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

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.