J Menopausal Med.  2014 Dec;20(3):133-137. 10.6118/jmm.2014.20.3.133.

Retroperitoneal Leiomyoma of the Uterus Mimicking Sarcoma in Perimenopausal Woman: Case Report

• Jeong GA

• KMID: 2325479
• DOI: http://doi.org/10.6118/jmm.2014.20.3.133

Abstract

Leiomyomas are very common benign tumors in the uterus and it is rare condition to present the retroperitoneal leiomyoma. The author reported a 48-year-old female patient who presented right pelvic mass with urinary incontinence and lower abdominal discomfort. Based on the preoperative imaging, provisional diagnosis was mesenchymal sarcoma. In the intraoperative findings, huge mass abutting to the uterus was observed in retroperitoneal space beneath the right broad ligament. After the exposure the retroperitoneal space, we encountered the well-demarcated tumor measuring 8 x 6 cm in diameter and this tumor attached the right surface of the uterus with fibrotic tissue. Pathologic findings demonstrated retroperitoneal uterine leiomyoma.

Keyword

Leiomyoma; Retroperitoneal neoplasms; Sarcoma; Uterus

MeSH Terms

Broad Ligament
Diagnosis
Female
Humans
Leiomyoma*
Middle Aged
Retroperitoneal Neoplasms
Retroperitoneal Space
Sarcoma*
Urinary Incontinence
Uterus*

Figure

• 

  Fig. 1 Pelvic magnetic resonance imaging showed 8-cm sized mass separating from uterus. This mass had the low signal intensity on T1-weighted images with enhancement and heterogeneous, high signal intensity on T2-weighted images. (A) Axial, T1-weighted image, (B) axial, T2-weighted image, (C) axial, enhanced T1-weighted image. U: uterus, M: retroperitoneal mass.

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  Fig. 2 The operative findings. (A) The uterus was normal size with smooth contour and there was no abnormal finding on both ovaries and fallopian tubes grossly. (B) The retroperitoneal tumor of size 8 × 6 cm was located beneath the right broad ligament of uterus. (C) After dissection from the right iliac vessels and the right surface of the uterus, the retroperitoneal tumor was excised completely. U: uterus, B: broad ligament, M: retroperitoneal mass.

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  Fig. 3 The macroscopic and microscopic findings. (A) Grossly, it is well circumscribed, and the cut surface shows gray-white whirling appearance. (B) The tumor consists of intersecting fascicles of slender-tapered spindle cells (H & E, ×100). (C) Immunohistochemical stain for desmin revealed positivity in the tumor cells, consistent with smooth muscle tumor (×200).

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