Yan J, Li Y, Long XY, Li DC, Li SJ. Giant cellular leiomyoma in the broad ligament of the uterus: A case report. World J Clin Cases 2022; 10(34): 12696-12702 [PMID: 36579084 DOI: 10.12998/wjcc.v10.i34.12696]
Corresponding Author of This Article
Dao-Cheng Li, PhD, Doctor, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 16 Airport Road, Guangzhou 510000, Guangdong Province, China. daochenli@126.com
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Dec 6, 2022; 10(34): 12696-12702 Published online Dec 6, 2022. doi: 10.12998/wjcc.v10.i34.12696
Giant cellular leiomyoma in the broad ligament of the uterus: A case report
Jiao Yan, Yu Li, Xing-Yu Long, Dao-Cheng Li, Si-Jin Li
Jiao Yan, Xing-Yu Long, The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China
Yu Li, The Sixth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China
Dao-Cheng Li, Si-Jin Li, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510000, Guangdong Province, China
Author contributions: Yan J wrote the manuscript; Li Y collected and collated case information; Long XY edited images; Li DC completed the operation as the major surgeon and reviewed the final manuscript; Li SJ followed up the patient as the doctor in charge; all authors have read and approved the final manuscript.
Informed consent statement: The patient provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors declare that they have no known competing financial interests or personal relationships that could influence the work reported in this paper.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dao-Cheng Li, PhD, Doctor, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 16 Airport Road, Guangzhou 510000, Guangdong Province, China. daochenli@126.com
Received: July 28, 2022 Peer-review started: July 28, 2022 First decision: September 27, 2022 Revised: October 11, 2022 Accepted: November 2, 2022 Article in press: November 2, 2022 Published online: December 6, 2022
Abstract
BACKGROUND
The treatment of large pelvic masses in postmenopausal women is a challenge in clinical practice. Although ultrasound or magnetic resonance imaging can be used to determine the size and location of the mass, it is still difficult to achieve a preoperative diagnosis. The majority of cellular leiomyomas are diagnosed by histopathology after surgery. We report the differential diagnosis and surgical management of a rare case of cellular leiomyoma in the broad ligament of the uterus.
CASE SUMMARY
A 52-year-old Chinese woman without sexual history was admitted to the First Affiliated Hospital of Guangzhou University of Chinese Medicine for the first time. The patient had a 1-year history of progressive abdominal enlargement as well as a 2-year history of menopause, and complained of frequent abdominal pain and low-grade fever. Computed tomography of the abdomen showed a solid cystic mass (29.4 cm × 18.8 cm × 37.7 cm) in the pelvis and abdomen. Moreover, routine blood test results indicated a baseline cancer antigen 125 (CA-125) level of 187.7 U/mL and C-reactive protein of 109.58 mg/L. Subsequently, retrograde hysterectomy and bilateral adnexectomy were performed in this patient. On histopathologic examination of the surgical specimen, a rare cellular leiomyoma in the broad ligament was diagnosed.
CONCLUSION
Clinicians need to constantly improve diagnosis and treatment for the challenges posed during clinical assessment, differential diagnosis, and surgical management.
Core Tip: Initially, a gynecological malignancy was suspected due to an elevated tumor blood index and large abdominal mass of unknown nature in this unmarried, childless middle-aged woman. The importance of differential diagnosis in this case was crucial and removal of the mass was also challenging. We performed an unconventional hysterectomy to ensure a smooth operation, which indicates the importance of surgical choice.
