A Case of a Round Ligament Leiomyoma which was Difficult to Diagnose Preoperatively

Abstract

The patient was a 53-year-old woman. She presented to the obstetrics and gynecology department with bulging and pain in the right inguinal region. Examination results led an inguinal hernia to be suspected and she was referred to our department. An abdominal ultrasonography and a contrast-enhanced CT scan of the abdomen revealed a 3-cm mass with contrast effect in the inguinal region and a continuous cord-like structure extending into the ileocecal area. Laparoscopic surgery with a suspected diagnosis of inguinal hernia or inguinal tumor showed no inguinal hernia, and intraoperative findings by means of the inguinal incision revealed a tumor connected to the round ligament. It was diagnosed as round ligament tumor, and was completely resected. Histopathological examination revealed spindle-shaped, intricate smooth muscle tissue, and we diagnosed it as a round ligament leiomyoma. We have experienced a case of a round ligament leiomyoma that was difficult to differentiate from an inguinal hernia. Leiomyoma of the round ligament is a very rare disease. However, if the lesion is an inguinal mass affecting women with a history of uterine myoma, it should be considered as a differential disease. Laparoscopic surgery appears to be useful for differentiating round ligament leiomyoma from inguinal hernia.