Can Cervical Leiomyoma be A Cause of Heavy Menstrual Bleeding in Adolescent Girl?
Background: Heavy menstrual bleeding (HMB) in adolescents is a very common problem but the diagnosis is often delayed due to its embarrassing nature, fear of disease and ignorance of the severity of the condition.
Case report: We report a case of young girl presented to Kahuta Research Laboratories (KRL) hospital, Islamabad with heavy menstrual bleeding and severe iron deficiency anaemia. After relevant investigations, blood was transfused. Initially she was managed on tranaxemic acid and Famila-28 but she failed to respond to medical treatment. So examination under anesthesia (EUA) was done which revealed a fibroid of 3*4cm protruding from cervical os and it was avulsed. Hysterocopic examination showed normal endometrium. Fibroid polyp and curettings were sent for histopathology. Her bleeding was settled after surgery. Histopathology revealed leiomyoma with normal secretory phase endometrium. She took famila-28 for the next 3 months and then stopped taking it. During her follow up for the next 3 months, she had normal menstrual cycle with average blood loss without any medication.
Conclusion: Cervical leimyoma as a cause of HMB in adolescent girls is a very rare event. Due to the cultural boundaries, pelvic examination is avoided in unmarried girls but in cases of HMB which is unresponsive to medical treatment and there is a suspicion of local cause, pelvic examination is mandatory to rule out the local pathology.
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