Background: Red degeneration of fibroid is a rare event, but when it occurs, it is reported more often during pregnancy as an acute clinical presentation. Its occurrence is even rare in nonpregnant woman. On gross appearance, it resembles leiomyosarcoma, a malignant neoplasm of uterine smooth muscle. Differentiation is important in the therapeutic point of view, which can be certain only by histopathologic examination. Case: A 37-year-old multiparous lady presented with severe anemia and pain in the abdomen, and a mass abdomen of 3 months' duration was found to have a fibroid uterus of 20 × 12 cm in size, which was confirmed by transabdominal ultrasonogram. The cause of her anemia was found to be infestation with hookworm (ankylostoma duodenale). She was treated with antihelminthics and blood transfusion before laparotomy. At laparotomy, a pedunculated subserous fibroid of 20 × 15 cm was found to be attached to the fundus of the uterus by a thin, short, necrotic pedicle. It was excised, and the cut section showed an hemorrhagic fleshy mass, which could not be differentiated from a leiomyosarcoma. Histopathologic examination revealed red degeneration. Conclusions: This case was reported because of the rare occurrence of red degeneration in a nonpregnant woman, chronic presentation, and its gross resemblance to that of leiomyosarcoma. (J GYNECOL SURG 26:63)
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