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A Case of Giant Uterine Lipoleiomyoma Simulating Malignancy.

Karaman E, Çim N, Bulut G, Elçi G, Andıç E, Tekin M, Kolusarı A - Case Rep Obstet Gynecol (2015)

Bottom Line: On operation, total abdominal hysterectomy with a pedunculated mass of size 30 × 23 × 12 cm and weighing 5.4 kg and bilateral salpingo-oophorectomy were performed.Discussion.Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Yuzuncu Yil University, 65000 Van, Turkey.

ABSTRACT
Introduction. Uterine leiomyoma is the most common benign pathology in women and lipoleiomyoma is an extremely rare and specific type of leiomyoma. Here, we report an unusual case of giant pedunculated subserous lipoleiomyoma misdiagnosed preoperatively as leiomyosarcoma. Case. A 45-year-old woman admitted to our gynecology outpatient clinic for complaints of abdominal distention, tiredness, and pelvic pain for the last 6 months. Sonography and abdominal magnetic resonance imaging (MRI) showed a giant semisolid mass that filled whole abdominal cavity from pelvis to subdiaphragmatic area. A primary diagnosis of uterine sarcoma or ovarian malignancy was made. On operation, total abdominal hysterectomy with a pedunculated mass of size 30 × 23 × 12 cm and weighing 5.4 kg and bilateral salpingo-oophorectomy were performed. The histopathology revealed a lipoleiomyoma with extensive cystic and fatty degeneration without any malignancy. Discussion. The diagnosis of leiomyoma is done usually with pelvic ultrasound but sometimes it is difficult to reach a correct diagnosis especially in cases of giant and pedunculated lipoleiomyoma that included fatty tissue which may mimick malignancy. Conclusion. Subserous pedunculated giant lipoleiomyoma should be kept in mind in the differential diagnosis of leiomyosarcoma or ovarian malignancy.

No MeSH data available.


Related in: MedlinePlus

The figure shows the sagittal view of mass that is filling abdominopelvic cavity.
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fig2: The figure shows the sagittal view of mass that is filling abdominopelvic cavity.

Mentions: A 45-year-old premenopausal multiparous woman was admitted to our hospital's outpatient gynecology clinic with complaints of lower abdominal pain and abdominal distension for the last 6 months. On detailed anamnesis, the patient had noticed a mass in her abdomen for 3 months and a gradually increasing pain with easy tiredness. She had four previous vaginal deliveries with no abdominal surgical operation. Her medical history was remarkable for 10 years of type II diabetes and hypercholesterolemia and had no history for family member with genital malignancy. She had no complaints related with menstrual bleeding. On physical examination, her vital signs were normal and abdominal palpation revealed a distended abdomen with palpable hard, solid mass filling whole abdominal cavity which cannot be lateralized. No abdominal rebound or tenderness was observed. The speculum examination showed a normal uterine cervix and vagina but fornices were full on pelvic examination. Initially, a transvaginal ultrasound was applied and showed a large, solid, and complex mass in pelvic cavity which extended to subdiaphragmatic area and its origin could not be found. An MRI scan of abdomen showed that a large solid mass with somewhere in cystic and fatty content, approximately 33 × 17 × 25 cm in size, which could not be separated from uterus was noticed (Figures 1 and 2). No normal ovaries were detected.


A Case of Giant Uterine Lipoleiomyoma Simulating Malignancy.

Karaman E, Çim N, Bulut G, Elçi G, Andıç E, Tekin M, Kolusarı A - Case Rep Obstet Gynecol (2015)

The figure shows the sagittal view of mass that is filling abdominopelvic cavity.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4525463&req=5

fig2: The figure shows the sagittal view of mass that is filling abdominopelvic cavity.
Mentions: A 45-year-old premenopausal multiparous woman was admitted to our hospital's outpatient gynecology clinic with complaints of lower abdominal pain and abdominal distension for the last 6 months. On detailed anamnesis, the patient had noticed a mass in her abdomen for 3 months and a gradually increasing pain with easy tiredness. She had four previous vaginal deliveries with no abdominal surgical operation. Her medical history was remarkable for 10 years of type II diabetes and hypercholesterolemia and had no history for family member with genital malignancy. She had no complaints related with menstrual bleeding. On physical examination, her vital signs were normal and abdominal palpation revealed a distended abdomen with palpable hard, solid mass filling whole abdominal cavity which cannot be lateralized. No abdominal rebound or tenderness was observed. The speculum examination showed a normal uterine cervix and vagina but fornices were full on pelvic examination. Initially, a transvaginal ultrasound was applied and showed a large, solid, and complex mass in pelvic cavity which extended to subdiaphragmatic area and its origin could not be found. An MRI scan of abdomen showed that a large solid mass with somewhere in cystic and fatty content, approximately 33 × 17 × 25 cm in size, which could not be separated from uterus was noticed (Figures 1 and 2). No normal ovaries were detected.

Bottom Line: On operation, total abdominal hysterectomy with a pedunculated mass of size 30 × 23 × 12 cm and weighing 5.4 kg and bilateral salpingo-oophorectomy were performed.Discussion.Conclusion.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Yuzuncu Yil University, 65000 Van, Turkey.

ABSTRACT
Introduction. Uterine leiomyoma is the most common benign pathology in women and lipoleiomyoma is an extremely rare and specific type of leiomyoma. Here, we report an unusual case of giant pedunculated subserous lipoleiomyoma misdiagnosed preoperatively as leiomyosarcoma. Case. A 45-year-old woman admitted to our gynecology outpatient clinic for complaints of abdominal distention, tiredness, and pelvic pain for the last 6 months. Sonography and abdominal magnetic resonance imaging (MRI) showed a giant semisolid mass that filled whole abdominal cavity from pelvis to subdiaphragmatic area. A primary diagnosis of uterine sarcoma or ovarian malignancy was made. On operation, total abdominal hysterectomy with a pedunculated mass of size 30 × 23 × 12 cm and weighing 5.4 kg and bilateral salpingo-oophorectomy were performed. The histopathology revealed a lipoleiomyoma with extensive cystic and fatty degeneration without any malignancy. Discussion. The diagnosis of leiomyoma is done usually with pelvic ultrasound but sometimes it is difficult to reach a correct diagnosis especially in cases of giant and pedunculated lipoleiomyoma that included fatty tissue which may mimick malignancy. Conclusion. Subserous pedunculated giant lipoleiomyoma should be kept in mind in the differential diagnosis of leiomyosarcoma or ovarian malignancy.

No MeSH data available.


Related in: MedlinePlus