Large subserous uterine leiomyoma presenting as intraabdominal tumor: A case report.

IF 0.9 Q4 ONCOLOGY
Rare Tumors Pub Date : 2024-09-12 eCollection Date: 2024-01-01 DOI:10.1177/20363613241285089
John A Ashindoitiang, Victor I Canice Nwagbara, Ekpo E Edet, Theophilus Ipeh Ugbem, Joseph S Ukam, Maurice E Asuquo
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Abstract

Uterine leiomyomas are common benign gynecological tumors due to the overgrowth of uterine smooth muscle. Pedunculated uterine leiomyoma occurs when the mass is in continuity with the uterus with a stalk and may grow either within the uterine cavity or outside of the uterus and may mimic ovarian neoplasms or intraabdominal tumors. Presented is a 28-year-old woman with a progressive abdominal swelling in the past 9 months seen at the surgical outpatient of our facility. Preoperative CT suggested a diagnosis of an intrabdominal cystic. She had laparotomy and was offered myomectomies on account of a large subserous uterine mass arising from the right side of the uterine fundus, small subserous fundal mass, intramural mass in the left side of the fundus and a cervical mass. Histology confirmed multiple uterine leiomyomas with extensive cystic degenerative changes of the large subserous uterine myoma and adenomyosis of the left fundal mass. Detecting the continuity of an abdominal mass even with extensive degenerative changes mimicking a cyst in continuity with the uterus by a pedicle sign on imaging in the absence of ascites should arouse the diagnosis of pedunculated subserosal leiomyoma. This should be further heightened when it is found in association with cervical myoma. Subserous uterine leiomyoma should be considered in a patient of childbearing age with a grossly distended abdomen without obvious evidence of pregnancy or malignancy. Large subserous uterine leiomyoma in an intraabdominal location may present with diagnostic and surgical challenges that require interdisciplinary cooperation.

表现为腹腔内肿瘤的巨大浆膜下子宫肌瘤:病例报告。
子宫平滑肌瘤是一种常见的妇科良性肿瘤,由子宫平滑肌过度增生所致。当肿块与子宫连成一体并带有蒂时,就会出现有蒂子宫良性肌瘤,可生长在子宫腔内或子宫腔外,并可能与卵巢肿瘤或腹腔内肿瘤相似。患者是一名 28 岁女性,过去 9 个月来腹部逐渐肿胀,在本院外科门诊就诊。术前 CT 提示诊断为腹内囊肿。她接受了开腹手术,并因子宫底右侧的巨大浆膜下子宫肿块、小的浆膜下子宫底肿块、子宫底左侧的壁内肿块和宫颈肿块而接受了子宫肌瘤剔除术。组织学检查证实了多发性子宫肌瘤,大的浆膜下子宫肌瘤有广泛的囊性退行性病变,左侧宫底肿块有腺肌症。如果在没有腹水的情况下,通过影像学检查发现腹部肿块的连续性,甚至伴有广泛的退行性改变,并通过梗阻征模仿与子宫连续的囊肿,则应引起梗阻性浆膜下子宫肌瘤的诊断。如果与宫颈肌瘤同时发现,则应进一步提高诊断率。如果育龄期患者腹部明显胀大,但没有明显的妊娠或恶性肿瘤迹象,则应考虑浆膜下子宫肌瘤。腹腔内巨大的浆膜下子宫肌瘤可能会给诊断和手术带来挑战,需要多学科合作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Rare Tumors
Rare Tumors ONCOLOGY-
CiteScore
1.50
自引率
0.00%
发文量
15
审稿时长
15 weeks
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