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巨大阔韧带肌瘤伴囊性变的诊断与手术治疗:1例病例报告

Diagnostic and surgical management of giant broad ligament myoma with cystic degeneration: A case report.

作者信息

Huang Xue, Yao Qiang, Wu Yi-Cheng, Liu Shi-Cong

机构信息

West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.

Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Chengdu 610041, Sichuan Province, China.

出版信息

World J Clin Cases. 2025 Sep 26;13(27):108923. doi: 10.12998/wjcc.v13.i27.108923.

Abstract

BACKGROUND

Leiomyomas or fibroids commonly originate from the uterus; extrauterine leiomyomas are rare and most often arise from the broad ligament. Diagnosing broad ligament leiomyomas becomes particularly challenging when they undergo degenerative changes because their clinical and radiological features often mimic those of ovarian tumors. We report a rare case of a giant broad ligament fibroid with cystic degeneration, which was initially mistaken for an ovarian mass.

CASE SUMMARY

A 49-year-old woman presented with mild abdominal distension and pain as the only symptoms. Upon abdominal examination, a large mass measuring approximately 30 cm and extending from the pelvic cavity to just below the xiphoid process was identified. Both transvaginal ultrasound and contrast-enhanced computed tomography suggested an ovarian origin of the mass. However, laparotomy confirmed that the mass originated from the right broad ligament. The mass was separated from the uterus and bilateral ovaries, with no involvement of the uterus or ovaries. The mass was completely resected with respecting the patient's desire to retain her uterus and adnexa. Postoperative histopathological examination confirmed leiomyoma with cystic degeneration.

CONCLUSION

Broad ligament myomas mimic ovarian tumors; accurate diagnosis and careful operation are critical to avoid complications and ensure safety.

摘要

背景

平滑肌瘤或纤维瘤通常起源于子宫;子宫外平滑肌瘤罕见,最常见于阔韧带。当阔韧带平滑肌瘤发生退行性变时,诊断变得特别具有挑战性,因为其临床和放射学特征常与卵巢肿瘤相似。我们报告一例罕见的巨大阔韧带纤维瘤伴囊性变病例,该病例最初被误诊为卵巢肿物。

病例摘要

一名49岁女性,仅以轻度腹胀和腹痛为症状就诊。腹部检查发现一个约30厘米大的肿物,从盆腔延伸至剑突下。经阴道超声和增强计算机断层扫描均提示肿物起源于卵巢。然而,剖腹手术证实肿物起源于右侧阔韧带。肿物与子宫及双侧卵巢分离,未累及子宫或卵巢。根据患者保留子宫和附件的意愿,完整切除了肿物。术后组织病理学检查证实为囊性变的平滑肌瘤。

结论

阔韧带肌瘤酷似卵巢肿瘤;准确诊断和谨慎手术对于避免并发症和确保安全至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b8b7/12362462/e39025c13a07/wjcc-13-27-108923-g003.jpg

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