A Rare Case of a Retroperitoneal Leiomyomatosis

Yüksel, Dilek; Kılıç, Çiğdem; Kodal, Bahadır; Çakır, Caner; Mesci, Cigdem Guler; Boran, Nurettin; Kayıkçıoğlu, Fulya

doi:10.1016/j.jogoh.2020.101760

Cited by 4 publications

(5 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Clinically, patients with retroperitoneal leiomyoma report non-specific symptoms such as discomfort, fatigue, and back pain, although most are asymptomatic and the leiomyoma is diagnosed incidentally. Preoperative imaging methods (TC, MRI) recognize the location of the lesion, but it does not unequivocally distinguish between malignant and benign conditions [1,2,11]. Although MRI is the most accurate imaging modality for evaluating retroperitoneal masses, histopathology remains the gold standard for definitive diagnosis.…”

Section: Discussionmentioning

confidence: 99%

“…In literature, we found patients treated with a laparotomy, robot-assisted or laparoscopic approach, as in this case. In a previously reported case, a laparotomy was the most chosen option, although this approach would cause huge wounds and a long hospitalization [2]. The laparotomy approach is indicated when the tumor size is relatively large and there is adherence to adjacent structures, so a laparoscopic or robot-assisted approach could be difficult [2].…”

Section: Discussionmentioning

confidence: 99%

“…In a previously reported case, a laparotomy was the most chosen option, although this approach would cause huge wounds and a long hospitalization [2]. The laparotomy approach is indicated when the tumor size is relatively large and there is adherence to adjacent structures, so a laparoscopic or robot-assisted approach could be difficult [2]. We decided for a laparoscopic approach because the tumor was relatively small and there were no adhesions with the pelvic organs on preoperative imaging.…”

Section: Discussionmentioning

confidence: 99%

“…Leiomyomas are the most common pelvic tumor, occurring in approximately 70% of women during the fourth and fifth decades of women's life [1]. However, extra-uterine leiomyomas located in the retroperitoneum are rare; in literature, only 105 cases have been registered [2]. Neoformations located in the retroperitoneum are most frequently sarcomas [3].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Laparoscopic tumorectomy for an unusual pelvic retroperitoneal leiomyoma: a case report.

Pace,

Moretti,

Tierno

et al. 2023

Preprint

View full text Add to dashboard Cite

Introduction: Leiomyomas are benign tumors, mostly located in the uterus. The pelvic localization is quite rare and it is associated with unusual growth patterns. It is important make an adequate differential diagnosis between malignant and benign retroperitoneal neoplasm because treatment is different. When it is not possible to have a precise preoperative diagnosis, a laparoscopic or laparotomy surgical tumorectomy is often required. To obtain a certain diagnosis, the goal of surgery is ensuring the complete excision of neoplasms and preservation of urination, defecation and sexual function. Case presentation: We report a rare case of a 58-year-old woman who underwent a laparoscopic tumorectomy for a pelvic retroperitoneal leiomyoma. The patient reported occasional episodes of dull pain in the pelvic region. Pelvic contrast CT scan and Magnetic Resonance Imaging (MRI) showed a retroperitoneal solid mass in contiguity with the posterior wall of the uterine body-isthmus, to be referred to a pedunculated uterine fibroma strictly posteriorly adherent to the sigma. She was first underwent to explorative laparoscopy by Gynecologist who did not find any uterine mass. The patient was subsequently admitted to Department of General Surgery and has done a second operative laparoscopy which highlighted the presence of an extra-peritoneal para-rectal mass which was completely excised. The histological examination of tumor indicated that it was a leiomyoma. The postoperative course was uneventful and the patient was discharged in III post-operative day (POD).

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Laparoscopic tumorectomy for an unusual pelvic retroperitoneal leiomyoma: a case report.

Pace,

Moretti,

Tierno

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…According to the previously reported cases, a laparotomy was the most chosen option, while the laparotomy would cause huge wounds and take a long time to recover. [39] Laparoscopy is another option, the “chopstick effect” of the operation instruments, however, in the narrow pelvic space will increase difficulty in resecting leiomyoma because of its huge size and the adherence to adjacent structures (including the rectum, vagina, and pelvic plexus). [40] Surgical robotic systems overcome limitations in laparoscopy such as the surgeon dexterity, sensory feedback, and visualization during operation.…”

Section: Discussionmentioning

confidence: 99%

Robot-assisted tumorectomy for an unusual pelvic retroperitoneal leiomyoma: A case report

2022

View full text Add to dashboard Cite

Rationale: Extrauterine leiomyoma occasionally occurs in rare locations with unusual growth patterns, especially pelvic retroperitoneal leiomyoma, which brings great challenges for surgeons to make a diagnosis. It is essential to distinguish benign from malignant retroperitoneal neoplasms according to the imaging manifestations. Laparotomy and laparoscopy are the common options for pelvic retroperitoneal neoplasms, while they may cause side effects during operation such as secondary damage. Appropriate surgical techniques should be adopted to ensure the complete excision of neoplasms meanwhile preserve the urination, defecation, and sexual function.Patient concerns: A 30-year-old woman was referred to our hospital because of dull pain in the perianal region for 1 month. Laboratory results including tumor markers were all within normal limits. The digital rectal examination revealed a huge and tough mass with smooth mucosa protruding into the rectal cavity from the rear area of rectum.Diagnosis: Imaging examinations were performed. Contrasted computed tomography (CT) of pelvis showed an enhanced retroperitoneal solid mass in the space between sacrum and rectum, and very close to the levator ani muscle. The mass was about 11.0*8.0 cm in size. Computerized tomography angiography (CTA) showed the distal branches of bilateral internal iliac artery went into the mass. Endoscopic ultrasonography (US) showed the mass compressed the rectum, as well as a clear boundary to the rectal wall. A histopathologic examination confirmed the mass was a pelvic retroperitoneal leiomyoma. Interventions:The patient underwent an operative resection with da Vinci Si surgical system after routine preoperative preparation. Anorectal motility was weekly monitored postoperation. No additional adjuvant therapy was performed.Outcomes: The patient could walk after 1 day and defecate normally on the third day after operation. She was discharged on the seventh postoperative day. No adverse events including pelvic floor hernia or defecation dysfunction occurred in the follow-up period. At 4 weeks follow-up, the patient was pain-free and recovered well.Lessons: Although imaging examinations were crucial for retroperitoneal neoplasms, histopathological examination remains the "gold standard" for making a definite diagnosis. This case highlights the possibility of retroperitoneal leiomyoma occurring in a woman of reproductive age and the advantages of robotic surgical system in pelvic retroperitoneal surgeries.Abbreviations: CD = cluster of differentiation, CT = computed tomography, CTA = computerized tomography angiography, ER = estrogen receptor, MRI = magnetic resonance imaging, PR = progesterone receptor, US = ultrasonography.

show abstract

Laparoscopic Tumorectomy for an Unusual Pelvic Retroperitoneal Leiomyoma: A Case Report

Pace,

Moretti,

Tierno

et al. 2024

SN Compr. Clin. Med.

View full text Add to dashboard Cite

Leiomyomas are benign tumors, mostly located in the uterus. The pelvic localization is quite rare, and it is associated with unusual growth patterns. It is important to make an adequate differential diagnosis between malignant and benign retroperitoneal neoplasm because treatment is different. When it is not possible to have a precise preoperative diagnosis, a laparoscopic or laparotomy surgical tumorectomy is often required. To obtain a certain diagnosis, the goal of surgery is ensuring the complete excision of neoplasms and preservation of urination, defecation, and sexual function. We report a rare case of a 58-year-old woman who underwent a laparoscopic tumorectomy for a pelvic retroperitoneal leiomyoma. The patient reported occasional episodes of dull pain in the pelvic region. Pelvic contrast CT scan and magnetic resonance imaging (MRI) showed a retroperitoneal solid mass in contiguity with the posterior wall of the uterine body-isthmus, to be referred to as a pedunculated uterine fibroma strictly posteriorly adherent to the sigma. She first underwent to explorative laparoscopy by a gynecologist who did not find any uterine mass. The patient was subsequently admitted to the department of general surgery and has done a second operative laparoscopy which highlighted the presence of an extra-peritoneal para-rectal mass which was completely excised. The histological examination of tumor indicated that it was a leiomyoma. The postoperative course was uneventful, and the patient was discharged in III post-operative day (POD).

show abstract

A Rare Case of a Retroperitoneal Leiomyomatosis

Cited by 4 publications

References 8 publications

Laparoscopic tumorectomy for an unusual pelvic retroperitoneal leiomyoma: a case report.

Laparoscopic tumorectomy for an unusual pelvic retroperitoneal leiomyoma: a case report.

Robot-assisted tumorectomy for an unusual pelvic retroperitoneal leiomyoma: A case report

Laparoscopic Tumorectomy for an Unusual Pelvic Retroperitoneal Leiomyoma: A Case Report

Contact Info

Product

Resources

About