Cervical leiomyoma associated with cervical elongation and pelvic organ prolapse in a nulliparous woman: a uterine-preserving surgical approach

Cervical leiomyomas are rare and may present with unusual clinical manifestations. Cervical elongation secondary to cervical leiomyoma is uncommon and may be associated with pelvic organ prolapse (POP). We present a 40-year-old nulliparous woman with a 4×3 cm cervical leiomyoma associated with marked cervical elongation and POP. She underwent surgical management with a Manchester–Fothergill procedure combined with sacrospinous hysteropexy. The leiomyoma was removed en bloc during cervical amputation, followed by cardinal ligament plication and sacrospinous hysteropexy. At 3- and 6-month follow-up, the patient remained asymptomatic with no evidence of recurrent prolapse. This case highlights the potential association between cervical leiomyoma, cervical elongation, and POP and demonstrates a uterine-preserving surgical approach that addresses both the elongated cervix and apical support defect.