A Rare Medical Breakthrough: A 20 cm Twisted Fibroid Removed
Pune, February 06th 2025: A 35-year-old unmarried woman was admitted to Ruby Hall Clinic Pune with excruciating abdominal pain, initially suspected to be related to gastrointestinal or liver issues. However, after further evaluation, doctors uncovered an exceptionally rare medical condition, a massive 20 cm, 1.5 kg fibroid in her uterus had twisted (torsion), cutting off its blood supply. In 40 years of global surgical experience, the lead surgeon, Dr. Sunita Tandulwadkar, Head of the Department of Obstetrics and Gynaecology, IVF, and Endoscopy Centre at Ruby Hall Clinic Pune and President of the Federation of Obstetric and Gynaecological Societies of India (FOGSI), had never encountered a fibroid of this size undergoing torsion. No similar case had been documented in medical literature. The patient was discharged after a smooth recovery.
The patient’s ordeal began when she experienced sudden, severe abdominal pain, primarily in the upper and middle parts of her abdomen. Initially evaluated for possible gastrointestinal or liver concerns, a mass was detected upon clinical examination. However, the intense tenderness made further assessments difficult, and an initial diagnosis remained unclear. With the pain persisting despite painkillers, further diagnostic steps were taken. A CT scan revealed a large fibroid arising from the uterine fundus. This finding prompted an urgent consultation with the gynecology team, considering the rarity of fibroids causing such acute symptoms.
Despite administering painkillers, the patient’s symptoms persisted, prompting further investigation. A 3D ultrasound with color Doppler was performed, revealing a startling loss of vascularity—clear evidence that the fibroid had undergone torsion. This condition is extremely rare, particularly for solid fibroids of such significant size. Normally, fibroids of this magnitude would not twist, making this case a medical outlier. Twisting typically occurs in fluid-filled ovarian cysts, not in solid fibroids—especially one weighing around 1.5 kg. In 40 years of experience and treating patients worldwide, Dr. Sunita Tandulwadkar had never encountered a fibroid of this size undergoing torsion. Even medical literature reports no similar cases, making this an unprecedented medical condition.
The laparoscopic surgery was conducted urgently to prevent further complications like necrosis. Upon removal and morcellation of the fibroid, an extraordinary discovery was made—the fibroid tissue appeared deep red and haemorrhagic, unlike the typical pale white fibroids observed in most cases. This unusual coloration was caused by trapped blood due to vascular compromise, highlighting the distinctive pathological changes induced by torsion.
Dr. Sunita Tandulwadkar, Head of the Department of Obstetrics and Gynaecology, IVF, and Endoscopy Centre at Ruby Hall Clinic Pune and President of the Federation of Obstetric and Gynaecological Societies of India (FOGSI), led the surgical intervention, performing laparoscopic surgery to remove the fibroid. “In my 40 years of practice, despite pioneering laparoscopic fibroid surgery and treating patients globally, I had never encountered a fibroid of this size undergoing torsion. This case not only presented an unprecedented surgical challenge but also emphasized the critical role of early detection and timely medical intervention in gynaecological health,” she explained.
Dr. Purvez Grant, Chief Cardiologist, Chairman, and Managing Trustee of Ruby Hall Clinic, stressed the significance of this case in raising awareness about routine gynaecological check-ups. “Women often remain unaware of conditions like fibroids until they become symptomatic. After the age of 35, regular ultrasounds of the uterus and ovaries can help detect such issues early, potentially preventing medical emergencies. This case serves as a strong reminder of the importance of proactive health screenings,” he remarked.
This case underscores the importance of not ignoring potential symptoms and the vital role of regular health check-ups. Women are often unaware of the presence of fibroids until they grow large enough to cause symptoms, leading to potentially life-threatening situations. Routine screenings, particularly after the age of 35, can help detect fibroids and other gynecological issues early, allowing for timely intervention and preventing serious complications.
As the patient recovered smoothly after the surgery and was discharged, this case serves as a stark reminder to women worldwide that health check-ups should never be delayed. Early detection can make a significant difference in reproductive and overall health, ensuring better outcomes for women. The groundbreaking nature of this case highlights the importance of continuing research and clinical awareness in the field of obstetrics and gynecology.
About Ruby Hall Clinic:
Ruby Hall Clinic is the flagship multi-disciplinary hospital of Grant Medical Foundation. Based in Pune, it has been recognized for its’ 8 NABH certifications and accreditations in healthcare provided by the Quality Council of India, the ‘Best Organ Transplant Centre’ by the Government of India, and ‘Best Medical Tourism Facility’ by the President of India. Serving the community since 1959, Ruby Hall Clinic is a family of 4000 doctors and support staff, and a system of 3 hospitals with 850 beds, 24 diagnostic centres and an array of other health services.
