Successful laparoscopic surgeries to a uterine adenomatoid tumor and a uterine leiomyoma

Abstract

Laparoscopic surgery is a valuable tool in the definitive diagnosis and treatment of benign uterine tumors. Here we report two cases diagnosed as benign uterine tumors by laparoscopic surgery: the first is an adenomatoid tumor that was suspected preoperatively as a uterine leiomyoma; the second is a uterine leiomyoma that was suspected preoperatively as an adenomatoid tumor.Cases: Case 1: A 63 year-old woman presented to our hospital complaining of lumbago. Uterine myoma was suspected and ultrasound and MRI were performed. A cystic uterine tumor suggesting benign uterine leiomyoma was discovered. However, malignancy could not be ruled out, therefore, the patient consented to LAVH (laparoscopic assisted vaginal hysterectomy). Upon removal of the patient's uterus, macroscopic examination of the tumor was strongly suggestive of uterine leiomyoma. The specimen was sent to pathology; microscopic examination and immunohistological testing provided the definitive diagnosis of benign adenomatoid tumor. Case 2: A 44 year-old woman presented to our hospital for periodic examination of a uterine myoma that she had been diagnosed with several years ago. MRI was performed and myoma nodule was found. To rule out malignancy, a diagnostic and therapeutic laparoscopic assisted myomectomy (LAM) was recommended. LAM was chosen because the tumor surface appeared as a usual myoma nodule. Final pathology findings on immunohistochemical study of the surgical specimen confirmed the diagnosis of uterine leiomyoma.Conclusion: Laparoscopic surgery provides many advantages in clinical gynecological practice. We stress the importance of laparoscopic surgery in preventing misdiagnosis, and in providing definitive diagnosis and treatment in cases of benign gynecologic tumors, including the rare uterine adenomatoid tumor presented herein. We recommend laparoscopic surgical intervention particularly in cases where various imaging studies including MRI, CT, and sonogram, are incompatible with or unable to confirm benign tumor origin.