Management of a Giant Leiomyoma Mimicking Ovarian Malignancy
Journal Title: GUJARAT CANCER SOCIETY RESEARCH JOURNAL - Year 2018, Vol 20, Issue 1
Abstract
A giant uterine leiomyomas can be sometimes confused for ovarian neoplasm. 36 year old nulliparous woman presented with dull aching pain and lump abdomen. On examination, there was a fixed, hard abdominopelvic mass uptill umbilicus , extending upto bilateral pelvic walls, obliterating POD and compressing rectum. In CT scan, there was 35x16x13 cm multilobulated, heterogeneously enhancing lesion in pelvis. Her CA125 was 62.33mIU/ml while CE19-9, beta hCG and alphafetoprotein were normal. With provisional diagnosis of ovarian cancer, patient was planned for chemotherapy. Later, biopsy of mass with IHC revealed leiomyoma.To reduce size of mass and facilitate surgery, patient was given four 3.75 mg monthly injection of leuprolide which led to reduction in size with increased mobility. Intraoperatively, there was a large abdominopelvic mass indenting inferior surface of liver and displacing transverse colon, extending deep in POD and rectovaginal septum. Intra-operative blood loss was 400ml. Postoperative period was uneventful. Final histopathology revealed multiple subserosal and intramural fibroids. The mass weighed around 3.8 kg. Bilateral ovaries were normal. At 3 months follow up, patient was asymptomatic with no radiological evidence of recurrence
Authors and Affiliations
Garima Pandey, Pariseema Dave, Anusha Kamanth, Renu Ranga
Keywords
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