Cystic Ovarian Leiomyoma in a Patient with Progressive Abdominal Pain

Abstract

Patient: Female, 45-year-old Final Diagnosis: Leiomyoma with massive cystic hydropic degeneration Symptoms: Abdominal distention and pain Medication:— Clinical Procedure: — Specialty: Surgery Objective: Rare disease Background: Ovarian leiomyomas are rare, benign, smooth muscle, solid tumors that occur in women aged 20 to 65 years. Because their histology is benign, the prognosis for patients is good. We report the case of a patient with a huge ovarian leiomyoma who presented to the General Surgery Clinic with chronic abdominal pain and progressive abdominal distention. Case Report: A 45-year-old woman with a history of multiple myomectomies and a total abdominal hysterectomy with right oophorectomy presented to the General Surgery Clinic with abdominal pain and a 4-year history of progressive distention. After being examined, the patient underwent an exploratory laparotomy, during which a pelvic cyst was found that measured 39×30.2 cm, was filled with serous fluid (10.5 L), and occupied most of the abdominal space. The surgery went smoothly and there were no complications during or after the procedure. The patient was discharged home 7 days later in stable condition. Postoperative pathology using hematoxylin and eosin staining and immunohistochemistry with desmin and alpha-smooth muscle actin resulted in a diagnosis of leiomyoma with cystic degeneration. When the patient was seen in the outpatient clinic 2 weeks and 3 and 6 months after surgery, her tumor markers were within normal limits. Abdominal and pelvic computed tomography scans performed at the 6-month visit showed resolution of the loculated intraperitoneal fluid and no gross local recurrence of the tumor. Conclusions: Ovarian leiomyomas are difficult to diagnose preoperatively. Suspicion for one should be high, however, in patients who present with a large cystic mass in adnexal tissues, especially if they have a history of hysterectomy and oophorectomy.

Ultrasonographic manifestations and misdiagnosis analysis of ovarian leiomyoma

“…The coexistence of ovarian leiomyomas with uterine leiomyomas has been reported ( 6 , 7 ). In this group of 7 OL patients, 3 had uterine leiomyomas and 2 had endometrial polyps, which are in good accordance with reports in the literature.…”

Ovarian leiomyoma accompanied by a neglected abdominal wall leiomyoma: A case report and literature review

“…Ovarian leiomyoma has a rare incidence, which is thought to account for 0.5%–1% of all benign ovarian tumors 1,2 . So far, fewer than 200 cases have been reported since it was first described in 1862 3 .…”

“…Ovarian leiomyoma has a rare incidence, which is thought to account for 0.5%–1% of all benign ovarian tumors. 1 , 2 So far, fewer than 200 cases have been reported since it was first described in 1862. 3 There are no specific clinical manifestations, tumor markers, or imaging features of ovarian leiomyoma.…”

Primary ovarian leiomyoma in a patient with uterine leiomyoma

“…Обычно ЛМЯ -это односторонняя опухоль небольшого размера, которая обнаруживается у пациенток с ЛММ [6,7]. В то же время описаны случаи двухстороннего поражения яичников этой опухолью.…”

“…ЛМЯ встречаются у женщин в возрасте от 20 до 65 лет [1,5]. В доступной литературе были представлены отчёты о клинических случаях ЛМЯ как у возрастных женщин в период постменопаузы [5,6], так и у пациенток, находящихся в молодом и даже подростковом возрасте. При этом обзор литературы показывает, что в отличие от пожилых пациенток у пациенток подросткового возраста и молодых женщин одновременно с ЛМЯ обычно не отмечается сопутствующая ЛММ.…”