An uncommon life-threatening pyomyoma after repeated hysteroscopic procedures for abnormal uterine bleeding

OBJECTIVE: Pyomyoma is a rare and potentially fatal infection of a uterine leiomyoma that typically occurs after vaginal delivery or uterine artery embolization. Hysteroscopy, a minimally invasive procedure that allows direct visualization of the uterine cavity, is generally considered a safe option for evaluating and managing intrauterine pathology. However, with the increasing number of women undergoing repeated hysteroscopic procedures more than their lifetime, potential complications may become more prevalent. CASE REPORT: We present the case of a 36-year-old woman with a history of abnormal uterine bleeding and significant history of myoma and adenomyosis who underwent repeated hysteroscopic procedures, subsequently developed a life-threatening pyomyoma in the left cornual area. Prompt recognition of infection and hysterectomy, along with prior antibiotic treatment, proved to be life-saving. CONCLUSION: This case highlights the potential risk of catastrophic infectious complications after repeated hysteroscopy. Clinicians should consider pyomyoma as a possible diagnosis when signs of infection and uterine bleeding develop after repeated hysteroscopic procedures.