Intra-ligamentous fibroid removed laparoscopically

Abstract

In this paper, we report the case of a left round ligament fibroid in a 24 year-old, gravida 0, female that was successfully managed laparoscopically. Operative findings also included severe adnexal adhesions bilaterally, severe adhesions of the liver to the anterior abdominal wall (Fitz-Hugh-Curtis syndrome), pigmented areas on the left tube, uterus and posterior broad ligament (that proved to be endometriosis), and low capacity bladder (450 cc at 70 cm water pressure) with florid glomerulations and Hunner's ulcers consistent with typical interstitial cystitis. Beside the feasibility of laparoscopic management of intra-ligamentous tumors this case highlights the common multifactorial nature of chronic pelvic pain and the frequent association of endometriosis and interstitial cystitis.