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VOLUME 6 , ISSUE 2 ( July-December, 2018 ) > List of Articles

CASE REPORT

Diagnostic Predicament of Cystic Degenerated Uterine Leiomyoma Presenting as Ovarian Cyst: A Case Report

Mayanglambam R Devi, Helen Kamei, Paikhomba Kharibam, Sylvia Keisham, Sunita Haobam

Keywords : Cystic degeneration, Leiomyoma, Ovarian cyst

Citation Information : Devi MR, Kamei H, Kharibam P, Keisham S, Haobam S. Diagnostic Predicament of Cystic Degenerated Uterine Leiomyoma Presenting as Ovarian Cyst: A Case Report. J South Asian Feder Menopause Soc 2018; 6 (2):126-128.

DOI: 10.5005/jp-journals-10032-1155

License: CC BY-NC 4.0

Published Online: 01-06-2019

Copyright Statement:  Copyright © 2018; The Author(s).


Abstract

A large degenerated fibroid may give a false impression of other abdominal gynecological abnormalities like in our case of a 46-year-old para 3, living 3 (P3L3) woman presented to our hospital with the complaint of distension of abdomen since last ten years. The increase in the size of the abdomen was slow initially, but it increased rapidly in last one month. She complained of right abdominal pain for the last one month along with difficulty in breathing and constipation. Abdomen examination revealed a huge abdominopelvic mass and a provisional diagnosis of the ovarian cyst was made clinically. Computed tomography (CT) scan showed a very large cystic lesion arising from the pelvis filling up the abdominal cavity. We planned for laparotomy and proceed. Intraoperatively, a giant cyst occupying the whole abdomen identified and control suction done with removal of ~5 liters of straw-colored fluid. The cyst was found to have adhered to the mesentery and also attached to the fundal area of the uterus. The cyst was severed from the uterus by clamping and cutting the pedicle of the cyst. Uterus and bilateral ovaries were looking normal. Total abdominal hysterectomy with bilateral salpingo-oophorectomy done. Cyst separated from guts and excised. Feeding vessels were from the mesenteric artery. Histopathological examination showed the features of leiomyoma with cystic degeneration. Leiomyoma with cystic degeneration is the rare secondary changes. But they can cause a diagnostic dilemma by mimicking huge ovarian cyst.


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  1. Leppert PC, Catherino WH, et al. A new hypothesis about the origin of uterine fibroids based on gene expression profiling with microarrays. Am J Obstet Gynaecol 2006;195:415-420.
  2. Szklaruk J, Tamm EP, et al. MR imaging of common and uncommon large pelvic masses. Radiographics 2003;23:403-424.
  3. Murase E, Siegelman ES, et al. Uterine leiomyomas, histopathologic features, MRI imaging findings, differential diagnosis and treatment. Radiographics 1999;19:1179-1197.
  4. Kaushik C, Prasad A, et al. Case series cystic degeneration in uterine leiomyomas. Indian Journal of Radiology and Imaging, 2008;(1):69-72.
  5. Arafa M, Basem EL. Extensive cystic degeneration of leiomyoma mimicking ovarian cystic neoplasm: Malayasias J Pathol 2012;34(2):165-166.
  6. Sonawane SS, Ambawade VD, et al. Giant cystic leiomyoma causing diagnostic dilemma–An usual case report. Int J Res Health Sci 2015;3(1):165-168.
  7. Bagchi S, Gupta AK, et al. A Rare case of Giant retroperitoneal uterine Leiomyoma with cystic degeneration mimicking huge ovarian cyst. The Southeast Asian J Case Rep Rev 2014;3(2)eISSN:675-682.
  8. Chowdhury M, Gupta V, et al. Dilemma in diagnosis of huge uterine fibroid: a case report. Int J Clin Trials. 2015;2(1):25-27.
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