A Case Report of Laparoscopic Resection of Primary Round Ligament Leiomyoma

Abstract

A 53-year-old woman presented to a clinic because of right lower quadrant abdominal intermittent pain once every two months for three years. An ovarian tumor was found by examinations, and she was referred to the department of gynecology in our hospital. A trans-vaginal ultrasound showed no evidence of the disease involving the uterus, bilateral ovaries and salpinx. An abdominal contrast-enhanced computed tomography (CT) scan showed an enhanced intra-pelvic ovoid tumor 3.5 cm in size which was adjacent to the small intestine. A pelvic contrast-enhanced magnetic resonance imaging (MRI) showed a high-intensity lesion with internal heterogeneous enhancement in T1 weighed fat suppression. A positron emission tomography scan showed an abnormally high FDG uptake in the tumor. She was diagnosed with GIST of the small intestine and was referred to our department. Laparoscopic surgery showed that the tumor was ovoid in shape with smooth surface and well movable and both the size and localization of the tumor accorded with those in the images. We found that the tumor had the origin of the round ligament of the uterus after the explosion of the tumor and then performed laparoscopically completely excision of the tumor. The histological findings showed that spindle-shaped tumor cells proliferated in disarray that were immunohistochemically positive for α-SMA and Desmin and negative for DOG-1. The tumor was diagnosed as leiomyoma of the round ligament of the uterus. The leiomyoma originated from the round ligament of the uterus is rare and we report this case with review of the literature.