Giant Plexiform Lipoleiomyoma of the Broad Ligament with Extensive Cystic Degeneration in a Reproductive-Age Female

Abstract

Abstract

Background: Lipoleiomyomas and plexiform leiomyomas are uncommon variants of leiomyomas, although myomas are the commonest neoplasms in women, particularly in the reproductive-age group. Giant leiomyomas are known to occur in the uterus and occasionally in the subserosal or broad-ligament locations. Nearly half of leiomyomas have some of the secondary changes such as hyaline, myxoid, cystic, or red degeneration. Ultrasonography (USG), computed tomography (CT), and magnetic resonance imaging (MRI) have all been used to delineate pelvic masses. Case: A 37-year-old female presented with an abdominal mass. She underwent USG, CT, and MRI, followed by surgical removal and histopathologic confirmation of the presence of a giant plexiform lipoleiomyoma of the broad ligament with extensive cystic degeneration. USG had shown a mixed solid-cystic mass with “honeycomb” areas. CT features were suggestive of a mixed-density tumor with small nodular areas separate from the uterus. MRI revealed the broad-ligament origin of the lesion with displaced ovaries. Surgical removal showed three lesions: one in the cervix and large and small broad-ligament lesions with cystic degeneration. Results: Histopathology of the large broad ligament lesion showed the presence of a plexiform lipoleiomyoma. The patient had an uneventful postoperative period and was discharged on the eleventh postoperative day. She was doing well at a 6-week follow-up, with a lipid profile within normal limits. Conclusions: A large broad-ligament lesion can mimic ovarian masses and preoperative imaging and histopathologic confirmation may help in avoiding radical surgery. (J GYNECOL SURG 31:107)