Lost in the ligament: a diagnostic odyssey of a massive broad ligament fibroid.

Abstract

True broad ligament leiomyomas are rare, accounting for less than 1% of all fibroids, and pose significant diagnostic and surgical challenges due to their atypical location and proximity to vital pelvic structures. We report a case of a 3.4 kg true broad ligament leiomyoma presenting as an abdominopelvic mass, initially suspected to be an ovarian neoplasm. Preoperative imaging was inconclusive, and a definitive diagnosis was made intraoperatively. Surgical excision required meticulous dissection to avoid injury to the ureters and iliac vessels. This case highlights the importance of differential diagnosis, careful preoperative planning, and precise surgical techniques in managing such rare tumors.