Huge Broad Ligament Fibroid with Paracervical Extension: A Safe Approach by Same Setting Myomectomy before...

Area of Science:

• Gynecology
• Surgical Oncology

Background:

• Broad ligament leiomyomas are uncommon uterine fibroids occurring outside the uterus.
• They represent the most frequent extrauterine site for leiomyomas, despite a low overall incidence.

Observation:

• A patient presented with lower abdominal pain and distension due to a large pelvic mass.
• Pelvic examination revealed a 24-week size firm mass, with ultrasonography suggesting a 20 cm broad ligament fibroid.
• Laparotomy confirmed a massive 20 cm broad ligament fibroid occupying the broad ligament and pelvis.

Findings:

• The broad ligament fibroid significantly displaced the uterus and cervix.
• Surgical intervention included initial myomectomy for decompression, followed by total hysterectomy with bilateral salpingo-oophorectomy.
• Careful ureter evaluation was crucial during the procedure to prevent injury.

Implications:

• This case highlights the diagnostic and surgical challenges posed by large broad ligament leiomyomas.
• It underscores the importance of meticulous surgical technique in managing rare gynecological masses.
• Reporting such rare cases contributes to understanding and improving management strategies for extrauterine fibroids.