Laparoscopic management of a pelvic retroperitoneal leiomyoma—case report

Abstract

Leiomyomas are benign tumors frequently found in the fourth and fifth decades of life. Although the uterus is the most common site of origin of leiomyomas, they can develop at any site where there is smooth muscle cell. Extrauterine leiomyomas are not common and usually their diagnostic are more challenging. In this paper, we report one case of pelvic retroperitoneal leiomyoma associated to vulvar/perineal leiomyomas. A 47-year-old female patient presented with a 6-month history of deep dyspareunia, abdominal pain, dysuria, and pain during defecation. She had a previous history of two open myomectomies, a supracervical hysterectomy associated to the exeresis of a vulvar leiomyoma, and a left salpingo-oophorectomy. On vaginal examination, there was a tender and firm mass at the vaginal vault and along the posterior vaginal wall. There was another tumor at the left vulvar/perineal region measuring around 6 cm. Magnetic resonance imaging demonstrated the presence of a mass at the Douglas pouch measuring 14×10×10 cm suggestive of uterine leiomyomatosis. She underwent a successful laparoscopic resection of the pelvic tumor with an operative time of 210 min. The vulvar/perineal lesions were resected by vaginal approach. She presented an uneventful postoperative course and was discharged home 3 days after surgery. Histopathology confirmed the diagnosis of leiomyomas. Laparoscopic approach for pelvic retroperitoneal leiomyoma is feasible. It is important to keep in mind the possibility of this entity as a differential diagnosis of retroperitoneal masses in women.

Retroperitoneal Leiomyoma of the Uterus Mimicking Sarcoma in Perimenopausal Woman: Case Report

“…So the approach of operation was selected to the open method for the purpose of radical resection of the tumor. The laparoscopic approach is the feasible method in the treatment of retroperitoneal leiomyoma 11 and the more accurate diagnosis might be possible to consider the laparoscopic approach in our case.…”

A case of retroperitoneal leiomyoma

“…Main stay of treatment is surgical removal of the mass which can be done by laparotomy or laparoscopy. Kondo et al [5] reported a case of retroperitoneal fibroid where resection was done by laparoscopic approach. Hysterectomy may be considered depending on the presence of symptomatic fibroids in the uterus.…”

Management of a giant retroperitoneal leiomyoma: a case report

“…A laparoscopic approach was described in only two cases [ 1 ]. The difficulty with laparoscopic or robot-assisted approaches is related mainly to the relatively large tumor size at diagnosis and the adherence to adjacent structures [ 14 ]. The principal aim is to ensure a one-piece excision of the tumor and to conserve the integrity of the surrounding organs and large vessels [ 15 ].…”