An Isolated Peritoneal Leiomyoma: A Rare Entity

Abstract

Background: Extrauterine leiomyoma is a rare entity. Disseminated peritoneal leiomyomata and parasitic leiomyoma are the variants of extrauterine leiomyoma found in the peritoneal cavity. A primary peritoneal leiomyoma was reported by Sang et al in a 51-year-old woman. The current report describes the case of a solitary peritoneal leiomyoma that presented as an adnexal mass in a perimenopausal woman is reported. Case: A 55-year-old woman, para 8, presented with polymenorrhagia. Gynecologic examination revealed a 7×7–cm right adnexal mass and a normal-sized uterus. Ultrasonography suggested a right ovarian tumor or subserous fibroid. The patient's serum CA-125 level was 6.9 U/mL. Laparotomy on November 21, 2011, revealed a soft-tissue mass of 6×6 cm in her peritoneum, mimicking adhered bowel loops. The undersurface was smooth and free from all intra-abdominal organs. The uterus was smooth and mildly enlarged. Histopathology of the peritoneal mass confirmed a serosal leiomyoma, with foci of hydropic degeneration. Results: Histopathology of the peritoneal mass confirmed a serosal leiomyoma with foci of hydropic degeneration. Histopathology of the uterus showed nonsecretory endometrium, papillary endocervicitis, and hypertrophied squamous epithelium. The right ovary showed a corpus luteal cyst. The rest of the adnexa was essentially normal histologically. The patient was discharged in satisfactory condition on the eigth postoperative day. Conclusions: Adnexal masses always create serious diagnostic dilemmas and errors. Solitary peritoneal leiomyoma is a new differential diagnosis. Solitary leiomyoma is a smooth muscle tumor that may arise in the peritoneum, in the absence of any uterine leiomyoma. (J GYNECOL SURG 29:271)