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Federación Mexicana de Ginecología y Obstetricia, A.C.

2017, Number 05

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Ginecol Obstet Mex 2017; 85 (05)

Giant cystic leiomyoma that mimics an ovarian tumor. Report a case

Vega-Ruiz FJ, Barceló-Mancillas DA, Gutiérrez-de la Vega D, Luis-Zárate H

Language: Spanish
References: 22
Page: 325-330
PDF size: 342.75 Kb.


ABSTRACT

Background: The fibroid or uterine fibroid is the most frequent benign tumor in women of childbearing age, with relative frequency, leiomyoma may be the site of degenerative phenomena, which may lead to confusion or error in diagnosis.
Case Report: A 48-year-old female, admitted to our service by the emergency department for a history of hypogastric pain radiating to both pits and flanks and an increase in the abdominal perimeter for a month And medium, negates weight loss, no history of chronic-degenerative diseases, or surgical. On abdominal examination, “globose” at the expense of adipose panicle and pelvic egg-dependent tumor, extending from symphysis pubis to below umbilical scar, solid consistency, regular edges, mobile, soft abdomen, not found Data of peritoneal irritation, during gynecological examination, external genitalia normal to speculum is found, mobile eutrophic cervix, non-painful, without endophytic or exophytic lesions, free sack bottoms, biimanual palpation is not possible to delimit uterine fundus or origin of The tumor, the results of requested paraclinics, including blood count, blood chemistry, liver function tests, coagulation tests and ovarian tumor markers were normal. The abdomino-pelvic ultrasound reports a normal uterus, well delimited margins, size 59 x 35 mm, with endometrium of 7 mm, as well as the presence of a large round-shaped tumor, the margins are smooth and well delimited, this lesion Presents liquid content with internal echoes, in addition to the presence of septa some up to 4 mm thick. Color Doppler is applied and there is only evidence of some thin vessels in peripheral form, the septa do not reveal vascularity, being compatible as first choice, with a cystadenoma, without being able to determine which side is the lesion. In the exploratory laparotomy, a 22 x 16 cm uterus is observed, with presence of myoma with probable cystic degeneration in the anterior face, macroscopically normal appendages, no free fluid is observed, total abdominal hysterectomy is performed.
Conclusion: Our case shows that, although the myoma presents typical images in most cases, when there are degenerative changes that distort the normal structure of the tumor, it may resemble an ovarian cystic tumor, and should therefore be Considered within the differential diagnosis of the adnexal masses.


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