecol. 2004;103:1130–3.CrossRef
4.
go back to reference Rajiah P, Eastwood KL, Gunn ML, Dighe M. Uterine diverticulum. Obstet Gynecol. 2009;113:525–7.CrossRef Rajiah P, Eastwood KL, Gunn ML, Dighe M. Uterine diverticulum. Obstet Gynecol. 2009;113:525–7.CrossRef
5.
go back to reference Noguchi M, Kitajima M, Abe S, Murakami N, Kitajima Y, Miura K, et al. Huge uterine fibroid arising from primary uterine cervical diverticulum: a case report and review of the literatures. J Obstet Gynaecol. 2019;39:1186–7. Noguchi M, Kitajima M, Abe S, Murakami N, Kitajima Y, Miura K, et al. Huge uterine fibroid arising from primary uterine cervical diverticulum: a case report and review of the literatures. J Obstet Gynaecol. 2019;39:1186–7.
6.
go back to reference Seoud M, Awwad J, Adra A, Usta I, Khalil A, Nassar A. Primary infertility associated with isolated cervical collecting diverticulum. Fertil Steril. 2002;77:179–82.CrossRef Seoud M, Awwad J, Adra A, Usta I, Khalil A, Nassar A. Primary infertility associated with isolated cervical collecting diverticulum. Fertil Steril. 2002;77:179–82.CrossRef
7.
go back to reference Engel G, Rushovich AM. True uterine diverticulum. A partial müllerian duct duplication? Arch Pathol Lab Med. 1984;108:734–6.PubMed Engel G, Rushovich AM. True uterine diverticulum. A partial müllerian duct duplication? Arch Pathol Lab Med. 1984;108:734–6.PubMed
8.
go back to reference Schmidt AP, Glitz CL, Passos EP, Arbo E, Cunha-Filho JS. Hysteroscopy and three-dimensional ultrasonography in uterine diverticulum diagnosis: a case report. Am J Obstet Gynecol. 2004;190:561–2.CrossRef Schmidt AP, Glitz CL, Passos EP, Arbo E, Cunha-Filho JS. Hysteroscopy and three-dimensional ultrasonography in uterine diverticulum diagnosis: a case report. Am J Obstet Gynecol. 2004;190:561–2.CrossRef
9.
go back to reference Coronado PJ, Fasero M, Vidart JA. Cervical diverticulum: an unusual cause of chronic menometrorrhagia. Eur J Obstet Gynecol Reprod Biol. 2008;137:126–7.CrossRef Coronado PJ, Fasero M, Vidart JA. Cervical diverticulum: an unusual cause of chronic menometrorrhagia. Eur J Obstet Gynecol Reprod Biol. 2008;137:126–7.CrossRef
10.
go back to reference Sun X, Xue M, Xiao S, Wan Y, Wang B. Uterine diverticulum complicating pregnancy diagnosed by ultrasound and uteroscopy. Int J Gynaecol Obstet. 2010;109:247–8.CrossRef Sun X, Xue M, Xiao S, Wan Y, Wang B. Uterine diverticulum complicating pregnancy diagnosed by ultrasound and uteroscopy. Int J Gynaecol Obstet. 2010;109:247–8.CrossRef
11.
go back to reference Bai J, Zheng G, Yang B, Lei L, Ren Q. Uterine cervical diverticulum containing a blood clot. Int J Gynaecol Obstet. 2010;111:269–71.CrossRef Bai J, Zheng G, Yang B, Lei L, Ren Q. Uterine cervical diverticulum containing a blood clot. Int J Gynaecol Obstet. 2010;111:269–71.CrossRef
12.
go back to reference Chufal S, Thapliyal N, Gupta M, Pangtey N. Huge uterine-cervical diverticulum mimicking as a cyst. Indian J Pathol Microbiol. 2012;55:372–4.CrossRef Chufal S, Thapliyal N, Gupta M, Pangtey N. Huge uterine-cervical diverticulum mimicking as a cyst. Indian J Pathol Microbiol. 2012;55:372–4.CrossRef
13.
go back to reference Tanaka K, Shiga N, Kuno T, Watanabe Z, Tachibana M, Yaegashi N. Successful pregnancy and vaginal delivery after laparoscopic excision of a congenital uterine cervical diverticulum: A case report. J Obstet Gynaecol Res. 2020;46:1460–4.CrossRef Tanaka K, Shiga N, Kuno T, Watanabe Z, Tachibana M, Yaegashi N. Successful pregnancy and vaginal delivery after laparoscopic excision of a congenital uterine cervical diverticulum: A case report. J Obstet Gynaecol Res. 2020;46:1460–4.CrossRef
14.
go back to reference Cramer SF, Oshri A, Heller DS. A Study of Myometrial Growth and Development. J Pediatr Adolesc Gynecol. 2015;28:387–94.CrossRef Cramer SF, Oshri A, Heller DS. A Study of Myometrial Growth and Development. J Pediatr Adolesc Gynecol. 2015;28:387–94.CrossRef
15.
go back to reference Swarray-Deen A, Mensah-Brown SA, Coleman J. Rare complication of fibroids in pregnancy: Spontaneous fibroid rupture. J Obstet Gynaecol Res. 2017;43:1485–8.CrossRef Swarray-Deen A, Mensah-Brown SA, Coleman J. Rare complication of fibroids in pregnancy: Spontaneous fibroid rupture. J Obstet Gynaecol Res. 2017;43:1485–8.CrossRef
16.
go back to reference Peng CR, Chen CP, Wang KG, Wang LK, Chen YY, Chen CY. Spontaneous rupture and massive hemoperitoneum from uterine leiomyomas and adenomyosis in a nongravid and unscarred uterus. Taiwan J Obstet Gynecol. 2015;54:198–200.CrossRef Peng CR, Chen CP, Wang KG, Wang LK, Chen YY, Chen CY. Spontaneous rupture and massive hemoperitoneum from uterine leiomyomas and adenomyosis in a nongravid and unscarred uterus. Taiwan J Obstet Gynecol. 2015;54:198–200.CrossRef
17.
go back to reference Mistry M, Bhatt M, Haque L, Owens O, Maharajan P. Degenerated uterine fibroid with rupture of the surface leading to haemoperitoneum. Eur J Obstet Gynecol Reprod Biol. 2017;211:216–7.CrossRef Mistry M, Bhatt M, Haque L, Owens O, Maharajan P. Degenerated uterine fibroid with rupture of the surface leading to haemoperitoneum. Eur J Obstet Gynecol Reprod Biol. 2017;211:216–7.CrossRef
18.
go back to reference Chandrasekaran N, Yudin MH, Berger H. Uterine Diverticulum With Fetal Leg Entrapment: A Case Report. J Obstet Gynaecol Can. 2017;39:894–6.CrossRef Chandrasekaran N, Yudin MH, Berger H. Uterine Diverticulum With Fetal Leg Entrapment: A Case Report. J Obstet Gynaecol Can. 2017;39:894–6.CrossRef
19.
go back to reference Hassim AM. Rupture of a diverticulum of the uterus. Hassim AM. Rupture of a. Am J Obstet Gynecol. 1968;101:1132–4.CrossRef Hassim AM. Rupture of a diverticulum of the uterus. Hassim AM. Rupture of a. Am J Obstet Gynecol. 1968;101:1132–4.CrossRef
Metadata
Title
Enlarged uterine fibroid forming uterine diverticulum during pregnancy: a case report
Authors
Erina Akashi
Tatsuya Ishiguro
Taro Nonaka
Akiko Kobayashi
Koichi Takakuwa
Takayuki Enomoto
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2021
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/s12884-020-03505-7

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