Cervical Myoma: No Need to Fear the 'Tumor' Label
Cervical Myoma: No Need to Fear the 'Tumor' Label
Many women find the term "uterine fibroids" appearing on their medical reports deeply concerning. The presence of the word "tumor" in the diagnosis can cause significant distress, especially when the described size is substantial, leading to panic.
On July 5, 2023, our hospital’s gynecology department admitted a 36-year-old patient, Ms. Wang. She was first diagnosed with a fibroid during an examination three years earlier—specifically, a cervical fibroid measuring approximately 5 cm. This type of fibroid, given its sensitive location, can compress surrounding organs when it grows to a certain size, causing complications such as difficulty defecating, urinary retention, ureteral dilation, and even hydronephrosis.
At the time of diagnosis, Ms. Wang had a single fibroid and no symptoms. She visited multiple hospitals, all of which recommended surgical intervention. However, she declined due to concerns about potential loss of her uterus and opted for observation instead.
Over the following three years, the fibroid grew silently. Recently, Ms. Wang experienced lower abdominal pressure worsening during menstruation, accompanied by a significant increase in vaginal discharge. Upon examination at our hospital, pelvic ultrasound revealed the cervical fibroid had enlarged to 12 cm.
Examination Findings:
- Cervix displaced toward the abdominal side due to fibroid compression
- Vaginal fornices appeared full and protruded
- Cervix enlarged to the size of a fetal head, fixed at the pelvic floor with restricted mobility
- Uterine body difficult to palpate
The enlarged fibroid drastically increased surgical complexity. Compounded by the patient’s desire for future fertility, we faced the dual challenge of alleviating symptoms while preserving her uterus and reproductive function. This presented significant pressure for our team.
Led by Director Wang Ruimei, we conducted thorough, repeated examinations and performed comprehensive imaging evaluations, including pelvic MRI and ultrasound. After extensive consultations, the team unanimously agreed to attempt uterine-preserving surgery: a cervical myomectomy. To ensure the best outcome, we invited provincial expert assistance for minimally invasive surgery. We were honored to secure the collaboration of Director Luan Hua from the Gynecology Department of Gansu Provincial Maternity and Child Health Care Hospital Center, who carefully reviewed the case and agreed to assist.
Prior to the surgery, we reconfirmed the patient's HPV test was negative; cervical TCT smear: Negative for Intraepithelial Lesion or Malignancy (NILM). Routine blood tests, liver function, kidney function, cardiac function, and pulmonary function all showed no significant abnormalities. Ultrasound and MRI examinations were performed (as shown in the images below).
2023-7 Transvaginal Color Doppler Sonography (TVCDS)
2023-7-5 Pelvic Magnetic Resonance Imaging, Sagittal Plane
2023-7-5 Pelvic Magnetic Resonance Imaging, Coronal Plane
On July 8, 2022, Director Luan Hua led the gynecological team of Director Wang Ruimei at our hospital to successfully perform a laparoscopic myomectomy for Ms. Wang. The procedure involved four small abdominal incisions and lasted nearly five hours. Intraoperative findings confirmed a central cervical fibroid measuring approximately 11x10x10 cm, which enveloped the anterior, posterior, and right lateral walls of the cervix. The tumor was meticulously removed while maintaining continuous hemostasis to minimize blood loss. Due to the tumor’s substantial size and compression of the right ureter, the urology department was consulted intraoperatively to place bilateral double-J ureteral stents, mitigating the risk of postoperative ureteral fistula.
The patient experienced no surgical complications. Pathological examination post-surgery confirmed a cervical leiomyoma. Ms. Wang recovered well and was discharged on postoperative day 8.
Cervical myoma (also termed cervical fibroid) is a specific type of uterine fibroid, accounting for approximately 2.4–7.0% of all uterine fibroid cases. Due to its low anatomical position near critical structures such as blood vessels, ureters, and other pelvic organs, cervical fibroids may displace adjacent tissues, disrupt normal anatomy, and significantly increase surgical difficulty and complication rates369.
Therefore, it is advised that women who are diagnosed with uterine fibroids—especially cervical fibroids—and experience the following conditions should consider timely surgical intervention:
1.Significant discomfort (e.g., abnormal bleeding, pelvic pain, urinary obstruction);
2.Infertility linked to fibroid location or size;
3.Large fibroids (>4–5 cm) or rapid growth suggesting potential malignant transformation.
Early surgery can mitigate disease-related damage and reduce surgical risks
Introduction to Gynecology Department
The Gynecology Department of Wuwei Cancer Hospital, a Key Medical Discipline in Wuwei City, has been established for nearly 30 years. In April 2022, it was subdivided into the Gynecology Department and Gynecologic Oncology Department to meet growing service demands.
Clinical Expertise
Our department boasts a specialized team including:
● 1 Chief Physician
● 2 Associate Chief Physicians
● 3 Resident Physicians
Scope of Services
We provide comprehensive diagnosis and treatment for:
1.Benign & Malignant Tumors:
● Cervical/ovarian/endometrial cancer, uterine sarcoma, vulvar/vaginal cancer
● Primary peritoneal carcinoma, gestational trophoblastic neoplasia
● Uterine fibroids, adenomyosis, ovarian cysts
2.HPV & Precancerous Lesions:
● Standardized management of HPV infection and cervical dysplasia
3.Pelvic Floor Disorders:
● Surgical correction of uterine prolapse, bladder prolapse, and urinary incontinence
4.Endocrine & Reproductive Health:
● Evidence-based care for menopause syndrome, infertility, amenorrhea, and menstrual disorders
Advanced Capabilities
● Minimally Invasive Surgery (＞85% utilization rate):
◦ Laparoscopic radical hysterectomy, ovarian cystectomy, ectopic pregnancy resection
◦ Hysteroscopic polypectomy, submucosal myomectomy
◦ Colposcopy-guided cervical biopsy
● Oncologic Therapies:
◦ Radical cancer surgery combined with chemotherapy and immuno-targeted therapy
● Cervical Cancer Prevention Center:
◦ Population-based screening programs
◦ Laser ablation/conization (LEEP and cold knife cone biopsy) for precancerous lesions
Director Wang Ruimei, Associate Chief Physician
Leading specialist with a bachelor's degree. Over 20 years of clinical experience in gynecology and gynecologic oncology. Professional training: 2008 - 1-year advanced study in OB/GYN at Lanzhou University First Hospital; 2013 - 6-month minimally invasive techniques training at Gansu Provincial Hospital Gynecological Endoscopy Center; 2016 - 1-year oncology mentorship under Professor Wu Lingying at National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences; 2023 - systematic training at Gansu Provincial Maternity and Child Care Hospital Cervical Cancer Prevention Center. Completed 3 scientific research projects as principal investigator and contributed to 2 additional projects. Published 10 papers in national and provincial journals.
Current affiliations: Committee Member of Wuwei Medical Association Oncology Specialty Committee, Committee Member of Wuwei Medical Association OB-GYN Branch Committee, Council Member of Western Oncology Specialist Alliance.
Specialties: Benign and malignant gynecologic tumors, cervical precancerous lesions, pelvic floor disorders (uterine prolapse, urinary incontinence etc.), and endocrine diseases (amenorrhea, menstrual disorders, PCOS etc.).
Director Cao Huilian, Chief Physician and Technical Director
Bachelor's degree, renowned obstetrician-gynecologist in Wuwei. Graduated from the Medical Department of Lanzhou Medical College in 1988. Previously served as Head of OB/GYN at Wuwei People's Hospital, Gynecological Director at Shanghai Haihua Hospital, and OB/GYN Director at Xi'an Cunji Maternity Hospital. Currently Technical Director of Gynecology at Wuwei Cancer Hospital. Holds honorary chair positions in OB/GYN and Gynecologic Oncology Committees of Wuwei Medical Association, and serves as National Committee Member of China Maternal and Child Health Association's OB/GYN Branch.
Clinical expertise: Menopausal syndrome, PCOS, infertility, amenorrhea, menstrual disorders, pelvic floor disorders (uterine prolapse, urinary incontinence), benign/malignant gynecological tumors, congenital reproductive tract malformations, and gynecological inflammatory diseases.
Xu Xiumei, Associate Chief Physician and Key Expert
Bachelor of Medicine with over 10 years of clinical experience in obstetrics and gynecology. Completed advanced training at the First Hospital of Lanzhou University (2011, 6 months) and Gynecologic Oncology Center of Zhejiang Cancer Hospital (2017, 6 months). Led one research initiative and published four peer-reviewed papers. Currently serves on the Oncology Committee of Wuwei Medical Association.
Clinical Expertise: Specialized in diagnosing and treating common/recurrent obstetrics and gynecology disorders, with proficiency in standardized management of benign/malignant gynecologic tumors including chemotherapy and immuno-targeted therapies for malignancies.
The Gynecology Department operates as a united team committed to patient-centered, disease-focused care. We maintain professional collaboration with Gansu Provincial Maternity and Child Care Hospital and Zhejiang Cancer Hospital’s Gynecology Department.
Gynecological Specialized Techniques
1.Laparoscopic radical surgery for endometrial cancer: Endometrial cancer is one of the three major gynecological malignancies, and surgery remains its primary treatment. Laparoscopic surgery has gained increasing preference due to minimal trauma, rapid recovery, and lower postoperative complication rates. Our department routinely performs laparoscopic radical hysterectomy, demonstrating superior vascular skeletonization, clearer operative field visualization, and reduced blood loss compared to open surgery. Adhering to the no-tumor principle, we utilize uterine suspension techniques and custom uterine elevators without uterine manipulator cups to prevent potential tumor dissemination.
2.Cold knife cervical conization + multiple cervical biopsies + endocervical curettage + cervical reconstruction: For cervical lesions, particularly high-grade squamous intraepithelial lesions (HSIL), cold knife conization is the preferred approach to preserve uterine function while ensuring therapeutic thoroughness. Chief specialist Dr. Wang Ruimei introduced this technique after advanced training at the Gynecologic Oncology Center of National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences in 2016. This method preserves cervical integrity, maintains anatomical aesthetics, and achieves complete lesion removal.
3.Uterine prolapse repair: Addressing pelvic organ prolapse (including uterine and vaginal wall descent) caused by childbirth or congenital factors, which manifests as pelvic pressure, urinary incontinence, or retention affecting quality of life. Our department routinely performs pelvic floor reconstruction surgeries to resolve these functional impairments.
4.High-risk HPV & Cervical Precancer Therapeutics Center: Despite the high prevalence of high-risk HPV infections and numerous suboptimal treatments available, our center provides comprehensive care including: standardized cervical cancer screening → evidence-based management of HR-HPV infection/cervical intraepithelial neoplasia → surgical intervention with adjuvant radiotherapy/chemotherapy for invasive cancer. This systematic approach has demonstrated significant efficacy and earned consistent patient recognition.
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