A Rare Case Report of Red Degeneration of a Large Intramural Leiomyoma in a Postmenopausal Nulligravid Patient

Leiomyoma, a benign tumor originating from the smooth muscle of the myometrium, typically undergoes red (carneous) degeneration in a gravid uterus.However, this case highlights a less common presentation.We report the case of a 45-year-old postmenopausal, nulligravid, and divorced female who presented with complaints of lower back pain, a sensation of heaviness, and a palpable abdominal mass.Clinical examination and radiological investigations confirmed the presence of a large uterine fibroid.After appropriate preoperative optimization, she underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy.Histopathological evaluation of the specimen revealed red degeneration of the leiomyoma-a rare but documented occurrence in postmenopausal women.This case underscores the importance of considering red degeneration even in nonpregnant and postmenopausal patients presenting with symptomatic fibroids.