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Clinicopathologic Features of Uterine Fibroids in a Private Gynecologic Setting in Calabar, Nigeria


 
 
 Uterine fibroid is a common gynecologic problem among adult females in Nigeria with variable clinical presentations. Unfortunately, these patients often seek medical attention very late after having consulted nonorthodox and/or traditional health practitioners.
 
 
 
 To assess the clinical outcome of patients diagnosed with uterine fibroids and review the pathologic features of specimens obtained from such patients managed over a 48-months period at Davis Medical Centre, a specialist gynecologic private health facility in Calabar, Nigeria.
 
 
 
 This retrospective study was conducted at Davis Medical Centre, located in a semirural community in Calabar Municipality. It involved the extraction of data from case notes of patients and review of laboratory reports and H&E-stained histopathologic slides of surgical specimens removed from patients who presented with abdominal mass/swelling, heavy menstrual bleeding, abdominal pain, and inability to get pregnant having excluded other causes of infertility and ultrasonographic features suggestive of leiomyoma.
 
 
 
 A total of 82 patients aged between 26 and 54 years (mean age 36 ± 2 SD) were seen, giving an annual rate of about 20 cases yearly in the 4-year period (2015-2018) studied. Forty-eight (58.5%) had giant uterine fibroids with uterine size between 16 and 28 weeks. Myomectomy was the mainstay of treatment in 93.9% while 6.1% had abdominal hysterectomy. Histologically, the number of fibroid nodules ranged from 1 to 60 nodules with the largest weighing 4,097 g. All had the typical whorled grayish-tan gross appearance of leiomyoma uteri with a large proportion histologically showing degenerative changes of the hyaline type (39%) and few having features suggestive of adenomyosis.
 
 
 
 Despite the grotesque, unusual macroscopic and characteristic microscopic findings, timely and careful surgical intervention can remedy the reproductive outcome and save lives of the affected patients when seen and managed by an experienced specialist gynecologist.
