Abstract
Few reports have explored laparoscopic adnexal tumorectomy as a treatment for large and symptomatic ovarian leiomyomas during pregnancy. The current study presents the case of a patient with a large and symptomatic ovarian leiomyoma at 14 weeks of pregnancy. A laparoscopic adnexal tumorectomy was performed without complications. The laparoscopic management of large primary ovarian leiomyoma during pregnancy has not been reported in literature. Therefore, laparoscopy may be considered as a minimally invasive and feasible alternative to laparotomy for the treatment of large ovarian solid tumors during pregnancy, resulting in reduced postoperative pain, a smaller scar and shorter recovery time. By contrast, with respect to the ovarian solid tumor, surgery prior to gestation is advised, even for tumors of <3 cm in diameter, due to the probability of rapid growth of the tumor during pregnancy.
Highlights
Leiomyoma is a rare ovarian tumors, which accounts for 0.5-1% of all benign ovarian tumors [1]
A total of 78% of ovarian leiomyoma cases are concomitantly observed with uterine leiomyoma and as hormone stimulation is a cause of uterine leiomyoma, it was hypothesized that hormone stimulation may be a cause of ovarian leiomyoma [2]
It is difficult to determine the treatment of adnexal masses in pregnancy, as surgery may pose a risk to the mother and fetus [6], but conservative management may result in severe complications, including torsion or rupture of the ovarian masses
Summary
Leiomyoma is a rare ovarian tumors, which accounts for 0.5-1% of all benign ovarian tumors [1]. Abdominal ultrasonography revealed a single normal fetus in the uterus and a right adnexal hypoechoic solid mass of 4.1x3.2 cm in size. Due to the increasing size of mass and the presence of pain, the patient was referred to Zhejiang Provincial People's Hospital (Hangzhou, China) for surgical intervention. One week later the patient was admitted to Zhejiang Provincial People's Hospital (Hangzhou, China) with slight abdominal pain on the right side. Pathological examination of the paraffin section following surgery demonstrated that the mass was comprised of typical smooth muscle cells, which formed strands and bundles arranged in a whorled interlacing pattern. The tumor cells stained positively for vimentin, inhibin and α‐smooth muscle actin, but not for the α‐helical rod domain of desmin, which aided in confirming the diagnosis of ovarian leiomyoma (Fig. 2). A 3.4‐kg healthy baby was delivered spontaneously at full term
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