Asymptomatic uterus-like mass (ULM) of the extraperitoneal space – a case report of a rare finding with unusual clinical presentation and review of the literature

Abstract

The paper presents a case of a uterus-like mass (ULM), a rare type of tumour of the female reproductive system, which did not present any clinical symptoms described in other cases of ULMs. There are 35 reported cases of this type of tumour. It is defined as a lesion composed of smooth muscle-like stromal cells with a central cavity lined with endometrial type epithelium. There are three theories on the pathogenesis of ULMs which we discuss along with clinical presentation, diagnostic features, treatment options and potential oncological implications of this type of tumour, based on our case, and the review of the literature.

Extrauterine adenomyoma: A case report and systematic review of the literature

“…Uterine tissue morcellation is not the only known cause of EA, indeed cases of EA have been reported in surgery‐free patients 16–20,42,45,60,65,67,73,75,79,83,85,86 …”

“…22,35,36,89 In accordance with the review of Darii et al, 25 Multiple subserous myomas measuring 2-5 cm in diameter Goswami 2017 85 Thick-walled cystic lesion in the pelvis extending about 7 cm above the level of pancreas, with fine internal echoes and small solid components. No evidence of any calcification Kim 2017 86 Left ovarian cyst measuring 7 cm, suspicious for endometrioma Muzykiewicz 2017 17 Indolent, partly solid, partly cystic mass at the right side of the pelvis Uterine tissue morcellation following laparoscopic or robotic hysterectomy is a widely reported common pathogenetic mechanism for EA, but it is also related to parasitic leiomyomatosis and disseminated peritoneal leiomyomatosis. 36,97,98 In 2020, the US Food and Drugs Administration (FDA) released a statement affirming that power morcellation of uterine masses should be performed only within tissue-containing bags to avoid unwanted occult malignancy dissemination.…”

“…Synonyms include uterus‐like mass and endomyometriosis. Uterus‐like mass is a form of EA characterized by a single central cavity lined by endometrium and surrounded by a thick wall of smooth muscle, resembling a normal uterus 14–19 . Endomyometriosis is another term formerly used to describe EA 20–22 …”

“…Uteruslike mass is a form of EA characterized by a single central cavity lined by endometrium and surrounded by a thick wall of smooth muscle, resembling a normal uterus. [14][15][16][17][18][19] Endomyometriosis is another term formerly used to describe EA. [20][21][22] Extrauterine adenomyoma is a rare condition that is usually located at the level of the pararectal space, the ovary, the peritoneum or the broad ligament.…”

Extrauterine adenomyoma of the lesser omentum: A case report and review of the literature

“…To the best of our knowledge, there are a total of 45 reports (53 cases) in English. [1–45] The most common location for a single mass was in the pelvic cavity (37 cases), including 12 cases in adnexa [7–15,27,44] and 7 cases in broad ligament. [16–22] There were 9 cases of single mass outside the pelvis, [29–33,35,36,38,43] of which 3 cases occurred in the liver.…”