Dr. Shabeen Naz Masood, MBBS, MCPS, FICS, FCPS, PhD, DCPS, Consultant Obstetrician & Gynecologist, Medical Superintendent,Sobhraj Maternity Hospital, KMC, Karachi, Pakistan.
Dr. Yasir Masood, MBBS, Ziauddin Medical University, Karachi, Pakistan.
Pak J Med Sci. 2014 Mar;30(2):452-4. doi: 10.12669/pjms.302.4361.
Fibroids are smooth muscle benign tumors; most commonly arise from uterus but may also rise from extra uterine sites like broad ligament. This case report of broad ligament myoma with extensive cystic degeneration is presented for its rarity and diagnostic challenges as they mimic pelvic adenexal tumors. Mrs. X, 43 years old p5+2, asymptomatic women with no co-morbids presented with mass in abdomen. The MRI showed mix attenuation mass of 19.7 x 16.8 x 13.7cms arising from right side of uterus extending up to epigastrium, with cystic and solid components and ascitic fluid. Resection of mass with abdominal hysterectomy with bilateral salphingo oophrectomy was done. No local or abdominal organ metastases were seen. Histopathology showed left broad ligament leiomyoma weighing 4000 grams with cystic degeneration.
Huge broad ligament leiomyoma with cystic degeneration and abdominal ascites may cause diagnostic dilemma with ovarian malignancy. This differential diagnosis must be considered before surgery.
肌瘤是平滑肌良性肿瘤;最常发生于子宫,但也可能发生于阔韧带等子宫外部位。本文报告了一例广泛韧带平滑肌瘤伴广泛囊性变性,因其具有罕见性和诊断挑战性而被呈现,因为它们类似于盆腔附属肿瘤。X 女士,43 岁,p5+2,无症状,无合并症,腹部有肿块。MRI 显示一个 19.7 x 16.8 x 13.7cms 的混杂密度肿块,源于子宫右侧,延伸至上腹部,有囊性和实性成分及腹水。行肿块切除术+腹式子宫切除术+双侧附件切除术。未见局部或腹部器官转移。组织病理学显示左侧阔韧带平滑肌瘤重 4000 克,伴囊性变性。
巨大的阔韧带平滑肌瘤伴囊性变性和腹腔腹水可能导致卵巢恶性肿瘤的诊断难题。在手术前必须考虑这种鉴别诊断。