Huge (9 Kg) broad ligament fibroid mimicking sarcoma of uterus: A case report and review of literature

Abstract

Fibroids are most common benign tumors of the uterus, mostly situated in the body of the uterus. Rarely, they arise from extrauterine sites with broad ligament fibroids being uncommon. We present a case of a 47-year-old female, multipara who presented in outpatient department in CAMA hospital with a history of sudden development of dysuria 10 days back. Intraoperatively, uterus was pushed to side and large broad ligament fibroid of 25 cm × 20 cm × 20 cm seen arising from right-sided broad ligament. The fibroid was densely adherent to bowel and bladder. Exploratory laparotomy with excision of broad ligament fibroid of 9 Kg with total abdominal hysterectomy with right salpingo-oophorectomy was done.

Removal of Large Broad Ligament Fibroid with Fertility Preserved: A Case Report

“…Uterine fibroids are the most prevailing non-malignant neoplasm mostly situated in the uterus but infrequently originating from the broad ligament. [5] Leiomyomas can give rise to cancer marker CA-125 advancing towards metastatic uterine neoplasm. [4] They are associated with the absence of ovulation and prominent levels of estrogen.…”

“…Generally, they evolve from the rise of a solitary smooth muscle cell gene, commonly in the estrogen susceptible uterine lining. [5] Many other theories have been put forward for the development of extra uterine tumors, comprising of mesenchymal stem cell metaplasia dependent on hormonal or genetic effects. [5] Generally, fibroids of the broad ligament do not show any symptoms but if overlooked for a longer period they can attain a huge size which then led to persistent pain in the pelvic region and increased pressure on adjacent structures like the urinary bladder and bowel resulting in their impaired functioning which may present as retention of urine and/or difficulty in defecation.…”

Giant broad ligament leiomyoma with postoperative infection diagnosed with contrast‐enhanced ultrasound: Case report and literature review

“…Characteristic performance is difficult to detect because of the degeneration and necrosis of leiomyoma, resulting a dilemma in diagnosis, and the misdiagnosis rate can reach 12%. 4 MRI can be used to facilitate the distinction.…”

“…Ultrasound in most reported cases of the literature review showed heterogeneous mass with multiple septations. Characteristic performance is difficult to detect because of the degeneration and necrosis of leiomyoma, resulting a dilemma in diagnosis, and the misdiagnosis rate can reach 12% 4 . MRI can be used to facilitate the distinction.…”

“…Broad ligament leiomyoma is a particular type of uterine leiomyoma with an incidence of less than 1% 1 . Giant broad ligament leiomyomas with a diameter larger than 12 cm are even rarer, and we have found only 21 cases reported thus far in the English language literature 1–21 . Patients usually show clinical manifestations of urinary, digestive, and neurological systems other than gynecology system 22 .…”