Giant uterine tumors: two cases with different clinical presentations.
BACKGROUND
Giant uterine tumors are uncommon. However, they may be life threatening because of pressure effects on the lungs and other adjacent organs. Proper surgical management and careful perioperative care are essential to assure a good outcome after excision.


METHODS
Two women with giant uterine leiomyomata (weighing more then 40 kg [88 lb]) are discussed. In one case the leiomyoma led to severe pulmonary hypertension and respiratory failure necessitating an emergency operation. Abdominal hysterectomy and bilateral salpingo-oophorectomy were successfully carried out in both cases, which are among the largest tumors ever removed with survival of the patient.


CONCLUSIONS
Different clinical manifestations can be expected in cases of giant uterine tumors according to which other organs are secondarily affected. Numerous difficulties may be encountered in the evaluation and removal of these tumors. A combined team consisting of gynecologic, general, and plastic surgeons is necessary for a successful outcome.
Department of Obstetrics and Gynecology, Sheba Medical Center, Sackler School of Medicine and Tel-Aviv University, Tel-Hashomer, Israel. goelsner@sheba.health.gov.il
Gabriel
G
Oelsner
Shai Elazar
SE
Elizur
Yair
Y
Frenkel
Howard
H
Carp
D002100:Cachexia / Q000209:etiology; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology; D007889:Leiomyoma / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D008875:Middle Aged; D012131:Respiratory Insufficiency / Q000209:etiology; D014594:Uterine Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*