Laparoscopic Removal of a Primary Leiomyoma of the Levator Ani Muscle

Abstract

A 60-year-old woman with no particular complaints underwent abdominal contrast-enhanced computed tomography after blood tests showed elevated CEA levels, and she was found to have a 5-cm tumor in the left lower rectum. Further investigations led to a diagnosis of either gastrointestinal stromal tumor of the rectum or neurogenic tumor of the levator ani muscle, and laparoscopic tumorectomy was performed. The tumor was not continuous with either the rectum or the mesorectum, but it was continuous with the levator ani muscle, and part of this muscle was resected during tumor removal. Leiomyoma was diagnosed by immunostaining of the resected specimen. The magnifying effect of laparoscopy and sharing of the field of view made the discontinuity between the tumor in the deep pelvis and the lower rectum easy to confirm, and laparoscopic surgery was useful in this case. An extremely rare case of leiomyoma occurring in the pararectal space (the space above the levator muscle) is reported.