Korean J Obstet Gynecol.  2012 Apr;55(4):285-289. 10.5468/KJOG.2012.55.4.285.

A rare case of primary ovarian leiomyoma with atypical Meigs' syndrome

• Choi SY
• Park JS
• Lee JW
• Kim BG
• Bae DS

• KMID: 1992628
• DOI: http://doi.org/10.5468/KJOG.2012.55.4.285

Abstract

Primary ovarian leiomyoma is a rare benign ovarian tumor. Ovarian leiomyoma accompanied with atypical Meigs' syndrome is extremely rare. A 13-year-old woman had underlying primary lymphedema and visited our clinic due to associated vulvar edema. During a gynecologic examination, we detected a right ovarian tumor with large amounts of ascites on transrectal ultrasonography. The tumor size increased from 4 to 7 cm during 6 months follow-up. After laparoscopic right ovarian tumorectomy, the final pathology of the tumor was primary ovarian leiomyoma. Ovarian leiomyomas are not typically suspected before surgery due to their extreme rarity and because they are easily misdiagnosed as fibroma during frozen biopsy due to similarities between both diseases. Here we introduce the case of a primary ovarian leiomyoma accompanied with atypical Meigs' syndrome.

Keyword

Ovarian leiomyoma; Meigs syndrome; Rare diseases; Ovary

MeSH Terms

Adolescent
Ascites
Biopsy
Edema
Female
Fibroma
Follow-Up Studies
Humans
Leiomyoma
Lymphedema
Meigs Syndrome
Ovary
Rare Diseases

Figure

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  Fig. 1 Poor delineation of the right ovarian mass measuring about 8cm in length on computed tomography.

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  Fig. 2 Gross picture of 5cm sized solid tumors originating from right ovary. The ovarian tumor and the surrounding whitish fragile tissues are separated from right tube and is limited to the right ovary.

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  Fig. 3 (A) Spindle-shaped cells with wavy nuclei and extensive hyalinization was seen in the right ovarian tumor (H&E, ×100). (B) On the high powered magnititude, no significant nuclear atypia or pleomorphism was seen (H&E, ×200).

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  Fig. 4 Immunohistochemically, the tumor cells were strongly positive for smooth muscle actin (smooth muscle actin, ×200).

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  Fig. 5 The tumor cells were strongly positive for reticulin and the tumor was confirmed as leiomyoma (reticulin, ×200).

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