GIANT UTERINE MYOMA AND OVARIAN MYOMA - ASSOCIATION OF TWO RARE ENTITIES. CASE REPORT AND LITERATURE REVIEW
Uterine myomas are the most common benign tumors of female reproductive system. They affect 25% of women of reproductive age. Giant uterine myomas are quite rare and are a challenge both for a complete diagnosis and for surgical management. Extra-uterine myomas are rare and they usually appear in the genitourinary tract (ovaries, vulva, broad ligament, round ligament, urethra). Primary ovarian leiomyoma is one of the rarest solid tumors of the ovary accounting for 0.5%–1% of all benign ovarian neoplasms. We report a 45-years-old nulliparous woman who came with abdominal distension and fatigue for several months. Abdominal-pelvic ultrasound and computer tomography showed a large myoma-like mass that filled the pelvis and abdomen. The diagnosis of giant uterine myoma was established and after careful discussion with the patient total hysterectomy was proposed. Surgery confirmed the diagnosis of a giant uterine myoma with several parasitic omental blood supplies. An additional ovarian myoma was discovered and total hysterectomy with right adnexectomy was performed. Our case stresses several clinical points that should be kept in mind before planning a surgery for a giant myoma - the possible presence of parasitic blood vessels and adherences which can pose some difficulties for the surgical team and the coexistence of different pathologies masked under the size of the tumor. It is important before planning a surgery to discuss with the patient the possibility to adapt the surgery according to associated pathology.
2. Fasih N, Prasad AK, Macdonald DB, Fraser MA, Papadatos D, Kielar AZ, et al. Leiomyomas beyond the uterus: unusual locations, rare manifestations. Radiographics 2008; 28(7): 1931-1948.
3. Van Winter JT, Stanhope CR. Giant ovarian leiomyoma associated with ascites and polymyositis. ObstetGynecol 1992; 80: 560-563.
4. Safaei A, Khanlari M, Azarpira N, Monabati A. Large ovarian leiomyoma in a postmenopausal woman. Indian J Pathol Microbiol 2011; 54: 413-414.
5. Doss BJ, Wanek SM, Jacques SM, Qureshi F, Ramirez NC, Lawrence WD. Ovarian leiomyomas: clinicopathologic features in fifteen cases. Int J Gynecol Pathol 1999; 18: 63-68.
6. Takeda A, Mori M, Sakai K. Parasitic peritoneal leiomyomatosis diagnosed 6 years after laparoscopic myomectomy with electric tissue morcellation: report of a case and review of the literature. J Minim Invasive Gynecol 2007; 14: 770-775.
7. Odofin O, Nasir N, Satyadas T, Lower AM, Akle C. An unusual case of ectopic or "parasitic" leio-myoma excised by laparoscopic surgery. Int Surg 2004; 89(3): 161-163.
8. Murase E, Siegelman ES, Outwater EK, Perez-Jaffe LA, Tureck RW. Uterine leiomyomas: histopath-ologic features, MR imaging findings, differential diagnosis, and treatment. Radiographics 1999; 19: 1179-1197.
9. McLucas B. Diagnosis, imaging and anatomical classification of uterine fibroids. Best Parct Res Clin Obstet Gynaecol 2008; 22: 627-642.
10. Aydin C, Eriş S, Yalçin Y, ŞenSelim H. A giant cystic leiomyoma mimicking an ovarian malignancy. International Journal of Surgery Case Reports 2013; 4(11): 1010-1012.
11. Cărăuleanu A., Socolov R., Anghelache Lupaşcu Ivona, Rugină V., Socolov Demetra. Giant intraliga-mentary uterine leiomyoma and its complications. Rev Med Chir Soc Med Nat 2016; 120(1): 145-151.
Once an article is accepted for publication, MSJ requests a transfer of copyrights for published articles.
COPYRIGHT TRANSFER FORM FOR
REVISTA MEDICO-CHIRURGICALĂ A SOCIETĂȚII DE MEDICI ȘI NATURALIȘTI DIN IAȘI /
THE MEDICAL-SURGICAL JOURNAL OF THE SOCIETY OF PHYSICIANS AND NATURALISTS FROM IASI
We, the undersigned authors of the manuscript entitled
warrant that this manuscript, which is submitted for publication in the REVISTA MEDICO-CHIRURGICALĂ, has not been published and it is not under consideration for publication in another journal.
- we give the consent for publication in the REVISTA MEDICO-CHIRURGICALĂ, in printed and electronic format and we transfer unconditioned and complete the copyright of this manuscript to the REVISTA MEDICO-CHIRURGICALĂ, in the event of its acceptance.
- the manuscript does not break the intellectual property rights of any other person.
- we have read the submitted version of the manuscript and we are fully responsible for the content.
Names and signatures of authors / copyright owners (the following sequence is the authorship of the article):
N.B. All the authors must sign this form