A 40 year old woman who presented with severe abdominal pain, fever and nausea was taken up for explorative laparotomy. It revealed a purple red tumour on the uterus with fishy odour. On careful examination some of the large veins on the tumour were thrombosed. What is the possible diagnosis?

Red degeneration is a complication of uterine myoma, though it mostly occurs in pregnancy it is not a rare cause of painful myomas in woman over the age of 40. Sarcomatous change in myoma is extremely rare and is yellow - gray in colour with haemorrhages to the naked eye. Ref: Shaw's Textbook of Gynaecology, 13th Edition, Pages 340-41.