Huge fibroid uterus mimicking an ovarian malignancy

Abstract

Leiomyoma of the uterus is the most common benign tumor arising from uterine smooth muscle. This is a case of a woman with an exophytic uterine leiomyoma mimicking an ovarian neoplasm. The potential for uterine leiomyomas to grow to an extreme size before causing symptoms is quite remarkable. This is likely due to the relatively large volume of the abdominal cavity, the distensibility of the abdominal wall and the slow growth rate of these tumors. In our case report, despite a fibroid of size reaching up to 34 weeks of gestation, our patient had minimal symptoms except for abdominal discomfort. There were no symptoms related to abnormal uterine bleeding or abnormal bowel or bladder habit. Also, the history and clinical examination of the patient favored a diagnosis of ovarian malignancy.

Cystic Degeneration of Uterine Leiomyoma Misdiagnosed as Ovarian Malignancy: A Case Report

“…In leiomyoma degenerative, ovarian specific tumour markers are normal [13]. In our case, these markers are normally similar to other previous reports [9] [11]. Elevated cancer antigen-125 of 71.88 kU/L (normal range 0 -35 kU/L) in our case as reported by Sobey N and al [11] would just be related to peritoneal irritation due to abdominal overdistension.…”

“…Giant myomas can cause emergencies due to genital haemorrhage or compression of the diaphragm or surrounding organs [10]. In our case, as reported by Guleria S and al [9], despite the massive size of the fibroid the patients had no complaints in regard to the fibroids, their location and size. There were no menstrual complaints, urinary complaints, bowel dysfunction, and pressure symptoms except for slight abdominal discomfort.…”

“…It gives information on leiomyoma size, characteristics and complications [11]. However, the atypical appearances that follow degenerative changes can cause confusion in diagnosis such as adenomyosis, hematometra, uterine sarcoma and ovarian masses [12] similar to other previous reports [9] [10]. Cystic degeneration is then difficult to distinguish from ovarian cysts.…”

“…Its potential to grow to an extreme size before causing symptoms is quite remarkable. This is likely due to the relatively large volume of the abdominal cavity, the distensibility of the abdominal wall and the slow growth rate of these tumors [9]. Giant myomas can cause emergencies due to genital haemorrhage or compression of the diaphragm or surrounding organs [10].…”