Round Ligament Fibroid: A Case Report

Abstract

Background: Round ligament fibroids are rare benign tumors that might manifest as vulvar, adnexal, or inguinal masses primarily because of their anatomical extension. Case Report: A 44-year-old lady who was not a known case of any medical illness was referred to the outpatient clinic in May 2022, after an incidental ultrasound finding of a subserosal fibroid. Upon examination, a hard mass was felt in the suprapubic area around 12 weeks size, yet due to the obese body type, proper examination was not possible. An ultrasound scan of the pelvis revealed multiple fibroids in the uterus, measuring 7x6 cm anteriorly, 4.5x3.5 cm posteriorly, and fundal 4.2x2.4 cm. After 12 months of conservative follow-up, another pelvic ultrasound scan was done, which revealed an anteverted bulky uterus measuring 11.9 x 8 cm, with multiple fibroids, the largest measuring 4.8x 4.5 cm at the lower uterine segment and 5.5x 4 cm at the fundus. These findings suggested a growing sessile subserosal uterine fibroid with extensions, dimensions, and relations. Finally, the patient was diagnosed with leiomyoma with cystic and hyaline degeneration, negative for atypia and malignancy. Laparotomy myomectomy was done, and the specimen consisted of a single oval mass weighing 410 gm and measuring 11x8x7.5 cm. Conclusion: The diagnosis of round ligament fibroid is often challenging due to its anatomical position. Keywords: Round ligament fibroid, laparotomy myomectomy, leiomyoma, case report