[Massive fibroma of the round ligament developing as an extraperitoneal abdominal mass]

The authors report the exceptionally rare case of a huge myofibroma of the round ligament. The localization of the myoma was very unusual. It developed from the inguinal insertion of the round ligament; and the fibroma had grown in the abdominal wall between muscle and the peritoneum. Consequently the mass was both abdominal and extra-peritoneal. To our knowledge, such an association has never before been described. In the case described here, the mass was asymptomatic and the patient presented because of her increasing abdominal size. Examination revealed an abdominal mass that almost reached the umbilicus and resembled a four months pregnancy. Ultrasonography showed that the uterus was normal. The mass was a 15 cm by 15 cm tumour of heterogenous structure. As the ovaries were not visualized it was impossible to decide whether the tumour was ovarian, intestinal or peritoneal. Laparotomy was performed with a preliminary diagnosis of a solid ovarian tumour. It was then possible to localize the mass accurately and to define it. Histological examination showed that it was a leiomyoma. Tumours of the round ligament are very uncommon. Among these tumours leiomyomas are the most frequent. Endometriotic tumours come next. Various very rare tumours can also be found. Leiomyoma of the round ligament may arise from each portion of the ligament: abdominal, inguinal or Labium Majus. But both abdominal and extra-peritoneal development from the inguinal insertion of the ligament is rare. They are usually single, and unilateral, and are found by chance.(ABSTRACT TRUNCATED AT 250 WORDS)