Abstract
Background:
Large leiomyomas can outgrow their blood supplies leading to cascades of inflammatory reactions and ischemic changes resulting in various kinds of degeneration. Massive cystic degeneration might mimic an ovarian cyst, posing a diagnostic dilemma. This article presents a case of a woman with marked cystic degeneration of a uterine leiomyoma mimicking an ovarian neoplasm.
Case:
A 42-year-old woman presented to the gynecology outpatient clinic of SRM Medical College Hospital and Research Centre, SRM Nagar, Chengalpattu District, Tamil Nadu, India. She had a huge abdominopelvic mass. Clinically and radiologically, the mass was suspected to be an ovarian neoplasm. This patient's tumor markers were normal. Intraoperatively, a huge mass filling the entire abdominal cavity was seen. The mass was decompressed and 4.5 L of serous fluid were drained. It was attached to the posterolateral wall of the uterus and left ovary. She underwent a total abdominal hysterectomy, a bilateral salpingo-oophorectomy, and an infracolic omentectomy
Results:
Histopathology confirmed a final diagnosis of a degenerated leiomyoma. The patient's postoperative course was uneventful and she was discharged on her eighth postoperative day.
Conclusions:
When a patient has a huge pelvic mass, cystic degeneration of this fibroid mass should be retained as a differential diagnosis prior to surgical intervention.
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