A rare case of a giant cystic leiomyoma presenting as a retroperitoneal mass.

Ümit Naykı, Cenk Naykı, Paşa Uluğ, Ismayil Yılmaz, Zeliha Cetin, Yusuf Yıldırım
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Abstract

Background: Giant retroperitoneal uterine leiomyomas are uncommon. Degenerative changes of a leiomyoma may lead to unusual presentation resulting in misdiagnosis preoperatively. The final diagnosis can be made either intraoperatively or histologically.

Case: We report a 45-year-old multiparous women presented with abdominal distension and fatigue for six months. Abdominopelvic Sonography and computed tomography showed a large cystic mass that filled the pelvis and abdomen. With the preoperative diagnosis of a malignant tumor, a laparotomy was planned. Intraoperatively, a cystic mass originated from the uterus near the left side of the broad ligament extending to the retroperitoneal space was observed. Total hysterectomy and bilateral salphingo-oopherectomy was administered. The histology revealed a leiomyoma with cystic degeneration.

Conclusion: Retroperitoneal leiomyomas should be kept in mind in the diferrential diagnosis of a giant cystic mass in abdomen.

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一例罕见的巨大囊性平滑肌瘤表现为腹膜后肿块。
背景:巨大的腹膜后子宫平滑肌瘤并不常见。平滑肌瘤的退行性改变可能导致不寻常的表现,从而导致术前误诊。最终的诊断可以在术中或组织学上做出。病例:我们报告一个45岁的多胎妇女提出腹胀和疲劳六个月。腹腔超音波及电脑断层显示一巨大囊性肿块,充满骨盆及腹部。术前诊断为恶性肿瘤,计划开腹手术。术中可见一囊性肿块,起源于子宫左侧阔韧带附近,并延伸至腹膜后间隙。行全子宫切除术和双侧输卵管切除术。组织学表现为平滑肌瘤伴囊性变性。结论:腹膜后平滑肌瘤在腹部巨大囊性肿块鉴别诊断中应予以重视。
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