BACKGROUND The treatment of large pelvic masses in postmenopausal women is a challenge in clinical practice.Although ultrasound or magnetic resonance imaging can be used to determine the size and location of the mass,...BACKGROUND The treatment of large pelvic masses in postmenopausal women is a challenge in clinical practice.Although ultrasound or magnetic resonance imaging can be used to determine the size and location of the mass,it is still difficult to achieve a preoperative diagnosis.The majority of cellular leiomyomas are diagnosed by histopathology after surgery.We report the differential diagnosis and surgical management of a rare case of cellular leiomyoma in the broad ligament of the uterus.CASE SUMMARY A 52-year-old Chinese woman without sexual history was admitted to the First Affiliated Hospital of Guangzhou University of Chinese Medicine for the first time.The patient had a 1-year history of progressive abdominal enlargement as well as a 2-year history of menopause,and complained of frequent abdominal pain and low-grade fever.Computed tomography of the abdomen showed a solid cystic mass(29.4 cm×18.8 cm×37.7 cm)in the pelvis and abdomen.Moreover,routine blood test results indicated a baseline cancer antigen 125(CA-125)level of 187.7 U/mL and C-reactive protein of 109.58 mg/L.Subsequently,retrograde hysterectomy and bilateral adnexectomy were performed in this patient.On histopathologic examination of the surgical specimen,a rare cellular leiomyoma in the broad ligament was diagnosed.CONCLUSION Clinicians need to constantly improve diagnosis and treatment for the challenges posed during clinical assessment,differential diagnosis,and surgical management.展开更多
文摘BACKGROUND The treatment of large pelvic masses in postmenopausal women is a challenge in clinical practice.Although ultrasound or magnetic resonance imaging can be used to determine the size and location of the mass,it is still difficult to achieve a preoperative diagnosis.The majority of cellular leiomyomas are diagnosed by histopathology after surgery.We report the differential diagnosis and surgical management of a rare case of cellular leiomyoma in the broad ligament of the uterus.CASE SUMMARY A 52-year-old Chinese woman without sexual history was admitted to the First Affiliated Hospital of Guangzhou University of Chinese Medicine for the first time.The patient had a 1-year history of progressive abdominal enlargement as well as a 2-year history of menopause,and complained of frequent abdominal pain and low-grade fever.Computed tomography of the abdomen showed a solid cystic mass(29.4 cm×18.8 cm×37.7 cm)in the pelvis and abdomen.Moreover,routine blood test results indicated a baseline cancer antigen 125(CA-125)level of 187.7 U/mL and C-reactive protein of 109.58 mg/L.Subsequently,retrograde hysterectomy and bilateral adnexectomy were performed in this patient.On histopathologic examination of the surgical specimen,a rare cellular leiomyoma in the broad ligament was diagnosed.CONCLUSION Clinicians need to constantly improve diagnosis and treatment for the challenges posed during clinical assessment,differential diagnosis,and surgical management.
