Lower Limb Monoparesis Secondary to Impacted Pedunculated Fibroid: A Case Report

Authors: Jombo S E, Ani V C1, Ozigbo C E

Abstract

Isolated monoparesis  of acute  onset could be a pointer to an insult on the central nervous system, however it has not been associated with uterine fibroid. We report a 36- year -old Para 0 plus 3 woman who presented with a slowly progressive lower abdominal swelling, heavy menstrual bleeding of 6 years duration and 3 weeks onset of intermittent inability to use the right lower limb associated with numbness, tingling sensation, pain and inability to completely extend the knee joint which became worse four days prior to presentation and was offered clutches as she could no longer bear weight. Abdominopelvic Ultrasound scan showed multiple uterine fibroids with one huge pedunculated fibroid that measured 30x15x20cmon the right lumbar region abutting on the vertebrae with bilateral hydronephrosis. She was optimized with blood transfusion and subsequently had open abdominal myomectomy. An impacted pedunculated fibroid measuring 31cmx26cm and weighing 1.5kg was removed. Patient had general anaesthesia but woke up with excitement 12 hours later observing complete resolution of symptoms. This shows a very rare manifestation of uterine fibroid and justifies the need for pelvic evaluation with ultrasonography for pelvic tumor in case of lower limb neuropathy in women.

Keywords

Monoparesis; Uterine Fibroid; Myomectomy; Pelvic Ultrasonography

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Lower Limb Monoparesis Secondary to Impacted Pedunculated Fibroid: A Case Report