Cover Image

A RARE CASE OF POST HYSTERECTOMY FIBROID

GOMATHI M

Abstract


Giant fibroids are known to arise from the uterus and very rarely from the round ligament and that too after hysterectomy. We report an interesting case of round  ligament fibroid in a previously hysterectomised woman. The patient presented with incidental finding of mass and pain in abdomen after 30 years of abdominal hysterectomy for  penetrating genital injury. Bimanual examination revealed a firm pelvic mass of 8x8 cm felt through the vault. Ultrasound and CT abdomen were suggestive of possible right ovarian mass because the right ovary was not visualised separately. Laparotomy was done which revealed a mass seen  originating from the remnant of the right sided round ligament. Bilateral ovaries were normal. Histopathology of the mass confirmed it to be leiomyoma. We report this case because it is a very rare entity to encounter such a round ligament fibroid occurring many decades after the removal of uterus and  because of the diagnostic dilemma it caused.

 


Full Text:

PDF

References


Duhan N, Sirohiwal D. Uterine myomas revisited. Eur J Obstet Gynecol Reprod Biol, 2010; 152:119–125.

Zaloudek C, Hendrickson MR. Mesenchymal tumors of the uterus. In: Kurman RJ, ed. Blaustein’s Pathology of the Female Genital Tract, 5th edn. New York, NY: Springer, 2002; 561–574.

Bhatla N. Tumours of the corpus uteri. In: Tindal VR editor. Jeffcoat’s Principles of Gynaecology. 7 th ed. London: Arnold Printers. 2008.

Warshauer, D.M. and Mandel, S.R. (1999) Leiomyoma of the extra-peritoneal round ligament: CT demonstration. Clinical Imaging, 23, 375-376.

Lösch, A., Haider-Angeler, M.G., Kainz, C., Breitenecker, G. and Lahodny, J. (1999) Leiomyoma of the round liga- ment in a post-menopausal woman. Maturitas, 31, 133- 135.

Harper GB, Jr, Awbrey BJ, Thomas CG, Jr, Askin FB. Mesothelial cysts of the round ligament simulating inguinal hernia: Report of four cases and a review of the literature. Am J Surg. 1986;151:515–7.

David MW, Stanley RM. Leiomyoma of extra-peritoneal round ligament: CT demonstration. Clin Imaging. 1999;23:375–6.

Alexander L, Maria GHA, Christian K, Gerhard B, Johann L. Leiomyoma of the round ligament in a post-menopausal woman. Maturitas. 1999;31:133–5.

Smith P, Heimer G, Norgren A, Ulmsten U. The round ligament: A target organ for steroid hormones.Gynecol Endocrinol. 1993;7:97–100.

Beavis ELG, Brown JB, Smith MA: Ovarian function after hysterectomy with conservation of the ovaries in premenopausal women. J Obstet Gynaecol Br. Commonw 76:969, 1969

Backstrom CT, Boyle H: Persistence of premenstrual tension symptoms in hysterectomized women. Br J Obstet Gynaecol 88:530, 1981

DeNeef JC, Hollenbeck ZJR: The fate of ovaries preserved at the time of hysterectomy. Am J Obstet Gynecol 96:538, 1966

Ranney B, Abu-Ghazaleh S: The future function and control of ovarian tissue which is retained in vivo during hysterectomy. Am J Obstet Gynecol 128:626, 1977

Rajanna DK, Pandey V, Janardhan S, Datti SN. Broad Ligament Fibroid Mimicking as Ovarian Tumor on Ultrasonography and Computed Tomography Scan. J Clin Imaging Sci. 2013; 3: 8.

Fasih N, Prasad Shanbhogue AK, Macdonald DB, Fraser-Hill MA, Papadatos D, Kielar AZ, et al. Leiomyomas beyond the uterus: Unusual locations, rare manifestations. Radiographics, 2008; 28:1931-1948.

R Srinivasan, U Saraiya. Recurrent Fibroids. J Obstet Gynecol Ind, 2004; 54: 363-66.


Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

An Initiative of The Tamil Nadu Dr MGR Medical University