Giant Leiomyoma of Uterus
Image Description
Giant Leiomyoma of Uterus: Uterine leiomyomas range in size from microscopic to giant. Subserosal leiomyomas can attain huge size given the large volume of the abdominal cavity and distensibility of the abdominal wall. Giant leiomyomas are quite uncommon. They can compress lungs or other vital structures and become life threatening. They can also mimic primary ovarian malignancy clinically and on imaging studies.
Case History: The patient was a 42 y/o female with gradual enlargement of abdomen, lower abdominal and pelvic pain since 18 months, and increased frequency of urine for last 4 months. On examination, there was a huge, firm, non-tender abdominopelvic mass. Contrast enhanced computed tomography revealed a large solid-cystic mass in the pelvis and extending and occupying large portion of abdominal cavity.
Intraoperatively, a giant, multilobated, solid-cystic mass thought to be of ovarian origin was noted. Frozen section favoured the diagnosis of leiomyoma. During intraoperative manipulation, the mass could be easily pulled up and was seen attached to right sided cornu of uterus with a thick pedicle (arrow shows the attachment site). The excised mass measured about 36 x 34 x 30 cms and weighed 9.8 kg. Cut surface revealed predominantly fleshy, whorled appearance with scattered cysts containing serous fluid (see next image). Microscopic examination showed leiomyoma associated with hyaline degeneration.
Case courtesy of: Dr. Sanjay D. Deshmukh (Professor of Pathology) and Dr. Ninad J. Gadekar (Consultant Oncosurgeon), Dr. Vithalrao Vikhe Patil Foundation's Medical College & Hospitals, Ahmednagar, India.
Case History: The patient was a 42 y/o female with gradual enlargement of abdomen, lower abdominal and pelvic pain since 18 months, and increased frequency of urine for last 4 months. On examination, there was a huge, firm, non-tender abdominopelvic mass. Contrast enhanced computed tomography revealed a large solid-cystic mass in the pelvis and extending and occupying large portion of abdominal cavity.
Intraoperatively, a giant, multilobated, solid-cystic mass thought to be of ovarian origin was noted. Frozen section favoured the diagnosis of leiomyoma. During intraoperative manipulation, the mass could be easily pulled up and was seen attached to right sided cornu of uterus with a thick pedicle (arrow shows the attachment site). The excised mass measured about 36 x 34 x 30 cms and weighed 9.8 kg. Cut surface revealed predominantly fleshy, whorled appearance with scattered cysts containing serous fluid (see next image). Microscopic examination showed leiomyoma associated with hyaline degeneration.
Case courtesy of: Dr. Sanjay D. Deshmukh (Professor of Pathology) and Dr. Ninad J. Gadekar (Consultant Oncosurgeon), Dr. Vithalrao Vikhe Patil Foundation's Medical College & Hospitals, Ahmednagar, India.