DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20172369

A case of broad ligament leiomyoma presenting as an ovarian mass

Rajesh Kumari, Vandana Vaishya, Vidushi Kulshrestha, Jai Bhagwan Sharma, Alka Kriplani

Abstract


The broad ligament is the commonest extra uterine site for the occurrence of leiomyoma but with a very low incidence rate. It poses both clinical and radiological challenge in differentiating from an ovarian tumour. A 25-year-old unmarried female presented with history of lower abdominal pain associated with rapidly increasing abdominal distension for last 3 months. General physical examination was unremarkable. Examination of the abdomen revealed a firm, non-tender mass, with limited mobility arising from the pelvis corresponding to a uterine size of 32 weeks. Ultrasonography of abdomen revealed a 20×17×11cm right adnexal multi-loculated cyst. Contrast enhanced computer tomography scan of abdomen and pelvis showed a 12×17×17 cm well defined cystic lesion arising from the pelvis and ascending in to the abdominal cavity. The lesion also showed internal septa and peripheral rim enhancement. Right ovary was not seen separately. Tumor markers including CA-125 (22.4 IU/ ml), CEA (1.83/ml), CA-19.9 (22U/ml), Beta HCG (1.20IU/ ml), LDH (1.17IU/ml), and alpha feto-protein (0.8 ng/ml) were within normal limit. Laparotomy revealed a cystic mass arising from the right broad ligament. Histopathological examination revealed a broad ligament leiomyoma with extensive cystic degeneration. Broad ligament leiomyoma is uncommon tumour of pelvis and its differentiation from ovarian masses may be challenging for the clinicians.

 


Keywords


Broad ligament, Leiomyoma, Ovarian tumour, Pelvic tumour

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References


Dutta DC, Konar H. Benign lesion of uterus In: DC Dutta’s Textbook of Gynecology. 7th ed. India: Jaypee Brothers; 2016:272-5.

Kumar P, Malhotra N. Tumours of the corpus uteri and tumours of the pelvic ligament. In: Jeffcoat’s Principles of Gynaecology 7th ed. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd.; 2008:487-516.

Cramer SF, Patel A. The frequency of uterine leiomyomas. Am J Clini Pathol. 1990;94(4):435-8.

Stewart EA. Uterine Fibroids. Lancet. 2001;357(9252);293-8.

Rajput DA, Gedam JK. Broad Ligament Fibroid: A Case Series. IJSS. 2015;1(11):8-11.

Asotra S, Kaushik R, Gulati A. Broad ligament fibroid with neurilemoma like pattern. J K Sci. 2009:11-215.

Godbole RR, Lakshmi KS, Vasant K. Rare case of giant broad ligament fibroid with myxoid degeneration. J Sci Soc. 2012;39(3):144-46.

Low SC, Chong CL. A case of cystic leiomyoma mimicking an ovarian malignancy. Ann Med Singapore. 2004;33;371-4.