A 37-years-old woman, G0P0, was admitted to the emergency room complainingof lower abdominal-pelvic pain and generally feeling unwell. No trauma or other gastrointestinal or genitourinary system problems were noted. She had started menses the day of admission. The symptomatology was of rough installation for 10 hours. Clinical examination had foundstable hemodynamicstate, an enormous median abdominal mass arriving up to the navel (consistent with a 20-week gestational uterus) and umbilical and right iliac fossa sensitivity.A pelvic ultrasound was performed. She showed polymyomatous uterus with a 11x10 centimeters serosal-type fundal uterine myoma (Figure 1) and 3 centimeters anterior is thmusmyoma with a small quantity of effusion in the Douglaspouch. Ovaries were not identified. The patient was followed for this polymyomatous uterus and myomectomy was programmed one month later in another hospital.Laboratory data were within normal ranges, hemoglobin level of 11.3 g/dL, blood ssHCGvalue was negative.The first evoked diagnosis was aruptured hemorrhagic ovarian cystbecause of the fast increase of the quantity of the effusion (in 12 hours)found on ultrasound. The decision was an urgent surgical exploration by laparotomy because the big size of the fundal myoma could block the access to the ovaries. To our surprise, ovaries had a normal aspect. Operative findings revealed a 1,000-mL hemoperitoneum. A bleedingsite was identified on the surface of the fundal myoma (Figure 2, Figure 3). This bleeder was derived from a superficial, tortuous and dilated vein.She underwent a myomectomy with a good evolution.