Red degeneration of uterine leiomyoma in a non-pregnant woman: a rare clinicopathological presentation
Year: 2026
Type: article
Study design: Case Report
Abstract: Red degeneration, also known as carneous degeneration or haemorrhagic infarction, is an uncommon form of secondary degeneration of uterine leiomyomas and is classically associated with pregnancy. Its occurrence in a non-pregnant woman is extremely rare. We report a case of red degeneration in a 44-year-old non-pregnant premenopausal woman who presented with abdominal pain and dysmenorrhoea. Ultrasonography revealed a large posterior-wall intramural leiomyoma measuring 86 × 75 mm and classified as FIGO type 3. A urine pregnancy test was negative. The patient underwent total abdominal hysterectomy. Gross examination revealed an 8 × 7 cm intramural fibroid with a predominantly red and soft cut surface. Histopathological examination demonstrated extensive coagulative necrosis with ghost cells, extravasated erythrocytes and occasional neutrophils. A thrombus was identified within a vascular channel, with viable interlacing smooth-muscle fibres preserved at the periphery. These findings were consistent with red degeneration of the leiomyoma. The final endometrial specimen showed disordered proliferative endometrium, with no evidence of malignancy. This case highlights the rare occurrence of red degeneration in a non-pregnant uterus and demonstrates the importance of gross and histopathological findings in establishing the diagnosis.
Subfield: Obstetrics and Gynecology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W7214100036
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