Case Report: A giant uterine leiomyoma with pseudo-Meigs syndrome combined with a triad of umbilical hernia-prolapse-thrombosis.

This report describes a rare and complex case in which a patient, due to personal beliefs, persistently refused surgery, allowing a uterine leiomyoma to grow to 27.5 × 19.1 × 23.1 cm. This led to a series of life-threatening complications, including pseudo-Meigs syndrome (PMS) with massive pleural and ascitic effusions, 90% atelectasis of the right lung, left lower limb deep vein thrombosis (DVT) and pulmonary embolism (PE), an umbilical hernia, and severe pelvic organ prolapse (POP). Through multidisciplinary team (MDT) collaboration and a staged management strategy-involving initial inferior vena cava filter placement, nutritional support, and drainage of pleural and ascitic fluid, followed by successful tumor resection-the patient recovered. Postoperative pathology confirmed a cellular leiomyoma. This case profoundly illustrates the "cascade effect" whereby a massive pelvic mass, through mechanical compression and a sharp increase in intra-abdominal pressure, can lead to multi-system dysfunction.