A Case of Massive Broad Ligament Leiomyoma Imitating an Ovarian Tumour

Bansal, Preeti; Garg, Dinesh

doi:10.7860/jcdr/2014/7642.4136

Cited by 13 publications

(17 citation statements)

References 5 publications

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“…Among 16 cases of leiomyomas [1–15], 12 [1, 3–11, 14] were derived from the uterus and 4 [2, 12, 13, 15] originated from a broad ligament or fallopian tube; these cases are summarized in Table 1 along with the present case. The 17 cases of an ovarian tumor-like leiomyoma had a predilection for middle-aged women (mean age 45 years, range 21–58 years) and a mean maximal size of 21 cm (range 5–40 cm).…”

Section: Discussionmentioning

confidence: 92%

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A subserosal, pedunculated, multilocular uterine leiomyoma with ovarian tumor-like morphology and histological architecture of adenomatoid tumors: a case report and review of the literature

et al. 2016

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BackgroundUterine leiomyomas are common uterine tumors, and typical cases of leiomyoma are easily diagnosed by imaging study. However, uterine leiomyomas are often altered by degenerative changes, which can cause difficulty and confusion in their clinical diagnosis. We describe the 17th reported case of a uterine leiomyoma clinically diagnosed as an ovarian tumor; however, the present case shows the most detailed radiological evaluation, including contrast-enhanced magnetic resonance imaging. We first show that a uterine leiomyoma can histologically mimic an adenomatoid tumor.Case presentationA 47-year-old premenopausal, nulliparous Japanese woman with a history of type 2 diabetes mellitus, hypertension, and hyperlipidemia had lower abdominal pain. Ultrasonography confirmed a 6-cm mass in the right-sided space of the pelvic cavity. Magnetic resonance imaging evaluation showed that a multilocular mass was present near the uterus, and a mucinous ovarian tumor was considered. Emergency surgery due to acute abdomen was performed under the diagnosis of pedicle torsion of the ovarian tumor. During surgery, a pedunculated uterine mass without stalk torsion was seen. The mass grossly contained serous and hemorrhagic fluids in the cavities, and pathology examination confirmed that the mass was a leiomyoma with hydropic and cystic degeneration. Anastomosing thin cord-like arrangements of the leiomyoma cells mimicked the architecture of adenomatoid tumors. The tumor cells were positive for the microphthalmia transcription factor but negative for other melanoma markers. Three days postoperatively, she was discharged without sequelae.ConclusionsMarked intratumoral deposition of fluids may induce the multilocular morphology of a tumor, and the cellular arrangement of the tumor cells with hydropic degeneration mimicked an adenomatoid tumor in this case. Clinicians need to be aware that a subserosal leiomyoma with cystic and hydropic degeneration can mimic an ovarian tumor, and pathologists should be aware that such leiomyomas can mimic adenomatoid tumors. Additionally, perivascular epithelioid cell tumors should not be diagnosed only based on its immunoreactivity for the microphthalmia transcription factor.

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Section: Discussionmentioning

confidence: 92%

“…All 16 cases of an ovarian tumor-like leiomyoma largely demonstrated degenerative changes similar to those in the present case. In 11 [1–7, 9, 12, 13, 15] of 16 cases, the contents of the cystic cavities were described, and 10 of these 11 cases had clear, yellow, or hemorrhagic fluids. One [1] of the 11 cases had mucinous materials.…”

Section: Discussionmentioning

confidence: 99%

A subserosal, pedunculated, multilocular uterine leiomyoma with ovarian tumor-like morphology and histological architecture of adenomatoid tumors: a case report and review of the literature

et al. 2016

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“…Its incidence is reported to be 4%. 5,6 Sometimes, this cystic degeneration is so massive that the myoma merely becomes a shell and is truly a "cystic tumor". 7 Such are the cases that creates a diagnostic conundrum.…”

Section: Discussionmentioning

confidence: 99%

Degenerated fibroid: a diagnostic dilemma

Gaur

Jha

2020

Int J Reprod Contracept Obstet Gynecol

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Leiomyoma is one of the most commonly encountered benign gynaecological neoplasms. With a wide range of symptoms, sometimes even asymptomatic, these tumors are easy to diagnose and treat, unless there are degenerative changes, which makes them difficult to diagnose and differentiating them from other serious conditions including malignancy, thereby, complicating their management also. Here, the case present to you a case of 48-year-old women with symptoms and clinical examination suggesting fibroid uterus but imaging studies inconclusive to differentiate fibroid uterus with ovarian malignancy, thus, creating a diagnostic dilemma. Ultimately, patient underwent exploratory laparotomy, keeping possibility of ovarian malignancy. Histopathological examination of the specimen of total abdominal hysterectomy with bilateral salpingo-oopherectomy concluded extensive cystic degeneration of leiomyoma and no evidence of malignancy.

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“…7 Besides, there have been case reports where broad ligament fibroid imitate ovarian tumor, but in our case it was an ovarian tumor which was mimicking a broad ligament fibroid radiologically. 8,9 Although fibrothecomas are of low malignant potential but their benign nature cannot be definitely diagnosed preoperatively and therefore, a safe removal must be achieved without peritoneal contamination.…”

Section: Discussionmentioning

confidence: 99%