A Large Cystic Degenerating Broad ligament Leiomyoma Masquerading as Ovarian Malignancy!

Abstract

We report an unusual case of a large, broad ligament uterine leiomyoma with cystic degenerations, masquerading as a malignant ovarian tumor on ultrasonography and CT with the diagnostic difficulties posed. A 40-year-old married female presented with complaints of abdominal distention and a palpable abdominopelvic mass occupying whole of lower abdomen. Ultrasonography and CT revealed a large solid mass with cystic areas extending into both uterine adnexa. The patient underwent a laparotomy. Gross examination revealed normal ovaries and a pedunculated mass with prominent cystic honeycomb degenerations, originating from the uterus. The tumor was excised through the peduncle and pathologic evaluation revealed a uterine leiomyoma with cystic degeneration. In conclusion, a large pedunculated leiomyoma with cystic degenerations can mimic a malignant ovarian neoplasm on imaging studies. Therefore, uterine leiomyoma with cystic degenerations should be considered during the differential diagnosis of large adnexal masses. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (creativecommons.org/licenses/by/3.0) Conflict of interest: None declared | Source of funding: Nil | DOI: http://dx.

True broad ligament fibroid mimicking ovarian mass in a postmenopausal woman

“…6 Fibroids in the broad ligament though not so common, but are well known for achieving enormous size, which may mimic a malignancy of the pelvis thereby altering the course of treatment offered. [7][8][9] This case reports a patient who presented with pain lower abdomen and mass per abdomen that seem to be arising out of the pelvis, had features of malignancy both clinically and radiologically and exploratory laparotomy was done for the same while intra-operative findings and histopathology confirmed it as a benign broad ligament fibroid. A similar case report has been reported by Gowri et al, for its diagnostic difficulties.…”

A rare case of huge broad ligament fibroid

“…Broad ligament leiomyoma is a benign smooth muscle tumour which originates from broad ligament hormone sensitive smooth muscle or secondarily from the smooth muscle of uterus. They are usually asymptomatic but have a potential to grow to a very large size which can present as pressure symptoms of pelvic pain and bladder or bowel dysfunction [4][5][6] . It can be single or multiple, with size variation from small to huge.…”

“…These broad ligament fibroids are usually asymptomatic but if neglected they reach huge size which results in chronic pelvic pain, compression of the bladder and the bowel with dysfunction. It can present with AUB with a coexisting intrauterine fibroid [3,4] . On account of its rarity, it poses specific diagnostic difficulties and may be responsible for erroneous diagnosis and management.…”

A Huge Broad Ligament Fibroid With Degenerative Changes: A Rare Case Report

“…In 50% of cases, they are asymptomatic. [4] The extra-uterine location of leiomyoma can be in broad ligament, ovary, urinary bladder, urethra, vulva, vagina or anywhere there is smooth muscle.…”