A Rare Case of Retroperitoneal Leiomyoma

Abstract

Introduction. Leiomyoma uteri is one of the most common benign conditions for which women undergo hysterectomy every year. Fibroids found retroperitoneally are a rare entity, especially, primary retroperitoneal fibroid. Case Presentation. We report a case of 42-year-old para 1 who presented to our hospital with recurring retention of urine, lower abdominal and pelvic pain, and dyspareunia . Provisional diagnosis on the basis of examination and imaging was large subserosal fibroid with mild right-sided hydroureteronephrosis, due to pressure effect of the fibroid. Abdominal hysterectomy was done for the patient, and intraoperatively, a bulky uterus was found with multiple small fibroids on anterior and posterior walls, and a large fibroid approx. 10 × 8 cm was found arising from the posterior surface at the level of internal os retroperitoneally, which was confirmed by histopathology as leiomyoma. Conclusion. Retroperitoneal fibroids are rare neoplasms and treatment is surgical removal. Preoperative imaging can only give provisional diagnosis and can be misguiding. Final diagnosis of retroperitoneal fibroid can be made only intraoperatively.

Atypical leiomyoma: unusual locations and findings coupled with uncommon presentation

“…Common symptoms include discomfort, fatigue, and back pain. 1,3,6,8,9 Some present with dysmenorrhea and dyspareunia. 4,13 While some present with urinary and bowel complaints.…”

“…4,13 While some present with urinary and bowel complaints. 1 The lesions are hormonally responsive and have clinical manifestations similar to those of uterine leiomyomas. 14 The most useful modalities for detecting extrauterine leiomyomas are ultrasonography, computed tomography, and magnetic resonance (MR) imaging.…”

“…1,4,6,16 Isolated retroperitoneal leiomyomas and pelvic retroperitoneal leiomyomas are rare occurrences, and the prognosis for patients with these lesions is good.…”

“…Retroperitoneal leiomyomas, defined as those located posterior to parietal peritoneum, are a very rare occurrence. [1][2][3][4] As of 2007 (1941-2007), only 37 retroperitoneal leiomyomas have been reported in the literature with comprehensive information. There is a need for further research on this condition.…”

A Rare Case of a Retroperitoneal Leiomyoma in the Obturator Fossa

“…Nearly 1/3 to 1/2 of women over 35 years of age have a uterine myoma (1). Although the etiology of myomas is not well understood, these tumors originate in smooth muscle cells.…”