Laparoscopic Management of Leiomyoma Arising from Müllerian Remnant in Mayer–Rokitansky–Küster–Hauser Syndrome

Abstract

Abstract

Background:

Leiomyomas arising from Müllerian remnants are a rare association with few case reports in literature. Most of the case reports have shown management with laparotomy. This report presents a case of a leiomyoma arising in a Müllerian remnant that was managed with laparoscopy.

Case:

A 33-year-old nulligravida presented with dyspareunia since marriage and an increase in urinary frequency since 3 years prior to presentation with no history of cyclical abdominal pain. Pelvic examination revealed a vaginal length of 7 cm and a 6 × 6 cm, firm right adnexal mass. Magnetic resonance imaging was suggestive of a hypoplastic uterus with a submucosal myoma or a broad ligament myoma. Laparoscopy showed a bilobed leiomyoma arising from the right Müllerian anlage with the right fallopian tube and ovary attached to its postero-superior surface. The bilobed leiomyoma, and the right Müllerian remnant along with the left rudimentary horn and both tubes were removed as a single contiguous specimen.

Results:

The patient's postoperative recovery was uneventful. Histopathology results were suggestive of a benign leiomyoma. On follow-up at 3 months, this patient was symptomatically improved.

Conclusions:

Leiomyomas from Müllerian remnants are rarely associated, which should be kept in mind in women with Mayer–Rokitansky–Küster–Hauser syndrome presenting with a pelvic mass. Laparoscopic management of such cases is feasible with the added advantages of minimally invasive surgery. (J GYNECOL SURG 33:276)