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A Diagnostic dilemma for the gynaecologist- an ovarian mass with an unexpected twist- a rare case of leiomyosarcoma arising from retroperitoneum

Indhumathy M .

Abstract


Ovarian mass is a commonly encountered clinical condition for the gynecologist. Several tumours in the pelvis and retroperitoneum can mimic an ovarian mass or                malignancy and can cause a diagnostic dilemma for the         gynecologist. Such tumours need to be dealt by a                       multi-disciplinary team. This case report highlights about a 30 year old female who was diagnosed to have a huge sub  serous fibroid complicating her second pregnancy which  increased in size to about 40x30 cm after delivery. Upon evaluation by MRI and CT scan the diagnosis was revised as an ovarian mass occupying entire abdominal cavity from  pelvis to the sub hepatic plane. Intraoperatively the tumour was found arising from the retroperitoneum with transverse colon and IVC adhesions with the uterus and ovaries being normal. The tumour was removed and histopathology revealed a leiomyosarcoma. Postoperatively patient recovered and is in continuous followup. This case is reported for the challenge it posed to the gynecologists in the               diagnosis and management.

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