Uterine Fibroid and Extensive Myxoid Degeneration- Is it Benign or Malignant?

Uterine leiomyomas are the most common benign uterine tumours that may undergo various types of degenerative changes. Rarely, myxoid degeneration can occur in giant leiomyomas that may pose difficulty in diagnosis and may be confused with choriocarcinoma, sarcomatous transformation or even hydatid cyst. This manuscript reports a large leiomyoma weighing approximately 4.5 kg, arising from the posterior wall of the uterus with myxoid degeneration in a 39-year-old female patient. She underwent a total abdominal hysterectomy with bilateral salpingectomy and left oophorectomy. Malignancy was ruled out after a histopathological examination. Through this case, the authors wish to highlight and learn about this rare pathology and understand the diagnostic challenges, thereby helping future gynaecologists to be familiar with the same.