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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 intra-abdominal view of multilobulated white-yellowish coloured mass with size of 30 × 23 × 12 cm and 5.4 kg.
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fig3: The figure shows intra-abdominal view of multilobulated white-yellowish coloured mass with size of 30 × 23 × 12 cm and 5.4 kg.

Mentions: Laboratory examinations for whole blood count, liver function tests, coagulation parameters, urea, creatinine, and serum electrolytes were in normal limits. Blood glucose, HgA1c level, and cholesterol levels were higher than normal limits. The serum level of cancer antigen-125 was detected to be high as 210 mIU/ml. So in the light of these clinical findings from ultrasound, MRI examinations and laboratory findings, we thought that leiomyosarcoma is the most likely diagnosis. We planned surgery for the patient and a midline xiphopubic vertical incision was made. At laparotomy, on inspection, a giant multilobulated solid mass with white-yellowish colour was noted and we thought a huge mass of ovarian malignancy, however when we put up the mass from abdomen out, then we saw that it was a pedunculated giant subserosal myoma with a thin stalk (Figure 3). Firstly, we excised the mass from uterus and sent it to frozen section. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were carried out. The frozen section revealed myoma uteri without malignancy. A drain was put into the pelvis and the surgery was completed. The drain was removed in second postoperative day and the patient was discharged 7 days after the operation with no complication.


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 intra-abdominal view of multilobulated white-yellowish coloured mass with size of 30 × 23 × 12 cm and 5.4 kg.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig3: The figure shows intra-abdominal view of multilobulated white-yellowish coloured mass with size of 30 × 23 × 12 cm and 5.4 kg.
Mentions: Laboratory examinations for whole blood count, liver function tests, coagulation parameters, urea, creatinine, and serum electrolytes were in normal limits. Blood glucose, HgA1c level, and cholesterol levels were higher than normal limits. The serum level of cancer antigen-125 was detected to be high as 210 mIU/ml. So in the light of these clinical findings from ultrasound, MRI examinations and laboratory findings, we thought that leiomyosarcoma is the most likely diagnosis. We planned surgery for the patient and a midline xiphopubic vertical incision was made. At laparotomy, on inspection, a giant multilobulated solid mass with white-yellowish colour was noted and we thought a huge mass of ovarian malignancy, however when we put up the mass from abdomen out, then we saw that it was a pedunculated giant subserosal myoma with a thin stalk (Figure 3). Firstly, we excised the mass from uterus and sent it to frozen section. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were carried out. The frozen section revealed myoma uteri without malignancy. A drain was put into the pelvis and the surgery was completed. The drain was removed in second postoperative day and the patient was discharged 7 days after the operation with no complication.

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