Uterus‐like mass of ovarian ligament: Image diagnosis and management by laparoendoscopic single‐site surgery

Abstract

Uterus-like mass composed of a cavity lined by mucosa resembling endometrium and surrounding smooth muscle layer simulating myometrium is an extremely rare disease entity of which the histogenesis is presently unknown. A 39-year-old, gravida 2, para 2, woman presented with sudden onset of lower abdominal pain and was found to have left adnexal mass with unusual image diagnostic appearance. The adnexal mass arising from the left ovarian ligament was excised by laparoendoscopic single-site surgery. Histopathological diagnosis was uterus-like mass of ovarian ligament.

Extrauterine adenomyoma of the liver with a focally cellular smooth muscle component occurring in a patient with a history of myomectomy: case report and review of the literature

“…In contrast, endometrioid glands and cysts are scattered within the smooth muscle tissue in adenomyoma, which typically forms a solitary nodule. Uterus-like masses are defined as extrauterine organoid masses in various sites, including the broad ligament, ovary and small intestine, that are characterized by a single central cavity lined by endometrium and surrounded by a thick wall of smooth muscle, resembling a normal uterus and most likely representing a particular form of extrauterine adenomyoma [6,28-32]. However, adenomyomas are typically with dispersed endometrioid glands and cysts and without an organoid arrangement with a single central cavity.…”

Leiomyomatosis Peritonealis Disseminata Associated with Endometriosis and Multiple Uterus-Like Mass: Report of Two Cases

“…In the same year, Rohlfing described the same association with the description of nodules resembling uterus miniature 20. The uterus-like mass is characterized by a central cavity lined by endometrium surrounded by a thick wall composed of smooth muscle and is still a very rare condition with a questionable histogenesis 8–10,16,21,22. Our cases show the classical presentation of LPD, but some of the nodules share many similarities with miniature uterus.…”

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

“…TheULMisanunusualgynaecologicalfindingdefinedasasmoothmuscletumourwithacentralcavity, thatislinedwithendometrium [13,18].Inthereview oftheEnglish-languageliteraturetodate,wefound ULMs localize themselves in various parts of the female reproductive system, the pelvic wall, uterine and ovarian ligaments, the bowel mucosa and thebowelmesentery [1,2,3,6,7,8,9,10,11,12,13,14,15,16,17]. There is also a case of a ULM foundinthescrotumofa82-yomalewhounderwent hormonal therapy [5].…”

“…There is also a case of a ULM foundinthescrotumofa82-yomalewhounderwent hormonal therapy [5]. Common clinical symptoms are non-specific and include lower abdominal pain (LAP),lowerbackpain(LBP),vaginalspotting,dysmenorrhea,vulvaritching,constipationanddysuria [2].TheageofwomendiagnosedwithULMranges from 12 to 59 years, while the man was 82 [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17]. DifferentsizesofULMsrangefrom2,5to21cm [2].…”

“…Uterus-likemass(ULM)isararetypeoftumour composedofsmoothmusclecellswithacentralcavitylinedwithendometrium.Itwasfirstdescribedin 1981 by Cozzutto, who found features resembling auterusinanovarianlesion [1].Untilnowthereare 35casesofULMreportedinEnglish-languageliterature [2,3,4,5].Thetypicalclinicalmanifestation includes:recurrentpelvicpain,dysmenorrhea,intermenstrualbleedingandoccasionallydysuria.Elevat-edserumCA125isalsoacommonfinding [3,6,7,8]. Therearereportedcasesofendometrial [9] and clear-cell [4]carcinomaarisingfromaULM.Reported location sites of ULMs include: the ovary [1,9,10],theuterinecervix [11],thebroadligament [12,13],theuterus [14,15],thesmallbowelmesentery [16],thecolonmucosa [2],theovarianligament [17] andscrotum [5].Wepresentacaseofa15cmULM arising in the extra-peritoneal space of the pelvis, rangingfromthecavumRetziimedially,totheright inguinalcanalandrightobturatorfossalaterally,and to the bifurcation of the right common iliac vessels cranially. Preoperative imaging raised suspicion of ovarianmalignancy,whilethepatientwasotherwise asymptomatic.Afterwards,potentialpathogenesisof ULMsisdiscussed,alongwithareviewoftheliterature.…”