Rare case of Giant retroperitoneal uterine Leiomyoma with cystic degeneration mimicking huge ovarian cyst

A rare case of giant retroperitoneal uterine Leiomyoma with cystic degeneration mimicking huge ovarian cyst

Abstract

Introduction: Leiomyomas are the most common benign tumors of the uterus. Retroperitoneal
uterine leiomyomas with cystic degeneration are very rare. They can pose diagnostic dilemma
and can mimmick ovarian cysts. Case report: We report the case of a 34 yrs old para 5 who
presented to our hospital with complaints of distention whole abdomen, heaviness lower
abdomen & decreased appetite. On examination a huge abdomino-pelvic cystic mass was felt.
Clinically provisional diagnosis of ? Ovarian cyst was made.CT scan showed a huge
retroperitoneal cystic mass. Laprotomy and proceed was planned. Intraoperatively a huge
retroperitoneal cyst attached with uterus just below the left fundal structures by a pedicle and
extending upto xiphisternum was found.Uterus was of normal size and both the ovaries and tubes
were distinctly separate from the mass .left ovary was slightly enalarged and unhealthy in
appearance. Cyst excision followed by total abdominal hysterectomy and left sided salpingooopherectomy
was done. Histopathological examination revealed degenerated leiomyoma with
immunohistochemistry positive for smooth muscle actin.To the best of our knowledge this case
is the largest retroperitoneal uterine leiomyoma with cystic degeneration in literature.
Conclusion: Retroperitoneal uterine leiomyoma with cystic degeneration are rare. They can pose
diagnostic difficulty preoperatively and even peroperatively. As in our case the retroperitoneal
leiomyoma with cystic degeneration was mimicking a huge ovarian cyst. Though CT scan was
guiding towards retroperitoneal lesion but its cystic nature created diagnostic dilemma.